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(2) adequate to meet the
needs of the child and family;
(3) culturally appropriate;
(4) available and
accessible;
(5) consistent and timely;
and
(6) realistic under the
circumstances.
In the alternative, the
court may determine that provision of services or further services for the
purpose of rehabilitation is futile and therefore unreasonable under the
circumstances or that reasonable efforts are not required as provided in
paragraph (a).
(i) This section does not
prevent out-of-home placement for treatment of a child with a mental disability
when the child's diagnostic assessment or individual treatment plan indicates
that appropriate and necessary treatment cannot be effectively provided outside
of a residential or inpatient treatment program.
(j) If continuation of
reasonable efforts to prevent placement or reunify the child with the parent or
guardian from whom the child was removed is determined by the court to be
inconsistent with the permanent plan for the child or upon the court making one
of the prima facie determinations under paragraph (a), reasonable efforts must
be made to place the child in a timely manner in a safe and permanent home and
to complete whatever steps are necessary to legally finalize the permanent
placement of the child.
(k) Reasonable efforts to
place a child for adoption or in another permanent placement may be made concurrently
with reasonable efforts to prevent placement or to reunify the child with the
parent or guardian from whom the child was removed. When the responsible social
services agency decides to concurrently make reasonable efforts for both
reunification and permanent placement away from the parent under paragraph (a),
the agency shall disclose its decision and both plans for concurrent reasonable
efforts to all parties and the court. When the agency discloses its decision to
proceed on both plans for reunification and permanent placement away from the
parent, the court's review of the agency's reasonable efforts shall include the
agency's efforts under both plans.
Sec. 62. Minnesota Statutes
2006, section 260.755, subdivision 12, is amended to read:
Subd. 12. Indian tribe. "Indian tribe"
means an Indian tribe, band, nation, or other organized group or community of
Indians recognized as eligible for the services provided to Indians by the
secretary because of their status as Indians, including any band
Native group under the Alaska Native Claims Settlement Act, United States
Code, title 43, section 1602, and exercising tribal governmental powers.
Sec. 63. Minnesota Statutes
2006, section 260.755, subdivision 20, is amended to read:
Subd. 20. Tribal court. "Tribal court"
means a court with federally recognized jurisdiction over child custody
proceedings and which is either a court of Indian offenses, or a court
established and operated under the code or custom of an Indian tribe, or the
any other administrative body of a tribe which is vested with authority
over child custody proceedings. Except as provided in section 260.771,
subdivision 5, nothing in this chapter shall be construed as conferring
jurisdiction on an Indian tribe.
Sec. 64. Minnesota Statutes
2006, section 260.761, subdivision 7, is amended to read:
Subd. 7. Identification of extended family members.
Any agency considering placement of an Indian child shall make reasonable
active efforts to identify and locate extended family members.
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Sec. 65. Minnesota Statutes
2006, section 260.765, subdivision 5, is amended to read:
Subd. 5. Identification of extended family members.
Any agency considering placement of an Indian child shall make reasonable
active efforts to identify and locate extended family members.
Sec. 66. Minnesota Statutes
2006, section 260.771, subdivision 1, is amended to read:
Subdivision 1. Indian tribe jurisdiction. An Indian
tribe with a tribal court has exclusive jurisdiction over a child
placement proceeding involving an Indian child who resides or is domiciled within
the reservation of such the tribe at the commencement of the
proceedings, except where jurisdiction is otherwise vested in the state
by existing federal law. When an Indian child is in the legal custody of
a person or agency pursuant to an order of a ward of the tribal
court, the Indian tribe retains exclusive jurisdiction, notwithstanding the
residence or domicile of the child.
Sec. 67. Minnesota Statutes
2006, section 260.771, subdivision 2, is amended to read:
Subd. 2. Court determination of tribal affiliation
of child. In any child placement proceeding, the court shall establish
whether an Indian child is involved and the identity of the Indian child's
tribe. This chapter and the federal Indian Child Welfare Act are applicable
without exception in any child custody proceeding, as defined in the federal
act, involving an Indian child. This chapter applies to child custody
proceedings involving an Indian child whether the child is in the physical or
legal custody of an Indian parent, Indian custodian, Indian extended family
member, or other person at the commencement of the proceedings. A court shall
not determine the applicability of this chapter or the federal Indian Child
Welfare Act to a child custody proceeding based upon whether an Indian child is
part of an existing Indian family or based upon the level of contact a child
has with the child's Indian tribe, reservation, society, or off-reservation
community.
Sec. 68. [260.852] PLACEMENT PROCEDURES.
Subdivision 1. Home study. The state must have procedures for the orderly
and timely interstate placement of children that are implemented in accordance
with an interstate compact and that, within 60 days after the state receives
from another state a request to conduct a study of a home environment for
purposes of assessing the safety and suitability of placing a child in the
home, the state shall, directly or by contract, conduct and complete a home
study and return to the other state a report on the results of the study, which
shall address the extent to which placement in the home would meet the needs of
the child; except in the case of a home study begun before October 1, 2008, if
the state fails to comply with conducting and completing the home study within
the 60-day period and this is as a result of circumstances beyond the control
of the state, the state has 75 days to comply if the state documents the
circumstances involved and certifies that completing the home study is in the
best interests of the child.
This subdivision does not
require the completion within the applicable period of the parts of the home
study involving the education and training of the prospective foster or
adoptive parents.
Subd. 2. Effect of received report. The state shall treat any
report described in subdivision 1 that is received from another state, an
Indian tribe, or a private agency under contract with another state or Indian
tribe as meeting any requirements imposed by the state for the completion of a
home study before placing a child in the home, unless, within 14 days after
receipt of the report, the state determines, based on grounds that are specific
to the content of the report, that making a decision in reliance on the report
would be contrary to the welfare of the child.
Subd. 3. Resources. The state shall make effective use of
cross-jurisdictional resources, including through contract for the purchase of
services, and shall eliminate legal barriers to facilitate timely adoptive or
permanent placements for waiting children. The state shall not impose any
restriction on the use of private agencies for the purpose of conducting a home
study to meet the 60-day requirement.
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Subd.
4. Incentive eligibility. Minnesota
is an incentive-eligible state and must:
(1)
have an approved plan as required by the United States Secretary of Health and
Human Services;
(2)
be in compliance with the data requirements of the United States Department of
Health and Human Services; and
(3)
have data that verify that a home study is completed within 30 days.
Subd.
5. Data requirements. The state
shall provide to the United States Secretary of Health and Human Services a
written report, covering the preceding fiscal year, that specifies:
(1)
the total number of interstate home studies requested by the state with respect
to children in foster care under the responsibility of the state, and with
respect to each study, the identity of the other state involved;
(2)
the total number of timely interstate home studies completed by the state with
respect to children in foster care under the responsibility of other states
and, with respect to each study, the identity of the other state involved; and
(3)
other information the United States Secretary of Health and Human Services requires
in order to determine whether Minnesota is a home study incentive-eligible
state.
Subd.
6. Definitions. (a) The
definitions in this subdivision apply to this section.
(b)
"Home study" means an evaluation of a home environment conducted in
accordance with applicable requirements of the state in which the home is
located, to determine whether a proposed placement of a child would meet the
individual needs of the child, including the child's safety; permanency;
health; well-being; and mental, emotional, and physical development.
(c)
"Interstate home study" means a home study conducted by a state at
the request of another state to facilitate an adoptive or foster placement in
the state of a child in foster care under the responsibility of the state.
(d)
"Timely interstate home study" means an interstate home study
completed by a state if the state provides to the state that requested the
study, within 30 days after receipt of the request, a report on the results of
the study, except that there is no requirement for completion within the 30-day
period of the parts of the home study involving the education and training of
the prospective foster or adoptive parents.
Subd.
7. Background study requirements for
adoption and foster care. (a) Background study requirements for an
adoption home study must be completed consistent with section 259.41,
subdivisions 1, 2, and 3.
(b)
Background study requirements for a foster care license must be completed
consistent with section 245C.08.
Subd.
8. Home visits. If a child has
been placed in foster care outside the state in which the home of the parents
of the child is located, periodically, but at least every six months, a
caseworker on the staff of the agency of the state in which the home of the
parents of the child is located or the state in which the child has been
placed, or a private agency under contract with either state, must visit the
child in the home or institution and submit a report on each visit to the
agency of the state in which the home of the parents of the child is located.
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Sec. 69. Minnesota Statutes
2006, section 260B.157, subdivision 1, is amended to read:
Subdivision 1. Investigation. Upon request of the
court the local social services agency or probation officer shall investigate
the personal and family history and environment of any minor coming within the
jurisdiction of the court under section 260B.101 and shall report its findings
to the court. The court may order any minor coming within its jurisdiction to
be examined by a duly qualified physician, psychiatrist, or psychologist
appointed by the court.
The court shall have
order a chemical use assessment conducted when a child is (1) found to be delinquent
for violating a provision of chapter 152, or for committing a felony-level
violation of a provision of chapter 609 if the probation officer determines
that alcohol or drug use was a contributing factor in the commission of the
offense, or (2) alleged to be delinquent for violating a provision of chapter
152, if the child is being held in custody under a detention order. The
assessor's qualifications and the assessment criteria shall comply with
Minnesota Rules, parts 9530.6600 to 9530.6655. If funds under chapter 254B are
to be used to pay for the recommended treatment, the assessment and placement
must comply with all provisions of Minnesota Rules, parts 9530.6600 to
9530.6655 and 9530.7000 to 9530.7030. The commissioner of human services shall
reimburse the court for the cost of the chemical use assessment, up to a
maximum of $100.
The court shall have
order a children's mental health screening conducted when a child is found
to be delinquent. The screening shall be conducted with a screening instrument
approved by the commissioner of human services and shall be conducted by a
mental health practitioner as defined in section 245.4871, subdivision 26, or a
probation officer who is trained in the use of the screening instrument. If the
screening indicates a need for assessment, the local social services agency, in
consultation with the child's family, shall have a diagnostic assessment
conducted, including a functional assessment, as defined in section 245.4871.
With the consent of the
commissioner of corrections and agreement of the county to pay the costs
thereof, the court may, by order, place a minor coming within its jurisdiction
in an institution maintained by the commissioner for the detention, diagnosis,
custody and treatment of persons adjudicated to be delinquent, in order that
the condition of the minor be given due consideration in the disposition of the
case. Any funds received under the provisions of this subdivision shall not
cancel until the end of the fiscal year immediately following the fiscal year
in which the funds were received. The funds are available for use by the
commissioner of corrections during that period and are hereby appropriated
annually to the commissioner of corrections as reimbursement of the costs of
providing these services to the juvenile courts.
Sec. 70. Minnesota Statutes
2006, section 260C.152, subdivision 5, is amended to read:
Subd. 5. Notice to foster parents and preadoptive
parents and relatives. The foster parents, if any, of a child and any
preadoptive parent or relative providing care for the child must be provided
notice of and an opportunity a right to be heard in any review or
hearing to be held with respect to the child. Any other relative may also
request, and must be granted, a notice and the opportunity to be heard under
this section. This subdivision does not require that a foster parent,
preadoptive parent, or relative providing care for the child be made a party to
a review or hearing solely on the basis of the notice and opportunity
right to be heard.
Sec. 71. Minnesota Statutes
2006, section 260C.163, subdivision 1, is amended to read:
Subdivision 1. General. (a) Except for hearings
arising under section 260C.425, hearings on any matter shall be without a jury and
may be conducted in an informal manner. In all adjudicatory proceedings
involving a child alleged to be in need of protection or services, the court
shall admit only evidence that would be admissible in a civil trial. To be
proved at trial, allegations of a petition alleging a child to be in need of
protection or services must be proved by clear and convincing evidence.
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(b)
Except for proceedings involving a child alleged to be in need of protection or
services and petitions for the termination of parental rights, hearings may be
continued or adjourned from time to time. In proceedings involving a child
alleged to be in need of protection or services and petitions for the termination
of parental rights, hearings may not be continued or adjourned for more than
one week unless the court makes specific findings that the continuance or
adjournment is in the best interests of the child. If a hearing is held on a
petition involving physical or sexual abuse of a child who is alleged to be in
need of protection or services or neglected and in foster care, the court shall
file the decision with the court administrator as soon as possible but no later
than 15 days after the matter is submitted to the court. When a continuance or
adjournment is ordered in any proceeding, the court may make any interim orders
as it deems in the best interests of the minor in accordance with the
provisions of sections 260C.001 to 260C.421.
(c)
Except as otherwise provided in this paragraph, the court shall exclude the
general public from hearings under this chapter and shall admit only those
persons who, in the discretion of the court, have a direct interest in the case
or in the work of the court.
(d)
Adoption hearings shall be conducted in accordance with the provisions of laws
relating to adoptions.
(e)
In any permanency hearing, including the transition of a child from foster care
to independent living, the court shall ensure that any consult with the child
is in an age-appropriate manner.
Sec.
72. Minnesota Statutes 2006, section 260C.201, subdivision 11, is amended to
read:
Subd.
11. Review of court-ordered placements;
permanent placement determination. (a) This subdivision and subdivision 11a
do not apply in cases where the child is in placement due solely to the child's
developmental disability or emotional disturbance, where legal custody has not
been transferred to the responsible social services agency, and where the court
finds compelling reasons under section 260C.007, subdivision 8, to continue the
child in foster care past the time periods specified in this subdivision.
Foster care placements of children due solely to their disability are governed
by section 260C.141, subdivision 2a. In all other cases where the child is in
foster care or in the care of a noncustodial parent under subdivision 1, the
court shall commence proceedings to determine the permanent status of a child
not later than 12 months after the child is placed in foster care or in the
care of a noncustodial parent. At the admit-deny hearing commencing such
proceedings, the court shall determine whether there is a prima facie basis for
finding that the agency made reasonable efforts, or in the case of an Indian
child active efforts, required under section 260.012 and proceed according to
the rules of juvenile court.
For
purposes of this subdivision, the date of the child's placement in foster care
is the earlier of the first court-ordered placement or 60 days after the date on
which the child has been voluntarily placed in foster care by the child's
parent or guardian. For purposes of this subdivision, time spent by a child
under the protective supervision of the responsible social services agency in
the home of a noncustodial parent pursuant to an order under subdivision 1
counts towards the requirement of a permanency hearing under this subdivision
or subdivision 11a. Time spent on a trial home visit does not count counts
towards the requirement of a permanency hearing under this subdivision or
and a permanency review for a child under eight years of age under subdivision
11a.
For
purposes of this subdivision, 12 months is calculated as follows:
(1)
during the pendency of a petition alleging that a child is in need of protection
or services, all time periods when a child is placed in foster care or in the
home of a noncustodial parent are cumulated;
(2)
if a child has been placed in foster care within the previous five years under
one or more previous petitions, the lengths of all prior time periods when the
child was placed in foster care within the previous five years are cumulated.
If a child under this clause has been in foster care for 12 months or more, the
court, if it is in the best interests of the child and for compelling reasons,
may extend the total time the child may continue out of the home under the
current petition up to an additional six months before making a permanency
determination.
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(b) Unless the responsible
social services agency recommends return of the child to the custodial parent
or parents, not later than 30 days prior to the admit-deny hearing required
under paragraph (a) and the rules of juvenile court, the responsible social
services agency shall file pleadings in juvenile court to establish the basis
for the juvenile court to order permanent placement of the child, including a
termination of parental rights petition, according to paragraph (d). Notice of
the hearing and copies of the pleadings must be provided pursuant to section
260C.152.
(c) The permanency
proceedings shall be conducted in a timely fashion including that any trial
required under section 260C.163 shall be commenced within 60 days of the
admit-deny hearing required under paragraph (a). At the conclusion of the
permanency proceedings, the court shall:
(1) order the child returned
to the care of the parent or guardian from whom the child was removed; or
(2) order a permanent
placement or termination of parental rights if permanent placement or
termination of parental rights is in the child's best interests. The "best
interests of the child" means all relevant factors to be considered and
evaluated. Transfer of permanent legal and physical custody, termination of
parental rights, or guardianship and legal custody to the commissioner through
a consent to adopt are preferred permanency options for a child who cannot
return home.
(d) If the child is not
returned to the home, the court must order one of the following dispositions:
(1) permanent legal and
physical custody to a relative in the best interests of the child according to
the following conditions:
(i) an order for transfer of
permanent legal and physical custody to a relative shall only be made after the
court has reviewed the suitability of the prospective legal and physical
custodian;
(ii) in transferring
permanent legal and physical custody to a relative, the juvenile court shall
follow the standards applicable under this chapter and chapter 260, and the
procedures set out in the juvenile court rules;
(iii) an order establishing
permanent legal and physical custody under this subdivision must be filed with
the family court;
(iv) a transfer of legal and
physical custody includes responsibility for the protection, education, care,
and control of the child and decision making on behalf of the child;
(v) the social services
agency may bring a petition or motion naming a fit and willing relative as a
proposed permanent legal and physical custodian. The commissioner of human
services shall annually prepare for counties information that must be given to
proposed custodians about their legal rights and obligations as custodians together
with information on financial and medical benefits for which the child is
eligible; and
(vi) the juvenile court may
maintain jurisdiction over the responsible social services agency, the parents
or guardian of the child, the child, and the permanent legal and physical
custodian for purposes of ensuring appropriate services are delivered to the
child and permanent legal custodian or for the purpose of ensuring conditions
ordered by the court related to the care and custody of the child are met;
(2) termination of parental
rights when the requirements of sections 260C.301 to 260C.328 are met or
according to the following conditions:
(i) order the social
services agency to file a petition for termination of parental rights in which
case all the requirements of sections 260C.301 to 260C.328 remain applicable;
and
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(ii) an adoption completed
subsequent to a determination under this subdivision may include an agreement
for communication or contact under section 259.58;
(3) long-term foster care
according to the following conditions:
(i) the court may order a
child into long-term foster care only if it approves the responsible social
service agency's compelling reasons that neither an award of permanent legal
and physical custody to a relative, nor termination of parental rights is in
the child's best interests;
(ii) further, the court may
only order long-term foster care for the child under this section if it finds
the following:
(A) the child has reached
age 12 and the responsible social services agency has made reasonable efforts
to locate and place the child with an adoptive family or with a fit and willing
relative who will agree to a transfer of permanent legal and physical custody
of the child, but such efforts have not proven successful; or
(B) the child is a sibling
of a child described in subitem (A) and the siblings have a significant
positive relationship and are ordered into the same long-term foster care home;
and
(iii) at least annually, the
responsible social services agency reconsiders its provision of services to the
child and the child's placement in long-term foster care to ensure that:
(A) long-term foster care
continues to be the most appropriate legal arrangement for meeting the child's
need for permanency and stability, including whether there is another permanent
placement option under this chapter that would better serve the child's needs
and best interests;
(B) whenever possible, there
is an identified long-term foster care family that is committed to being the
foster family for the child as long as the child is a minor or under the
jurisdiction of the court;
(C) the child is receiving
appropriate services or assistance to maintain or build connections with the
child's family and community;
(D) the child's physical and
mental health needs are being appropriately provided for; and
(E) the child's educational
needs are being met;
(4) foster care for a
specified period of time according to the following conditions:
(i) foster care for a
specified period of time may be ordered only if:
(A) the sole basis for an
adjudication that the child is in need of protection or services is the child's
behavior;
(B) the court finds that
foster care for a specified period of time is in the best interests of the
child; and
(C) the court approves the
responsible social services agency's compelling reasons that neither an award
of permanent legal and physical custody to a relative, nor termination of
parental rights is in the child's best interests;
(ii) the order does not
specify that the child continue in foster care for any period exceeding one
year; or
(5) guardianship and legal custody
to the commissioner of human services under the following procedures and
conditions:
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(i) there is an identified
prospective adoptive home agreed to by the responsible social services agency
having legal custody of the child pursuant to court order under this section
that has agreed to adopt the child and the court accepts the parent's voluntary
consent to adopt under section 259.24, except that such consent executed by a parent
under this item, following proper notice that consent given under this
provision is irrevocable upon acceptance by the court, shall be irrevocable
unless fraud is established and an order issues permitting revocation as stated
in item (vii);
(ii) if the court accepts a
consent to adopt in lieu of ordering one of the other enumerated permanency
dispositions, the court must review the matter at least every 90 days. The
review will address the reasonable efforts of the agency to achieve a finalized
adoption;
(iii) a consent to adopt
under this clause vests all legal authority regarding the child, including
guardianship and legal custody of the child, with the commissioner of human
services as if the child were a state ward after termination of parental
rights;
(iv) the court must forward
a copy of the consent to adopt, together with a certified copy of the order
transferring guardianship and legal custody to the commissioner, to the
commissioner;
(v) if an adoption is not
finalized by the identified prospective adoptive parent within 12 months of the
execution of the consent to adopt under this clause, the commissioner of human
services or the commissioner's delegate shall pursue adoptive placement in
another home unless the commissioner certifies that the failure to finalize is
not due to either an action or a failure to act by the prospective adoptive
parent;
(vi) notwithstanding item
(v), the commissioner of human services or the commissioner's designee must
pursue adoptive placement in another home as soon as the commissioner or
commissioner's designee determines that finalization of the adoption with the
identified prospective adoptive parent is not possible, that the identified
prospective adoptive parent is not willing to adopt the child, that the
identified prospective adoptive parent is not cooperative in completing the
steps necessary to finalize the adoption, or upon the commissioner's
determination to withhold consent to the adoption.
(vii) unless otherwise
required by the Indian Child Welfare Act, United States Code, title 25, section
1913, a consent to adopt executed under this section, following proper notice
that consent given under this provision is irrevocable upon acceptance by the
court, shall be irrevocable upon acceptance by the court except upon order
permitting revocation issued by the same court after written findings that
consent was obtained by fraud.
(e) In ordering a permanent
placement of a child, the court must be governed by the best interests of the
child, including a review of the relationship between the child and relatives
and the child and other important persons with whom the child has resided or
had significant contact. When the court has determined that permanent
placement of the child away from the parent is necessary, the court shall
consider permanent alternative homes that are available both inside and outside
the state.
(f) Once a permanent
placement determination has been made and permanent placement has been
established, further court reviews are necessary if:
(1) the placement is
long-term foster care or foster care for a specified period of time;
(2) the court orders further
hearings because it has retained jurisdiction of a transfer of permanent legal
and physical custody matter;
(3) an adoption has not yet
been finalized; or
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(4) there is a disruption of
the permanent or long-term placement.
(g) Court reviews of an
order for long-term foster care, whether under this section or section
260C.317, subdivision 3, paragraph (d), must be conducted at least yearly and
must review the child's out-of-home placement plan and the reasonable efforts
of the agency to finalize the permanent plan for the child including the
agency's efforts to:
(1) ensure that long-term
foster care continues to be the most appropriate legal arrangement for meeting
the child's need for permanency and stability or, if not, to identify and
attempt to finalize another permanent placement option under this chapter that
would better serve the child's needs and best interests;
(2) identify a specific
long-term foster home for the child, if one has not already been identified;
(3) support continued
placement of the child in the identified home, if one has been identified;
(4) ensure appropriate
services are provided to address the physical health, mental health, and
educational needs of the child during the period of long-term foster care and
also ensure appropriate services or assistance to maintain relationships with
appropriate family members and the child's community; and
(5) plan for the child's
independence upon the child's leaving long-term foster care living as required
under section 260C.212, subdivision 1.
(h) In the event it is
necessary for a child that has been ordered into foster care for a specified
period of time to be in foster care longer than one year after the permanency
hearing held under this section, not later than 12 months after the time the
child was ordered into foster care for a specified period of time, the matter
must be returned to court for a review of the appropriateness of continuing the
child in foster care and of the responsible social services agency's reasonable
efforts to finalize a permanent plan for the child; if it is in the child's
best interests to continue the order for foster care for a specified period of
time past a total of 12 months, the court shall set objectives for the child's
continuation in foster care, specify any further amount of time the child may
be in foster care, and review the plan for the safe return of the child to the
parent.
(i) An order permanently
placing a child out of the home of the parent or guardian must include the
following detailed findings:
(1) how the child's best
interests are served by the order;
(2) the nature and extent of
the responsible social service agency's reasonable efforts, or, in the case of
an Indian child, active efforts to reunify the child with the parent or
guardian where reasonable efforts are required;
(3) the parent's or parents'
efforts and ability to use services to correct the conditions which led to the
out-of-home placement; and
(4) that the conditions
which led to the out-of-home placement have not been corrected so that the child
can safely return home.
(j) An order for permanent
legal and physical custody of a child may be modified under sections 518.18 and
518.185. The social services agency is a party to the proceeding and must
receive notice. A parent may only seek modification of an order for long-term
foster care upon motion and a showing by the parent of a substantial change in
the parent's circumstances such that the parent could provide appropriate care
for the child and that removal of the child from the child's permanent
placement and the return to the parent's care would be in the best interest of
the child. The responsible social services agency may ask the court to vacate
an order for long-term foster care upon a
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prima facie showing that
there is a factual basis for the court to order another permanency option under
this chapter and that such an option is in the child's best interests. Upon a
hearing where the court determines that there is a factual basis for vacating
the order for long-term foster care and that another permanent order regarding
the placement of the child is in the child's best interests, the court may
vacate the order for long-term foster care and enter a different order for
permanent placement that is in the child's best interests. The court shall not
require further reasonable efforts to reunify the child with the parent or
guardian as a basis for vacating the order for long-term foster care and
ordering a different permanent placement in the child's best interests. The
county attorney must file pleadings and give notice as required under the rules
of juvenile court in order to modify an order for long-term foster care under
this paragraph.
(k) The court shall issue an
order required under this section within 15 days of the close of the
proceedings. The court may extend issuing the order an additional 15 days when
necessary in the interests of justice and the best interests of the child.
(l) This paragraph applies
to proceedings required under this subdivision when the child is on a trial
home visit:
(1) if the child is on a
trial home visit 12 months after the child was placed in foster care or in the
care of a noncustodial parent as calculated in this subdivision, the
responsible social services agency may file a report with the court regarding
the child's and parent's progress on the trial home visit and its reasonable
efforts to finalize the child's safe and permanent return to the care of the
parent in lieu of filing the pleadings required under paragraph (b). The court
shall make findings regarding reasonableness of the responsible social services
efforts to finalize the child's return home as the permanent order in the best
interests of the child. The court may continue the trial home visit to a total
time not to exceed six months as provided in subdivision 1. If the court finds
the responsible social services agency has not made reasonable efforts to
finalize the child's return home as the permanent order in the best interests
of the child, the court may order other or additional efforts to support the
child remaining in the care of the parent; and
(2) if a trial home visit
ordered or continued at proceedings under this subdivision terminates, the
court shall re-commence proceedings under this subdivision to determine the
permanent status of the child not later than 30 days after the child is
returned to foster care.
Sec. 73. Minnesota Statutes
2006, section 260C.212, subdivision 1, is amended to read:
Subdivision 1. Out-of-home placement; plan. (a) An
out-of-home placement plan shall be prepared within 30 days after any child is
placed in a residential facility by court order or by the voluntary release of
the child by the parent or parents.
For purposes of this
section, a residential facility means any group home, family foster home or
other publicly supported out-of-home residential facility, including any
out-of-home residential facility under contract with the state, county or other
political subdivision, or any agency thereof, to provide those services or
foster care as defined in section 260C.007, subdivision 18.
(b) An out-of-home placement
plan means a written document which is prepared by the responsible social
services agency jointly with the parent or parents or guardian of the child and
in consultation with the child's guardian ad litem, the child's tribe, if the
child is an Indian child, the child's foster parent or representative of the
residential facility, and, where appropriate, the child. For a child in
placement due solely or in part to the child's emotional disturbance,
preparation of the out-of-home placement plan shall additionally include the
child's mental health treatment provider. As appropriate, the plan shall be:
(1) submitted to the court
for approval under section 260C.178, subdivision 7;
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(2) ordered by the court,
either as presented or modified after hearing, under section 260C.178, subdivision
7, or 260C.201, subdivision 6; and
(3) signed by the parent or
parents or guardian of the child, the child's guardian ad litem, a
representative of the child's tribe, the responsible social services agency,
and, if possible, the child.
(c) The out-of-home
placement plan shall be explained to all persons involved in its
implementation, including the child who has signed the plan, and shall set
forth:
(1) a description of the
residential facility including how the out-of-home placement plan is designed
to achieve a safe placement for the child in the least restrictive, most
family-like, setting available which is in close proximity to the home of the
parent or parents or guardian of the child when the case plan goal is
reunification, and how the placement is consistent with the best interests and
special needs of the child according to the factors under subdivision 2,
paragraph (b);
(2) the specific reasons for
the placement of the child in a residential facility, and when reunification is
the plan, a description of the problems or conditions in the home of the parent
or parents which necessitated removal of the child from home and the changes
the parent or parents must make in order for the child to safely return home;
(3) a description of the
services offered and provided to prevent removal of the child from the home and
to reunify the family including:
(i) the specific actions to
be taken by the parent or parents of the child to eliminate or correct the
problems or conditions identified in clause (2), and the time period during
which the actions are to be taken; and
(ii) the reasonable efforts,
or in the case of an Indian child, active efforts to be made to achieve a safe
and stable home for the child including social and other supportive services to
be provided or offered to the parent or parents or guardian of the child, the
child, and the residential facility during the period the child is in the
residential facility;
(4) a description of any
services or resources that were requested by the child or the child's parent,
guardian, foster parent, or custodian since the date of the child's placement
in the residential facility, and whether those services or resources were
provided and if not, the basis for the denial of the services or resources;
(5) the visitation plan for
the parent or parents or guardian, other relatives as defined in section
260C.007, subdivision 27, and siblings of the child if the siblings are not
placed together in the residential facility, and whether visitation is consistent
with the best interest of the child, during the period the child is in the
residential facility;
(6) documentation of steps
to finalize the adoption or legal guardianship of the child if the court has
issued an order terminating the rights of both parents of the child or of the
only known, living parent of the child, and. At a minimum, the
documentation must include child-specific recruitment efforts such as relative
search and the use of state, regional, and national adoption exchanges to
facilitate orderly and timely placements in and outside of the state. A
copy of this documentation shall be provided to the court in the review
required under section 260C.317, subdivision 3, paragraph (b);
(7) to the extent
available and accessible, the health and educational records of the child
including the most recent information available regarding:
(i) the names and addresses
of the child's health and educational providers;
(ii) the child's grade level
performance;
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(iii)
the child's school record;
(iv)
assurances that the child's placement in foster care takes into account
proximity to the school in which the child is enrolled at the time of
placement;
(v)
a record of the child's immunizations;
(vi)
the child's known medical problems, including any known communicable diseases,
as defined in section 144.4172, subdivision 2;
(vii)
the child's medications; and
(viii)
any other relevant health and education information;
(8)
an independent living plan for a child age 16 or older who is in placement as a
result of a permanency disposition. The plan should include, but not be limited
to, the following objectives:
(i)
educational, vocational, or employment planning;
(ii)
health care planning and medical coverage;
(iii)
transportation including, where appropriate, assisting the child in obtaining a
driver's license;
(iv)
money management;
(v)
planning for housing;
(vi)
social and recreational skills; and
(vii)
establishing and maintaining connections with the child's family and community;
and
(9)
for a child in placement due solely or in part to the child's emotional
disturbance, diagnostic and assessment information, specific services relating
to meeting the mental health care needs of the child, and treatment outcomes.
(d)
The parent or parents or guardian and the child each shall have the right to
legal counsel in the preparation of the case plan and shall be informed of the
right at the time of placement of the child. The child shall also have the
right to a guardian ad litem. If unable to employ counsel from their own
resources, the court shall appoint counsel upon the request of the parent or
parents or the child or the child's legal guardian. The parent or parents may
also receive assistance from any person or social services agency in
preparation of the case plan.
After
the plan has been agreed upon by the parties involved or approved or ordered by
the court, the foster parents shall be fully informed of the provisions of the
case plan and shall be provided a copy of the plan.
Upon
discharge from foster care, the parent, adoptive parent, or permanent legal and
physical custodian, as appropriate, and the child, if appropriate, must be
provided with a current copy of the child's health and education record.
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Sec. 74. Minnesota Statutes
2006, section 260C.212, subdivision 4, is amended to read:
Subd. 4. Responsible social service agency's duties
for children in placement. (a) When a child is in placement, the
responsible social services agency shall make diligent efforts to identify,
locate, and, where appropriate, offer services to both parents of the child.
(1) The responsible social
services agency shall assess whether a noncustodial or nonadjudicated parent is
willing and capable of providing for the day-to-day care of the child
temporarily or permanently. An assessment under this clause may include, but is
not limited to, obtaining information under section 260C.209. If after
assessment, the responsible social services agency determines that a
noncustodial or nonadjudicated parent is willing and capable of providing
day-to-day care of the child, the responsible social services agency may seek
authority from the custodial parent or the court to have that parent assume
day-to-day care of the child. If a parent is not an adjudicated parent, the
responsible social services agency shall require the nonadjudicated parent to
cooperate with paternity establishment procedures as part of the case plan.
(2) If, after assessment,
the responsible social services agency determines that the child cannot be in
the day-to-day care of either parent, the agency shall:
(i) prepare an out-of-home
placement plan addressing the conditions that each parent must meet before the
child can be in that parent's day-to-day care; and
(ii) provide a parent who is
the subject of a background study under section 260C.209 15 days' notice that
it intends to use the study to recommend against putting the child with that
parent, as well as the notice provided in section 260C.209, subdivision 4, and
the court shall afford the parent an opportunity to be heard concerning the
study.
The results of a background
study of a noncustodial parent shall not be used by the agency to determine
that the parent is incapable of providing day-to-day care of the child unless
the agency reasonably believes that placement of the child into the home of
that parent would endanger the child's health, safety, or welfare.
(3) If, after the provision
of services following an out-of-home placement plan under this section, the
child cannot return to the care of the parent from whom the child was removed
or who had legal custody at the time the child was placed in foster care, the
agency may petition on behalf of a noncustodial parent to establish legal
custody with that parent under section 260C.201, subdivision 11. If paternity
has not already been established, it may be established in the same proceeding
in the manner provided for under chapter 257.
(4) The responsible social
services agency may be relieved of the requirement to locate and offer services
to both parents by the juvenile court upon a finding of good cause after the
filing of a petition under section 260C.141.
(b) The responsible social
services agency shall give notice to the parent or parents or guardian of each
child in a residential facility, other than a child in placement due solely to
that child's developmental disability or emotional disturbance, of the
following information:
(1) that residential care of
the child may result in termination of parental rights or an order permanently
placing the child out of the custody of the parent, but only after notice and a
hearing as required under chapter 260C and the juvenile court rules;
(2) time limits on the
length of placement and of reunification services, including the date on which
the child is expected to be returned to and safely maintained in the home of
the parent or parents or placed for adoption or otherwise permanently removed
from the care of the parent by court order;
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(3) the nature of the
services available to the parent;
(4) the consequences to the
parent and the child if the parent fails or is unable to use services to
correct the circumstances that led to the child's placement;
(5) the first consideration
for placement with relatives;
(6) the benefit to the child
in getting the child out of residential care as soon as possible, preferably by
returning the child home, but if that is not possible, through a permanent
legal placement of the child away from the parent;
(7) when safe for the child,
the benefits to the child and the parent of maintaining visitation with the
child as soon as possible in the course of the case and, in any event,
according to the visitation plan under this section; and
(8) the financial
responsibilities and obligations, if any, of the parent or parents for the
support of the child during the period the child is in the residential
facility.
(c) The responsible social
services agency shall inform a parent considering voluntary placement of a
child who is not developmentally disabled or emotionally disturbed of the
following information:
(1) the parent and the child
each has a right to separate legal counsel before signing a voluntary placement
agreement, but not to counsel appointed at public expense;
(2) the parent is not
required to agree to the voluntary placement, and a parent who enters a
voluntary placement agreement may at any time request that the agency return
the child. If the parent so requests, the child must be returned within 24
hours of the receipt of the request;
(3) evidence gathered during
the time the child is voluntarily placed may be used at a later time as the
basis for a petition alleging that the child is in need of protection or
services or as the basis for a petition seeking termination of parental rights
or other permanent placement of the child away from the parent;
(4) if the responsible
social services agency files a petition alleging that the child is in need of
protection or services or a petition seeking the termination of parental rights
or other permanent placement of the child away from the parent, the parent
would have the right to appointment of separate legal counsel and the child
would have a right to the appointment of counsel and a guardian ad litem as
provided by law, and that counsel will be appointed at public expense if they
are unable to afford counsel; and
(5) the timelines and
procedures for review of voluntary placements under subdivision 3, and the
effect the time spent in voluntary placement on the scheduling of a permanent
placement determination hearing under section 260C.201, subdivision 11.
(d) When an agency accepts a
child for placement, the agency shall determine whether the child has had a
physical examination by or under the direction of a licensed physician within
the 12 months immediately preceding the date when the child came into the
agency's care. If there is documentation that the child has had an examination
within the last 12 months, the agency is responsible for seeing that the child
has another physical examination within one year of the documented examination
and annually in subsequent years. If the agency determines that the child has
not had a physical examination within the 12 months immediately preceding
placement, the agency shall ensure that the child has an examination within 30
days of coming into the agency's care and once a year in subsequent years.
(e) If a child leaves foster
care by reason of having attained the age of majority under state law, the
child must be given at no cost a copy of the child's health and education
report.
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Sec. 75. Minnesota Statutes
2006, section 260C.212, subdivision 9, is amended to read:
Subd. 9. Review of certain child placements. (a)
When a developmentally disabled child or emotionally disturbed child needs
placement in a residential facility for the sole reason of accessing services
or a level of skilled care that cannot be provided in the parent's home, the
child must be placed pursuant to a voluntary placement agreement between the
responsible social services agency and the child's parent. The voluntary
placement agreement must give the responsible social services agency legal
responsibility for the child's physical care, custody, and control, but must
not transfer legal custody of the child to the agency. The voluntary placement
agreement must be executed in a form developed and promulgated by the
commissioner of human services. The responsible social services agency shall
report to the commissioner the number of children who are the subject of a
voluntary placement agreement under this subdivision and other information
regarding these children as the commissioner may require.
(b) If a developmentally
disabled child or a child diagnosed as emotionally disturbed has been placed in
a residential facility pursuant to a voluntary release by the child's parent or
parents because of the child's disabling conditions or need for long-term
residential treatment or supervision, the social services agency responsible
for the placement shall report to the court and bring a petition for review of
the child's foster care status as required in section 260C.141, subdivision 2a.
(b) (c) If a child is in
placement due solely to the child's developmental disability or emotional
disturbance, and the court finds compelling reasons not to proceed under
section 260C.201, subdivision 11, and custody of the child is not
transferred to the responsible social services agency under section 260C.201,
subdivision 1, paragraph (a), clause (2), and no petition is required by
section 260C.201, subdivision 11.
(c) (d) Whenever a
petition for review is brought pursuant to this subdivision, a guardian ad litem
shall be appointed for the child.
Sec. 76. Minnesota Statutes
2006, section 260C.317, subdivision 3, is amended to read:
Subd. 3. Order; retention of jurisdiction. (a) A
certified copy of the findings and the order terminating parental rights, and a
summary of the court's information concerning the child shall be furnished by
the court to the commissioner or the agency to which guardianship is
transferred. The orders shall be on a document separate from the findings. The
court shall furnish the individual to whom guardianship is transferred a copy
of the order terminating parental rights.
(b) The court shall retain
jurisdiction in a case where adoption is the intended permanent placement
disposition until the child's adoption is finalized, the child is 18 years of
age, or the child is otherwise ordered discharged from the jurisdiction of the
court. The guardian ad litem and counsel for the child shall continue on the
case until an adoption decree is entered. A hearing must be held every 90 days
following termination of parental rights for the court to review progress
toward an adoptive placement and the specific recruitment efforts the agency
has taken to find an adoptive family or other placement living arrangement for
the child and to finalize the adoption or other permanency plan.
(c) The responsible social
services agency may make a determination of compelling reasons for a child to
be in long-term foster care when the agency has made exhaustive efforts to
recruit, identify, and place the child in an adoptive home, and the child
continues in foster care for at least 24 months after the court has issued the
order terminating parental rights. A child of any age who is under the
guardianship of the commissioner of the Department of Human Services and is
legally available for adoption may not refuse or waive the commissioner's
agent's exhaustive efforts to recruit, identify, and place the child in an
adoptive home required under paragraph (b) or sign a document relieving county
social services agencies of all recruitment efforts on the child's behalf. Upon
approving the agency's determination of compelling reasons, the court may order
the child placed in long-term foster
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care. At least every 12
months thereafter as long as the child continues in out-of-home placement, the
court shall conduct a permanency review hearing to determine the future status
of the child using the review requirements of section 260C.201, subdivision 11,
paragraph (g).
(d) The court shall retain
jurisdiction through the child's minority in a case where long-term foster care
is the permanent disposition whether under paragraph (c) or section 260C.201,
subdivision 11.
Sec. 77. Minnesota Statutes 2006,
section 260C.331, subdivision 1, is amended to read:
Subdivision 1. Care, examination, or treatment. (a)
Except where parental rights are terminated,
(1) whenever legal custody
of a child is transferred by the court to a responsible social services agency,
(2) whenever legal custody
is transferred to a person other than the responsible social services agency,
but under the supervision of the responsible social services agency, or
(3) whenever a child is
given physical or mental examinations or treatment under order of the court,
and no provision is otherwise made by law for payment for the care,
examination, or treatment of the child, these costs are a charge upon the
welfare funds of the county in which proceedings are held upon certification of
the judge of juvenile court.
(b) The court shall order,
and the responsible social services agency shall require, the parents or
custodian of a child, while the child is under the age of 18, to use the total
income and resources attributable to the child for the period of care,
examination, or treatment, except for clothing and personal needs allowance as
provided in section 256B.35, to reimburse the county for the cost of care,
examination, or treatment. Income and resources attributable to the child include,
but are not limited to, Social Security benefits, supplemental security income
(SSI), veterans benefits, railroad retirement benefits and child support. When
the child is over the age of 18, and continues to receive care, examination, or
treatment, the court shall order, and the responsible social services agency
shall require, reimbursement from the child for the cost of care, examination,
or treatment from the income and resources attributable to the child less the
clothing and personal needs allowance. Income does not include earnings from
a child over the age of 18 who is working as part of a plan under section
260C.212, subdivision 1, paragraph (c), clause (8), to transition from foster
care.
(c) If the income and
resources attributable to the child are not enough to reimburse the county for
the full cost of the care, examination, or treatment, the court shall inquire
into the ability of the parents to support the child and, after giving the
parents a reasonable opportunity to be heard, the court shall order, and the
responsible social services agency shall require, the parents to contribute to
the cost of care, examination, or treatment of the child. When determining the
amount to be contributed by the parents, the court shall use a fee schedule based
upon ability to pay that is established by the responsible social services
agency and approved by the commissioner of human services. The income of a
stepparent who has not adopted a child shall be excluded in calculating the
parental contribution under this section.
(d) The court shall order
the amount of reimbursement attributable to the parents or custodian, or
attributable to the child, or attributable to both sources, withheld under
chapter 518A from the income of the parents or the custodian of the child. A
parent or custodian who fails to pay without good reason may be proceeded
against for contempt, or the court may inform the county attorney, who shall
proceed to collect the unpaid sums, or both procedures may be used.
(e)
If the court orders a physical or mental examination for a child, the
examination is a medically necessary service for purposes of determining
whether the service is covered by a health insurance policy, health maintenance
contract, or other health coverage plan. Court-ordered treatment shall be
subject to policy, contract, or plan
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requirements for medical
necessity. Nothing in this paragraph changes or eliminates benefit limits,
conditions of coverage, co-payments or deductibles, provider restrictions, or
other requirements in the policy, contract, or plan that relate to coverage of
other medically necessary services.
Sec.
78. Minnesota Statutes 2006, section 270B.14, subdivision 1, is amended to read:
Subdivision
1. Disclosure to commissioner of human
services. (a) On the request of the commissioner of human services, the
commissioner shall disclose return information regarding taxes imposed by chapter
290, and claims for refunds under chapter 290A, to the extent provided in
paragraph (b) and for the purposes set forth in paragraph (c).
(b)
Data that may be disclosed are limited to data relating to the identity,
whereabouts, employment, income, and property of a person owing or alleged to
be owing an obligation of child support.
(c)
The commissioner of human services may request data only for the purposes of
carrying out the child support enforcement program and to assist in the
location of parents who have, or appear to have, deserted their children. Data
received may be used only as set forth in section 256.978.
(d)
The commissioner shall provide the records and information necessary to
administer the supplemental housing allowance to the commissioner of human
services.
(e)
At the request of the commissioner of human services, the commissioner of
revenue shall electronically match the Social Security numbers and names of
participants in the telephone assistance plan operated under sections 237.69 to
237.711, with those of property tax refund filers, and determine whether each
participant's household income is within the eligibility standards for the
telephone assistance plan.
(f)
The commissioner may provide records and information collected under sections
295.50 to 295.59 to the commissioner of human services for purposes of the
Medicaid Voluntary Contribution and Provider-Specific Tax Amendments of 1991,
Public Law 102-234. Upon the written agreement by the United States Department
of Health and Human Services to maintain the confidentiality of the data, the
commissioner may provide records and information collected under sections
295.50 to 295.59 to the Centers for Medicare and Medicaid Services section of
the United States Department of Health and Human Services for purposes of
meeting federal reporting requirements.
(g)
The commissioner may provide records and information to the commissioner of
human services as necessary to administer the early refund of refundable tax
credits.
(h) The commissioner may disclose information to
the commissioner of human services necessary to verify income for eligibility
and premium payment under the MinnesotaCare program, under section 256L.05,
subdivision 2.
(i)
The commissioner may disclose information to the commissioner of human services
necessary to verify whether applicants or recipients for the Minnesota family
investment program, general assistance, food support, and Minnesota
supplemental aid program, and child care assistance have claimed refundable
tax credits under chapter 290 and the property tax refund under chapter 290A,
and the amounts of the credits.
Sec.
79. Minnesota Statutes 2006, section 626.556, subdivision 2, is amended to
read:
Subd.
2. Definitions. As used in this
section, the following terms have the meanings given them unless the specific
content indicates otherwise:
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(a) "Family
assessment" means a comprehensive assessment of child safety, risk of subsequent
child maltreatment, and family strengths and needs that is applied to a child
maltreatment report that does not allege substantial child endangerment. Family
assessment does not include a determination as to whether child maltreatment
occurred but does determine the need for services to address the safety of
family members and the risk of subsequent maltreatment.
(b)
"Investigation" means fact gathering related to the current safety of
a child and the risk of subsequent maltreatment that determines whether child
maltreatment occurred and whether child protective services are needed. An
investigation must be used when reports involve substantial child endangerment,
and for reports of maltreatment in facilities required to be licensed under
chapter 245A or 245B; under sections 144.50 to 144.58 and 241.021; in a school
as defined in sections 120A.05, subdivisions 9, 11, and 13, and 124D.10; or in
a nonlicensed personal care provider association as defined in sections
256B.04, subdivision 16, and 256B.0625, subdivision 19a.
(c) "Substantial child
endangerment" means a person responsible for a child's care, and in the
case of sexual abuse includes a person who has a significant relationship
to the child as defined in section 609.341, or a person in a position of
authority as defined in section 609.341, who by act or omission commits or
attempts to commit an act against a child under their care that constitutes any
of the following:
(1) egregious harm as
defined in section 260C.007, subdivision 14;
(2) sexual abuse as defined
in paragraph (d);
(3) abandonment under
section 260C.301, subdivision 2;
(4) neglect as defined in
paragraph (f), clause (2), that substantially endangers the child's physical or
mental health, including a growth delay, which may be referred to as failure to
thrive, that has been diagnosed by a physician and is due to parental neglect;
(5) murder in the first,
second, or third degree under section 609.185, 609.19, or 609.195;
(6) manslaughter in the
first or second degree under section 609.20 or 609.205;
(7) assault in the first,
second, or third degree under section 609.221, 609.222, or 609.223;
(8) solicitation,
inducement, and promotion of prostitution under section 609.322;
(9) criminal sexual conduct
under sections 609.342 to 609.3451;
(10) solicitation of
children to engage in sexual conduct under section 609.352;
(11) malicious punishment or
neglect or endangerment of a child under section 609.377 or 609.378;
(12) use of a minor in
sexual performance under section 617.246; or
(13) parental behavior,
status, or condition which mandates that the county attorney file a termination
of parental rights petition under section 260C.301, subdivision 3, paragraph
(a).
(d)
"Sexual abuse" means the subjection of a child by a person
responsible for the child's care, by a person who has a significant
relationship to the child, as defined in section 609.341, or by a person in a
position of authority, as defined in section 609.341, subdivision 10, to any
act which constitutes a violation of section 609.342 (criminal sexual conduct
in the first degree), 609.343 (criminal sexual conduct in the second degree),
609.344 (criminal sexual
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conduct in the third
degree), 609.345 (criminal sexual conduct in the fourth degree), or 609.3451
(criminal sexual conduct in the fifth degree). Sexual abuse also includes any
act which involves a minor which constitutes a violation of prostitution
offenses under sections 609.321 to 609.324 or 617.246. Sexual abuse includes
threatened sexual abuse.
(e)
"Person responsible for the child's care" means (1) an individual
functioning within the family unit and having responsibilities for the care of
the child such as a parent, guardian, or other person having similar care
responsibilities, or (2) an individual functioning outside the family unit and
having responsibilities for the care of the child such as a teacher, school administrator,
other school employees or agents, or other lawful custodian of a child having
either full-time or short-term care responsibilities including, but not limited
to, day care, babysitting whether paid or unpaid, counseling, teaching, and
coaching.
(f)
"Neglect" means:
(1)
failure by a person responsible for a child's care to supply a child with
necessary food, clothing, shelter, health, medical, or other care required for
the child's physical or mental health when reasonably able to do so;
(2)
failure to protect a child from conditions or actions that seriously endanger
the child's physical or mental health when reasonably able to do so, including
a growth delay, which may be referred to as a failure to thrive, that has been
diagnosed by a physician and is due to parental neglect;
(3)
failure to provide for necessary supervision or child care arrangements
appropriate for a child after considering factors as the child's age, mental
ability, physical condition, length of absence, or environment, when the child
is unable to care for the child's own basic needs or safety, or the basic needs
or safety of another child in their care;
(4)
failure to ensure that the child is educated as defined in sections 120A.22 and
260C.163, subdivision 11, which does not include a parent's refusal to provide
the parent's child with sympathomimetic medications, consistent with section
125A.091, subdivision 5;
(5)
nothing in this section shall be construed to mean that a child is neglected
solely because the child's parent, guardian, or other person responsible for
the child's care in good faith selects and depends upon spiritual means or
prayer for treatment or care of disease or remedial care of the child in lieu
of medical care; except that a parent, guardian, or caretaker, or a person
mandated to report pursuant to subdivision 3, has a duty to report if a lack of
medical care may cause serious danger to the child's health. This section does
not impose upon persons, not otherwise legally responsible for providing a child
with necessary food, clothing, shelter, education, or medical care, a duty to
provide that care;
(6)
prenatal exposure to a controlled substance, as defined in section 253B.02,
subdivision 2, used by the mother for a nonmedical purpose, as evidenced by
withdrawal symptoms in the child at birth, results of a toxicology test
performed on the mother at delivery or the child at birth, or medical effects
or developmental delays during the child's first year of life that medically
indicate prenatal exposure to a controlled substance;
(7)
"medical neglect" as defined in section 260C.007, subdivision 6,
clause (5);
(8)
chronic and severe use of alcohol or a controlled substance by a parent or person
responsible for the care of the child that adversely affects the child's basic
needs and safety; or
(9)
emotional harm from a pattern of behavior which contributes to impaired
emotional functioning of the child which may be demonstrated by a substantial
and observable effect in the child's behavior, emotional response, or cognition
that is not within the normal range for the child's age and stage of
development, with due regard to the child's culture.
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(g) "Physical
abuse" means any physical injury, mental injury, or threatened injury,
inflicted by a person responsible for the child's care on a child other than by
accidental means, or any physical or mental injury that cannot reasonably be
explained by the child's history of injuries, or any aversive or deprivation
procedures, or regulated interventions, that have not been authorized under
section 121A.67 or 245.825. Abuse does not include reasonable and moderate
physical discipline of a child administered by a parent or legal guardian which
does not result in an injury. Abuse does not include the use of reasonable
force by a teacher, principal, or school employee as allowed by section
121A.582. Actions which are not reasonable and moderate include, but are not
limited to, any of the following that are done in anger or without regard to
the safety of the child:
(1) throwing, kicking,
burning, biting, or cutting a child;
(2) striking a child with a
closed fist;
(3) shaking a child under
age three;
(4) striking or other
actions which result in any nonaccidental injury to a child under 18 months of
age;
(5) unreasonable
interference with a child's breathing;
(6) threatening a child with
a weapon, as defined in section 609.02, subdivision 6;
(7) striking a child under
age one on the face or head;
(8) purposely giving a child
poison, alcohol, or dangerous, harmful, or controlled substances which were not
prescribed for the child by a practitioner, in order to control or punish the
child; or other substances that substantially affect the child's behavior,
motor coordination, or judgment or that results in sickness or internal injury,
or subjects the child to medical procedures that would be unnecessary if the
child were not exposed to the substances;
(9) unreasonable physical
confinement or restraint not permitted under section 609.379, including but not
limited to tying, caging, or chaining; or
(10) in a school facility or
school zone, an act by a person responsible for the child's care that is a
violation under section 121A.58.
(h) "Report" means
any report received by the local welfare agency, police department, county
sheriff, or agency responsible for assessing or investigating maltreatment
pursuant to this section.
(i) "Facility"
means:
(1) a licensed or unlicensed
day care facility, residential facility, agency, hospital, sanitarium, or other
facility or institution required to be licensed under sections 144.50 to
144.58, 241.021, or 245A.01 to 245A.16, or chapter 245B;
(2) a school as defined in
sections 120A.05, subdivisions 9, 11, and 13; and 124D.10; or
(3) a nonlicensed personal
care provider organization as defined in sections 256B.04, subdivision 16, and
256B.0625, subdivision 19a.
(j) "Operator"
means an operator or agency as defined in section 245A.02.
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(k) "Commissioner"
means the commissioner of human services.
(l) "Practice of social
services," for the purposes of subdivision 3, includes but is not limited
to employee assistance counseling and the provision of guardian ad litem and
parenting time expeditor services.
(m) "Mental
injury" means an injury to the psychological capacity or emotional
stability of a child as evidenced by an observable or substantial impairment in
the child's ability to function within a normal range of performance and
behavior with due regard to the child's culture.
(n) "Threatened
injury" means a statement, overt act, condition, or status that represents
a substantial risk of physical or sexual abuse or mental injury. Threatened
injury includes, but is not limited to, exposing a child to a person
responsible for the child's care, as defined in paragraph (e), clause (1), who
has:
(1) subjected a child to, or
failed to protect a child from, an overt act or condition that constitutes
egregious harm, as defined in section 260C.007, subdivision 14, or a similar
law of another jurisdiction;
(2) been found to be
palpably unfit under section 260C.301, paragraph (b), clause (4), or a similar
law of another jurisdiction;
(3) committed an act that
has resulted in an involuntary termination of parental rights under section
260C.301, or a similar law of another jurisdiction; or
(4) committed an act that
has resulted in the involuntary transfer of permanent legal and physical
custody of a child to a relative under section 260C.201, subdivision 11,
paragraph (d), clause (1), or a similar law of another jurisdiction.
(o) Persons who conduct
assessments or investigations under this section shall take into account
accepted child-rearing practices of the culture in which a child participates
and accepted teacher discipline practices, which are not injurious to the
child's health, welfare, and safety.
Sec. 80. Minnesota Statutes
2006, section 626.556, subdivision 3, is amended to read:
Subd. 3. Persons mandated to report. (a) A
person who knows or has reason to believe a child is being neglected or
physically or sexually abused, as defined in subdivision 2, or has been
neglected or physically or sexually abused within the preceding three years,
shall immediately report the information to the local welfare agency, agency
responsible for assessing or investigating the report, police department, or
the county sheriff if the person is:
(1) a professional or
professional's delegate who is engaged in the practice of the healing arts,
social services, hospital administration, psychological or psychiatric
treatment, child care, education, correctional supervision, probation and
correctional services, or law enforcement; or
(2) employed as a member of
the clergy and received the information while engaged in ministerial duties,
provided that a member of the clergy is not required by this subdivision to
report information that is otherwise privileged under section 595.02,
subdivision 1, paragraph (c).
The police department or the
county sheriff, upon receiving a report, shall immediately notify the local
welfare agency or agency responsible for assessing or investigating the report,
orally and in writing. The local welfare agency, or agency responsible for
assessing or investigating the report, upon receiving a report, shall
immediately notify the local police department or the county sheriff orally and
in writing. The county sheriff and the head of every local welfare agency,
agency responsible for assessing or investigating reports, and police
department shall
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each designate a person
within their agency, department, or office who is responsible for ensuring that
the notification duties of this paragraph and paragraph (b) are carried out.
Nothing in this subdivision shall be construed to require more than one report
from any institution, facility, school, or agency.
(b) Any person may
voluntarily report to the local welfare agency, agency responsible for
assessing or investigating the report, police department, or the county sheriff
if the person knows, has reason to believe, or suspects a child is being or has
been neglected or subjected to physical or sexual abuse. The police department
or the county sheriff, upon receiving a report, shall immediately notify the
local welfare agency or agency responsible for assessing or investigating the
report, orally and in writing. The local welfare agency or agency responsible
for assessing or investigating the report, upon receiving a report, shall
immediately notify the local police department or the county sheriff orally and
in writing.
(c) A person mandated to
report physical or sexual child abuse or neglect occurring within a licensed
facility shall report the information to the agency responsible for licensing
the facility under sections 144.50 to 144.58; 241.021; 245A.01 to 245A.16; or
chapter 245B; or a nonlicensed personal care provider organization as defined
in sections 256B.04, subdivision 16; and 256B.0625, subdivision 19. A health or
corrections agency receiving a report may request the local welfare agency to
provide assistance pursuant to subdivisions 10, 10a, and 10b. A board or other
entity whose licensees perform work within a school facility, upon receiving a
complaint of alleged maltreatment, shall provide information about the
circumstances of the alleged maltreatment to the commissioner of education.
Section 13.03, subdivision 4, applies to data received by the commissioner of
education from a licensing entity.
(d) Any person mandated to
report shall receive a summary of the disposition of any report made by that
reporter, including whether the case has been opened for child protection or
other services, or if a referral has been made to a community organization,
unless release would be detrimental to the best interests of the child. Any
person who is not mandated to report shall, upon request to the local welfare
agency, receive a concise summary of the disposition of any report made by that
reporter, unless release would be detrimental to the best interests of the
child.
(e) For purposes of this subdivision
section, "immediately" means as soon as possible but in no event
longer than 24 hours.
Sec. 81. Minnesota Statutes
2006, section 626.556, is amended by adding a subdivision to read:
Subd. 3e. Agency responsibility for assessing or investigating reports of
sexual abuse. The local welfare agency is the agency responsible for
investigating allegations of sexual abuse if the alleged offender is the
parent, guardian, sibling, or an individual functioning within the family unit
as a person responsible for the child's care, or a person with a significant
relationship to the child if that person resides in the child's household.
Sec. 82. Minnesota Statutes
2006, section 626.556, is amended by adding a subdivision to read:
Subd. 3f. Law enforcement agency responsibility for investigating
maltreatment. The local law enforcement agency has responsibility
for investigating any report of child maltreatment if a violation of a criminal
statute is alleged. Law enforcement and the responsible agency must coordinate
their investigations or assessments as required under subdivision 10.
Sec. 83. Minnesota Statutes
2006, section 626.556, subdivision 10, is amended to read:
Subd. 10. Duties of local welfare agency and local
law enforcement agency upon receipt of a report. (a) Upon receipt of a
report, the local welfare agency shall determine whether to conduct a family
assessment or an investigation as appropriate to prevent or provide a remedy
for child maltreatment. The local welfare agency:
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(1) shall conduct an
investigation on reports involving substantial child endangerment;
(2) shall begin an immediate
investigation if, at any time when it is using a family assessment response, it
determines that there is reason to believe that substantial child endangerment
or a serious threat to the child's safety exists;
(3) may conduct a family
assessment for reports that do not allege substantial child endangerment. In determining
that a family assessment is appropriate, the local welfare agency may consider
issues of child safety, parental cooperation, and the need for an immediate
response; and
(4) may conduct a family
assessment on a report that was initially screened and assigned for an
investigation. In determining that a complete investigation is not required,
the local welfare agency must document the reason for terminating the
investigation and notify the local law enforcement agency if the local law
enforcement agency is conducting a joint investigation.
If the report alleges
neglect, physical abuse, or sexual abuse by a parent, guardian, or individual
functioning within the family unit as a person responsible for the child's
care, or sexual abuse by a person with a significant relationship to the
child when that person resides in the child's household or by a sibling, the
local welfare agency shall immediately conduct a family assessment or
investigation as identified in clauses (1) to (4). In conducting a family
assessment or investigation, the local welfare agency shall gather information
on the existence of substance abuse and domestic violence and offer services
for purposes of preventing future child maltreatment, safeguarding and
enhancing the welfare of the abused or neglected minor, and supporting and
preserving family life whenever possible. If the report alleges a violation of
a criminal statute involving sexual abuse, physical abuse, or neglect or
endangerment, under section 609.378, the local law enforcement agency and local
welfare agency shall coordinate the planning and execution of their respective
investigation and assessment efforts to avoid a duplication of fact-finding
efforts and multiple interviews. Each agency shall prepare a separate report of
the results of its investigation. In cases of alleged child maltreatment
resulting in death, the local agency may rely on the fact-finding efforts of a
law enforcement investigation to make a determination of whether or not
maltreatment occurred. When necessary the local welfare agency shall seek
authority to remove the child from the custody of a parent, guardian, or adult
with whom the child is living. In performing any of these duties, the local
welfare agency shall maintain appropriate records.
If the family assessment or
investigation indicates there is a potential for abuse of alcohol or other
drugs by the parent, guardian, or person responsible for the child's care, the
local welfare agency shall conduct a chemical use assessment pursuant to Minnesota
Rules, part 9530.6615. The local welfare agency shall report the determination
of the chemical use assessment, and the recommendations and referrals for
alcohol and other drug treatment services to the state authority on alcohol and
drug abuse.
(b) When a local agency
receives a report or otherwise has information indicating that a child who is a
client, as defined in section 245.91, has been the subject of physical abuse,
sexual abuse, or neglect at an agency, facility, or program as defined in section
245.91, it shall, in addition to its other duties under this section,
immediately inform the ombudsman established under sections 245.91 to 245.97.
The commissioner of education shall inform the ombudsman established under
sections 245.91 to 245.97 of reports regarding a child defined as a client in
section 245.91 that maltreatment occurred at a school as defined in sections
120A.05, subdivisions 9, 11, and 13, and 124D.10.
(c) Authority of the local
welfare agency responsible for assessing or investigating the child abuse or
neglect report, the agency responsible for assessing or investigating the
report, and of the local law enforcement agency for investigating the alleged
abuse or neglect includes, but is not limited to, authority to interview, without
parental consent, the alleged victim and any other minors who currently reside
with or who have resided with the alleged offender. The interview may take
place at school or at any facility or other place where the alleged victim or
other
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minors might be found or the
child may be transported to, and the interview conducted at, a place
appropriate for the interview of a child designated by the local welfare agency
or law enforcement agency. The interview may take place outside the presence of
the alleged offender or parent, legal custodian, guardian, or school official.
For family assessments, it is the preferred practice to request a parent or
guardian's permission to interview the child prior to conducting the child
interview, unless doing so would compromise the safety assessment. Except as
provided in this paragraph, the parent, legal custodian, or guardian shall be
notified by the responsible local welfare or law enforcement agency no later
than the conclusion of the investigation or assessment that this interview has
occurred. Notwithstanding rule 49.02 32 of the Minnesota Rules of
Procedure for Juvenile Courts, the juvenile court may, after hearing on an ex
parte motion by the local welfare agency, order that, where reasonable cause
exists, the agency withhold notification of this interview from the parent,
legal custodian, or guardian. If the interview took place or is to take place
on school property, the order shall specify that school officials may not
disclose to the parent, legal custodian, or guardian the contents of the
notification of intent to interview the child on school property, as provided
under this paragraph, and any other related information regarding the interview
that may be a part of the child's school record. A copy of the order shall be
sent by the local welfare or law enforcement agency to the appropriate school
official.
(d)
When the local welfare, local law enforcement agency, or the agency responsible
for assessing or investigating a report of maltreatment determines that an
interview should take place on school property, written notification of intent
to interview the child on school property must be received by school officials
prior to the interview. The notification shall include the name of the child to
be interviewed, the purpose of the interview, and a reference to the statutory
authority to conduct an interview on school property. For interviews conducted
by the local welfare agency, the notification shall be signed by the chair of
the local social services agency or the chair's designee. The notification
shall be private data on individuals subject to the provisions of this
paragraph. School officials may not disclose to the parent, legal custodian, or
guardian the contents of the notification or any other related information
regarding the interview until notified in writing by the local welfare or law
enforcement agency that the investigation or assessment has been concluded,
unless a school employee or agent is alleged to have maltreated the child.
Until that time, the local welfare or law enforcement agency or the agency
responsible for assessing or investigating a report of maltreatment shall be
solely responsible for any disclosures regarding the nature of the assessment
or investigation.
Except
where the alleged offender is believed to be a school official or employee, the
time and place, and manner of the interview on school premises shall be within
the discretion of school officials, but the local welfare or law enforcement
agency shall have the exclusive authority to determine who may attend the
interview. The conditions as to time, place, and manner of the interview set by
the school officials shall be reasonable and the interview shall be conducted
not more than 24 hours after the receipt of the notification unless another
time is considered necessary by agreement between the school officials and the
local welfare or law enforcement agency. Where the school fails to comply with
the provisions of this paragraph, the juvenile court may order the school to
comply. Every effort must be made to reduce the disruption of the educational
program of the child, other students, or school staff when an interview is
conducted on school premises.
(e)
Where the alleged offender or a person responsible for the care of the alleged
victim or other minor prevents access to the victim or other minor by the local
welfare agency, the juvenile court may order the parents, legal custodian, or
guardian to produce the alleged victim or other minor for questioning by the
local welfare agency or the local law enforcement agency outside the presence
of the alleged offender or any person responsible for the child's care at
reasonable places and times as specified by court order.
(f)
Before making an order under paragraph (e), the court shall issue an order to
show cause, either upon its own motion or upon a verified petition, specifying
the basis for the requested interviews and fixing the time and place of the
hearing. The order to show cause shall be served personally and shall be heard
in the same manner as provided in other cases in the juvenile court. The court
shall consider the need for appointment of a guardian ad litem to protect the
best interests of the child. If appointed, the guardian ad litem shall be
present at the hearing on the order to show cause.
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(g) The commissioner of human
services, the ombudsman for mental health and developmental disabilities, the
local welfare agencies responsible for investigating reports, the commissioner
of education, and the local law enforcement agencies have the right to enter
facilities as defined in subdivision 2 and to inspect and copy the facility's
records, including medical records, as part of the investigation.
Notwithstanding the provisions of chapter 13, they also have the right to
inform the facility under investigation that they are conducting an
investigation, to disclose to the facility the names of the individuals under
investigation for abusing or neglecting a child, and to provide the facility
with a copy of the report and the investigative findings.
(h) The local welfare agency
responsible for conducting a family assessment or investigation shall
collect available and relevant information to determine child safety, risk of
subsequent child maltreatment, and family strengths and needs and share not
public information with an Indian's tribal social services agency without
violating any law of the state that may otherwise impose duties of
confidentiality on the local welfare agency in order to implement the tribal
state agreement. The local welfare agency or the agency responsible for
investigating the report shall collect available and relevant information to
ascertain whether maltreatment occurred and whether protective services are
needed. Information collected includes, when relevant, information with regard
to the person reporting the alleged maltreatment, including the nature of the
reporter's relationship to the child and to the alleged offender, and the basis
of the reporter's knowledge for the report; the child allegedly being
maltreated; the alleged offender; the child's caretaker; and other collateral
sources having relevant information related to the alleged maltreatment. The
local welfare agency or the agency responsible for assessing or investigating
the report may make a determination of no maltreatment early in an assessment,
and close the case and retain immunity, if the collected information shows no
basis for a full assessment or investigation.
Information relevant to the
assessment or investigation must be asked for, and may include:
(1) the child's sex and age,
prior reports of maltreatment, information relating to developmental
functioning, credibility of the child's statement, and whether the information
provided under this clause is consistent with other information collected
during the course of the assessment or investigation;
(2) the alleged offender's
age, a record check for prior reports of maltreatment, and criminal charges and
convictions. The local welfare agency or the agency responsible for assessing
or investigating the report must provide the alleged offender with an
opportunity to make a statement. The alleged offender may submit supporting
documentation relevant to the assessment or investigation;
(3) collateral source
information regarding the alleged maltreatment and care of the child.
Collateral information includes, when relevant: (i) a medical examination of
the child; (ii) prior medical records relating to the alleged maltreatment or
the care of the child maintained by any facility, clinic, or health care
professional and an interview with the treating professionals; and (iii)
interviews with the child's caretakers, including the child's parent, guardian,
foster parent, child care provider, teachers, counselors, family members,
relatives, and other persons who may have knowledge regarding the alleged
maltreatment and the care of the child; and
(4) information on the
existence of domestic abuse and violence in the home of the child, and
substance abuse.
Nothing in this paragraph
precludes the local welfare agency, the local law enforcement agency, or the
agency responsible for assessing or investigating the report from collecting
other relevant information necessary to conduct the assessment or
investigation. Notwithstanding section 13.384 or 144.335, the local welfare
agency has access to medical data and records for purposes of clause (3).
Notwithstanding the data's classification in the possession of any other
agency, data acquired by the local welfare agency or the agency responsible for
assessing or investigating the report during the course of the assessment or
investigation are private data on individuals and must be maintained in
accordance with subdivision 11. Data of the commissioner of education collected
or maintained during and for the purpose of an investigation of alleged
maltreatment in a school are governed by this section, notwithstanding the
data's classification as educational, licensing, or personnel data under
chapter 13.
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In
conducting an assessment or investigation involving a school facility as
defined in subdivision 2, paragraph (i), the commissioner of education shall
collect investigative reports and data that are relevant to a report of
maltreatment and are from local law enforcement and the school facility.
(i)
Upon receipt of a report, the local welfare agency shall conduct a face-to-face
contact with the child reported to be maltreated and with the child's primary
caregiver sufficient to complete a safety assessment and ensure the immediate safety
of the child. The face-to-face contact with the child and primary caregiver
shall occur immediately if substantial child endangerment is alleged and within
five calendar days for all other reports. If the alleged offender was not
already interviewed as the primary caregiver, the local welfare agency shall
also conduct a face-to-face interview with the alleged offender in the early
stages of the assessment or investigation. At the initial contact, the local
child welfare agency or the agency responsible for assessing or investigating
the report must inform the alleged offender of the complaints or allegations
made against the individual in a manner consistent with laws protecting the
rights of the person who made the report. The interview with the alleged
offender may be postponed if it would jeopardize an active law enforcement
investigation.
(j)
When conducting an investigation, the local welfare agency shall use a question
and answer interviewing format with questioning as nondirective as possible to
elicit spontaneous responses. For investigations only, the following
interviewing methods and procedures must be used whenever possible when
collecting information:
(1)
audio recordings of all interviews with witnesses and collateral sources; and
(2)
in cases of alleged sexual abuse, audio-video recordings of each interview with
the alleged victim and child witnesses.
(k)
In conducting an assessment or investigation involving a school facility as
defined in subdivision 2, paragraph (i), the commissioner of education shall
collect available and relevant information and use the procedures in paragraphs
(i), (k), and subdivision 3d, except that the requirement for face-to-face
observation of the child and face-to-face interview of the alleged offender is
to occur in the initial stages of the assessment or investigation provided that
the commissioner may also base the assessment or investigation on investigative
reports and data received from the school facility and local law enforcement,
to the extent those investigations satisfy the requirements of paragraphs (i)
and (k), and subdivision 3d.
Sec.
84. Minnesota Statutes 2006, section 626.556, subdivision 10a, is amended to
read:
Subd.
10a. Abuse outside family unit
Law enforcement agency responsibility for investigation; welfare agency
reliance on law enforcement fact-finding; welfare agency offer of services.
(a) If the report alleges neglect, physical abuse, or sexual abuse by a
person who is not a parent, guardian, sibling, person responsible for
the child's care functioning outside within the family unit,
or a person who lives in the child's household and who has a significant
relationship to the child, in a setting other than a facility as defined in
subdivision 2, the local welfare agency shall immediately notify the
appropriate law enforcement agency, which shall conduct an investigation of the
alleged abuse or neglect if a violation of a criminal statute is alleged.
(b)
The local agency may rely on the fact-finding efforts of the law enforcement investigation
conducted under this subdivision to make a determination whether or not
threatened harm or other maltreatment has occurred under subdivision 2 if an
alleged offender has minor children or lives with minors.
(c)
The local
welfare agency shall offer appropriate social services for the purpose of
safeguarding and enhancing the welfare of the abused or neglected minor.
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Sec.
85. Minnesota Statutes 2006, section 626.556, subdivision 10c, is amended to
read:
Subd.
10c. Duties of local social service
agency upon receipt of a report of medical neglect. If the report alleges
medical neglect as defined in section 260C.007, subdivision 4 6, clause
(5), the local welfare agency shall, in addition to its other duties under this
section, immediately consult with designated hospital staff and with the
parents of the infant to verify that appropriate nutrition, hydration, and
medication are being provided; and shall immediately secure an independent
medical review of the infant's medical charts and records and, if necessary,
seek a court order for an independent medical examination of the infant. If the
review or examination leads to a conclusion of medical neglect, the agency
shall intervene on behalf of the infant by initiating legal proceedings under
section 260C.141 and by filing an expedited motion to prevent the withholding
of medically indicated treatment.
Sec.
86. Minnesota Statutes 2006, section 626.556, subdivision 10f, is amended to
read:
Subd.
10f. Notice of determinations.
Within ten working days of the conclusion of a family assessment, the local
welfare agency shall notify the parent or guardian of the child of the need for
services to address child safety concerns or significant risk of subsequent
child maltreatment. The local welfare agency and the family may also jointly
agree that family support and family preservation services are needed. Within
ten working days of the conclusion of an investigation, the local welfare
agency or agency responsible for assessing or investigating the report shall
notify the parent or guardian of the child, the person determined to be
maltreating the child, and if applicable, the director of the facility, of the
determination and a summary of the specific reasons for the determination. The
notice must also include a certification that the information collection
procedures under subdivision 10, paragraphs (h), (i), and (j), were followed
and a notice of the right of a data subject to obtain access to other private
data on the subject collected, created, or maintained under this section. In
addition, the notice shall include the length of time that the records will be
kept under subdivision 11c. The investigating agency shall notify the parent or
guardian of the child who is the subject of the report, and any person or
facility determined to have maltreated a child, of their appeal or review
rights under this section or section 256.022. The notice must also state
that a finding of maltreatment may result in denial of a license application or
background study disqualification under chapter 245C related to employment or
services that are licensed by the Department of Human Services under chapter
245A, the Department of Health under chapter 144 or 144A, the Department of
Corrections under section 241.021, and from providing services related to an
unlicensed personal care provider organization under chapter 256B.
Sec.
87. KINSHIP NAVIGATOR PROGRAM;
DEMONSTRATION GRANT.
(a)
The commissioner of human services shall fund a two-year demonstration grant to
be transferred to a nonprofit organization experienced in kinship advocacy and
policy that has:
(1)
experience working with grandparents and relatives who are raising kinship
children;
(2)
an established statewide outreach network;
(3)
established kinship support groups;
(4)
an intergenerational approach to programming; and
(5)
a board of directors consisting of 50 percent grandparents and relatives
raising kinship children.
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(b) The purpose of the grant
is to provide support to grandparents or relatives raising kinship children.
One site must be in the metropolitan area, and the other in the Bemidji region.
One-stop services may include, but are not limited to, legal services,
education, information, family activities, support groups, mental health
access, advocacy, mentors, and information related to foster care licensing.
Funds may also be used for a media campaign to inform kinship families about
available information and services, support sites, and other program
development.
Sec. 88. MFIP PILOT PROGRAM; WORKFORCE U.
Subdivision 1. Establishment. A pilot program is established in Stearns
and Benton Counties to expand the Workforce U program administered by the
Stearns-Benton Employment and Training Council.
Subd. 2. Evaluation. The Workforce U pilot program must be
evaluated by a research and evaluation organization with experience evaluating
welfare programs. The evaluation must include information on the total number
of persons served, percentage of participants exiting the program, percentage
of former participants reentering the program, average wages of program
participants, and recommendations to the legislature for possible statewide
implementation of the program. The evaluation must be presented to the
legislature by February 15, 2011.
Subd. 3. Expiration. The Workforce U pilot program expires on June
30, 2011.
Sec. 89. LEECH LAKE YOUTH TREATMENT CENTER
PROPOSAL.
(a) The commissioner of
human services shall provide a planning grant to address the unmet need for
local, effective, culturally relevant alcohol and drug treatment for American Indian
youth, and develop a plan for a family-based youth treatment center in the
Leech Lake area. The planning grant must be provided to a volunteer board
consisting of at least four members appointed by the commissioner, to include
at least the following:
(1) two members of the Leech
Lake Tribal Council or their designees;
(2) one member appointed by
the Cass County Social Services administrator; and
(3) one member appointed by
the Cass Lake-Bena Public School superintendent.
(b) The plan must include:
(1) an interest,
feasibility, and suitability of location study;
(2) defining scope of
programs and services to be offered;
(3) defining site use
limitations and restrictions, including physical and capacity;
(4) defining facilities
required for programs and services offered;
(5) identifying partners,
partnership roles, and partner resources;
(6) developing proposed
operating and maintenance budgets;
(7) identifying funding
sources;
(8) developing a long-term
funding plan; and
(9) developing a formal
steering committee, structure, and bylaws.
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(c) The plan is due to the
legislative committees having jurisdiction over chemical health issues no later
than September 2008 in order to provide the 12 months necessary to complete the
plan.
Sec. 90. MINNESOTA FOOD SUPPORT PROGRAM
SIMPLIFIED APPLICATION.
The Department of Human
Services shall create a simplified application for the Minnesota food support
program for persons over the age of 60 and persons with disabilities. The
application must be no longer than three pages in length.
EFFECTIVE DATE. This section is
effective January 1, 2008.
Sec. 91. INSPECTION OF LEGAL UNLICENSED CHILD
CARE PROVIDERS.
The commissioner of human
services, in consultation with the commissioners of health and education and
the counties, shall develop and present recommendations to the legislature in
January 2008 in order for each legally unlicensed child care provider receiving
child care assistance funds to receive a onetime home visit to receive
information on health and safety, and school readiness.
Sec. 92. COMMISSIONER OF HUMAN SERVICES DUTIES;
EARLY CHILDHOOD AND SCHOOL-AGE PROFESSIONAL DEVELOPMENT TRAINING.
Subdivision 1. Development and implementation of an early childhood and school-age
professional development system. (a) The commissioner of human
services, in cooperation with the commissioners of education and health, shall
develop and phase-in the implementation of a professional development system
for practitioners serving children in early childhood and school-age programs.
The system shall provide training options and supports for practitioners to
voluntarily choose, as they complete or exceed existing licensing requirements.
The system must, at a
minimum, include the following features:
(1) a continuum of training
content based on the early childhood and school-age care practitioner core competencies
that translates knowledge into improved practice to support children's school
success;
(2) training strategies that
provide direct feedback about practice to practitioners through ongoing
consultation, mentoring, or coaching with special emphasis on early literacy
and early mathematics;
(3) an approval process for
trainers;
(4) a professional
development registry for early childhood and school-age care practitioners that
will provide tracking and recognition of practitioner training/career development
progress;
(5) a career lattice that
includes a range of professional development and educational opportunities that
provide appropriate coursework and degree pathways;
(6) development of a plan
with public higher education institutions for an articulated system of
education, training, and professional development that includes credit for
prior learning and development of equivalences to two- and four-year degrees;
(7) incentives and supports
for early childhood and school-age care practitioners to seek additional
training and education, including TEACH, other scholarships, and career
guidance; and
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(8)
coordinated and accessible delivery of training to early childhood and
school-age care practitioners.
(b)
By January 1, 2008, the commissioner, in consultation with the organizations
named in subdivision 2 shall develop additional opportunities in order to
qualify more licensed family child care providers under section 119B.13,
subdivision 3a.
(c)
The commissioner of human services must evaluate the professional development
system and make continuous improvements.
(d)
Beginning July 1, 2007, as appropriations permit, the commissioner shall phase-in
the professional development system.
Subd.
2. Two-hour early childhood training.
By January 15, 2008, the commissioner of human services, with input from the
Minnesota Licensed Family Child Care Association and the Minnesota Professional
Development Council, shall identify trainings that qualify for the two-hour
early childhood development training requirement for new child care
practitioners under Minnesota Statutes, section 245A.14, subdivision 9a,
paragraphs (a) and (b). For licensed family child care, the commissioner shall
also seek the input of labor unions that serve licensed family child care
providers, if the union has been recognized by a county to serve licensed
family child care providers.
Sec.
93. SCHOOL READINESS SERVICE
AGREEMENTS.
Subdivision
1. Overview. (a) Effective July
1, 2007, funds must be made available to allow the commissioner to pay higher
rates to up to 50 child care providers who are deemed by the commissioner to
meet the requirements of a school readiness service agreement (SRSA) provider
and perform services that support school readiness for children and economic
stability for parents.
(b)
A provider may be paid a rate above that currently allowed under Minnesota
Statutes, section 119B.13, if:
(1)
the provider has entered into an SRSA with the commissioner;
(2)
a family using that provider receives child care assistance under any provision
in Minnesota Statutes, chapter 119B, except Minnesota Statutes, section
119B.035;
(3)
the family using that provider meets the criteria in this section; and
(4)
funding is available under this section.
Subd.
2. Provider eligibility. (a) To
be considered for an SRSA, a provider shall apply to the commissioner. To be
eligible to apply for an SRSA, a provider shall:
(1)
be eligible for child care assistance payments under Minnesota Statutes,
chapter 119B;
(2)
have at least 25 percent of the children enrolled with the provider subsidized
through the child care assistance program;
(3)
provide full-time, full-year child care services; and
(4)
serve at least one child who is subsidized through the child care assistance
program and who is expected to enter kindergarten within the following 30
months.
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(b) The commissioner may
waive the 25 percent requirement in paragraph (a), clause (2), if necessary to
achieve geographic distribution of SRSA providers and diversity of types of
care provided by SRSA providers.
(c) An eligible provider who
would like to enter into an SRSA with the commissioner shall submit an SRSA
application. To determine whether to enter into an SRSA with a provider, the
commissioner shall evaluate the following factors:
(1) the qualifications of
the provider and the provider's staff;
(2) the provider's
staff-child ratios;
(3) the provider's
curriculum;
(4) the provider's current
or planned parent education activities;
(5) the provider's current
or planned social service and employment linkages;
(6) the provider's child
development assessment plan;
(7) the geographic
distribution needed for SRSA providers;
(8) the inclusion of a
variety of child care delivery models; and
(9) other related factors
determined by the commissioner.
Subd. 3. Family and child eligibility. (a) A family eligible to
choose an SRSA provider for their children shall:
(1) be eligible to receive
child care assistance under any provision in Minnesota Statutes, chapter 119B,
except Minnesota Statutes, section 119B.035;
(2) be in an authorized
activity for an average of at least 35 hours per week when initial eligibility
is determined; and
(3) include a child who has
not yet entered kindergarten.
(b) A family who is
determined to be eligible to choose an SRSA provider remains eligible to be
paid at a higher rate through the SRSA provider when the following conditions
exist:
(1) the child attends child
care with the SRSA provider a minimum of 25 hours per week, on average;
(2) the family has a child
who has not yet entered kindergarten; and
(3) the family maintains
eligibility under Minnesota Statutes, chapter 119B, except Minnesota Statutes,
section 119B.035.
(c) For the 12 months after
initial eligibility has been determined, a decrease in the family's authorized
activities to an average of less than 35 hours per week does not result in
ineligibility for the SRSA rate.
(d) A family that moves
between counties but continues to use the same SRSA provider shall continue to
receive SRSA funding for the increased payments.
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Subd.
4. Requirements of providers. An
SRSA must include assessment, evaluation, and reporting requirements that
promote the goals of improved school readiness and movement toward appropriate
child development milestones. A provider who enters into an SRSA shall comply
with the assessment, evaluation, and reporting requirements in the SRSA.
Subd.
5. Relationship to current law. (a)
The following provisions in Minnesota Statutes, chapter 119B, must be waived or
modified for families receiving services under this section.
(b)
Notwithstanding Minnesota Statutes, section 119B.13, subdivisions 1 and 1a,
maximum weekly rates under this section are 125 percent of the existing maximum
weekly rate for like-care. Providers eligible for a differential rate under
Minnesota Statutes, section 119B.13, subdivision 3a, remain eligible for the
differential above the rate identified in this section. Only care for children
who have not yet entered kindergarten may be paid at the maximum rate under
this section. The provider's charge for service provided through an SRSA may
not exceed the rate that the provider charges a private-pay family for like-care
arrangements.
(c)
A family or child care provider may not be assessed an overpayment for care
provided through an SRSA unless:
(1)
there was an error in the amount of care authorized for the family; or
(2)
the family or provider did not timely report a change as required under the
law.
(d)
Care provided through an SRSA is authorized on a weekly basis.
(e)
Funds appropriated under this section to serve families eligible under
Minnesota Statutes, section 119B.03, are not allocated through the basic sliding
fee formula under Minnesota Statutes, section 119B.03. Funds appropriated under
this section are used to offset increased costs when payments are made under
SRSA's.
(f)
Notwithstanding Minnesota Statutes, section 119B.09, subdivision 6, the maximum
amount of child care assistance that may be authorized for a child receiving
care through an SRSA in a two-week period is 160 hours per child.
Subd.
6. Establishment of service agreements.
(a) The commissioner shall approve SRSA's for up to 50 providers that
represent diverse parts of the state and a variety of child care delivery
models. Entering into a service agreement does not guarantee that a provider
will receive payment at a higher rate for families receiving child care
assistance. A family eligible under this section shall choose a provider
participating in an SRSA in order for a higher rate to be paid. Payments
through SRSA's are also limited by the availability of SRSA funds.
(b)
Nothing in this section shall be construed to limit parent choice as defined in
Minnesota Statutes, section 119B.09, subdivision 5.
(c)
The commissioner may allow for startup time for some providers if failing to do
so would limit geographic diversity of SRSA providers or a variety of child
care delivery models.
Sec.
94. FAMILY, FRIEND, AND NEIGHBOR
GRANT PROGRAM.
Subdivision
1. Establishment. A family,
friend, and neighbor (FFN) grant program is established to promote children's
early literacy, healthy development, and school readiness, and to foster
community partnerships to promote children's school readiness. The commissioner
shall attempt to ensure that grants are made in all areas of the state. The
commissioner of human services shall make grants available to fund:
community-based organizations, nonprofit organizations, and Indian tribes
working with FFN caregivers under subdivision 2, paragraph (a); and
community-based partnerships to implement early literacy programs under
subdivision 2, paragraph (b).
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Subd.
2. Program components. (a)(1)
Grants that the commissioner awards under this section must be used by
community-based organizations, nonprofit organizations, and Indian tribes
working with FFN caregivers in local communities, cultural communities, and
Indian tribes to:
(i)
provide training, support, and resources to FFN caregivers in order to improve
and promote children's health, safety, nutrition, and school readiness;
(ii)
connect FFN caregivers and children's families with appropriate community
resources that support the families' health, mental health, economic, and
developmental needs;
(iii)
connect FFN caregivers and children's families to early childhood screening
programs and facilitate referrals where appropriate;
(iv)
provide FFN caregivers and children's families with information about early
learning guidelines from the Departments of Human Services and Education;
(v)
provide FFN caregivers and children's families with information about becoming
a licensed family child care provider; and
(vi)
provide FFN caregivers and children's families with information about early
learning allowances and enrollment opportunities in high quality
community-based child-care and preschool programs.
(2)
Grants that the commissioner awards under this paragraph also may be used for:
(i)
health and safety and early learning kits for FFN caregivers;
(ii)
play-and-learn groups with FFN caregivers;
(iii)
culturally appropriate early childhood training for FFN caregivers;
(iv)
transportation for FFN caregivers and children's families to school readiness
and other early childhood training activities;
(v)
other activities that promote school readiness;
(vi)
data collection and evaluation;
(vii)
staff outreach and outreach activities;
(viii)
translation needs; or
(ix)
administrative costs that equal up to 12 percent of the recipient's grant
award.
(b)
Grants that the commissioner awards under this section also must be used to
fund partnerships among Minnesota public and regional library systems,
community-based organizations, nonprofit organizations, and Indian tribes to
implement early literacy programs in low-income communities, including tribal
communities, to:
(1)
purchase and equip early childhood read-mobiles that provide FFN caregivers and
children's families with books, training, and early literacy activities;
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(2)
provide FFN caregivers and children's families with translations of early
childhood books, training, and early literacy activities in native languages;
or
(3)
provide FFN caregivers and children's families with early literacy activities
in local libraries.
Subd.
3. Grant awards. Interested
entities eligible to receive a grant under this section may apply to the
commissioner in the form and manner the commissioner determines. The
commissioner shall awards grants to eligible entities consistent with the
requirements of this section.
Subd.
4. Evaluation. The commissioner,
in consultation with early childhood care and education experts at the
University of Minnesota, must evaluate the impact of the grants under
subdivision 2 on children's school readiness and submit a written report to the
human services and education finance and policy committees of the legislature
by February 15, 2010.
EFFECTIVE DATE. This section is
effective the day following final enactment.
Sec.
95. CHILD CARE PROVIDER STUDY.
The
commissioner of human services is directed to study the implications of
restricting the use of state subsidies in center-based child care to centers
meeting state quality standards under Minnesota Statutes, section 124D.175,
paragraph (c), and to publish the results no later than January 1, 2010. The
study must include:
(1)
the likelihood of there being sufficient child care providers meeting the
standards;
(2)
the cost to bring providers up to the standards and how this cost would be
funded;
(3)
how the standards and the ratings would be communicated to both parents and the
general public; and
(4)
a determination whether a similar system could be implemented for
non-center-based care.
Sec.
96. DIRECTION TO COMMISSIONER.
(a)
The commissioner of human services shall offer a request for proposals to
identify a research and evaluation firm with experience working with:
(1)
homeless youth providers;
(2)
data; and
(3)
the topics of housing, homelessness, and a continuum of care for youth.
(b)
The research and evaluation firm identified under paragraph (a) shall monitor
and evaluate the programs receiving funding under Minnesota Statutes, section
256K.45.
Sec.
97. REVISOR'S INSTRUCTION.
(a)
The revisor shall renumber Minnesota Statutes, section 626.556, subdivision 3d,
as Minnesota Statutes, section 626.556, subdivision 3g.
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(b) The revisor shall change
references to Minnesota Statutes, section 260.851, to section 260.853 and
references to Minnesota Statutes, section 260.851, article 5, to section
260.853, article 4, wherever those references appear in Minnesota Statutes and
Minnesota Rules.
Sec. 98. REPEALER.
(a) Minnesota Statutes 2006,
sections 119B.08, subdivision 4; 256J.29; 256J.37, subdivisions 3a and 3b; and
256J.626, subdivisions 7 and 9, are repealed.
(b) Laws 1997, chapter 8,
section 1, is repealed.
(c) Minnesota Rules, part
9560.0102, subpart 2, item C, is repealed.
ARTICLE 2
LICENSING
Section 1. Minnesota
Statutes 2006, section 245A.035, is amended to read:
245A.035 RELATIVE FOSTER CARE; UNLICENSED EMERGENCY LICENSE
RELATIVE PLACEMENT.
Subdivision 1. Grant of Emergency license
placement. Notwithstanding section 245A.03, subdivision 2a, or 245C.13,
subdivision 2, a county agency may place a child for foster care with a
relative who is not licensed to provide foster care, provided the requirements
of subdivision 2 this section are met. As used in this section,
the term "relative" has the meaning given it under section 260C.007,
subdivision 27.
Subd. 2. Cooperation with emergency licensing
placement process. (a) A county agency that places a child with a
relative who is not licensed to provide foster care must begin the process
of securing an emergency license for the relative as soon as possible and must
conduct the initial inspection required by subdivision 3, clause (1), whenever
possible, prior to placing the child in the relative's home, but no later than
three working days after placing the child in the home. A child placed in the
home of a relative who is not licensed to provide foster care must be removed
from that home if the relative fails to cooperate with the county agency in
securing an emergency foster care license. The commissioner may issue an
emergency foster care license to a relative with whom the county agency wishes
to place or has placed a child for foster care, or to a relative with whom a
child has been placed by court order.
(b) If a child is to be
placed in the home of a relative not licensed to provide foster care, either
the placing agency or the county agency in the county in which the relative
lives shall conduct the emergency licensing placement process as
required in this section.
Subd. 3. Requirements for emergency license
placement. Before an emergency license placement may be issued
made, the following requirements must be met:
(1) the county agency must
conduct an initial inspection of the premises where the foster care
placement is to be provided made to ensure the health and
safety of any child placed in the home. The county agency shall conduct the
inspection using a form developed by the commissioner;
(2) at the time of the
inspection or placement, whichever is earlier, the county agency must
provide the relative being considered for an emergency license shall
receive placement an application form for a child foster care
license;
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(3)
whenever possible, prior to placing the child in the relative's home, the
relative being considered for an emergency license placement
shall provide the information required by section 245C.05; and
(4)
if the county determines, prior to the issuance of an emergency license
placement, that anyone requiring a background study may be prior
to licensure of the home is disqualified under section 245C.14 and
chapter 245C, and the disqualification is one which the commissioner cannot set
aside, an emergency license shall placement must not be issued
made.
Subd.
4. Applicant study. When the county
agency has received the information required by section 245C.05, the county
agency shall begin an applicant study according to the procedures in chapter
245C. The commissioner may issue an emergency license upon recommendation of
the county agency once the initial inspection has been successfully completed
and the information necessary to begin the applicant background study has been
provided. If the county agency does not recommend that the emergency license be
granted, the agency shall notify the relative in writing that the agency is
recommending denial to the commissioner; shall remove any child who has been
placed in the home prior to licensure; and shall inform the relative in writing
of the procedure to request review pursuant to subdivision 6. An emergency
license shall be effective until a child foster care license is granted or
denied, but shall in no case remain in effect more than 120 days from the date
of placement submit the information to the commissioner according to
section 245C.05.
Subd.
5. Child foster care license
application. (a) The relatives with whom the emergency license
holder placement has been made shall complete the child foster care license
application and necessary paperwork within ten days of the placement. The
county agency shall assist the emergency license holder applicant
to complete the application. The granting of a child foster care license to a
relative shall be under the procedures in this chapter and according to the
standards set forth by foster care rule in Minnesota Rules, chapter
2960. In licensing a relative, the commissioner shall consider the
importance of maintaining the child's relationship with relatives as an additional
significant factor in determining whether to a background study
disqualification should be set aside a licensing disqualifier under
section 245C.22, or to grant a variance of licensing requirements
should be granted under sections 245C.21 to 245C.27 section
245C.30.
(b)
When the county or private child-placing agency is processing an application
for child foster care licensure of a relative as defined in section 260B.007,
subdivision 12, or 260C.007, subdivision 27, the county agency or child-placing
agency must explain the licensing process to the prospective licensee,
including the background study process and the procedure for reconsideration of
an initial disqualification for licensure. The county or private child-placing
agency must also provide the prospective relative licensee with information
regarding appropriate options for legal representation in the pertinent
geographic area. If a relative is initially disqualified under section 245C.14,
the county or child-placing agency commissioner must provide
written notice of the reasons for the disqualification and the right to request
a reconsideration by the commissioner as required under section 245C.17.
(c)
The commissioner shall maintain licensing data so that activities related to applications
and licensing actions for relative foster care providers may be distinguished
from other child foster care settings.
Subd.
6. Denial of emergency license. If
the commissioner denies an application for an emergency foster care license
under this section, that denial must be in writing and must include reasons for
the denial. Denial of an emergency license is not subject to appeal under
chapter 14. The relative may request a review of the denial by submitting to
the commissioner a written statement of the reasons an emergency license should
be granted. The commissioner shall evaluate the request for review and
determine whether to grant the emergency license. The commissioner's review
shall be based on a review of the records submitted by the county agency and
the relative. Within 15 working days of the receipt of the request for review,
the commissioner shall notify the relative requesting review in written form
whether the emergency license will be granted. The commissioner's review shall
be based on a review of the records submitted by the county agency and the
relative. A child shall not be placed or remain placed in the relative's home
while the request for review is pending. Denial of an emergency license shall
not preclude an individual from reapplying for an emergency license or from
applying for a child foster care license. The decision of the commissioner is
the final administrative agency action.
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Sec.
2. Minnesota Statutes 2006, section 245A.10, subdivision 2, is amended to read:
Subd.
2. County fees for background studies
and licensing inspections. (a) For purposes of family and group family
child care licensing under this chapter, a county agency may charge a fee to
an applicant or license holder to recover the actual cost of background
studies, but in any case not to exceed $100 annually. A county agency may also
charge a license fee to an applicant or license holder to recover
the actual cost of licensing inspections, but in any case not to exceed $150
annually $50 for a one-year license or $100 for a two-year license.
(b)
A county agency may charge a fee to a legal nonlicensed child care provider or
applicant for authorization to recover the actual cost of background studies
completed under section 119B.125, but in any case not to exceed $100 annually.
(c)
Counties may elect to reduce or waive the fees in paragraph (a) or (b):
(1)
in cases of financial hardship;
(2)
if the county has a shortage of providers in the county's area;
(3)
for new providers; or
(4)
for providers who have attained at least 16 hours of training before seeking
initial licensure.
(d)
Counties may allow providers to pay the applicant fees in paragraph (a) or (b)
on an installment basis for up to one year. If the provider is receiving child
care assistance payments from the state, the provider may have the fees under
paragraph (a) or (b) deducted from the child care assistance payments for up to
one year and the state shall reimburse the county for the county fees collected
in this manner.
EFFECTIVE DATE. This section is
effective the day following final enactment.
Sec.
3. Minnesota Statutes 2006, section 245A.16, subdivision 1, is amended to read:
Subdivision
1. Delegation of authority to agencies.
(a) County agencies and private agencies that have been designated or licensed
by the commissioner to perform licensing functions and activities under section
245A.04 and background studies for adult foster care, family adult
day services, family child care, and child foster care under chapter 245C,;
to recommend denial of applicants under section 245A.05,; to
issue correction orders, to issue variances, and recommend a conditional
license under section 245A.06, or to recommend suspending or revoking a license
or issuing a fine under section 245A.07, shall comply with rules and directives
of the commissioner governing those functions and with this section. The
following variances are excluded from the delegation of variance authority and
may be issued only by the commissioner:
(1)
dual licensure of family child care and child foster care, dual licensure of
child and adult foster care, and adult foster care and family child care;
(2)
adult foster care maximum capacity;
(3)
adult foster care minimum age requirement;
(4)
child foster care maximum age requirement;
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(5) variances regarding
disqualified individuals except that county agencies may issue variances under
section 245C.30 regarding disqualified individuals when the county is
responsible for conducting a consolidated reconsideration according to sections
245C.25 and 245C.27, subdivision 2, clauses (a) and (b), of a county
maltreatment determination and a disqualification based on serious or recurring
maltreatment; and
(6) the required presence of
a caregiver in the adult foster care residence during normal sleeping hours.
(b) County agencies must
report:
(1) information about
disqualification reconsiderations under sections 245C.25 and 245C.27,
subdivision 2, clauses paragraphs (a) and (b), and variances
granted under paragraph (a), clause (5), to the commissioner at least monthly
in a format prescribed by the commissioner; and.
(2) for relative child
foster care applicants and license holders, the number of relatives, as defined
in section 260C.007, subdivision 27, and household members of relatives who are
disqualified under section 245C.14; the disqualifying characteristics under section
245C.15; the number of these individuals who requested reconsideration under
section 245C.21; the number of set-asides under section 245C.22; and variances
under section 245C.30 issued. This information shall be reported to the
commissioner annually by January 15 of each year in a format prescribed by the
commissioner.
(c) For family day care
programs, the commissioner may authorize licensing reviews every two years
after a licensee has had at least one annual review.
(d) For family adult day
services programs, the commissioner may authorize licensing reviews every two
years after a licensee has had at least one annual review.
(e) A license issued under
this section may be issued for up to two years.
(f) The commissioner shall
work with counties to determine the cost and propose an ongoing funding
allocation from the general fund to cover the cost to counties to implement an
annual license review for licensed family child care providers. The
commissioner shall solicit input from counties to determine the outcome. The
commissioner shall report to the committees of the house of representatives and
senate having jurisdiction over early childhood programs by January 15, 2008,
as to the costs and the funding allocation recommended for future use.
EFFECTIVE DATE. This section is
effective January 1, 2008.
Sec. 4. Minnesota Statutes
2006, section 245A.16, subdivision 3, is amended to read:
Subd. 3. Recommendations to the commissioner.
The county or private agency shall not make recommendations to the commissioner
regarding licensure without first conducting an inspection, and for adult
foster care, family adult day services, family child care, and child foster
care, a background study of the applicant, and evaluation pursuant to
under chapter 245C. The county or private agency must forward its
recommendation to the commissioner regarding the appropriate licensing action
within 20 working days of receipt of a completed application.
EFFECTIVE DATE. This section is
effective January 1, 2008.
Sec. 5. Minnesota Statutes
2006, section 245C.02, is amended by adding a subdivision to read:
Subd. 14a. Private agency. "Private agency" has the
meaning given in section 245A.02, subdivision 12.
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Sec.
6. Minnesota Statutes 2006, section 245C.04, subdivision 1, is amended to read:
Subdivision
1. Licensed programs. (a) The
commissioner shall conduct a background study of an individual required to be studied
under section 245C.03, subdivision 1, at least upon application for initial
license for all license types.
(b)
The commissioner shall conduct a background study of an individual required to
be studied under section 245C.03, subdivision 1, at reapplication for a license
for family child care, child foster care, and adult foster care, and
family adult day services.
(c)
The commissioner is not required to conduct a study of an individual at the
time of reapplication for a license if the individual's background study was
completed by the commissioner of human services for an adult foster care
license holder that is also:
(1)
registered under chapter 144D; or
(2)
licensed to provide home and community-based services to people with
disabilities at the foster care location and the license holder does not reside
in the foster care residence; and
(3)
the following conditions are met:
(i)
a study of the individual was conducted either at the time of initial licensure
or when the individual became affiliated with the license holder;
(ii)
the individual has been continuously affiliated with the license holder since
the last study was conducted; and
(iii)
the last study of the individual was conducted on or after October 1, 1995.
(d)
From July 1, 2007, to June 30, 2009, the commissioner of human services
shall conduct a study of an individual required to be studied under section
245C.03, at the time of reapplication for a child foster care license. The
county or private agency shall collect and forward to the commissioner the
information required under section 245C.05, subdivisions 1, paragraphs (a) and
(b), and 5, paragraphs (a) and (b). The background study conducted by the
commissioner of human services under this paragraph must include a review of the
information required under section 245C.08, subdivisions 1, paragraph (a),
clauses (1) to (4), and 3.
(e)
The commissioner of human services shall conduct a background study of an
individual specified under section 245C.03, subdivision 1, paragraph (a), clauses
(2) to (6), who is newly affiliated with a child foster care license holder.
The county or private agency shall collect and forward to the commissioner the
information required under section 245C.05, subdivisions 1 and 5. The
background study conducted by the commissioner of human services under this
paragraph must include a review of the information required under section
245C.08, subdivisions 1, paragraph (a), and 3.
(f)
Applicants
for licensure, license holders, and other entities as provided in this chapter
must submit completed background study forms to the commissioner before
individuals specified in section 245C.03, subdivision 1, begin positions
allowing direct contact in any licensed program.
(e) (g) For purposes of this
section, a physician licensed under chapter 147 is considered to be
continuously affiliated upon the license holder's receipt from the commissioner
of health or human services of the physician's background study results.
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Sec.
7. Minnesota Statutes 2006, section 245C.04, subdivision 1, is amended to read:
Subdivision
1. Licensed programs. (a) The
commissioner shall conduct a background study of an individual required to be studied
under section 245C.03, subdivision 1, at least upon application for initial
license for all license types.
(b)
The commissioner shall conduct a background study of an individual required to
be studied under section 245C.03, subdivision 1, at reapplication for a license
for family child care, child foster care, and adult foster care.
(c)
The commissioner is not required to conduct a study of an individual at the
time of reapplication for a license if the individual's background study was
completed by the commissioner of human services for an adult foster care
license holder that is also:
(1)
registered under chapter 144D; or
(2)
licensed to provide home and community-based services to people with
disabilities at the foster care location and the license holder does not reside
in the foster care residence; and
(3)
the following conditions are met:
(i)
a study of the individual was conducted either at the time of initial licensure
or when the individual became affiliated with the license holder;
(ii)
the individual has been continuously affiliated with the license holder since
the last study was conducted; and
(iii)
the last study of the individual was conducted on or after October 1, 1995.
(d)
From January 1, 2008, to December 31, 2009, the commissioner shall conduct a
study of an individual required to be studied under section 245C.03, at the
time of reapplication for a family child care license. The county shall collect
and forward to the commissioner the information required under section 245C.05,
subdivisions 1 and 5. The background study conducted by the commissioner under
this paragraph must include a review of the information required under section
245C.08, subdivisions 1, paragraph (a), and 3.
(e)
The commissioner shall conduct a background study of an individual specified
under section 245C.03, subdivision 1, paragraph (a), clauses (2) to (6), who is
newly affiliated with a family child care license holder. The county shall
collect and forward to the commissioner the information required under section
245C.05, subdivisions 1 and 5. The background study conducted by the
commissioner under this paragraph must include a review of the information
required under section 245C.08, subdivisions 1, paragraph (a), and 3.
(f) Applicants for licensure,
license holders, and other entities as provided in this chapter must submit
completed background study forms to the commissioner before individuals
specified in section 245C.03, subdivision 1, begin positions allowing direct
contact in any licensed program.
(e) (g) For purposes of
this section, a physician licensed under chapter 147 is considered to be
continuously affiliated upon the license holder's receipt from the commissioner
of health or human services of the physician's background study results.
EFFECTIVE DATE. This section is
effective January 1, 2008.
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Sec.
8. Minnesota Statutes 2006, section 245C.05, subdivision 1, is amended to read:
Subdivision
1. Individual studied. (a) The
individual who is the subject of the background study must provide the
applicant, license holder, or other entity under section 245C.04 with
sufficient information to ensure an accurate study, including:
(1)
the individual's first, middle, and last name and all other names by which the
individual has been known;
(2)
home address, city, and state of residence;
(3)
zip code;
(4)
sex;
(5)
date of birth; and
(6)
Minnesota driver's license number or state identification number.
(b)
Every subject of a background study conducted or initiated by counties
or private agencies under this chapter must also provide the home address,
city, county, and state of residence for the past five years.
(c)
Every subject of a background study related to child foster care licensed
through a private agency shall also provide the commissioner a signed consent
for the release of any information received from national crime information databases
to the private agency that initiated the background study.
(d)
The subject of a background study shall provide fingerprints as required in
subdivision 5, paragraph (c).
Sec.
9. Minnesota Statutes 2006, section 245C.05, is amended by adding a subdivision
to read:
Subd.
2a. County or private agency. For
background studies related to child foster care, county and private agencies
must collect the information under subdivision 1 and forward it to the
commissioner.
Sec.
10. Minnesota Statutes 2006, section 245C.05, is amended by adding a
subdivision to read:
Subd.
2b. County agency. For background
studies related to family child care, county agencies must collect the
information under subdivision 1 and forward it to the commissioner.
EFFECTIVE DATE. This section is
effective January 1, 2008.
Sec.
11. Minnesota Statutes 2006, section 245C.05, subdivision 4, is amended to
read:
Subd.
4. Electronic transmission. For
background studies conducted by the Department of Human Services, the
commissioner shall implement a system for the electronic transmission of:
(1)
background study information to the commissioner; and
(2)
background study results to the license holder; and
(3)
background study results to county and private agencies for background studies
conducted by the commissioner for family child care and child foster care.
EFFECTIVE DATE. This section is
effective January 1, 2008.
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Sec.
12. Minnesota Statutes 2006, section 245C.05, subdivision 5, is amended to
read:
Subd.
5. Fingerprints. (a) Except as
provided in paragraph (c), for any background study completed under this chapter,
when the commissioner has reasonable cause to believe that further pertinent
information may exist on the subject of the background study, the subject shall
provide the commissioner with a set of classifiable fingerprints obtained from
an authorized law enforcement agency.
(b)
For purposes of requiring fingerprints, the commissioner has reasonable cause
when, but not limited to, the:
(1)
information from the Bureau of Criminal Apprehension indicates that the subject
is a multistate offender;
(2)
information from the Bureau of Criminal Apprehension indicates that multistate
offender status is undetermined; or
(3)
commissioner has received a report from the subject or a third party indicating
that the subject has a criminal history in a jurisdiction other than Minnesota.
(c)
Except as specified under section 245C.04, subdivision 1, paragraph (d), for
background studies conducted by the commissioner for child foster care, the
subject of the background study shall provide the commissioner with a set of
classifiable fingerprints obtained from an authorized agency.
Sec.
13. Minnesota Statutes 2006, section 245C.05, subdivision 7, is amended to
read:
Subd.
7. Probation officer and corrections
agent. (a) A probation officer or corrections agent shall notify the
commissioner of an individual's conviction if the individual is:
(1)
affiliated with a program or facility regulated by the Department of Human
Services or Department of Health, a facility serving children or youth licensed
by the Department of Corrections, or any type of home care agency or provider
of personal care assistance services; and
(2)
convicted of a crime constituting a disqualification under section 245C.14.
(b)
For the purpose of this subdivision, "conviction" has the meaning
given it in section 609.02, subdivision 5.
(c)
The commissioner, in consultation with the commissioner of corrections, shall
develop forms and information necessary to implement this subdivision and shall
provide the forms and information to the commissioner of corrections for
distribution to local probation officers and corrections agents.
(d)
The commissioner shall inform individuals subject to a background study that
criminal convictions for disqualifying crimes will be reported to the
commissioner by the corrections system.
(e)
A probation officer, corrections agent, or corrections agency is not civilly or
criminally liable for disclosing or failing to disclose the information
required by this subdivision.
(f)
Upon receipt of disqualifying information, the commissioner shall provide the
notice required under section 245C.17, as appropriate, to agencies on record as
having initiated a background study or making a request for documentation of
the background study status of the individual.
(g)
This subdivision does not apply to family child care and child foster care
programs.
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Sec.
14. Minnesota Statutes 2006, section 245C.05, subdivision 7, is amended to read:
Subd.
7. Probation officer and corrections
agent. (a) A probation officer or corrections agent shall notify the
commissioner of an individual's conviction if the individual is:
(1)
affiliated with a program or facility regulated by the Department of Human
Services or Department of Health, a facility serving children or youth licensed
by the Department of Corrections, or any type of home care agency or provider
of personal care assistance services; and
(2)
convicted of a crime constituting a disqualification under section 245C.14.
(b)
For the purpose of this subdivision, "conviction" has the meaning
given it in section 609.02, subdivision 5.
(c)
The commissioner, in consultation with the commissioner of corrections, shall develop
forms and information necessary to implement this subdivision and shall provide
the forms and information to the commissioner of corrections for distribution
to local probation officers and corrections agents.
(d)
The commissioner shall inform individuals subject to a background study that
criminal convictions for disqualifying crimes will be reported to the
commissioner by the corrections system.
(e)
A probation officer, corrections agent, or corrections agency is not civilly or
criminally liable for disclosing or failing to disclose the information
required by this subdivision.
(f)
Upon receipt of disqualifying information, the commissioner shall provide the
notice required under section 245C.17, as appropriate, to agencies on record as
having initiated a background study or making a request for documentation of
the background study status of the individual.
(g)
This subdivision does not apply to family child care and child foster
care programs.
EFFECTIVE DATE. This section is
effective January 1, 2008.
Sec.
15. Minnesota Statutes 2006, section 245C.08, subdivision 1, is amended to
read:
Subdivision
1. Background studies conducted by
commissioner of human services. (a) For a background study conducted by the
commissioner, the commissioner shall review:
(1)
information related to names of substantiated perpetrators of maltreatment of
vulnerable adults that has been received by the commissioner as required under
section 626.557, subdivision 9c, paragraph (i);
(2)
the commissioner's records relating to the maltreatment of minors in licensed
programs, and from county agency findings of maltreatment of minors as
indicated through the social service information system;
(3)
information from juvenile courts as required in subdivision 4 for individuals
listed in section 245C.03, subdivision 1, clauses (2), (5), and (6); and
(4)
information from the Bureau of Criminal Apprehension.;
(5)
except as provided in clause (6), information from the national crime information
system when the commissioner has reasonable cause as defined under section
245C.05, subdivision 5; and
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(6) for a background study
related to a child foster care application for licensure, the commissioner
shall also review:
(i) information from the
child abuse and neglect registry for any state in which the background study
subject has resided in for the past five years; and
(ii) information from
national crime information databases.
(b) Notwithstanding
expungement by a court, the commissioner may consider information obtained
under paragraph (a), clauses (3) and (4), unless the commissioner received
notice of the petition for expungement and the court order for expungement is
directed specifically to the commissioner.
Sec. 16. Minnesota Statutes
2006, section 245C.08, subdivision 2, is amended to read:
Subd. 2. Background studies conducted by a county or
private agency. (a) For a background study conducted by a county or
private agency for child foster care, adult foster care, family
adult day services, and family child care homes, the commissioner shall
review:
(1) information from the
county agency's record of substantiated maltreatment of adults and the maltreatment
of minors;
(2) information from
juvenile courts as required in subdivision 4 for individuals listed in section
245C.03, subdivision 1, clauses (2), (5), and (6);
(3) information from the
Bureau of Criminal Apprehension; and
(4) arrest and investigative
records maintained by the Bureau of Criminal Apprehension, county attorneys,
county sheriffs, courts, county agencies, local police, the National Criminal
Records Repository, and criminal records from other states.
(b) If the individual has
resided in the county for less than five years, the study shall include the
records specified under paragraph (a) for the previous county or counties of
residence for the past five years.
(c) Notwithstanding
expungement by a court, the county or private agency may consider
information obtained under paragraph (a), clauses (3) and (4), unless the
commissioner received notice of the petition for expungement and the court
order for expungement is directed specifically to the commissioner.
Sec. 17. Minnesota Statutes
2006, section 245C.08, subdivision 2, is amended to read:
Subd. 2. Background studies conducted by a county or
private agency. (a) For a background study conducted by a county or private
agency for child foster care, and adult foster care, and
family child care homes, the commissioner shall review:
(1) information from the
county agency's record of substantiated maltreatment of adults and the
maltreatment of minors;
(2) information from
juvenile courts as required in subdivision 4 for individuals listed in section
245C.03, subdivision 1, clauses (2), (5), and (6);
(3) information from the
Bureau of Criminal Apprehension; and
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(4)
arrest and investigative records maintained by the Bureau of Criminal
Apprehension, county attorneys, county sheriffs, courts, county agencies, local
police, the National Criminal Records Repository, and criminal records from
other states.
(b)
If the individual has resided in the county for less than five years, the study
shall include the records specified under paragraph (a) for the previous county
or counties of residence for the past five years.
(c)
Notwithstanding expungement by a court, the county or private agency may
consider information obtained under paragraph (a), clauses (3) and (4), unless
the commissioner received notice of the petition for expungement and the court
order for expungement is directed specifically to the commissioner.
EFFECTIVE DATE. This section is
effective January 1, 2008.
Sec.
18. Minnesota Statutes 2006, section 245C.10, is amended by adding a
subdivision to read:
Subd.
4. Temporary personnel agencies,
educational programs, and professional services agencies. The commissioner
shall recover the cost of the background studies initiated by temporary
personnel agencies, educational programs, and professional services agencies
that initiate background studies under section 245C.03, subdivision 4, through
a fee of no more than $20 per study charged to the agency. In fiscal years 2008
and 2009, the fees collected under this subdivision are appropriated to the
commissioner for the purpose of conducting background studies.
Sec.
19. Minnesota Statutes 2006, section 245C.11, subdivision 1, is amended to
read:
Subdivision
1. Adult foster care; criminal
conviction data. For individuals who are required to have background
studies under section 245C.03, subdivisions 1 and 2, and who have been
continuously affiliated with a an adult foster care provider that
is licensed in more than one county, criminal conviction data may be shared
among those counties in which the adult foster care programs are
licensed. A county agency's receipt of criminal conviction data from another
county agency shall meet the criminal data background study requirements of
this chapter.
Sec.
20. Minnesota Statutes 2006, section 245C.11, subdivision 2, is amended to
read:
Subd.
2. Jointly licensed programs. A
county agency may accept a background study completed by the commissioner under
this chapter in place of the background study required under section 245A.16,
subdivision 3, in programs with joint licensure as home and community-based
services and adult foster care for people with developmental disabilities when
the license holder does not reside in the adult foster care residence
and the subject of the study has been continuously affiliated with the license
holder since the date of the commissioner's study.
Sec.
21. Minnesota Statutes 2006, section 245C.12, is amended to read:
245C.12 BACKGROUND STUDY;
TRIBAL ORGANIZATIONS.
(a)
For the
purposes of background studies completed by tribal organizations performing
licensing activities otherwise required of the commissioner under this chapter,
after obtaining consent from the background study subject, tribal licensing
agencies shall have access to criminal history data in the same manner as
county licensing agencies and private licensing agencies under this chapter.
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(b)
Tribal organizations may contract with the commissioner to obtain background
study data on individuals under tribal jurisdiction related to adoptions
according to section 245C.34. Tribal organizations may also contract with the
commissioner to obtain background study data on individuals under tribal
jurisdiction related to child foster care according to section 245C.34.
Sec.
22. Minnesota Statutes 2006, section 245C.16, subdivision 1, is amended to read:
Subdivision
1. Determining immediate risk of harm.
(a) If the commissioner determines that the individual studied has a
disqualifying characteristic, the commissioner shall review the information
immediately available and make a determination as to the subject's immediate
risk of harm to persons served by the program where the individual studied will
have direct contact.
(b)
The commissioner shall consider all relevant information available, including the
following factors in determining the immediate risk of harm:
(1)
the recency of the disqualifying characteristic;
(2)
the recency of discharge from probation for the crimes;
(3)
the number of disqualifying characteristics;
(4)
the intrusiveness or violence of the disqualifying characteristic;
(5)
the vulnerability of the victim involved in the disqualifying characteristic;
(6)
the similarity of the victim to the persons served by the program where the
individual studied will have direct contact; and
(7)
whether the individual has a disqualification from a previous background study
that has not been set aside.
(c)
This section does not apply when the subject of a background study is regulated
by a health-related licensing board as defined in chapter 214, and the subject
is determined to be responsible for substantiated maltreatment under section
626.556 or 626.557.
(d)
This section does not apply to a background study related to an initial
application for a child foster care license.
(e)
If the commissioner
has reason to believe, based on arrest information or an active maltreatment
investigation, that an individual poses an imminent risk of harm to persons
receiving services, the commissioner may order that the person be continuously
supervised or immediately removed pending the conclusion of the maltreatment
investigation or criminal proceedings.
Sec.
23. Minnesota Statutes 2006, section 245C.17, is amended by adding a
subdivision to read:
Subd.
5. Notice to county or private agency.
For studies on individuals related to a license to provide child foster
care, the commissioner shall also provide a notice of the background study
results to the county or private agency that initiated the background study.
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Sec. 24. Minnesota Statutes
2006, section 245C.17, is amended by adding a subdivision to read:
Subd. 5a. Notice to county agency. For studies on individuals
related to a license to provide family child care, the commissioner shall also
provide a notice of the background study results to the county or private
agency that initiated the background study.
EFFECTIVE DATE. This section is
effective January 1, 2008.
Sec. 25. Minnesota Statutes
2006, section 245C.21, is amended by adding a subdivision to read:
Subd. 1a. Submission of reconsideration request to county or private agency.
(a) For disqualifications related to studies conducted by county agencies,
and for disqualifications related to studies conducted by the commissioner for
child foster care, the individual shall submit the request for reconsideration
to the county or private agency that initiated the background study.
(b) A reconsideration
request shall be submitted within the time frames specified in subdivision 2.
(c) The county or private
agency shall forward the individual's request for reconsideration and provide
the commissioner with a recommendation whether to set aside the individual's
disqualification.
Sec. 26. Minnesota Statutes
2006, section 245C.21, is amended by adding a subdivision to read:
Subd. 1a. Submission of reconsideration request to county agency. (a)
For disqualifications related to studies conducted by county agencies, and for
disqualifications related to studies conducted by the commissioner for family
child care, the individual shall submit the request for reconsideration to the
county that initiated the background study.
(b) A reconsideration
request shall be submitted within the time frames specified in subdivision 2.
(c) The county agency shall
forward the individual's request for reconsideration and provide the
commissioner with a recommendation whether to set aside the individual's
disqualification.
EFFECTIVE DATE. This section is
effective January 1, 2008.
Sec. 27. Minnesota Statutes
2006, section 245C.23, subdivision 2, is amended to read:
Subd. 2. Commissioner's notice of disqualification
that is not set aside. (a) The commissioner shall notify the license holder
of the disqualification and order the license holder to immediately remove the
individual from any position allowing direct contact with persons receiving
services from the license holder if:
(1) the individual studied
does not submit a timely request for reconsideration under section 245C.21;
(2) the individual submits a
timely request for reconsideration, but the commissioner does not set aside the
disqualification for that license holder under section 245C.22;
(3) an individual who has a
right to request a hearing under sections 245C.27 and 256.045, or 245C.28 and
chapter 14 for a disqualification that has not been set aside, does not request
a hearing within the specified time; or
(4) an individual submitted
a timely request for a hearing under sections 245C.27 and 256.045, or 245C.28
and chapter 14, but the commissioner does not set aside the disqualification
under section 245A.08, subdivision 5, or 256.045.
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(b)
If the commissioner does not set aside the disqualification under section
245C.22, and the license holder was previously ordered under section 245C.17 to
immediately remove the disqualified individual from direct contact with persons
receiving services or to ensure that the individual is under continuous, direct
supervision when providing direct contact services, the order remains in effect
pending the outcome of a hearing under sections 245C.27 and 256.045, or 245C.28
and chapter 14.
(c)
For background studies related to child foster care, the commissioner shall
also notify the county or private agency that initiated the study of the
results of the reconsideration.
Sec.
28. Minnesota Statutes 2006, section 245C.23, subdivision 2, is amended to
read:
Subd.
2. Commissioner's notice of
disqualification that is not set aside. (a) The commissioner shall notify
the license holder of the disqualification and order the license holder to
immediately remove the individual from any position allowing direct contact
with persons receiving services from the license holder if:
(1)
the individual studied does not submit a timely request for reconsideration
under section 245C.21;
(2)
the individual submits a timely request for reconsideration, but the commissioner
does not set aside the disqualification for that license holder under section
245C.22;
(3)
an individual who has a right to request a hearing under sections 245C.27 and
256.045, or 245C.28 and chapter 14 for a disqualification that has not been set
aside, does not request a hearing within the specified time; or
(4)
an individual submitted a timely request for a hearing under sections 245C.27
and 256.045, or 245C.28 and chapter 14, but the commissioner does not set aside
the disqualification under section 245A.08, subdivision 5, or 256.045.
(b)
If the commissioner does not set aside the disqualification under section
245C.22, and the license holder was previously ordered under section 245C.17 to
immediately remove the disqualified individual from direct contact with persons
receiving services or to ensure that the individual is under continuous, direct
supervision when providing direct contact services, the order remains in effect
pending the outcome of a hearing under sections 245C.27 and 256.045, or 245C.28
and chapter 14.
(c)
For background studies related to family child care, the commissioner shall
also notify the county that initiated the study of the results of the
reconsideration.
EFFECTIVE DATE. This section is
effective January 1, 2008.
Sec.
29. Minnesota Statutes 2006, section 245C.24, subdivision 2, is amended to
read:
Subd.
2. Permanent bar to set aside a
disqualification. (a) Except as provided in paragraph (b), the commissioner
may not set aside the disqualification of any individual disqualified pursuant
to this chapter, in connection with a license to provide family child care
for children, foster care for children in the provider's home, or foster care
or day care services for adults in the provider's home regardless of how
much time has passed, if the individual was disqualified for a crime or conduct
listed in section 245C.15, subdivision 1.
(b)
For an individual in the chemical dependency field who was disqualified for a
crime or conduct listed under section 245C.15, subdivision 1, and whose
disqualification was set aside prior to July 1, 2005, the commissioner must
consider granting a variance pursuant to section 245C.30 for the license holder
for a program dealing primarily with adults. A request for reconsideration evaluated
under this paragraph must include a letter of recommendation from the license
holder that was subject to the prior set-aside decision addressing the
individual's quality of care to children or vulnerable adults and the
circumstances of the individual's departure from that service.
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Sec. 30. [245C.33] ADOPTION BACKGROUND STUDY
REQUIREMENTS.
Subdivision 1. Background studies conducted by commissioner. Before
placement of a child for purposes of adoption, the commissioner shall conduct a
background study on individuals listed in section 259.41, subdivision 3, for
county agencies and private agencies licensed to place children for adoption.
Subd. 2. Information and data provided to county or private agency. The
subject of the background study shall provide the following information to the
county or private agency:
(1) the information
specified in section 245C.05;
(2) a set of classifiable
fingerprints obtained from an authorized agency; and
(3) for studies initiated by
a private agency, a signed consent for the release of information received from
national crime information databases to the private agency.
Subd. 3. Information and data provided to commissioner. The county
or private agency shall forward the data collected under subdivision 2 to the
commissioner.
Subd. 4. Information commissioner reviews. (a) The commissioner
shall review the following information regarding the background study subject:
(1) the information under
section 245C.08, subdivisions 1, 3, and 4;
(2) information from the
child abuse and neglect registry for any state in which the subject has resided
for the past five years; and
(3) information from
national crime information databases.
(b) The commissioner shall
provide any information collected under this subdivision to the county or
private agency that initiated the background study. The commissioner shall
indicate if the information collected shows that the subject of the background
study has a conviction listed in United States Code, title 42, section
671(a)(20)(A).
Sec. 31. [245C.34] ADOPTION AND CHILD FOSTER CARE
BACKGROUND STUDIES; TRIBAL ORGANIZATIONS.
Subdivision 1. Background studies may be conducted by commissioner. (a)
Tribal organizations may contract with the commissioner under section 245C.12
to obtain background study data on individuals under tribal jurisdiction
related to adoptions.
(b) Tribal organizations may
contract with the commissioner under section 245C.12 to obtain background study
data on individuals under tribal jurisdiction related to child foster care.
(c) Background studies
initiated by tribal organizations under paragraphs (a) and (b) must be
conducted as provided in subdivisions 2 and 3.
Subd. 2. Information and data provided to tribal organization. The
background study subject must provide the following information to the tribal
organization:
(1) for background studies
related to adoptions, the information under section 245C.05;
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(2)
for background studies related to child foster care, the information under
section 245C.05;
(3)
a set of classifiable fingerprints obtained from an authorized agency; and
(4)
a signed consent for the release of information received from national crime
information databases to the tribal organization.
Subd.
3. Information and data provided to
commissioner. The tribal organization shall forward the data
collected under subdivision 2 to the commissioner.
Subd.
4. Information commissioner reviews.
(a) The commissioner shall review the following information regarding the
background study subject:
(1)
the information under section 245C.08, subdivisions 1, 3, and 4;
(2)
information from the child abuse and neglect registry for any state in which
the subject has resided for the past five years; and
(3)
information from national crime information databases.
(b)
The commissioner shall provide any information collected under this subdivision
to the tribal organization that initiated the background study. The
commissioner shall indicate if the information collected shows that the subject
of the background study has a conviction listed in United States Code, title
42, section 671(a)(20)(A).
Sec.
32. Minnesota Statutes 2006, section 259.20, subdivision 2, is amended to read:
Subd.
2. Other applicable law. (a) Portions
of chapters 245A, 245C, 257, 260, and 317A may also affect the adoption of a
particular child.
(b)
Provisions
of the Indian Child Welfare Act, United States Code, title 25, chapter 21,
sections 1901-1923, may also apply in the adoption of an Indian child, and may
preempt specific provisions of this chapter.
(c)
Consistent with section 245C.33 and Public Law 109-248, a completed background
study is required before the approval of any foster or adoptive placement in a
related or an unrelated home.
Sec.
33. Minnesota Statutes 2006, section 259.29, subdivision 1, is amended to read:
Subdivision
1. Best interests of the child. (a)
The policy of the state of Minnesota is to ensure that the best interests of
the child are met by requiring individualized determination of the needs of the
child and of how the adoptive placement will serve the needs of the child.
(b)
Among the factors the agency shall consider in determining the needs of the
child are those specified under section 260C.193, subdivision 3, paragraph (b).
(c)
Except for emergency placements provided for in section 245A.035, a completed
background study is required under section 245C.33 before the approval of an
adoptive placement in a home.
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Sec. 34. Minnesota Statutes
2006, section 259.41, is amended to read:
259.41 ADOPTION STUDY.
Subdivision 1. Study required before placement; certain
relatives excepted. (a) An approved adoption study; completed
background study, as required under section 245C.33; and written report
must be completed before the child is placed in a prospective adoptive home
under this chapter, except as allowed by section 259.47, subdivision 6. In an
agency placement, the report must be filed with the court at the time the
adoption petition is filed. In a direct adoptive placement, the report must be
filed with the court in support of a motion for temporary preadoptive custody
under section 259.47, subdivision 3, or, if the study and report are complete,
in support of an emergency order under section 259.47, subdivision 6. The study
and report shall be completed by a licensed child-placing agency and must be
thorough and comprehensive. The study and report shall be paid for by the
prospective adoptive parent, except as otherwise required under section 259.67
or 259.73.
(b) A placement for adoption
with an individual who is related to the child, as defined by section 245A.02,
subdivision 13, is not subject to this section except as required by section
sections 245C.33 and 259.53, subdivision 2, paragraph (c).
(c) In the case of a
licensed foster parent seeking to adopt a child who is in the foster parent's
care, any portions of the foster care licensing process that duplicate
requirements of the home study may be submitted in satisfaction of the relevant
requirements of this section.
Subd. 2. Form of study. (a) The adoption study
must include at least one in-home visit with the prospective adoptive parent.
At a minimum, the study must include document the following
information about the prospective adoptive parent:
(1) a background check
study as required by subdivision 3 and section 245C.33, and
including:
(i) an evaluation
assessment of the data and information provided by section 245C.33, subdivision
4, to determine if the prospective adoptive parent and any other person over
the age of 13 living in the home has a felony conviction consistent with
subdivision 3 and section 471(a)(2) of the Social Security Act; and
(ii) an assessment of the effect of a
any conviction or finding of substantiated maltreatment on the ability
to capacity of the prospective adoptive parent to safely care for
and parent a child;
(2) a medical and social
history and assessment of current health;
(3) an assessment of
potential parenting skills;
(4) an assessment of ability
to provide adequate financial support for a child; and
(5) an assessment of the
level of knowledge and awareness of adoption issues including, where
appropriate, matters relating to interracial, cross-cultural, and special needs
adoptions.
(b) The adoption study is
the basis for completion of a written report. The report must be in a format
specified by the commissioner and must contain recommendations regarding the
suitability of the subject of the study to be an adoptive parent.
Subd. 3. Background check; affidavit of history
study. (a) At the time an adoption study is commenced, each prospective
adoptive parent must:
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(1) authorize access by the
agency to any private data needed to complete the study;
(2) provide all addresses at
which the prospective adoptive parent and anyone in the household over the age of
13 has resided in the previous five years; and
(3) disclose any names used
previously other than the name used at the time of the study.
(b) When the requirements of
paragraph (a) have been met, the agency shall immediately begin
initiate a background check, study under section 245C.33 to be
completed by the commissioner on each person over the age of 13 living in
the home, consisting, at a minimum, of the following:. As required
under section 245C.33 and Public Law 109-248, a completed background study is
required before the approval of any foster or adoptive placement in a related
or an unrelated home. The required background study must be completed as part
of the home study.
(1) a check of criminal
conviction data with the Bureau of Criminal Apprehension and local law
enforcement authorities;
(2) a check for data on
substantiated maltreatment of a child or vulnerable adult and domestic violence
data with local law enforcement and social services agencies and district
courts; and
(3) for those persons under
the age of 25, a check of juvenile court records.
Notwithstanding the
provisions of section 260B.171 or 260C.171, the Bureau of Criminal
Apprehension, local law enforcement and social services agencies, district
courts, and juvenile courts shall release the requested information to the
agency completing the adoption study.
(c) When paragraph (b)
requires checking the data or records of local law enforcement and social
services agencies and district and juvenile courts, the agency shall check with
the law enforcement and social services agencies and courts whose jurisdictions
cover the addresses under paragraph (a), clause (2). In the event that the
agency is unable to complete any of the record checks required by paragraph
(b), the agency shall document the fact and the agency's efforts to obtain the
information.
(d) For a study completed
under this section, when the agency has reasonable cause to believe that
further information may exist on the prospective adoptive parent or household
member over the age of 13 that may relate to the health, safety, or welfare of
the child, the prospective adoptive parent or household member over the age of
13 shall provide the agency with a set of classifiable fingerprints obtained
from an authorized law enforcement agency and the agency may obtain criminal
history data from the National Criminal Records Repository by submitting
fingerprints to the Bureau of Criminal Apprehension. The agency has reasonable
cause when, but not limited to, the:
(1) information from the
Bureau of Criminal Apprehension indicates that the prospective adoptive parent
or household member over the age of 13 is a multistate offender;
(2) information from the
Bureau of Criminal Apprehension indicates that multistate offender status is
undetermined;
(3) the agency has received
a report from the prospective adoptive parent or household member over the age
of 13 or a third party indicating that the prospective adoptive parent or
household member over the age of 13 has a criminal history in a jurisdiction
other than Minnesota; or
(4) the prospective adoptive
parent or household member over the age of 13 is or has been a resident of a
state other than Minnesota in the prior five years.
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(e)
At any time prior to completion of the background check required under
paragraph (b), a prospective adoptive parent may submit to the agency
conducting the study a sworn affidavit stating whether they or any person
residing in the household have been convicted of a crime. The affidavit shall
also state whether the adoptive parent or any other person residing in the
household is the subject of an open investigation of, or have been the subject
of a substantiated allegation of, child or vulnerable-adult maltreatment within
the past ten years. A complete description of the crime, open investigation, or
substantiated abuse, and a complete description of any sentence, treatment, or
disposition must be included. The affidavit must contain an acknowledgment that
if, at any time before the adoption is final, a court receives evidence leading
to a conclusion that a prospective adoptive parent knowingly gave false
information in the affidavit, it shall be determined that the adoption of the
child by the prospective adoptive parent is not in the best interests of the
child.
(f)
For the purposes of subdivision 1 and section 259.47, subdivisions 3 and 6, an
adoption study is complete for placement, even though the background checks
required by paragraph (b) have not been completed, if each prospective adoptive
parent has completed the affidavit allowed by paragraph (e) and the other
requirements of this section have been met. The background checks required by
paragraph (b) must be completed before an adoption petition is filed. If an
adoption study has been submitted to the court under section 259.47,
subdivision 3 or 6, before the background checks required by paragraph (b) were
complete, an updated adoption study report which includes the results of the
background check must be filed with the adoption petition. In the event that an
agency is unable to complete any of the records checks required by paragraph
(b), the agency shall submit with the petition to adopt an affidavit
documenting the agency's efforts to complete the checks.
(c)
A home study under paragraph (b) used to consider placement of any child on
whose behalf Title IV-E adoption assistance payments are to be made must not be
approved if a background study reveals a felony conviction at any time for:
(1)
child abuse or neglect;
(2)
spousal abuse;
(3)
a crime against children, including child pornography; or
(4)
a crime involving violence, including rape, sexual assault, or homicide, but not
including other physical assault or battery.
(d)
A home study under paragraph (b) used to consider placement of any child on
whose behalf Title IV-E adoption assistance payments are to be made must not be
approved if a background study reveals a felony conviction within the past five
years for:
(1)
physical assault or battery; or
(2)
a drug-related offense.
Subd.
4. Updates to adoption study; period of
validity. An agency may update an adoption study and report as needed,
regardless of when the original study and report or most recent update was
completed. An update must be in a format specified by the commissioner and must
verify the continuing accuracy of the elements of the original report and
document any changes to elements of the original report. An update to a study
and report not originally completed under this section must ensure that the
study and report, as updated, meet the requirements of this section. An
adoption study is valid if the report has been completed or updated within the
previous 12 months.
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Sec.
35. Minnesota Statutes 2006, section 259.53, subdivision 2, is amended to read:
Subd.
2. Adoption agencies; postplacement
assessment and report. (a) The agency to which the petition has been
referred under subdivision 1 shall conduct a postplacement assessment and file
a report with the court within 90 days of receipt of a copy of the adoption
petition. The agency shall send a copy of the report to the commissioner at the
time it files the report with the court. The assessment and report must
evaluate the environment and antecedents of the child to be adopted, the home
of the petitioners, whether placement with the petitioners meets the needs of the
child as described in section 259.57, subdivision 2. The report must include a
recommendation to the court as to whether the petition should or should not be
granted.
In
making evaluations and recommendations, the postplacement assessment and report
must, at a minimum, address the following:
(1)
the level of adaptation by the prospective adoptive parents to parenting the
child;
(2)
the health and well-being of the child in the prospective adoptive parents'
home;
(3)
the level of incorporation by the child into the prospective adoptive parents'
home, extended family, and community; and
(4)
the level of inclusion of the child's previous history into the prospective
adoptive home, such as cultural or ethnic practices, or contact with former
foster parents or biological relatives.
(b)
A postplacement adoption report is valid for 12 months following its date of
completion.
(c)
If the petitioner is an individual who is related to the child, as defined by
section 245A.02, subdivision 13, the agency, as part of its postplacement
assessment and report under paragraph (a), shall conduct a background check
meeting the requirements of section 259.41, subdivision 3, paragraph (b). The
prospective adoptive parent shall cooperate in the completion of the background
check by supplying the information and authorizations described in section
259.41, subdivision 3, paragraph (a).
(d) (c) If the report recommends
that the court not grant the petition to adopt the child, the provisions of
this paragraph apply. Unless the assessment and report were completed by the
local social services agency, the agency completing the report, at the time it
files the report with the court under paragraph (a), must provide a copy of the
report to the local social services agency in the county where the prospective
adoptive parent lives. The agency or local social services agency may recommend
that the court dismiss the petition. If the local social services agency
determines that continued placement in the home endangers the child's physical
or emotional health, the agency shall seek a court order to remove the child
from the home.
(e) (d) If, through no fault of the
petitioner, the agency to whom the petition was referred under subdivision 1,
paragraph (b), fails to complete the assessment and file the report within 90
days of the date it received a copy of the adoption petition, the court may
hear the petition upon giving the agency and the local social services agency,
if different, five days' notice by mail of the time and place of the hearing.
Sec.
36. Minnesota Statutes 2006, section 259.57, subdivision 2, is amended to read:
Subd.
2. Protection of child's best interests.
(a) The policy of the state of Minnesota is to ensure that the best interests of
children are met by requiring an individualized determination of the needs of
the child and how the adoptive placement will serve the needs of the child.
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(b)
Among the factors the court shall consider in determining the needs of the
child are those specified under section 260C.193, subdivision 3, paragraph (b).
Consistent with section 245C.33 and Public Law 109-248, a complete
background study is required before the approval of an adoptive placement in a
home.
(c)
In reviewing adoptive placement and in determining appropriate adoption, the
court shall consider placement, consistent with the child's best interests and
in the following order, with (1) a relative or relatives of the child, or (2)
an important friend with whom the child has resided or had significant contact.
Placement of a child cannot be delayed or denied based on race, color, or
national origin of the adoptive parent or the child. Whenever possible,
siblings should be placed together unless it is determined not to be in the
best interests of a sibling.
(d)
If the child's birth parent or parents explicitly request that relatives and
important friends not be considered, the court shall honor that request
consistent with the best interests of the child.
If
the child's birth parent or parents express a preference for placing the child
in an adoptive home of the same or a similar religious background to that of
the birth parent or parents, the court shall place the child with a family that
also meets the birth parent's religious preference. Only if no family is
available as described in clause (a) or (b) may the court give preference to a
family described in clause (c) that meets the parent's religious preference.
(e)
This subdivision does not affect the Indian Child Welfare Act, United States
Code, title 25, sections 1901 to 1923, and the Minnesota Indian Family
Preservation Act, sections 260.751 to 260.835.
Sec.
37. Minnesota Statutes 2006, section 260C.209, is amended to read:
260C.209 BACKGROUND CHECKS.
Subdivision
1. Subjects. The responsible social
services agency must conduct initiate a background check
study to be completed by the commissioner under this section of
chapter 245C on the following individuals:
(1)
a noncustodial parent or nonadjudicated parent who is being assessed for
purposes of providing day-to-day care of a child temporarily or permanently
under section 260C.212, subdivision 4, and any member of the parent's household
who is over the age of 13 when there is a reasonable cause to believe that the
parent or household member over age 13 has a criminal history or a history of
maltreatment of a child or vulnerable adult which would endanger the child's
health, safety, or welfare;
(2)
an individual whose suitability for relative placement under section 260C.212,
subdivision 5, is being determined and any member of the relative's household
who is over the age of 13 when:
(i)
the relative must be licensed for foster care; or
(ii)
the agency must conduct a background study is required under
section 259.53, subdivision 2; or
(iii)
the agency or the commissioner has reasonable cause to believe the
relative or household member over the age of 13 has a criminal history which
would not make transfer of permanent legal and physical custody to the relative
under section 260C.201, subdivision 11, in the child's best interest; and
(3)
a parent, following an out-of-home placement, when the responsible social
services agency has reasonable cause to believe that the parent has been
convicted of a crime directly related to the parent's capacity to maintain the
child's health, safety, or welfare or the parent is the subject of an open
investigation of, or has been the subject of a substantiated allegation of,
child or vulnerable-adult maltreatment within the past ten years.
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"Reasonable cause"
means that the agency has received information or a report from the subject or
a third person that creates an articulable suspicion that the individual has a
history that may pose a risk to the health, safety, or welfare of the child.
The information or report must be specific to the potential subject of the
background check and shall not be based on the race, religion, ethnic
background, age, class, or lifestyle of the potential subject.
Subd.
2. General procedures. (a) When conducting
initiating a background check under subdivision 1, the agency may
shall require the individual being assessed to provide sufficient
information to ensure an accurate assessment under this section, including:
(1)
the individual's first, middle, and last name and all other names by which the
individual has been known;
(2)
home address, zip code, city, county, and state of residence for the past ten
five years;
(3)
sex;
(4)
date of birth; and
(5)
driver's license number or state identification number.
(b)
When notified by the commissioner or the responsible social services
agency that it is conducting an assessment under this section, the Bureau of
Criminal Apprehension, commissioners of health and human services, law
enforcement, and county agencies must provide the commissioner or the
responsible social services agency or county attorney with the following
information on the individual being assessed: criminal history data, reports
about the maltreatment of adults substantiated under section 626.557, and
reports of maltreatment of minors substantiated under section 626.556.
Subd.
3. Multistate information. (a)
For any assessment every background study completed under this
section, if the responsible social services agency has reasonable cause to
believe that the individual is a multistate offender, the individual must
the subject of the background study shall provide the responsible social
services agency or the county attorney with a set of classifiable
fingerprints obtained from an authorized law enforcement agency. The
responsible social services agency or county attorney may shall
provide the fingerprints to the commissioner, and the commissioner shall
obtain criminal history data from the National Criminal Records Repository by
submitting the fingerprints to the Bureau of Criminal Apprehension.
(b)
For purposes of this subdivision, the responsible social services agency has
reasonable cause when, but not limited to:
(1)
information from the Bureau of Criminal Apprehension indicates that the
individual is a multistate offender;
(2)
information from the Bureau of Criminal Apprehension indicates that multistate
offender status is undetermined;
(3)
the social services agency has received a report from the individual or a third
party indicating that the individual has a criminal history in a jurisdiction
other than Minnesota; or
(4)
the individual is or has been a resident of a state other than Minnesota at any
time during the prior ten years.
Subd.
4. Notice upon receipt. The responsible
social services agency commissioner must provide the subject of the
background study with the results of the study as required under this
section within 15 business days of receipt or at least 15 days prior to the
hearing at which the results will be presented, whichever comes first. The
subject may provide written information to the agency that the results are
incorrect and may provide additional or clarifying information to the agency
and to the court through a party to the proceeding. This provision does not
apply to any background study conducted under chapters 245A and chapter
245C.
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Sec.
38. Minnesota Statutes 2006, section 260C.212, subdivision 2, is amended to
read:
Subd.
2. Placement decisions based on best
interest of the child. (a) The policy of the state of Minnesota is to
ensure that the child's best interests are met by requiring an individualized
determination of the needs of the child and of how the selected placement will
serve the needs of the child being placed. The authorized child-placing agency
shall place a child, released by court order or by voluntary release by the
parent or parents, in a family foster home selected by considering placement
with relatives and important friends in the following order:
(1)
with an individual who is related to the child by blood, marriage, or adoption;
or
(2)
with an individual who is an important friend with whom the child has resided
or had significant contact.
(b)
Among the factors the agency shall consider in determining the needs of the
child are the following:
(1)
the child's current functioning and behaviors;
(2)
the medical, educational, and developmental needs of the child;
(3)
the child's history and past experience;
(4)
the child's religious and cultural needs;
(5)
the child's connection with a community, school, and church;
(6)
the child's interests and talents;
(7)
the child's relationship to current caretakers, parents, siblings, and
relatives; and
(8)
the reasonable preference of the child, if the court, or the child-placing
agency in the case of a voluntary placement, deems the child to be of
sufficient age to express preferences.
(c)
Placement of a child cannot be delayed or denied based on race, color, or
national origin of the foster parent or the child.
(d)
Siblings should be placed together for foster care and adoption at the earliest
possible time unless it is determined not to be in the best interests of a
sibling or unless it is not possible after appropriate efforts by the
responsible social services agency.
(e)
Except for emergency placement as provided for in section 245A.035, a completed
background study is required under section 245C.08 before the approval of a
foster placement in a related or unrelated home.
ARTICLE
3
HEALTH
CARE
Section
1. Minnesota Statutes 2006, section 16A.724, subdivision 2, is amended to read:
Subd.
2. Transfers. (a) Notwithstanding
section 295.581, to the extent available resources in the health care access
fund exceed expenditures in that fund, effective with the biennium beginning
July 1, 2007, the commissioner shall transfer funds from the health care
access fund to the general fund to offset the costs of MinnesotaCare enrollees
shifting to medical assistance due to the implementation of an automated
eligibility determination system. The medical assistance costs shall be
identified and updated in the November and February forecasts.
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(b)
In addition to the amounts in paragraph (a), the commissioner of finance shall transfer
the excess funds from the health care access fund to the general fund on June
30 of each year, provided that the amount transferred in any fiscal biennium
shall not exceed $96,000,000. For the biennium ending June 30, 2011, the
transfer shall not exceed $48,000,000.
(b) (c) For fiscal years
2006 to 2009, MinnesotaCare shall be a forecasted program, and, if necessary,
the commissioner shall reduce these transfers from the health care access fund
to the general fund to meet annual MinnesotaCare expenditures or, if necessary,
transfer sufficient funds from the general fund to the health care access fund
to meet annual MinnesotaCare expenditures.
Sec.
2. Minnesota Statutes 2006, section 256.969, subdivision 3a, is amended to
read:
Subd.
3a. Payments. (a) Acute care
hospital billings under the medical assistance program must not be submitted
until the recipient is discharged. However, the commissioner shall establish
monthly interim payments for inpatient hospitals that have individual patient
lengths of stay over 30 days regardless of diagnostic category. Except as
provided in section 256.9693, medical assistance reimbursement for treatment of
mental illness shall be reimbursed based on diagnostic classifications. Individual
hospital payments established under this section and sections 256.9685,
256.9686, and 256.9695, in addition to third party and recipient liability, for
discharges occurring during the rate year shall not exceed, in aggregate, the
charges for the medical assistance covered inpatient services paid for the same
period of time to the hospital. This payment limitation shall be calculated
separately for medical assistance and general assistance medical care services.
The limitation on general assistance medical care shall be effective for
admissions occurring on or after July 1, 1991. Services that have rates
established under subdivision 11 or 12, must be limited separately from other
services. After consulting with the affected hospitals, the commissioner may consider
related hospitals one entity and may merge the payment rates while maintaining
separate provider numbers. The operating and property base rates per admission
or per day shall be derived from the best Medicare and claims data available
when rates are established. The commissioner shall determine the best Medicare
and claims data, taking into consideration variables of recency of the data,
audit disposition, settlement status, and the ability to set rates in a timely
manner. The commissioner shall notify hospitals of payment rates by December 1
of the year preceding the rate year. The rate setting data must reflect the
admissions data used to establish relative values. Base year changes from 1981
to the base year established for the rate year beginning January 1, 1991, and
for subsequent rate years, shall not be limited to the limits ending June 30,
1987, on the maximum rate of increase under subdivision 1. The commissioner may
adjust base year cost, relative value, and case mix index data to exclude the
costs of services that have been discontinued by the October 1 of the year
preceding the rate year or that are paid separately from inpatient services.
Inpatient stays that encompass portions of two or more rate years shall have
payments established based on payment rates in effect at the time of admission
unless the date of admission preceded the rate year in effect by six months or
more. In this case, operating payment rates for services rendered during the
rate year in effect and established based on the date of admission shall be
adjusted to the rate year in effect by the hospital cost index.
(b)
For fee-for-service admissions occurring on or after July 1, 2002, the total
payment, before third-party liability and spenddown, made to hospitals for inpatient
services is reduced by .5 percent from the current statutory rates.
(c)
In addition to the reduction in paragraph (b), the total payment for
fee-for-service admissions occurring on or after July 1, 2003, made to hospitals
for inpatient services before third-party liability and spenddown, is reduced
five percent from the current statutory rates. Mental health services within
diagnosis related groups 424 to 432, and facilities defined under
subdivision 16, and, effective for admissions occurring on or after July 1,
2007, a long-term hospital as designated by the Medicare program that is
located in a city of the first class as defined in section 410.01, are
excluded from this paragraph.
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(d)
In addition to the reduction in paragraphs (b) and (c), the total payment for
fee-for-service admissions occurring on or after July 1, 2005, made to
hospitals for inpatient services before third-party liability and spenddown, is
reduced 6.0 percent from the current statutory rates. Mental health services
within diagnosis related groups 424 to 432 and, facilities
defined under subdivision 16, and, effective for admissions occurring on or
after July 1, 2007, a long-term hospital as designated by the Medicare program
that is located in a city of the first class as defined in section 410.01,
are excluded from this paragraph. Notwithstanding section 256.9686, subdivision
7, for purposes of this paragraph, medical assistance does not include general
assistance medical care. Payments made to managed care plans shall be reduced
for services provided on or after January 1, 2006, to reflect this reduction.
Sec.
3. Minnesota Statutes 2006, section 256.969, subdivision 9, is amended to read:
Subd.
9. Disproportionate numbers of
low-income patients served. (a) For admissions occurring on or after
October 1, 1992, through December 31, 1992, the medical assistance
disproportionate population adjustment shall comply with federal law and shall
be paid to a hospital, excluding regional treatment centers and facilities of
the federal Indian Health Service, with a medical assistance inpatient
utilization rate in excess of the arithmetic mean. The adjustment must be
determined as follows:
(1)
for a hospital with a medical assistance inpatient utilization rate above the
arithmetic mean for all hospitals excluding regional treatment centers and
facilities of the federal Indian Health Service but less than or equal to one
standard deviation above the mean, the adjustment must be determined by
multiplying the total of the operating and property payment rates by the
difference between the hospital's actual medical assistance inpatient
utilization rate and the arithmetic mean for all hospitals excluding regional
treatment centers and facilities of the federal Indian Health Service; and
(2)
for a hospital with a medical assistance inpatient utilization rate above one
standard deviation above the mean, the adjustment must be determined by
multiplying the adjustment that would be determined under clause (1) for that
hospital by 1.1. If federal matching funds are not available for all
adjustments under this subdivision, the commissioner shall reduce payments on a
pro rata basis so that all adjustments qualify for federal match. The
commissioner may establish a separate disproportionate population operating
payment rate adjustment under the general assistance medical care program. For
purposes of this subdivision medical assistance does not include general
assistance medical care. The commissioner shall report annually on the number
of hospitals likely to receive the adjustment authorized by this paragraph. The
commissioner shall specifically report on the adjustments received by public
hospitals and public hospital corporations located in cities of the first
class.
(b)
For admissions occurring on or after July 1, 1993, the medical assistance
disproportionate population adjustment shall comply with federal law and shall
be paid to a hospital, excluding regional treatment centers and facilities of
the federal Indian Health Service, with a medical assistance inpatient
utilization rate in excess of the arithmetic mean. The adjustment must be
determined as follows:
(1)
for a hospital with a medical assistance inpatient utilization rate above the
arithmetic mean for all hospitals excluding regional treatment centers and
facilities of the federal Indian Health Service but less than or equal to one
standard deviation above the mean, the adjustment must be determined by
multiplying the total of the operating and property payment rates by the
difference between the hospital's actual medical assistance inpatient
utilization rate and the arithmetic mean for all hospitals excluding regional
treatment centers and facilities of the federal Indian Health Service;
(2)
for a hospital with a medical assistance inpatient utilization rate above one
standard deviation above the mean, the adjustment must be determined by
multiplying the adjustment that would be determined under clause (1) for that
hospital by 1.1. The commissioner may establish a separate disproportionate
population operating payment rate adjustment under the general assistance
medical care program. For purposes of this subdivision, medical assistance does
not include general assistance medical care. The commissioner shall report
annually on the number of hospitals likely to receive the adjustment authorized
by this paragraph. The commissioner shall specifically report on the
adjustments received by public hospitals and public hospital corporations
located in cities of the first class;
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(3) for a hospital that had
medical assistance fee-for-service payment volume during calendar year 1991 in
excess of 13 percent of total medical assistance fee-for-service payment
volume, a medical assistance disproportionate population adjustment shall be
paid in addition to any other disproportionate payment due under this subdivision
as follows: $1,515,000 due on the 15th of each month after noon, beginning July
15, 1995. For a hospital that had medical assistance fee-for-service payment
volume during calendar year 1991 in excess of eight percent of total medical
assistance fee-for-service payment volume and was the primary hospital
affiliated with the University of Minnesota, a medical assistance
disproportionate population adjustment shall be paid in addition to any other
disproportionate payment due under this subdivision as follows: $505,000 due on
the 15th of each month after noon, beginning July 15, 1995; and
(4) effective August 1,
2005, the payments in paragraph (b), clause (3), shall be reduced to zero.
(c) The commissioner shall
adjust rates paid to a health maintenance organization under contract with the
commissioner to reflect rate increases provided in paragraph (b), clauses (1)
and (2), on a nondiscounted hospital-specific basis but shall not adjust those
rates to reflect payments provided in clause (3).
(d) If federal matching
funds are not available for all adjustments under paragraph (b), the
commissioner shall reduce payments under paragraph (b), clauses (1) and (2), on
a pro rata basis so that all adjustments under paragraph (b) qualify for
federal match.
(e) For purposes of this
subdivision, medical assistance does not include general assistance medical
care.
(f) For hospital services
occurring on or after July 1, 2005, to June 30, 2007, general assistance
medical care expenditures for fee-for-service inpatient and outpatient
hospital services made by the department and by prepaid health plans
participating in general assistance medical care effective July 1, 2007,
payments under section 256B.199 shall be considered Medicaid
disproportionate share hospital payments, except as limited below: by
clauses (1) to (5);
(1) only the portion of
Minnesota's disproportionate share hospital allotment under section 1923(f) of
the Social Security Act that is not spent on the disproportionate population
adjustments in paragraph (b), clauses (1) and (2), may be used for general
assistance medical care expenditures;
(2) only those general
assistance medical care expenditures made to hospitals that qualify for
disproportionate share payments under section 1923 of the Social Security Act
and the Medicaid state plan may be considered disproportionate share hospital
payments;
(3) only those general
assistance medical care expenditures made to an individual hospital that
would not cause the hospital to exceed its individual hospital limits under
section 1923 of the Social Security Act may be considered; and
(4) general assistance
medical care expenditures may be considered only to the extent of
Minnesota's aggregate allotment under section 1923 of the Social Security Act.
All hospitals and prepaid
health plans participating in general assistance medical care must provide any
necessary expenditure, cost, and revenue information required by the
commissioner as necessary for purposes of obtaining federal Medicaid matching
funds for general assistance medical care expenditures. Medicaid
disproportionate share payments; and
(5) expenditures under
general assistance medical care shall be used to the fullest extent before
payments under section 256B.199.
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(g) Upon federal approval of
the related state plan amendment, paragraph (f) is effective retroactively from
July 1, 2005, or the earliest effective date approved by the Centers for Medicare
and Medicaid Services.
Sec. 4. Minnesota Statutes
2006, section 256.969, is amended by adding a subdivision to read:
Subd. 28. Long-term hospital payment adjustment. For admissions
occurring on or after July 1, 2009, the commissioner shall increase the medical
assistance payments to a long-term hospital with a medical assistance inpatient
utilization rate of 17.95 percent of total patient days as of the base year in
effect on July 1, 2005, by an amount equal to 13 percent of the total of the operating
and property payment rates. Payments made to managed care plans shall not
reflect this payment increase. For purposes of this subdivision, medical
assistance does not include general assistance medical care. Payments to a
hospital under this subdivision shall be reduced by the amount of any payments
made under subdivision 27.
Sec. 5. Minnesota Statutes
2006, section 256B.04, subdivision 14, is amended to read:
Subd. 14. Competitive bidding. (a) When determined
to be effective, economical, and feasible, the commissioner may utilize volume
purchase through competitive bidding and negotiation under the provisions of
chapter 16C, to provide items under the medical assistance program including
but not limited to the following:
(1) eyeglasses;
(2) oxygen. The commissioner
shall provide for oxygen needed in an emergency situation on a short-term
basis, until the vendor can obtain the necessary supply from the contract
dealer;
(3) hearing aids and
supplies; and
(4) durable medical
equipment, including but not limited to:
(i) hospital beds;
(ii) commodes;
(iii) glide-about chairs;
(iv) patient lift apparatus;
(v) wheelchairs and
accessories;
(vi) oxygen administration
equipment;
(vii) respiratory therapy
equipment;
(viii) electronic
diagnostic, therapeutic and life support systems;
(5) special nonemergency
transportation services level of need determinations,
disbursement of public transportation passes and tokens, and volunteer and
recipient mileage and parking reimbursements; and
(6) drugs.
(b) Rate changes under this
chapter and chapters 256D and 256L do not affect contract payments under this
subdivision unless specifically identified.
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Sec. 6. Minnesota Statutes
2006, section 256B.04, is amended by adding a subdivision to read:
Subd. 14a. Level of need determination. Nonemergency medical
transportation level of need determinations must be performed by a physician, a
registered nurse working under direct supervision of a physician, a physician's
assistant, a nurse practitioner, a licensed practical nurse, or a discharge
planner. Nonemergency medical transportation level of need determinations must not
be performed more than semiannually on any individual, unless the individual's
circumstances have sufficiently changed so as to require a new level of need
determination. Individuals residing in licensed nursing facilities and
individuals requiring stretcher transportation are exempt from a level of need
determination and are eligible for special transportation services until the
individual no longer resides in a licensed nursing facility or no longer
requires stretcher transportation.
Sec. 7. Minnesota Statutes
2006, section 256B.056, is amended by adding a subdivision to read:
Subd. 1d. Treatment of certain monetary gifts. The commissioner
shall disregard as income any portion of a monetary gift received by an
applicant or enrollee that is designated to purchase a prosthetic device not
covered by insurance, other third-party payers, or medical assistance.
Sec. 8. Minnesota Statutes
2006, section 256B.0625, subdivision 3f, is amended to read:
Subd. 3f. Circumcision for newborns. Newborn
Circumcision is not covered, unless the procedure is medically necessary or
required because of a well-established religious practice.
Sec. 9. Minnesota Statutes
2006, section 256B.0625, is amended by adding a subdivision to read:
Subd. 8d. Chiropractic services. Medical assistance covers the
following medically necessary chiropractic services: one initial or progress
exam per year, manual manipulation of the spine, and x-rays.
EFFECTIVE DATE. This section is
effective July 1, 2007.
Sec. 10. Minnesota Statutes
2006, section 256B.0625, subdivision 13c, is amended to read:
Subd. 13c. Formulary committee. The commissioner,
after receiving recommendations from professional medical associations and
professional pharmacy associations, and consumer groups shall designate a
Formulary Committee to carry out duties as described in subdivisions 13 to 13g.
The Formulary Committee shall be comprised of four licensed physicians actively
engaged in the practice of medicine in Minnesota one of whom must be actively
engaged in the treatment of persons with mental illness; at least three
licensed pharmacists actively engaged in the practice of pharmacy in Minnesota;
and one consumer representative; the remainder to be made up of health care
professionals who are licensed in their field and have recognized knowledge in
the clinically appropriate prescribing, dispensing, and monitoring of covered
outpatient drugs. Members of the Formulary Committee shall not be employed by
the Department of Human Services, but the committee shall be staffed by an
employee of the department who shall serve as an ex officio, nonvoting member
of the board committee. The department's medical director shall
also serve as an ex officio, nonvoting member for the committee. Committee
members shall serve three-year terms and may be reappointed by the
commissioner. The Formulary Committee shall meet at least quarterly. The
commissioner may require more frequent Formulary Committee meetings as needed.
An honorarium of $100 per meeting and reimbursement for mileage shall be paid
to each committee member in attendance.
Sec. 11. Minnesota Statutes
2006, section 256B.0625, subdivision 13d, is amended to read:
Subd. 13d. Drug formulary. (a) The
commissioner shall establish a drug formulary. Its establishment and
publication shall not be subject to the requirements of the Administrative
Procedure Act, but the Formulary Committee shall review and comment on the
formulary contents.
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(b)
The
formulary shall not include:
(1)
drugs or products for which there is no federal funding;
(2)
over-the-counter drugs, except as provided in subdivision 13;
(3)
drugs used for weight loss, except that medically necessary lipase inhibitors may
be covered for a recipient with type II diabetes;
(4)
drugs when used for the treatment of impotence or erectile dysfunction;
(5)
drugs for which medical value has not been established; and
(6)
drugs from manufacturers who have not signed a rebate agreement with the
Department of Health and Human Services pursuant to section 1927 of title XIX
of the Social Security Act.
(c)
If a single-source drug used by at least two percent of the fee-for-service
medical assistance recipients is removed from the formulary due to the failure
of the manufacturer to sign a rebate agreement with the Department of Health
and Human Services, the commissioner shall notify prescribing practitioners
within 30 days of receiving notification from the Centers for Medicare and Medicaid
Services (CMS) that a rebate agreement was not signed.
EFFECTIVE DATE. This section is
effective the day following final enactment.
Sec.
12. Minnesota Statutes 2006, section 256B.0625, is amended by adding a
subdivision to read:
Subd.
13i. Medicare Part D. Notwithstanding
subdivision 13, paragraph (d), for recipients who are enrolled in a Medicare
Part D prescription drug plan or Medicare Advantage special needs plan, medical
assistance covers co-payments which the recipient is responsible for under a
Medicare Part D prescription drug plan or Medicare Advantage special needs
plan, once the recipient has paid $12 per month in prescription drug
co-payments, and according to the requirements of the plan.
Sec.
13. Minnesota Statutes 2006, section 256B.0625, subdivision 17, is amended to
read:
Subd.
17. Transportation costs. (a)
Medical assistance covers transportation costs incurred solely for obtaining
emergency medical care or transportation costs incurred by eligible persons in
obtaining emergency or nonemergency medical care when paid directly to an
ambulance company, common carrier, or other recognized providers of
transportation services.
(b)
Medical assistance covers special transportation, as defined in Minnesota
Rules, part 9505.0315, subpart 1, item F, if the recipient has a physical or
mental impairment that would prohibit the recipient from safely accessing and
using a bus, taxi, other commercial transportation, or private automobile.
The commissioner may use an
order by the recipient's attending physician to certify that the recipient
requires special transportation services. Special transportation includes
driver-assisted service to eligible individuals. Driver-assisted service
includes passenger pickup at and return to the individual's residence or place
of business, assistance with admittance of the individual to the medical
facility, and assistance in passenger securement or in securing of wheelchairs
or stretchers in the vehicle. Special transportation providers must obtain
written documentation from the health care service provider who is serving the
recipient being transported, identifying the time that the recipient arrived.
Special transportation providers may not bill for separate base rates for the
continuation of a trip beyond the original destination. Special transportation
providers must take recipients to the nearest appropriate health care provider,
using the most direct quickest route available as determined
by a commercially available mileage software program approved by the
commissioner. The maximum medical assistance reimbursement rates for
special transportation services are:
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(1) $17 for the base rate
and $1.35 $1.43 per mile for services to eligible persons who
need a wheelchair-accessible van;
(2) $11.50 for the base rate
and $1.30 per mile for services to eligible persons who do not need a
wheelchair-accessible van; and
(3) $60 for the base rate
and $2.40 per mile, and an attendant rate of $9 per trip, for services to
eligible persons who need a stretcher-accessible vehicle.
Sec. 14. Minnesota Statutes
2006, section 256B.0625, subdivision 18a, is amended to read:
Subd. 18a. Access to medical services. (a) Medical
assistance reimbursement for meals for persons traveling to receive medical
care may not exceed $5.50 for breakfast, $6.50 for lunch, or $8 for dinner.
(b) Medical assistance
reimbursement for lodging for persons traveling to receive medical care may not
exceed $50 per day unless prior authorized by the local agency.
(c) Medical assistance
direct mileage reimbursement to the an eligible person or the
an eligible person's driver may not exceed 20 cents per mile friend,
neighbor, or relative that is providing direct transportation to a covered
service shall be at 15 cents below the current Internal Revenue Service mileage
reimbursement for business purposes.
(d) Medical assistance
covers oral language interpreter services when provided by an enrolled health
care provider during the course of providing a direct, person-to-person covered
health care service to an enrolled recipient with limited English proficiency.
Sec. 15. Minnesota Statutes
2006, section 256B.0625, is amended by adding a subdivision to read:
Subd. 49. Community health worker. (a) Medical assistance covers
the care coordination and patient education services provided by a community
health worker if the community health worker has:
(1) received a certificate
from the Minnesota State Colleges and Universities System approved community
health worker curriculum; or
(2) at least five years of
supervised experience with an enrolled physician or advanced practice
registered nurse.
Community health workers
eligible for payment under clause (2) must complete the certification program
by January 1, 2010, to continue to be eligible for payment.
(b) Community health workers
must work under the supervision of a medical assistance enrolled physician or
advanced practice registered nurse.
Sec. 16. Minnesota Statutes
2006, section 256B.0644, is amended to read:
256B.0644 REIMBURSEMENT UNDER OTHER STATE HEALTH CARE PROGRAMS.
(a) A vendor of medical care, as
defined in section 256B.02, subdivision 7, and a health maintenance
organization, as defined in chapter 62D, must participate as a provider or
contractor in the medical assistance program, general assistance medical care
program, and MinnesotaCare as a condition of participating as a provider in
health insurance plans and programs or contractor for state employees
established under section 43A.18, the public employees insurance program under
section 43A.316, for health insurance plans offered to local statutory or
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home rule charter city,
county, and school district employees, the workers' compensation system under
section 176.135, and insurance plans provided through the Minnesota
Comprehensive Health Association under sections 62E.01 to 62E.19. The
limitations on insurance plans offered to local government employees shall not
be applicable in geographic areas where provider participation is limited by
managed care contracts with the Department of Human Services.
(b) For providers other than
health maintenance organizations, participation in the medical assistance
program means that:
(1) the provider accepts new
medical assistance, general assistance medical care, and MinnesotaCare patients
or;
(2) for providers other than
dental service providers, at least 20 percent of the provider's patients are
covered by medical assistance, general assistance medical care, and
MinnesotaCare as their primary source of coverage, or; or
(3) for dental service
providers, at least ten percent of the provider's patients are covered by
medical assistance, general assistance medical care, and MinnesotaCare as their
primary source of coverage, or the provider accepts new medical assistance
and MinnesotaCare patients who are children with special health care needs. For
purposes of this section, "children with special health care needs"
means children up to age 18 who: (i) require health and related services beyond
that required by children generally; and (ii) have or are at risk for a chronic
physical, developmental, behavioral, or emotional condition, including:
bleeding and coagulation disorders; immunodeficiency disorders; cancer;
endocrinopathy; developmental disabilities; epilepsy, cerebral palsy, and other
neurological diseases; visual impairment or deafness; Down syndrome and other
genetic disorders; autism; fetal alcohol syndrome; and other conditions
designated by the commissioner after consultation with representatives of
pediatric dental providers and consumers.
(c) Patients seen on a volunteer
basis by the provider at a location other than the provider's usual place of
practice may be considered in meeting this the participation
requirement in this section. The commissioner shall establish
participation requirements for health maintenance organizations. The
commissioner shall provide lists of participating medical assistance providers
on a quarterly basis to the commissioner of employee relations, the
commissioner of labor and industry, and the commissioner of commerce. Each of
the commissioners shall develop and implement procedures to exclude as
participating providers in the program or programs under their jurisdiction
those providers who do not participate in the medical assistance program. The
commissioner of employee relations shall implement this section through
contracts with participating health and dental carriers.
Sec. 17. [256B.0751] CARE COORDINATION FOR
CHILDREN WITH HIGH-COST MEDICAL CONDITIONS.
Subdivision 1. Care coordination required. (a) The commissioner of human
services shall contract with the U special kids program to provide care
coordination, beginning October 1, 2007, for medical assistance enrollees who
are children with high-cost medical conditions, and to perform the other duties
specified in this section.
(b) For purposes of this
section, "care coordination" means collaboration with primary care
physicians and specialists to manage care, development of medical management
plans for recurrent acute illnesses, oversight and coordination of all aspects
of care in partnership with families, organization of medical information into
a summary of critical information, coordination and appropriate sequencing of
tests and multiple appointments, information and assistance with accessing resources,
and telephone triage for acute illnesses or problems.
Subd. 2. Referrals. The commissioner shall develop a mechanism to
refer children to the U special kids program for care coordination. Beginning
October 1, 2007, and subject to the limits on total program enrollment
specified in subdivision 3, the commissioner shall refer to the U special kids
program children who:
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(1)
incur medical expenses that exceed the qualifying level specified in
subdivision 3;
(2)
have medical conditions that involve four or more major systems; require
multiple specialists; require use of technology such as G-tube, trach, central
line, or oxygen; and require multiple medications;
(3)
do not have a medical case manager for cancer, organ transplantation, epilepsy,
or bone marrow replacement; and
(4)
voluntarily agree to participate in the program.
Subd.
3. Qualifying level of medical expenses.
(a) For the period October 1, 2007, through September 30, 2008, the
commissioner shall refer children for care coordination under this section if
they incurred medical expenses of $500,000 or more during the fiscal year
ending June 30, 2007.
(b)
For the period October 1, 2008, through September 30, 2009, the commissioner
shall refer children for care coordination under this section if they incurred
medical expenses of $400,000 or more during the fiscal year ending June 30,
2008.
(c)
For the period October 1, 2009, through September 30, 2010, the commissioner
shall refer children for care coordination under this section if they incurred
medical expenses of $300,000 or more during the fiscal year ending June 30,
2009.
(d)
Beginning October 1, 2010, the commissioner shall refer children for care
coordination under this section if they incurred medical expenses of $250,000
or more during the previous fiscal year.
(e)
The commissioner shall limit referrals to the extent necessary to ensure that total
enrollment in the U special kids program does not exceed 100 children for the
period October 1, 2007, through September 30, 2008, and does not exceed 150
children beginning October 1, 2008.
Subd.
4. Case management. Beginning October
1, 2007, the U special kids program shall coordinate all nonmedical case
management services provided to children who are required to receive care
coordination under this section. The program may require all nonmedical case
managers, including, but not limited to, county case managers and case managers
for children served under a home and community-based waiver, to submit care
plans for approval, and to document client compliance with the care plans. The
U special kids program, beginning October 1, 2008, may employ or contract with
nonmedical case managers to provide all nonmedical case management services to
children required to receive care coordination under this section. The
commissioner shall reimburse the U special kids program for case management
services through the medical assistance program.
Subd.
5. Statewide availability of care
coordination. The U special kids program may contract with other
entities to provide care coordination services as defined in subdivision 1, in
order to ensure the availability of these services in all regions of the state.
Subd.
6. Advance practice nurse telephone triage
system. The U special kids program shall establish and operate an
advance practice nurse telephone triage system that is available statewide, 24
hours a day, seven days per week. The system must provide advance practice
nurses with access to a Web-based information system to appropriately triage
medical problems, manage care, and reduce unnecessary hospitalizations.
Subd.
7. Monitoring and evaluation. The
commissioner shall monitor program outcomes and evaluate the extent to which
referrals to the U special kids program have improved the quality and
coordination of care and provided financial savings to the medical assistance
program. The U special kids program shall submit to the commissioner, in the
form and manner specified by the commissioner, all data and information
necessary to monitor program outcomes and evaluate the program. The
commissioner shall present a preliminary evaluation to the legislature by
January 15, 2008, and a final evaluation to the legislature by January 15,
2010.
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EFFECTIVE DATE. This section is
effective October 1, 2007, or upon federal approval, whichever is later.
Sec.
18. [256B.0752] CARE COORDINATION FOR
CHILDREN WITH HIGH-COST MENTAL HEALTH CONDITIONS.
Subdivision
1. Care coordination required. (a)
The commissioner of human services shall contract with the U special kids
program to provide care coordination, beginning October 1, 2007, for medical
assistance enrollees who are children with high-cost mental health conditions
and behavioral problems, and to perform the other duties specified in this
section.
(b)
For purposes of this section, "care coordination" means:
collaboration with primary care physicians and specialists to manage care;
development of mental health management plans for recurrent mental health
issues; oversight and coordination of all aspects of care in partnership with families;
organization of medical, treatment, and therapy information into a summary of
critical information; coordination and appropriate sequencing of evaluations
and multiple appointments; information and assistance with accessing resources;
and telephone triage for behavior or other problems.
Subd.
2. Referrals. The commissioner
shall develop a mechanism to refer children to the program for care
coordination. Beginning October 1, 2007, and subject to the limits on total
program enrollment specified in subdivision 3, the commissioner shall refer to
the U special kids program children who:
(1)
incur mental health expenses that exceed the qualifying level specified in
subdivision 3;
(2)
are currently receiving or at risk of needing inpatient mental health
treatment, foster home care, or both; and
(3)
voluntarily agree to participate in the program.
Subd.
3. Qualifying level of medical expenses.
(a) Beginning October 1, 2007, the commissioner shall refer children for
care coordination under this section if they incurred medical and mental health
expenses of $250,000 or more in the previous fiscal year.
(b)
The commissioner shall limit referrals to the extent necessary to ensure that
total enrollment in the U special kids program does not exceed 25 children for
the period October 1, 2007, through September 30, 2008; does not exceed 75
children for the period October 1, 2008, through September 30, 2009; and does
not exceed 125 children beginning October 1, 2009.
Subd.
4. Case management. The U
special kids program, beginning October 1, 2007, shall coordinate all
nonmedical case management services provided to children who are required to
receive care coordination under this section. The program may require all
nonmedical case managers, including but not limited to county case managers and
case managers for children served under a home and community-based waiver, to
submit care plans for approval, and to document client compliance with the care
plans. The U special kids program, beginning October 1, 2008, may employ or
contract with nonmedical case managers to provide all nonmedical case
management services to children required to receive care coordination under
this section. The commissioner shall reimburse the U special kids program for
case management services through the medical assistance program.
Subd.
5. Statewide availability of care
coordination. The program may contract with other entities to
provide care coordination services as defined in subdivision 1, in order to
ensure the availability of these services in all regions of the state.
Subd.
6. Monitoring and evaluation. The
commissioner shall monitor program outcomes and shall evaluate the extent to
which referrals to the U special kids program have improved the quality and
coordination of care and provided financial savings to the medical assistance
program. The U special kids program shall submit to the commissioner, in the
form and manner specified by the commissioner, all data and information
necessary to monitor program outcomes and evaluate the program. The
commissioner shall present a preliminary evaluation to the legislature by
January 15, 2008, and a final evaluation to the legislature by January 15,
2010.
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EFFECTIVE DATE. This section is
effective October 1, 2007, or upon federal approval, whichever is later. The
commissioner shall notify the Office of the Revisor of Statutes when federal
approval is obtained.
Sec.
19. [256B.194] FEDERAL PAYMENTS.
Subdivision
1. Payments at actual cost. If
the Centers for Medicare & Medicaid Services (CMS) promulgates a final rule
consistent with its stated intent in the proposed rule published at 72 Federal
Register, No. 11, January 18, 2007, regarding limiting payments to units of
government, and notwithstanding Minnesota Statutes or Minnesota Rules to the
contrary, for providers that are units of government, the commissioner may
limit medical assistance and MinnesotaCare payments to a provider's actual cost
of providing services, in accordance with the CMS final rule. If a final rule
is promulgated, the commissioner may also require medical assistance and
MinnesotaCare providers to provide any information necessary to determine
Medicaid-related costs, and require the cooperation of providers in any audit
or review necessary to ensure payments are limited to cost. This section does
not apply to providers who are exempt from the provisions of the CMS final
rule.
Subd.
2. Loss of federal financial participation.
For all transfers, certified expenditures, and medical assistance payments
listed below, if the commissioner determines that federal financial
participation is no longer available for the medical assistance payments
listed, then related obligations for the nonfederal share of payments and the
medical assistance payments shall terminate. The commissioner shall notify all
affected parties of the loss of federal financial participation, and the
resulting payments and obligations that are terminated. If the commissioner
determines that federal financial participation is no longer available for any
medical assistance payments or contributions to the nonfederal share of medical
assistance payments that have already been made, the commissioner may collect
the medical assistance payments from providers and return contributions of the
nonfederal share to its source. The transfers, certified expenditures, and
medical assistance payments subject to this section are those specified in:
sections 62J.692, subdivision 7, paragraphs (b) and (c); 256B.19, subdivisions
1c and 1d; 256B.195; 256B.431, subdivision 23; and 256B.69, subdivision 5c,
paragraph (a), clauses (2), (3), and (4); Laws 2002, chapter 220, article 17,
section 2, subdivision 3; and Laws 2005, First Special Session chapter 4,
article 9, section 2, subdivision 1.
Sec.
20. Minnesota Statutes 2006, section 256B.199, is amended to read:
256B.199 PAYMENTS REPORTED
BY GOVERNMENTAL ENTITIES.
(a)
Hennepin County, and Hennepin County Medical Center, Ramsey
County, Regions Hospital, the University of Minnesota, and Fairview-University
Medical Center shall report quarterly to the commissioner beginning June 1,
2007, payments made during the second previous quarter that may qualify for
reimbursement under federal law.
(b)
Based on these reports, the commissioner shall apply for federal matching
funds. These funds are appropriated to the commissioner for the payments
under section 256.969, subdivision 27 to Hennepin County Medical
Center.
(c)
By May 1 of each year, beginning May 1, 2007, the commissioner shall inform the
nonstate entities listed in paragraph (a) of the amount of federal
disproportionate share hospital payment money expected to be available in the
current federal fiscal year.
(d)
This section sunsets on June 30, 2009. The commissioner shall report to the
legislature by December 15, 2008, with recommendations for maximizing federal
disproportionate share hospital payments after June 30, 2009.
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Sec. 21. Minnesota Statutes
2006, section 256B.75, is amended to read:
256B.75 HOSPITAL OUTPATIENT REIMBURSEMENT.
(a) For outpatient hospital
facility fee payments for services rendered on or after October 1, 1992, the
commissioner of human services shall pay the lower of (1) submitted charge, or
(2) 32 percent above the rate in effect on June 30, 1992, except for those
services for which there is a federal maximum allowable payment. Effective for
services rendered on or after January 1, 2000, payment rates for nonsurgical
outpatient hospital facility fees and emergency room facility fees shall be
increased by eight percent over the rates in effect on December 31, 1999,
except for those services for which there is a federal maximum allowable
payment. Services for which there is a federal maximum allowable payment shall
be paid at the lower of (1) submitted charge, or (2) the federal maximum
allowable payment. Total aggregate payment for outpatient hospital facility fee
services shall not exceed the Medicare upper limit. If it is determined that a
provision of this section conflicts with existing or future requirements of the
United States government with respect to federal financial participation in
medical assistance, the federal requirements prevail. The commissioner may, in
the aggregate, prospectively reduce payment rates to avoid reduced federal
financial participation resulting from rates that are in excess of the Medicare
upper limitations.
(b) Notwithstanding
paragraph (a), payment for outpatient, emergency, and ambulatory surgery
hospital facility fee services for critical access hospitals designated under
section 144.1483, clause (10), shall be paid on a cost-based payment system
that is based on the cost-finding methods and allowable costs of the Medicare
program. All hospital outpatient services provided by any hospital
exclusively devoted to the care of pediatric patients under age 21 that is
located in a Minnesota metropolitan statistical area must be paid for using the
methodology established for critical access hospitals at a rate equal to
fee-for-service rates plus 46 percent, as limited by allowable costs.
(c) Effective for services provided
on or after July 1, 2003, rates that are based on the Medicare outpatient
prospective payment system shall be replaced by a budget neutral prospective
payment system that is derived using medical assistance data. The commissioner
shall provide a proposal to the 2003 legislature to define and implement this
provision.
(d) For fee-for-service
services provided on or after July 1, 2002, the total payment, before
third-party liability and spenddown, made to hospitals for outpatient hospital
facility services is reduced by .5 percent from the current statutory rate.
(e) In addition to the
reduction in paragraph (d), the total payment for fee-for-service services
provided on or after July 1, 2003, made to hospitals for outpatient hospital
facility services before third-party liability and spenddown, is reduced five
percent from the current statutory rates. Facilities defined under section
256.969, subdivision 16, are excluded from this paragraph.
EFFECTIVE DATE. This section is
effective July 1, 2007, and applies to services provided on or after that date.
Sec. 22. Minnesota Statutes
2006, section 256B.76, is amended to read:
256B.76 PHYSICIAN AND DENTAL REIMBURSEMENT.
(a) Effective for services
rendered on or after October 1, 1992, the commissioner shall make payments for
physician services as follows:
(1) payment for level one
Centers for Medicare and Medicaid Services' common procedural coding system
codes titled "office and other outpatient services," "preventive
medicine new and established patient," "delivery, antepartum, and
postpartum care," "critical care," cesarean delivery and
pharmacologic management provided to
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psychiatric patients, and
level three codes for enhanced services for prenatal high risk, shall be paid
at the lower of (i) submitted charges, or (ii) 25 percent above the rate in
effect on June 30, 1992. If the rate on any procedure code within these
categories is different than the rate that would have been paid under the
methodology in section 256B.74, subdivision 2, then the larger rate shall be
paid;
(2) payments for all other
services shall be paid at the lower of (i) submitted charges, or (ii) 15.4
percent above the rate in effect on June 30, 1992;
(3) all physician rates
shall be converted from the 50th percentile of 1982 to the 50th percentile of
1989, less the percent in aggregate necessary to equal the above increases
except that payment rates for home health agency services shall be the rates in
effect on September 30, 1992;
(4) effective for services
rendered on or after January 1, 2000, payment rates for physician and
professional services shall be increased by three percent over the rates in
effect on December 31, 1999, except for home health agency and family planning
agency services; and
(5) the increases in clause
(4) shall be implemented January 1, 2000, for managed care.
(b) Effective for services
rendered on or after October 1, 1992, the commissioner shall make payments for dental
services as follows:
(1) dental services shall be
paid at the lower of (i) submitted charges, or (ii) 25 percent above the rate
in effect on June 30, 1992;
(2) dental rates shall be
converted from the 50th percentile of 1982 to the 50th percentile of 1989, less
the percent in aggregate necessary to equal the above increases;
(3) effective for services
rendered on or after January 1, 2000, payment rates for dental services shall
be increased by three percent over the rates in effect on December 31, 1999;
(4) the commissioner shall
award grants to community clinics or other nonprofit community organizations,
political subdivisions, professional associations, or other organizations that
demonstrate the ability to provide dental services effectively to public
program recipients. Grants may be used to fund the costs related to
coordinating access for recipients, developing and implementing patient care
criteria, upgrading or establishing new facilities, acquiring furnishings or
equipment, recruiting new providers, or other development costs that will
improve access to dental care in a region. In awarding grants, the commissioner
shall give priority to applicants that plan to serve areas of the state in
which the number of dental providers is not currently sufficient to meet the
needs of recipients of public programs or uninsured individuals. The
commissioner shall consider the following in awarding the grants:
(i) potential to
successfully increase access to an underserved population;
(ii) the ability to raise
matching funds;
(iii) the long-term
viability of the project to improve access beyond the period of initial
funding;
(iv) the efficiency in the
use of the funding; and
(v) the experience of the
proposers in providing services to the target population.
The commissioner shall
monitor the grants and may terminate a grant if the grantee does not increase
dental access for public program recipients. The commissioner shall consider
grants for the following:
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(i) implementation of new
programs or continued expansion of current access programs that have
demonstrated success in providing dental services in underserved areas;
(ii) a pilot program for utilizing
hygienists outside of a traditional dental office to provide dental hygiene
services; and
(iii) a program that
organizes a network of volunteer dentists, establishes a system to refer
eligible individuals to volunteer dentists, and through that network provides
donated dental care services to public program recipients or uninsured
individuals;
(5) beginning October 1,
1999, the payment for tooth sealants and fluoride treatments shall be the lower
of (i) submitted charge, or (ii) 80 percent of median 1997 charges;
(6) the increases listed in
clauses (3) and (5) shall be implemented January 1, 2000, for managed care; and
(7) effective for services
provided on or after January 1, 2002, payment for diagnostic examinations and
dental x-rays provided to children under age 21 shall be the lower of (i) the
submitted charge, or (ii) 85 percent of median 1999 charges.
(c) Effective for dental
services rendered on or after January 1, 2002, the commissioner may, within
the limits of available appropriation, increase reimbursements to dentists
and dental clinics deemed by the commissioner to be critical access dental
providers. Reimbursement to a critical access dental provider may be
increased by not more than 50 percent above the reimbursement rate that would
otherwise be paid to the provider. Payments to For dental services
rendered after June 30, 2007, the commissioner shall increase reimbursement by
33 percent above the reimbursement rate that would otherwise be paid to the
provider. The commissioner shall pay the health plan companies shall be
adjusted in amounts sufficient to reflect increased reimbursements
to critical access dental providers as approved by the commissioner. In
determining which dentists and dental clinics shall be deemed critical access
dental providers, the commissioner shall review:
(1) the utilization rate in
the service area in which the dentist or dental clinic operates for dental
services to patients covered by medical assistance, general assistance medical
care, or MinnesotaCare as their primary source of coverage;
(2) the level of services
provided by the dentist or dental clinic to patients covered by medical
assistance, general assistance medical care, or MinnesotaCare as their primary
source of coverage; and
(3) whether the level of
services provided by the dentist or dental clinic is critical to maintaining
adequate levels of patient access within the service area.
In the absence of a critical
access dental provider in a service area, the commissioner may designate a dentist
or dental clinic as a critical access dental provider if the dentist or dental
clinic is willing to provide care to patients covered by medical assistance,
general assistance medical care, or MinnesotaCare at a level which
significantly increases access to dental care in the service area.
The commissioner shall
annually establish a reimbursement schedule for critical access dental
providers and provider-specific limits on total reimbursement received under
the reimbursement schedule, and shall notify each critical access dental
provider of the schedule and limit.
(d) An entity that operates
both a Medicare certified comprehensive outpatient rehabilitation facility and
a facility which was certified prior to January 1, 1993, that is licensed under
Minnesota Rules, parts 9570.2000 to 9570.3600, and for whom at least 33 percent
of the clients receiving rehabilitation services in the most recent
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calendar year are medical assistance
recipients, shall be reimbursed by the commissioner for rehabilitation services
at rates that are 38 percent greater than the maximum reimbursement rate
allowed under paragraph (a), clause (2), when those services are (1) provided
within the comprehensive outpatient rehabilitation facility and (2) provided to
residents of nursing facilities owned by the entity.
(e) Effective for services
rendered on or after January 1, 2007, the commissioner shall make payments for
physician and professional services based on the Medicare relative value units
(RVU's). This change shall be budget neutral and the cost of implementing RVU's
will be incorporated in the established conversion factor.
Sec. 23. Minnesota Statutes
2006, section 256D.03, subdivision 4, is amended to read:
Subd. 4. General assistance medical care; services.
(a)(i) For a person who is eligible under subdivision 3, paragraph (a), clause
(2), item (i), general assistance medical care covers, except as provided in
paragraph (c):
(1) inpatient hospital
services;
(2) outpatient hospital
services;
(3) services provided by
Medicare certified rehabilitation agencies;
(4) prescription drugs and
other products recommended through the process established in section
256B.0625, subdivision 13;
(5) equipment necessary to
administer insulin and diagnostic supplies and equipment for diabetics to
monitor blood sugar level;
(6) eyeglasses and eye
examinations provided by a physician or optometrist;
(7) hearing aids;
(8) prosthetic devices;
(9) laboratory and X-ray
services;
(10) physician's services;
(11) medical transportation
except special transportation;
(12) chiropractic services
as covered under the medical assistance program;
(13) podiatric services;
(14) dental services as
covered under the medical assistance program;
(15) outpatient services
provided by a mental health center or clinic that is under contract with the
county board and is established under section 245.62;
(16) day treatment services
for mental illness provided under contract with the county board;
(17) prescribed medications
for persons who have been diagnosed as mentally ill as necessary to prevent
more restrictive institutionalization;
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(18) psychological services,
medical supplies and equipment, and Medicare premiums, coinsurance and
deductible payments;
(19) medical equipment not
specifically listed in this paragraph when the use of the equipment will
prevent the need for costlier services that are reimbursable under this
subdivision;
(20) services performed by a
certified pediatric nurse practitioner, a certified family nurse practitioner,
a certified adult nurse practitioner, a certified obstetric/gynecological nurse
practitioner, a certified neonatal nurse practitioner, or a certified geriatric
nurse practitioner in independent practice, if (1) the service is otherwise
covered under this chapter as a physician service, (2) the service provided on
an inpatient basis is not included as part of the cost for inpatient services
included in the operating payment rate, and (3) the service is within the scope
of practice of the nurse practitioner's license as a registered nurse, as
defined in section 148.171;
(21) services of a certified
public health nurse or a registered nurse practicing in a public health nursing
clinic that is a department of, or that operates under the direct authority of,
a unit of government, if the service is within the scope of practice of the
public health nurse's license as a registered nurse, as defined in section
148.171;
(22) telemedicine
consultations, to the extent they are covered under section 256B.0625,
subdivision 3b; and
(23) mental health
telemedicine and psychiatric consultation as covered under section 256B.0625,
subdivisions 46 and 48.;
(24) care coordination and
patient education services provided by a community health worker according to
section 256B.0625, subdivision 49; and
(25) regardless of the
number of employees that an enrolled health care provider may have, sign
language interpreter services when provided by an enrolled health care provider
during the course of providing a direct, person-to-person covered health care
service to an enrolled recipient who has a hearing loss and uses interpreting
services.
(ii) Effective October 1,
2003, for a person who is eligible under subdivision 3, paragraph (a), clause
(2), item (ii), general assistance medical care coverage is limited to
inpatient hospital services, including physician services provided during the
inpatient hospital stay. A $1,000 deductible is required for each inpatient
hospitalization.
(b) Effective August 1,
2005, sex reassignment surgery is not covered under this subdivision.
(c) In order to contain costs,
the commissioner of human services shall select vendors of medical care who can
provide the most economical care consistent with high medical standards and
shall where possible contract with organizations on a prepaid capitation basis
to provide these services. The commissioner shall consider proposals by
counties and vendors for prepaid health plans, competitive bidding programs,
block grants, or other vendor payment mechanisms designed to provide services
in an economical manner or to control utilization, with safeguards to ensure
that necessary services are provided. Before implementing prepaid programs in
counties with a county operated or affiliated public teaching hospital or a
hospital or clinic operated by the University of Minnesota, the commissioner
shall consider the risks the prepaid program creates for the hospital and allow
the county or hospital the opportunity to participate in the program in a
manner that reflects the risk of adverse selection and the nature of the
patients served by the hospital, provided the terms of participation in the
program are competitive with the terms of other participants considering the
nature of the population served. Payment for services provided pursuant to this
subdivision shall be as provided to medical assistance vendors of these
services under sections 256B.02, subdivision 8, and 256B.0625. For payments
made during fiscal year 1990 and later years, the commissioner shall consult
with an independent actuary in establishing prepayment rates, but shall retain
final control over the rate methodology.
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(d)
Effective January 1, 2008, drug coverage under general assistance medical care
is limited to prescription drugs that:
(i)
are covered under the medical assistance program as described in section
256B.0625, subdivisions 13 and 13d; and
(ii)
are provided by manufacturers that have fully executed general assistance
medical care rebate agreements with the commissioner and comply with the
agreements. Prescription drug coverage under general assistance medical care
must conform to coverage under the medical assistance program according to
section 256B.0625, subdivisions 13 to 13g.
(d) (e) Recipients eligible under subdivision
3, paragraph (a), shall pay the following co-payments for services provided on
or after October 1, 2003:
(1)
$25 for eyeglasses;
(2)
$25 for nonemergency visits to a hospital-based emergency room;
(3)
$3 per brand-name drug prescription and $1 per generic drug prescription,
subject to a $12 per month maximum for prescription drug co-payments. No
co-payments shall apply to antipsychotic drugs when used for the treatment of
mental illness; and
(4)
50 percent coinsurance on restorative dental services.
(e) (f) Co-payments shall be
limited to one per day per provider for nonpreventive visits, eyeglasses, and
nonemergency visits to a hospital-based emergency room. Recipients of general
assistance medical care are responsible for all co-payments in this
subdivision. The general assistance medical care reimbursement to the provider
shall be reduced by the amount of the co-payment, except that reimbursement for
prescription drugs shall not be reduced once a recipient has reached the $12
per month maximum for prescription drug co-payments. The provider collects the
co-payment from the recipient. Providers may not deny services to recipients
who are unable to pay the co-payment, except as provided in paragraph (f).
(f) (g) If it is the routine
business practice of a provider to refuse service to an individual with
uncollected debt, the provider may include uncollected co-payments under this
section. A provider must give advance notice to a recipient with uncollected
debt before services can be denied.
(g) (h) Any county may, from its
own resources, provide medical payments for which state payments are not made.
(h) (i) Chemical dependency
services that are reimbursed under chapter 254B must not be reimbursed under
general assistance medical care.
(i) (j) The maximum payment for new
vendors enrolled in the general assistance medical care program after the base
year shall be determined from the average usual and customary charge of the
same vendor type enrolled in the base year.
(j) (k) The conditions of payment
for services under this subdivision are the same as the conditions specified in
rules adopted under chapter 256B governing the medical assistance program,
unless otherwise provided by statute or rule.
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(k) (l) Inpatient and outpatient
payments shall be reduced by five percent, effective July 1, 2003. This
reduction is in addition to the five percent reduction effective July 1, 2003, and
incorporated by reference in paragraph (i).
(l) (m) Payments for all other
health services except inpatient, outpatient, and pharmacy services shall be
reduced by five percent, effective July 1, 2003.
(m) (n) Payments to managed care
plans shall be reduced by five percent for services provided on or after
October 1, 2003.
(n) (o) A hospital receiving a
reduced payment as a result of this section may apply the unpaid balance toward
satisfaction of the hospital's bad debts.
(o) (p) Fee-for-service payments
for nonpreventive visits shall be reduced by $3 for services provided on or
after January 1, 2006. For purposes of this subdivision, a visit means an
episode of service which is required because of a recipient's symptoms,
diagnosis, or established illness, and which is delivered in an ambulatory
setting by a physician or physician ancillary, chiropractor, podiatrist,
advance practice nurse, audiologist, optician, or optometrist.
(p) (q) Payments to managed care
plans shall not be increased as a result of the removal of the $3 nonpreventive
visit co-payment effective January 1, 2006.
Sec. 24. Minnesota Statutes
2006, section 256L.03, subdivision 5, is amended to read:
Subd. 5. Co-payments and coinsurance. (a) Except
as provided in paragraphs (b) and (c), the MinnesotaCare benefit plan shall
include the following co-payments and coinsurance requirements for all
enrollees:
(1) ten percent of the paid
charges for inpatient hospital services for adult enrollees, subject to an
annual inpatient out-of-pocket maximum of $1,000 per individual and $3,000 per
family;
(2) $3 per prescription for
adult enrollees;
(3) $25 for eyeglasses for
adult enrollees;
(4) $3 per nonpreventive
visit. For purposes of this subdivision, a "visit" means an episode
of service which is required because of a recipient's symptoms, diagnosis, or
established illness, and which is delivered in an ambulatory setting by a
physician or physician ancillary, chiropractor, podiatrist, nurse midwife,
advanced practice nurse, audiologist, optician, or optometrist; and
(5) $6 for nonemergency
visits to a hospital-based emergency room.
(b) Paragraph (a), clause
(1), does not apply to parents and relative caretakers of children under the
age of 21 in households with family income equal to or less than 175 percent of
the federal poverty guidelines. Paragraph (a), clause (1), does not apply to
parents and relative caretakers of children under the age of 21 in households
with family income greater than 175 percent of the federal poverty guidelines for
inpatient hospital admissions occurring on or after January 1, 2001.
(c) Paragraph (a),
clauses (1) to (4), do does not apply to pregnant women and children
under the age of 21.
(d) Adult enrollees with family
gross income that exceeds 175 percent of the federal poverty guidelines and who
are not pregnant shall be financially responsible for the coinsurance amount,
if applicable, and amounts which exceed the $10,000 inpatient hospital benefit
limit.
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(e) When a MinnesotaCare
enrollee becomes a member of a prepaid health plan, or changes from one prepaid
health plan to another during a calendar year, any charges submitted towards the
$10,000 annual inpatient benefit limit, and any out-of-pocket expenses incurred
by the enrollee for inpatient services, that were submitted or incurred prior
to enrollment, or prior to the change in health plans, shall be disregarded.
Sec. 25. Minnesota Statutes
2006, section 256L.04, subdivision 1, is amended to read:
Subdivision 1. Families with children. (a) Families
with children with family income equal to or less than 275 percent of the
federal poverty guidelines for the applicable family size shall be eligible for
MinnesotaCare according to this section. All other provisions of sections
256L.01 to 256L.18, including the insurance-related barriers to enrollment
under section 256L.07, shall apply unless otherwise specified.
(b) Parents who enroll in
the MinnesotaCare program must also enroll their children, if the children are
eligible. Children may be enrolled separately without enrollment by parents.
However, if one parent in the household enrolls, both parents must enroll,
unless other insurance is available. If one child from a family is enrolled,
all children must be enrolled, unless other insurance is available. If one
spouse in a household enrolls, the other spouse in the household must also
enroll, unless other insurance is available. Families cannot choose to enroll
only certain uninsured members.
(c) Beginning October 1,
2003, the dependent sibling definition no longer applies to the MinnesotaCare
program. These persons are no longer counted in the parental household and may
apply as a separate household.
(d) Beginning July 1, 2003,
or upon federal approval, whichever is later, parents are not eligible for
MinnesotaCare if their gross income exceeds $50,000 $25,000 for the
six-month period of eligibility.
Sec. 26. Minnesota Statutes
2006, section 256L.04, subdivision 12, is amended to read:
Subd. 12. Persons in detention. Beginning January
1, 1999, an applicant residing in a correctional or detention facility is not
eligible for MinnesotaCare. An enrollee residing in a correctional or detention
facility is not eligible at renewal of eligibility under section 256L.05,
subdivision 3b 3a.
Sec. 27. Minnesota Statutes
2006, section 256L.11, subdivision 7, is amended to read:
Subd. 7. Critical access dental providers.
Effective for dental services provided to MinnesotaCare enrollees on or
after between January 1, 2007, and June 30, 2007, the
commissioner shall increase payment rates to dentists and dental clinics deemed
by the commissioner to be critical access providers under section 256B.76,
paragraph (c), by 50 percent above the payment rate that would otherwise be
paid to the provider. Effective for dental services provided to
MinnesotaCare enrollees on or after July 1, 2007, the commissioner shall
increase payment rates to dentists and dental clinics deemed by the
commissioner to be critical access providers under section 256B.76, paragraph
(c), by 33 percent above the payment rate that would otherwise be paid to the
provider. The commissioner shall adjust the rates paid on or after
January 1, 2007, to pay the prepaid health plans under contract with
the commissioner amounts sufficient to reflect this rate increase. The
prepaid health plan must pass this rate increase to providers who have been
identified by the commissioner as critical access dental providers under
section 256B.76, paragraph (c).
Sec. 28. HENNEPIN COUNTY PILOT PROJECT.
The
commissioner of human services shall support a pilot project in Hennepin County
to demonstrate the effectiveness of alternative strategies to redetermine
eligibility for certain recipient populations in the medical assistance
program. The target populations for the demonstration are persons who are
eligible based upon disability or age, who have chronic medical conditions, and
who are expected to experience minimal change in income or
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assets from month to month.
The commissioner and the county shall analyze the issues and strategies
employed and the outcomes to determine reasonable efforts to streamline
eligibility statewide. The duration of the pilot project shall be no more than
two years. The commissioner shall apply for any federal waivers needed to implement
this section.
Sec.
29. COUNTY-BASED PURCHASING STUDY.
The
commissioner of health shall study county-based purchasing initiatives
established under Minnesota Statutes, section 256B.692, and compare these
initiatives to managed care plans serving medical assistance, general
assistance medical care, and MinnesotaCare enrollees. The study must:
(1)
provide a history and description of county-based purchasing initiatives,
including state and federal requirements and any federal waivers Minnesota
counties have applied for or received;
(2)
provide a history and description of managed care plan participation in the
prepaid medical assistance, prepaid general assistance medical care, and
prepaid Minnesota programs, and the provision by managed care plans of
third-party administrator services for county-based purchasing initiatives;
(3)
provide relevant data, including limitations on data, data that was requested
but not received, and explanations for why requested data was not received;
(4)
provide recommendations for further data collection and research;
(5)
summarize successes and challenges of the two service delivery methods;
(6)
provide recommendations for possible expansion of county-based purchasing in
rural and urban settings; and
(7)
identify and describe features of county-based purchasing and managed care
plans serving medical assistance, general assistance medical care, and
MinnesotaCare enrollees, to provide a comparison of cost, quality, access, and
community health improvement that includes, but is not limited to:
(i)
descriptions of how health care and social services are integrated and
coordinated for persons with complex care needs, including persons with
high-risk pregnancies, adolescents, persons who are disabled, persons who are
elderly, and persons with chronic health care and social needs;
(ii)
use of monetary grants and surpluses to:
(A)
increase provider reimbursement, including dental care reimbursement, in order
to improve health care access; and
(B)
improve community health beyond the requirements of the public health care
programs, such as the funding of public education, research, and community
initiatives to enhance utilization of preventive services, social services, or
mental health care;
(iii)
administrative costs, including billing and collection of unpaid fees, co-pays
or other charges, and top five management salaries;
(iv)
reporting requirements of contracts with the Department of Human Services;
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(v)
public access to all information about management and administration, including
but not limited to provider contracts and reimbursement, models of care
management and coordination, utilization review, contracts with consultants and
other vendors, handling of monetary grants and surpluses, and health outcomes
data;
(vi)
provider reimbursement by clinical practice area;
(vii)
populations served, described by age, disability, income, race, language,
occupation, and other demographic characteristics;
(viii)
utilization of community-based prevention interventions, including but not
limited to public health nursing visits to new parents, use of nurse-managed
interventions to reduce cardiac hospitalizations, and the use of medical homes
for chronic disease management;
(ix)
utilization of cancer screening;
(x)
utilization of interpreter services;
(xi)
immunization rates for children age five and under;
(xii)
hospitalization rates for conditions related to diabetes, asthma, or cardiac
illnesses;
(xiii)
rates of rehospitalization within a month of hospital discharge;
(xiv)
coordination with county agencies to increase enrollment;
(xv)
number of new program enrollees and the rate of enrollment, including the
percentage of eligible persons who become enrollees;
(xvi)
enrollee satisfaction with their care; and
(xvii)
number of enrollees who do not receive care.
Managed
care plans, county-based purchasing initiatives, health care providers,
counties, and the commissioner of human services shall, upon request, provide
data to the commissioner of health that is necessary to complete the study. The
commissioner of health shall submit the study to the legislature by December
31, 2007.
Sec.
30. GRANT FOR TOLL-FREE HEALTH CARE
ACCESS NUMBER.
The
commissioner of human services shall award a grant to the Neighborhood Health
Care Network to pay the costs of maintaining and staffing a toll-free telephone
number to provide callers with information on health coverage options,
eligibility for MinnesotaCare and other health care programs, and health care
providers that offer free or reduced-cost health care services.
Sec.
31. IMPLEMENTATION OF PHARMACY
DISPENSING FEE INCREASE.
The
commissioner, after consulting with the Pharmacy Payment Reform Advisory
Committee established under Laws 2006, chapter 282, article 16, section 15, may
proportionally increase or decrease the dispensing fee for multiple-source
generic drugs under Minnesota Statutes, section 256B.0625, subdivision 13e,
paragraph (a), to reflect the actual amount of reductions in program cost for
ingredient reimbursement savings obtained.
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EFFECTIVE DATE. This section is effective
upon implementation of changes to the federal upper reimbursement limit under
title VI, chapter IV of the federal Deficit Reduction Act of 2005, United
States Code, title 42, section 1396r-8(e)(5).
Sec.
32. REPEALER.
Minnesota
Statutes 2006, section 256.969, subdivision 27, is repealed effective July 1,
2007.
ARTICLE
4
CONTINUING
CARE
Section
1. Minnesota Statutes 2006, section 144A.071, subdivision 4c, is amended to
read:
Subd.
4c. Exceptions for replacement beds
after June 30, 2003. (a) The commissioner of health, in coordination with
the commissioner of human services, may approve the renovation, replacement,
upgrading, or relocation of a nursing home or boarding care home, under the
following conditions:
(1)
to license and certify an 80-bed city-owned facility in Nicollet County to be
constructed on the site of a new city-owned hospital to replace an existing
85-bed facility attached to a hospital that is also being replaced. The
threshold allowed for this project under section 144A.073 shall be the maximum
amount available to pay the additional medical assistance costs of the new
facility;
(2)
to license and certify 29 beds to be added to an existing 69-bed facility in
St. Louis County, provided that the 29 beds must be transferred from active or
layaway status at an existing facility in St. Louis County that had 235 beds on
April 1, 2003.
The licensed capacity at the
235-bed facility must be reduced to 206 beds, but the payment rate at that
facility shall not be adjusted as a result of this transfer. The operating
payment rate of the facility adding beds after completion of this project shall
be the same as it was on the day prior to the day the beds are licensed and
certified. This project shall not proceed unless it is approved and financed
under the provisions of section 144A.073;
(3)
to license and certify a new 60-bed facility in Austin, provided that: (i) 45
of the new beds are transferred from a 45-bed facility in Austin under common ownership
that is closed and 15 of the new beds are transferred from a 182-bed facility
in Albert Lea under common ownership; (ii) the commissioner of human services
is authorized by the 2004 legislature to negotiate budget-neutral planned
nursing facility closures; and (iii) money is available from planned closures
of facilities under common ownership to make implementation of this clause
budget-neutral to the state. The bed capacity of the Albert Lea facility shall
be reduced to 167 beds following the transfer. Of the 60 beds at the new
facility, 20 beds shall be used for a special care unit for persons with
Alzheimer's disease or related dementias; and
(4)
to license and certify up to 80 beds transferred from an existing state-owned
nursing facility in Cass County to a new facility located on the grounds of the
Ah-Gwah-Ching campus. The operating cost payment rates for the new facility
shall be determined based on the interim and settle-up payment provisions of
Minnesota Rules, part 9549.0057, and the reimbursement provisions of section
256B.431. The property payment rate for the first three years of operation
shall be $35 per day. For subsequent years, the property payment rate of $35
per day shall be adjusted for inflation as provided in section 256B.434,
subdivision 4, paragraph (c), as long as the facility has a contract under
section 256B.434.; and
(5)
to license and certify 180 beds transferred from an existing facility in
Minneapolis to a new facility in Robbinsdale; provided that the beds are transferred
from a 219-bed facility under common ownership that shall be closed following
the transfer. The operating payment rate of the new facility after completion
of this project shall be adjusted upward by $35 per day and the property
payment rate shall be $34.049 per day.
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(b) Projects approved under
this subdivision shall be treated in a manner equivalent to projects approved
under subdivision 4a.
EFFECTIVE DATE. This section is
effective the day following final enactment.
Sec. 2. Minnesota Statutes
2006, section 252.27, subdivision 2a, is amended to read:
Subd. 2a. Contribution amount. (a) The natural or
adoptive parents of a minor child, including a child determined eligible for
medical assistance without consideration of parental income, must contribute to
the cost of services used by making monthly payments on a sliding scale based
on income, unless the child is married or has been married, parental rights
have been terminated, or the child's adoption is subsidized according to
section 259.67 or through title IV-E of the Social Security Act. The
parental contribution is a partial or full payment for medical services
provided for diagnostic, therapeutic, curing, treating, mitigating,
rehabilitation, and maintenance and personal care services as defined in United
States Code, title 26, section 213, needed by the child with a chronic illness
or disability.
(b) For households with
adjusted gross income equal to or greater than 100 percent of federal poverty
guidelines, the parental contribution shall be computed by applying the
following schedule of rates to the adjusted gross income of the natural or
adoptive parents:
(1) if the adjusted gross
income is equal to or greater than 100 percent of federal poverty guidelines
and less than 175 percent of federal poverty guidelines, the parental
contribution is $4 per month;
(2) if the adjusted gross
income is equal to or greater than 175 percent of federal poverty guidelines
and less than or equal to 545 percent of federal poverty guidelines, the
parental contribution shall be determined using a sliding fee scale established
by the commissioner of human services which begins at one percent of adjusted
gross income at 175 percent of federal poverty guidelines and increases to 7.5
percent of adjusted gross income for those with adjusted gross income up to 545
percent of federal poverty guidelines;
(3) if the adjusted gross income
is greater than 545 percent of federal poverty guidelines and less than 675
percent of federal poverty guidelines, the parental contribution shall be 7.5
percent of adjusted gross income;
(4) if the adjusted gross
income is equal to or greater than 675 percent of federal poverty guidelines
and less than 975 percent of federal poverty guidelines, the parental
contribution shall be determined using a sliding fee scale established by the
commissioner of human services which begins at 7.5 percent of adjusted gross
income at 675 percent of federal poverty guidelines and increases to ten
percent of adjusted gross income for those with adjusted gross income up to 975
percent of federal poverty guidelines; and
(5) if the adjusted gross
income is equal to or greater than 975 percent of federal poverty guidelines,
the parental contribution shall be 12.5 percent of adjusted gross income.
If the child lives with the
parent, the annual adjusted gross income parental contribution is
reduced by $2,400 prior to calculating the parental contribution $100
per month. If the child resides in an institution specified in section
256B.35, the parent is responsible for the personal needs allowance specified
under that section in addition to the parental contribution determined under
this section. The parental contribution is reduced by any amount required to be
paid directly to the child pursuant to a court order, but only if actually
paid.
(c) The household size to be
used in determining the amount of contribution under paragraph (b) includes
natural and adoptive parents and their dependents, including the child
receiving services. Adjustments in the contribution amount due to annual
changes in the federal poverty guidelines shall be implemented on the first day
of July following publication of the changes.
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(d)
For purposes of paragraph (b), "income" means the adjusted gross
income of the natural or adoptive parents determined according to the previous
year's federal tax form, except, effective retroactive to July 1, 2003, taxable
capital gains to the extent the funds have been used to purchase a home shall
not be counted as income.
(e)
The contribution shall be explained in writing to the parents at the time
eligibility for services is being determined. The contribution shall be made on
a monthly basis effective with the first month in which the child receives
services. Annually upon redetermination or at termination of eligibility, if
the contribution exceeded the cost of services provided, the local agency or
the state shall reimburse that excess amount to the parents, either by direct
reimbursement if the parent is no longer required to pay a contribution, or by
a reduction in or waiver of parental fees until the excess amount is exhausted.
(f)
The monthly contribution amount must be reviewed at least every 12 months; when
there is a change in household size; and when there is a loss of or gain in
income from one month to another in excess of ten percent. The local agency
shall mail a written notice 30 days in advance of the effective date of a
change in the contribution amount. A decrease in the contribution amount is
effective in the month that the parent verifies a reduction in income or change
in household size.
(g)
Parents of a minor child who do not live with each other shall each pay the
contribution required under paragraph (a). An amount equal to the annual
court-ordered child support payment actually paid on behalf of the child
receiving services shall be deducted from the adjusted gross income of the
parent making the payment prior to calculating the parental contribution under
paragraph (b).
(h)
The contribution under paragraph (b) shall be increased by an additional five
percent if the local agency determines that insurance coverage is available but
not obtained for the child. For purposes of this section, "available"
means the insurance is a benefit of employment for a family member at an annual
cost of no more than five percent of the family's annual income. For purposes
of this section, "insurance" means health and accident insurance
coverage, enrollment in a nonprofit health service plan, health maintenance
organization, self-insured plan, or preferred provider organization.
Parents
who have more than one child receiving services shall not be required to pay
more than the amount for the child with the highest expenditures. There shall
be no resource contribution from the parents. The parent shall not be required
to pay a contribution in excess of the cost of the services provided to the
child, not counting payments made to school districts for education-related
services. Notice of an increase in fee payment must be given at least 30 days
before the increased fee is due.
(i)
The contribution under paragraph (b) shall be reduced by $300 per fiscal year
if, in the 12 months prior to July 1:
(1)
the parent applied for insurance for the child;
(2)
the insurer denied insurance;
(3)
the parents submitted a complaint or appeal, in writing to the insurer,
submitted a complaint or appeal, in writing, to the commissioner of health or
the commissioner of commerce, or litigated the complaint or appeal; and
(4)
as a result of the dispute, the insurer reversed its decision and granted insurance.
For
purposes of this section, "insurance" has the meaning given in
paragraph (h).
A
parent who has requested a reduction in the contribution amount under this
paragraph shall submit proof in the form and manner prescribed by the
commissioner or county agency, including, but not limited to, the insurer's
denial of insurance, the written letter or complaint of the parents, court
documents, and the written response of the insurer approving insurance. The
determinations of the commissioner or county agency under this paragraph are
not rules subject to chapter 14.
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Sec. 3. Minnesota Statutes
2006, section 252.32, subdivision 3, is amended to read:
Subd. 3. Amount of support grant; use. Support
grant amounts shall be determined by the county social service agency. Services
and items purchased with a support grant must:
(1) be over and above the
normal costs of caring for the dependent if the dependent did not have a
disability;
(2) be directly attributable
to the dependent's disabling condition; and
(3) enable the family to
delay or prevent the out-of-home placement of the dependent.
The design and delivery of
services and items purchased under this section must suit the dependent's
chronological age and be provided in the least restrictive environment
possible, consistent with the needs identified in the individual service plan.
Items and services purchased
with support grants must be those for which there are no other public or
private funds available to the family. Fees assessed to parents for health or
human services that are funded by federal, state, or county dollars are not
reimbursable through this program.
In approving or denying
applications, the county shall consider the following factors:
(1) the extent and areas of
the functional limitations of the disabled child;
(2) the degree of need in
the home environment for additional support; and
(3) the potential
effectiveness of the grant to maintain and support the person in the family
environment.
The maximum monthly grant
amount shall be $250 per eligible dependent, or $3,000 per eligible dependent
per state fiscal year, within the limits of available funds and as adjusted
by any legislatively authorized cost of living adjustment. The county
social service agency may consider the dependent's supplemental security income
in determining the amount of the support grant.
Any adjustments to their
monthly grant amount must be based on the needs of the family and funding
availability.
Sec. 4. Minnesota Statutes
2006, section 252.46, is amended by adding a subdivision to read:
Subd. 22. Provider rate increase; St. Louis County. A day training
and habilitation provider in St. Louis County licensed to provide services to
up to 80 individuals shall receive a per diem rate increase that does not
exceed 95 percent of the greater of 125 percent of the current statewide median
or 125 percent of the regional average per diem rate, whichever is higher.
Sec. 5. Minnesota Statutes
2006, section 256.01, is amended by adding a subdivision to read:
Subd. 24. Disability linkage line. The commissioner shall establish
the disability linkage line, a statewide consumer information, referral, and
assistance system for people with disabilities and chronic illnesses that:
(1) provides information
about state and federal eligibility requirements, benefits, and service
options;
(2) makes referrals to
appropriate support entities;
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(3) delivers information and
assistance based on national and state standards;
(4) assists people to make
well-informed decisions; and
(5) supports the timely
resolution of service access and benefit issues.
Sec. 6. Minnesota Statutes
2006, section 256.476, subdivision 1, is amended to read:
Subdivision 1. Purpose and goals. The commissioner of
human services shall establish a consumer support grant program for individuals
with functional limitations and their families who wish to purchase and secure
their own supports. The commissioner and local agencies shall jointly
develop an implementation plan which must include a way to resolve the issues
related to county liability. The program shall:
(1) make support grants
available to individuals or families as an effective alternative to the developmental
disability family support program, personal care attendant services, home
health aide services, and private duty nursing services;
(2) provide consumers more
control, flexibility, and responsibility over their services and supports;
(3) promote local program
management and decision making; and
(4) encourage the use of
informal and typical community supports.
Sec. 7. Minnesota Statutes
2006, section 256.476, subdivision 2, is amended to read:
Subd. 2. Definitions. For purposes of this
section, the following terms have the meanings given them:
(a) "County board"
means the county board of commissioners for the county of financial
responsibility as defined in section 256G.02, subdivision 4, or its designated
representative. When a human services board has been established under sections
402.01 to 402.10, it shall be considered the county board for the purposes of
this section.
(b) "Family" means
the person's birth parents, adoptive parents or stepparents, siblings or
stepsiblings, children or stepchildren, grandparents, grandchildren, niece,
nephew, aunt, uncle, or spouse. For the purposes of this section, a family
member is at least 18 years of age.
(c) "Functional
limitations" means the long-term inability to perform an activity or task
in one or more areas of major life activity, including self-care, understanding
and use of language, learning, mobility, self-direction, and capacity for independent
living. For the purpose of this section, the inability to perform an activity
or task results from a mental, emotional, psychological, sensory, or physical
disability, condition, or illness.
(d) "Informed
choice" means a voluntary decision made by the person or,
the person's legal representative, or other authorized representative after
becoming familiarized with the alternatives to:
(1) select a preferred
alternative from a number of feasible alternatives;
(2) select an alternative
which may be developed in the future; and
(3) refuse any or all
alternatives.
(e) "Local agency"
means the local agency authorized by the county board or, for counties not
participating in the consumer grant program by July 1, 2002, the commissioner,
to carry out the provisions of this section.
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(f) "Person" or
"persons" means a person or persons meeting the eligibility criteria
in subdivision 3.
(g) "Authorized
representative" means an individual designated by the person or their
legal representative to act on their behalf. This individual may be a family
member, guardian, representative payee, or other individual designated by the
person or their legal representative, if any, to assist in purchasing and
arranging for supports. For the purposes of this section, an authorized
representative is at least 18 years of age.
(h) "Screening"
means the screening of a person's service needs under sections 256B.0911 and
256B.092.
(i) "Supports"
means services, care, aids, environmental modifications, or assistance
purchased by the person or the person's family, the person's legal
representative, or other authorized representative. Examples of supports
include respite care, assistance with daily living, and assistive technology.
For the purpose of this section, notwithstanding the provisions of section
144A.43, supports purchased under the consumer support program are not
considered home care services.
(j) "Program of
origination" means the program the individual transferred from when
approved for the consumer support grant program.
Sec. 8. Minnesota Statutes
2006, section 256.476, subdivision 3, is amended to read:
Subd. 3. Eligibility to apply for grants. (a) A
person is eligible to apply for a consumer support grant if the person meets
all of the following criteria:
(1) the person is eligible
for and has been approved to receive services under medical assistance as
determined under sections 256B.055 and 256B.056 or the person has been approved
to receive a grant under the developmental disability family support
program under section 252.32;
(2) the person is able to
direct and purchase the person's own care and supports, or the person has a
family member, legal representative, or other authorized representative who can
purchase and arrange supports on the person's behalf;
(3) the person has
functional limitations, requires ongoing supports to live in the community, and
is at risk of or would continue institutionalization without such supports; and
(4) the person will live in
a home. For the purpose of this section, "home" means the person's
own home or home of a person's family member. These homes are natural home
settings and are not licensed by the Department of Health or Human Services.
(b) Persons may not
concurrently receive a consumer support grant if they are:
(1) receiving personal care
attendant and home health aide services, or private duty nursing under section
256B.0625; a developmental disability family support grant; or
alternative care services under section 256B.0913; or
(2) residing in an
institutional or congregate care setting.
(c) A person or person's
family receiving a consumer support grant shall not be charged a fee or premium
by a local agency for participating in the program.
(d) Individuals receiving
home and community-based waivers under United States Code, title 42, section
1396h(c), are not eligible for the consumer support grant, except for
individuals receiving consumer support grants before July 1, 2003, as long as
other eligibility criteria are met.
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(e) The commissioner shall
establish a budgeted appropriation each fiscal year for the consumer support grant
program. The number of individuals participating in the program will be
adjusted so the total amount allocated to counties does not exceed the amount
of the budgeted appropriation. The budgeted appropriation will be adjusted
annually to accommodate changes in demand for the consumer support grants.
Sec. 9. Minnesota Statutes
2006, section 256.476, subdivision 4, is amended to read:
Subd. 4. Support grants; criteria and limitations.
(a) A county board may choose to participate in the consumer support grant
program. If a county has not chosen to participate by July 1, 2002, the
commissioner shall contract with another county or other entity to provide
access to residents of the nonparticipating county who choose the consumer
support grant option. The commissioner shall notify the county board in a
county that has declined to participate of the commissioner's intent to enter
into a contract with another county or other entity at least 30 days in advance
of entering into the contract. The local agency shall establish written
procedures and criteria to determine the amount and use of support grants.
These procedures must include, at least, the availability of respite care,
assistance with daily living, and adaptive aids. The local agency may establish
monthly or annual maximum amounts for grants and procedures where exceptional
resources may be required to meet the health and safety needs of the person on
a time-limited basis, however, the total amount awarded to each individual may
not exceed the limits established in subdivision 11.
(b) Support grants to a
person or a person's family, a person's legal representative, or
other authorized representative will be provided through a monthly subsidy
payment and be in the form of cash, voucher, or direct county payment to
vendor. Support grant amounts must be determined by the local agency. Each
service and item purchased with a support grant must meet all of the following
criteria:
(1) it must be over and
above the normal cost of caring for the person if the person did not have
functional limitations;
(2) it must be directly
attributable to the person's functional limitations;
(3) it must enable the
person or the person's family, a person's legal representative, or
other authorized representative to delay or prevent out-of-home placement
of the person; and
(4) it must be consistent
with the needs identified in the service agreement, when applicable.
(c) Items and services
purchased with support grants must be those for which there are no other public
or private funds available to the person or the person's family, a
person's legal representative, or other authorized representative. Fees
assessed to the person or the person's family for health and human services are
not reimbursable through the grant.
(d) In approving or denying
applications, the local agency shall consider the following factors:
(1) the extent and areas of
the person's functional limitations;
(2) the degree of need in
the home environment for additional support; and
(3) the potential effectiveness
of the grant to maintain and support the person in the family environment or
the person's own home.
(e)
At the time of application to the program or screening for other services, the
person or the person's family, a person's legal representative, or
other authorized representative shall be provided sufficient information to
ensure an informed choice of alternatives by the person, the person's legal
representative, or other authorized representative, if
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any, or the person's
family. The application shall be made to the local agency and shall specify
the needs of the person and family, the form and amount of grant requested, the
items and services to be reimbursed, and evidence of eligibility for medical
assistance.
(f)
Upon approval of an application by the local agency and agreement on a support
plan for the person or person's family, the local agency shall make grants to
the person or the person's family. The grant shall be in an amount for the
direct costs of the services or supports outlined in the service agreement.
(g)
Reimbursable costs shall not include costs for resources already available,
such as special education classes, day training and habilitation, case
management, other services to which the person is entitled, medical costs
covered by insurance or other health programs, or other resources usually
available at no cost to the person or the person's family.
(h)
The state of Minnesota, the county boards participating in the consumer support
grant program, or the agencies acting on behalf of the county boards in the
implementation and administration of the consumer support grant program shall
not be liable for damages, injuries, or liabilities sustained through the
purchase of support by the individual, the individual's family, or the
authorized representative under this section with funds received through the
consumer support grant program. Liabilities include but are not limited to:
workers' compensation liability, the Federal Insurance Contributions Act
(FICA), or the Federal Unemployment Tax Act (FUTA). For purposes of this
section, participating county boards and agencies acting on behalf of county
boards are exempt from the provisions of section 268.04.
Sec.
10. Minnesota Statutes 2006, section 256.476, subdivision 5, is amended to
read:
Subd.
5. Reimbursement, allocations, and
reporting. (a) For the purpose of transferring persons to the consumer
support grant program from the developmental disability family support
program and personal care assistant services, home health aide services, or
private duty nursing services, the amount of funds transferred by the
commissioner between the developmental disability family support program
account, the medical assistance account, or the consumer support grant account
shall be based on each county's participation in transferring persons to the
consumer support grant program from those programs and services.
(b)
At the beginning of each fiscal year, county allocations for consumer support
grants shall be based on:
(1)
the number of persons to whom the county board expects to provide consumer
supports grants;
(2)
their eligibility for current program and services;
(3)
the amount of nonfederal dollars allowed under subdivision 11; and
(4)
projected dates when persons will start receiving grants. County allocations
shall be adjusted periodically by the commissioner based on the actual transfer
of persons or service openings, and the nonfederal dollars associated with
those persons or service openings, to the consumer support grant program.
(c)
The amount of funds transferred by the commissioner from the medical assistance
account for an individual may be changed if it is determined by the county or
its agent that the individual's need for support has changed.
(d)
The authority to utilize funds transferred to the consumer support grant
account for the purposes of implementing and administering the consumer support
grant program will not be limited or constrained by the spending authority
provided to the program of origination.
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(e)
The commissioner may use up to five percent of each county's allocation, as
adjusted, for payments for administrative expenses, to be paid as a
proportionate addition to reported direct service expenditures.
(f)
The county allocation for each individual or individual's family cannot exceed
the amount allowed under subdivision 11.
(g)
The commissioner may recover, suspend, or withhold payments if the county
board, local agency, or grantee does not comply with the requirements of this
section.
(h)
Grant funds unexpended by consumers shall return to the state once a year. The
annual return of unexpended grant funds shall occur in the quarter following
the end of the state fiscal year.
Sec.
11. Minnesota Statutes 2006, section 256.476, subdivision 10, is amended to
read:
Subd.
10. Consumer responsibilities.
Persons receiving grants under this section shall:
(1)
spend the grant money in a manner consistent with their agreement with the
local agency;
(2)
notify the local agency of any necessary changes in the grant or the items on
which it is spent;
(3)
notify the local agency of any decision made by the person, the a
person's legal representative, or the person's family or other
authorized representative that would change their eligibility for consumer
support grants;
(4)
arrange and pay for supports; and
(5)
inform the local agency of areas where they have experienced difficulty
securing or maintaining supports.
Sec.
12. Minnesota Statutes 2006, section 256.974, is amended to read:
256.974 OFFICE OF OMBUDSMAN
FOR OLDER MINNESOTANS LONG-TERM CARE; LOCAL PROGRAMS.
The
ombudsman for older Minnesotans long-term care serves in the
classified service under section 256.01, subdivision 7, in an office within the
Minnesota Board on Aging that incorporates the long-term care ombudsman program
required by the Older Americans Act, Public Law 100-75 as amended,
United States Code, title 42, section 3027(a)(12) (9) and 3058g (a),
and established within the Minnesota Board on Aging. The Minnesota Board on
Aging may make grants to and designate local programs for the provision of
ombudsman services to clients in county or multicounty areas. The local program
may not be an agency engaged in the provision of nursing home care, hospital
care, or home care services either directly or by contract, or have the
responsibility for planning, coordinating, funding, or administering nursing
home care, hospital care, or home care services.
Sec.
13. Minnesota Statutes 2006, section 256.9741, subdivision 1, is amended to
read:
Subdivision
1. Long-term care facility.
"Long-term care facility" means a nursing home licensed under
sections 144A.02 to 144A.10 or; a boarding care home licensed
under sections 144.50 to 144.56; or a licensed or registered residential
setting which provides or arranges for the provision of home care services.
Sec.
14. Minnesota Statutes 2006, section 256.9741, subdivision 3, is amended to
read:
Subd.
3. Client. "Client" means
an individual who requests, or on whose behalf a request is made for, ombudsman
services and is (a) a resident of a long-term care facility or (b) a Medicare
beneficiary who requests assistance relating to access, discharge, or denial of
inpatient or outpatient services, or (c) an individual reserving, receiving,
or requesting a home care service.
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Sec. 15. Minnesota Statutes
2006, section 256.9742, subdivision 3, is amended to read:
Subd. 3. Posting. Every long-term care facility
and acute care facility shall post in a conspicuous place the address and
telephone number of the office. A home care service provider shall provide all
recipients, including those in elderly housing with services under
chapter 144D, with the address and telephone number of the office. Counties
shall provide clients receiving a consumer support grant or a service
allowance long-term care consultation services under section 256B.0911
or home and community-based services through a state or federally funded
program with the name, address, and telephone number of the office. The
posting or notice is subject to approval by the ombudsman.
Sec. 16. Minnesota Statutes
2006, section 256.9742, subdivision 4, is amended to read:
Subd. 4. Access to long-term care and acute care
facilities and clients. The ombudsman or designee may:
(1) enter any long-term care
facility without notice at any time;
(2) enter any acute care
facility without notice during normal business hours;
(3) enter any acute care
facility without notice at any time to interview a patient or observe services
being provided to the patient as part of an investigation of a matter that is
within the scope of the ombudsman's authority, but only if the ombudsman's or
designee's presence does not intrude upon the privacy of another patient or
interfere with routine hospital services provided to any patient in the
facility;
(4) communicate privately
and without restriction with any client in accordance with section 144.651,
as long as the ombudsman has the client's consent for such communication;
(5) inspect records of a
long-term care facility, home care service provider, or acute care facility
that pertain to the care of the client according to sections section 144.335
and 144.651; and
(6) with the consent of a
client or client's legal guardian, the ombudsman or designated staff shall have
access to review records pertaining to the care of the client according to sections
section 144.335 and 144.651. If a client cannot consent and has
no legal guardian, access to the records is authorized by this section.
A person who denies access
to the ombudsman or designee in violation of this subdivision or aids, abets,
invites, compels, or coerces another to do so is guilty of a misdemeanor.
Sec. 17. Minnesota Statutes
2006, section 256.9742, subdivision 6, is amended to read:
Subd. 6. Prohibition against discrimination or
retaliation. (a) No entity shall take discriminatory, disciplinary, or
retaliatory action against an employee or volunteer, or a patient, resident, or
guardian or family member of a patient, resident, or guardian for filing in
good faith a complaint with or providing information to the ombudsman or
designee including volunteers. A person who violates this subdivision or who
aids, abets, invites, compels, or coerces another to do so is guilty of a
misdemeanor.
(b) There shall be a
rebuttable presumption that any adverse action, as defined below, within 90
days of report, is discriminatory, disciplinary, or retaliatory. For the
purpose of this clause, the term "adverse action" refers to action
taken by the entity involved in a report against the person making the report
or the person with respect to whom the report was made because of the report,
and includes, but is not limited to:
(1) discharge or transfer
from a facility;
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(2) termination of service;
(3) restriction or
prohibition of access to the facility or its residents;
(4) discharge from or
termination of employment;
(5) demotion or reduction in
remuneration for services; and
(6) any restriction of
rights set forth in section 144.651 or, 144A.44, or 144A.751.
Sec. 18. Minnesota Statutes
2006, section 256.9744, subdivision 1, is amended to read:
Subdivision 1. Classification. Except as provided in
this section, data maintained by the office under sections 256.974 to 256.9744
are private data on individuals or nonpublic data as defined in section 13.02,
subdivision 9 or 12, and must be maintained in accordance with the requirements
of Public Law 100-75 the Older Americans Act, as amended, United
States Code, title 42, section 3027(a)(12)(D) 3058g(d).
Sec. 19. Minnesota Statutes
2006, section 256.975, subdivision 7, is amended to read:
Subd. 7. Consumer information and assistance; senior
linkage. (a) The Minnesota Board on Aging shall operate a statewide
information and assistance service to aid older Minnesotans and their families
in making informed choices about long-term care options and health care
benefits. Language services to persons with limited English language skills may
be made available. The service, known as Senior LinkAge Line, must be available
during business hours through a statewide toll-free number and must also be
available through the Internet.
(b) The service must assist
older adults, caregivers, and providers in accessing information about choices
in long-term care services that are purchased through private providers or
available through public options. The service must:
(1) develop a comprehensive
database that includes detailed listings in both consumer- and
provider-oriented formats;
(2) make the database
accessible on the Internet and through other telecommunication and
media-related tools;
(3) link callers to
interactive long-term care screening tools and make these tools available
through the Internet by integrating the tools with the database;
(4) develop community
education materials with a focus on planning for long-term care and evaluating
independent living, housing, and service options;
(5) conduct an outreach
campaign to assist older adults and their caregivers in finding information on
the Internet and through other means of communication;
(6) implement a messaging
system for overflow callers and respond to these callers by the next business
day;
(7) link callers with county
human services and other providers to receive more in-depth assistance and
consultation related to long-term care options; and
(8) link callers with
quality profiles for nursing facilities and other providers developed by the
commissioner of health.; and
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(9) incorporate information
about housing with services and consumer rights within the MinnesotaHelp.info
network long-term care database to facilitate consumer comparison of services
and costs among housing with services establishments and with other in-home
services and to support financial self-sufficiency as long as possible. Housing
with services establishments and their arranged home care providers shall
provide information to the commissioner of human services that is consistent
with information required by the commissioner of health under section 144G.06,
the Uniform Consumer Information Guide. The commissioner of human services
shall provide the data to the Minnesota Board on Aging for inclusion in the
MinnesotaHelp.info network long-term care database.
(c) The Minnesota Board on
Aging shall conduct an evaluation of the effectiveness of the statewide
information and assistance, and submit this evaluation to the legislature by
December 1, 2002. The evaluation must include an analysis of funding adequacy,
gaps in service delivery, continuity in information between the service and identified
linkages, and potential use of private funding to enhance the service.
EFFECTIVE DATE. This section is
effective the day following final enactment.
Sec. 20. Minnesota Statutes
2006, section 256B.056, subdivision 1a, is amended to read:
Subd. 1a. Income and assets generally. Unless
specifically required by state law or rule or federal law or regulation, the
methodologies used in counting income and assets to determine eligibility for
medical assistance for persons whose eligibility category is based on
blindness, disability, or age of 65 or more years, the methodologies for the
supplemental security income program shall be used, except as provided under
subdivision 3, paragraph (f). Increases in benefits under title II of the
Social Security Act shall not be counted as income for purposes of this
subdivision until July 1 of each year. Effective upon federal approval, for
children eligible under section 256B.055, subdivision 12, or for home and
community-based waiver services whose eligibility for medical assistance is
determined without regard to parental income, child support payments, including
any payments made by an obligor in satisfaction of or in addition to a
temporary or permanent order for child support, and Social Security payments
are not counted as income. For families and children, which includes all other
eligibility categories, the methodologies under the state's AFDC plan in effect
as of July 16, 1996, as required by the Personal Responsibility and Work
Opportunity Reconciliation Act of 1996 (PRWORA), Public Law 104-193, shall be
used, except that effective October 1, 2003, the earned income disregards and
deductions are limited to those in subdivision 1c. For these purposes, a
"methodology" does not include an asset or income standard, or
accounting method, or method of determining effective dates.
Sec. 21. Minnesota Statutes
2006, section 256B.056, subdivision 3, is amended to read:
Subd. 3. Asset limitations for aged, blind, or
disabled individuals and families. To be eligible for medical
assistance, a person whose eligibility is based on blindness, disability, or
age of 65 or more years must not individually own more than $3,000
$6,000 in assets, or if a member of a household with two family members,
husband and wife, or parent and child, the household must not own more than $6,000
$12,000 in assets, plus $200 $400 for each additional legal
dependent. In addition to these maximum amounts, an eligible individual or
family may accrue interest on these amounts, but they must be reduced to the
maximum at the time of an eligibility redetermination. The accumulation of the
clothing and personal needs allowance according to section 256B.35 must also be
reduced to the maximum at the time of the eligibility redetermination. The
value of assets that are not considered in determining eligibility for medical
assistance is the value of those assets excluded under the supplemental
security income program for aged, blind, and disabled persons, with the
following exceptions:
(a) Household goods and
personal effects are not considered.
(b) Capital and operating
assets of a trade or business that the local agency determines are necessary to
the person's ability to earn an income are not considered.
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(c) Motor vehicles are
excluded to the same extent excluded by the supplemental security income
program.
(d) Assets designated as
burial expenses are excluded to the same extent excluded by the supplemental
security income program. Burial expenses funded by annuity contracts or life
insurance policies must irrevocably designate the individual's estate as
contingent beneficiary to the extent proceeds are not used for payment of
selected burial expenses.
(e) Effective upon federal
approval, for a person who no longer qualifies as an employed person with a
disability due to loss of earnings, assets allowed while eligible for medical
assistance under section 256B.057, subdivision 9, are not considered for 12
months, beginning with the first month of ineligibility as an employed person
with a disability, to the extent that the person's total assets remain within
the allowed limits of section 256B.057, subdivision 9, paragraph (b).
(f) When a person enrolled
in medical assistance under section 256B.057, subdivision 9, reaches age 65 and
has been enrolled during each of the 24 consecutive months before the person's
65th birthday, the assets owned by the person and the person's spouse must be
disregarded, up to the limits of section 256B.057, subdivision 9, paragraph
(b), when determining eligibility for medical assistance under section
256B.055, subdivision 7. The income of a spouse of a person enrolled in medical
assistance under section 256B.057, subdivision 9, during each of the 24
consecutive months before the person's 65th birthday must be disregarded when
determining eligibility for medical assistance under section 256B.055,
subdivision 7, when the person reaches age 65. This paragraph does not apply at
the time the person or the person's spouse requests medical assistance payment
for long-term care services.
EFFECTIVE DATE. This section is
effective July 1, 2007, except that the increase in the asset standard for
persons whose eligibility for medical assistance is based on blindness,
disability, or age of 65 or more years is effective July 1, 2008.
Sec. 22. Minnesota Statutes
2006, section 256B.056, subdivision 5c, is amended to read:
Subd. 5c. Excess income standard. (a) The excess
income standard for families with children is the standard specified in
subdivision 4.
(b) The excess income
standard for a person whose eligibility is based on blindness, disability, or
age of 65 or more years is 70 percent of the federal poverty guidelines for the
family size. Effective July 1, 2002, the excess income standard for this
paragraph shall equal 75 percent of the federal poverty guidelines. Effective
July 1, 2007, the excess income standard for this paragraph shall equal 85
percent of the federal poverty guidelines. The excess income standard for this
paragraph shall be increased by five percentage points on July 1 of each of the
next three years, so that the excess income standard shall equal 100 percent of
the federal poverty guidelines effective July 1, 2010.
EFFECTIVE DATE. This section is
effective July 1, 2007.
Sec. 23. Minnesota Statutes
2006, section 256B.0621, subdivision 11, is amended to read:
Subd. 11. Data use agreement; Notice of
relocation assistance. The commissioner shall execute a data use
agreement with the Centers for Medicare and Medicaid Services to obtain the
long-term care minimum data set data to assist residents of nursing facilities
who have establish a process with the Centers for Independent Living
that allows a person residing in a Minnesota nursing facility to receive needed
information, consultation, and assistance from one of the centers about the
available community support options that may enable the person to relocate to
the community, if the person: (1) is under the age of 65, (2) has indicated
a desire to live in the community. The commissioner shall in turn enter into
agreements with the Centers for Independent Living to provide information about
assistance for persons who want to move to the community. The commissioner
shall work with the Centers
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for Independent Living on
both the content of the information to be provided and privacy protections for
the individual residents, and (3) has signed a release of information authorized by the person
or the person's appointed legal representative. The process established under
this subdivision shall be coordinated with the long-term care consultation
service activities established in section 256B.0911.
Sec. 24. Minnesota Statutes
2006, section 256B.0625, subdivision 18a, is amended to read:
Subd. 18a. Access to medical services. (a) Medical
assistance reimbursement for meals for persons traveling to receive medical
care may not exceed $5.50 for breakfast, $6.50 for lunch, or $8 for dinner.
(b) Medical assistance
reimbursement for lodging for persons traveling to receive medical care may not
exceed $50 per day unless prior authorized by the local agency.
(c) Medical assistance
direct mileage reimbursement to the eligible person or the eligible person's
driver may not exceed 20 cents per mile.
(d) Regardless of the
number of employees that an enrolled health care provider may have, medical
assistance covers sign and oral language interpreter services when
provided by an enrolled health care provider during the course of providing a
direct, person-to-person covered health care service to an enrolled recipient
with limited English proficiency or who has a hearing loss and uses
interpreting services.
Sec. 25. Minnesota Statutes
2006, section 256B.0625, is amended by adding a subdivision to read:
Subd. 49. Self-directed supports option. Upon federal approval,
medical assistance covers the self-directed supports option as defined under
section 256B.0657 and section 6087 of the Federal Deficit Reduction Act of
2005, Public Law 109-171.
EFFECTIVE DATE. This section is
effective upon federal approval of the state Medicaid plan amendment. The
commissioner of human services shall inform the Office of the Revisor of
Statutes when approval is obtained.
Sec. 26. [256B.0657] SELF-DIRECTED SUPPORTS
OPTION.
Subdivision 1. Definition. "Self-directed supports option" means
personal assistance, supports, items, and related services purchased under an
approved budget plan and budget by a recipient.
Subd. 2. Eligibility. (a) The self-directed supports option is
available to a person who:
(1) is a recipient of
medical assistance as determined under sections 256B.055, 256B.056, and
256B.057, subdivision 9;
(2) is eligible for personal
care assistant services under section 256B.0655;
(3) lives in the person's
own apartment or home, which is not owned, operated, or controlled by a
provider of services not related by blood or marriage;
(4) has the ability to hire,
fire, supervise, establish staff compensation for, and manage the individuals
providing services, and to choose and obtain items, related services, and supports
as described in the participant's plan. If the recipient is not able to carry
out these functions but has a legal guardian or parent to carry them out, the
guardian or parent may fulfill these functions on behalf of the recipient; and
(5) has not been excluded or
disenrolled by the commissioner.
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(b) The commissioner may
disenroll or exclude recipients, including guardians and parents, under the
following circumstances:
(1) recipients who have been
restricted by the Primary Care Utilization Review Committee may be excluded for
a specified time period; and
(2) recipients who exit the
self-directed supports option during the recipient's service plan year shall
not access the self-directed supports option for the remainder of that service
plan year.
Subd. 3. Eligibility for other services. Selection of the
self-directed supports option by a recipient shall not restrict access to other
medically necessary care and services furnished under the state plan medical
assistance benefit, including home care targeted case management, except that a
person receiving home and community-based waiver services, a family support
grant or a consumer support grant is not eligible for funding under the
self-directed supports option.
Subd. 4. Assessment requirements. (a) The self-directed supports
option assessment must meet the following requirements:
(1) it shall be conducted by
the county public health nurse or a certified public health nurse under
contract with the county;
(2) it shall be conducted
face-to-face in the recipient's home initially, and at least annually
thereafter; when there is a significant change in the recipient's condition;
and when there is a change in the need for personal care assistant services. A
recipient who is residing in a facility may be assessed for the self-directed
support option for the purpose of returning to the community using this option;
and
(3) it shall be completed
using the format established by the commissioner.
(b) The results of the
assessment and recommendations shall be communicated to the commissioner and
the recipient by the county public health nurse or certified public health
nurse under contract with the county.
Subd. 5. Self-directed supports option plan requirements. (a) The
plan for the self-directed supports option must meet the following
requirements:
(1) the plan must be
completed using a person-centered process that:
(i) builds upon the
recipient's capacity to engage in activities that promote community life;
(ii) respects the
recipient's preferences, choices, and abilities;
(iii) involves families,
friends, and professionals in the planning or delivery of services or supports
as desired or required by the recipient; and
(iv) addresses the need for
personal care assistant services identified in the recipient's self-directed
supports option assessment;
(2) the plan shall be
developed by the recipient or by the guardian of an adult recipient or by a
parent or guardian of a minor child, with the assistance of an enrolled medical
assistance home care targeted case manager provider who meets the requirements
established for using a person-centered planning process and shall be reviewed
at least annually upon reassessment or when there is a significant change in
the recipient's condition; and
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(3) the plan must include
the total budget amount available divided into monthly amounts that cover the number
of months of personal care assistant services authorization included in the
budget. The amount used each month may vary, but additional funds shall not be
provided above the annual personal care assistant services authorized amount
unless a change in condition is documented.
(b) The commissioner shall:
(1) establish the format and
criteria for the plan as well as the requirements for providers who assist with
plan development;
(2) review the assessment and
plan and, within 30 days after receiving the assessment and plan, make a
decision on approval of the plan;
(3) notify the recipient,
parent, or guardian of approval or denial of the plan and provide notice of the
right to appeal under section 256.045; and
(4) provide a copy of the
plan to the fiscal support entity selected by the recipient.
Subd. 6. Services covered. (a) Services covered under the
self-directed supports option include:
(1) personal care assistant
services under section 256B.0655; and
(2) items, related services,
and supports, including assistive technology, that increase independence or
substitute for human assistance to the extent expenditures would otherwise be
used for human assistance.
(b) Items, supports, and
related services purchased under this option shall not be considered home care
services for the purposes of section 144A.43.
Subd. 7. Noncovered services. Services or supports that are not
eligible for payment under the self-directed supports option include:
(1) services, goods, or
supports that do not benefit the recipient;
(2) any fees incurred by the
recipient, such as Minnesota health care program fees and co-pays, legal fees,
or costs related to advocate agencies;
(3) insurance, except for
insurance costs related to employee coverage or fiscal support entity payments;
(4) room and board and
personal items that are not related to the disability, except that medically
prescribed specialized diet items may be covered if they reduce the need for
human assistance;
(5) home modifications that
add square footage;
(6) home modifications for a
residence other than the primary residence of the recipient, or in the event of
a minor with parents not living together, the primary residences of the
parents;
(7) expenses for travel,
lodging, or meals related to training the recipient, the parent or guardian of
an adult recipient, or the parent or guardian of a minor child, or paid or
unpaid caregivers that exceed $500 in a 12-month period;
(8) experimental treatment;
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(9)
any service or item covered by other medical assistance state plan services,
including prescription and over-the-counter medications, compounds, and
solutions and related fees, including premiums and co-payments;
(10)
membership dues or costs, except when the service is necessary and appropriate
to treat a physical condition or to improve or maintain the recipient's
physical condition. The condition must be identified in the recipient's plan of
care and monitored by a Minnesota health care program enrolled physician;
(11)
vacation expenses other than the cost of direct services;
(12)
vehicle maintenance or modifications not related to the disability;
(13)
tickets and related costs to attend sporting or other recreational events; and
(14)
costs related to Internet access, except when necessary for operation of
assistive technology, to increase independence, or to substitute for human
assistance.
Subd.
8. Self-directed budget requirements.
The budget for the provision of the self-directed service option shall be
equal to the greater of either:
(1)
the annual amount of personal care assistant services under section 256B.0655 that
the recipient has used in the most recent 12-month period; or
(2)
the amount determined using the consumer support grant methodology under
section 256.476, subdivision 11, except that the budget amount shall include
the federal and nonfederal share of the average service costs.
Subd.
9. Quality assurance and risk management.
(a) The commissioner shall establish quality assurance and risk management
measures for use in developing and implementing self-directed plans and budgets
that (1) recognize the roles and responsibilities involved in obtaining
services in a self-directed manner, and (2) assure the appropriateness of such
plans and budgets based upon a recipient's resources and capabilities. These
measures must include (i) background studies, and (ii) backup and emergency
plans, including disaster planning.
(b)
The commissioner shall provide ongoing technical assistance and resource and
educational materials for families and recipients selecting the self-directed
option.
(c)
Performance assessments measures, such as of a recipient's satisfaction with
the services and supports, and ongoing monitoring of health and well-being
shall be identified in consultation with the stakeholder group.
Subd.
10. Fiscal support entity. (a)
Each recipient shall choose a fiscal support entity provider certified by the
commissioner to make payments for services, items, supports, and administrative
costs related to managing a self-directed service plan authorized for payment
in the approved plan and budget. Recipients shall also choose the payroll,
agency with choice, or the fiscal conduit model of financial and service
management.
(b)
The fiscal support entity:
(1)
may not limit or restrict the recipient's choice of service or support
providers, including use of the payroll, agency with choice, or fiscal conduit
model of financial and service management;
(2)
must have a written agreement with the recipient or the recipient's
representative that identifies the duties and responsibilities to be performed
and the specific related charges;
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(3)
must provide the recipient and the home care targeted case manager with a
monthly written summary of the self-directed supports option services that were
billed, including charges from the fiscal support entity;
(4)
must be knowledgeable of and comply with Internal Revenue Service requirements
necessary to process employer and employee deductions, provide appropriate and timely
submission of employer tax liabilities, and maintain documentation to support
medical assistance claims;
(5)
must have current and adequate liability insurance and bonding and sufficient
cash flow and have on staff or under contract a certified public accountant or
an individual with a baccalaureate degree in accounting; and
(6)
must maintain records to track all self-directed supports option services
expenditures, including time records of persons paid to provide supports and
receipts for any goods purchased. The records must be maintained for a minimum
of five years from the claim date and be available for audit or review upon
request. Claims submitted by the fiscal support entity must correspond with
services, amounts, and time periods as authorized in the recipient's
self-directed supports option plan.
(c)
The commissioner shall have authority to:
(1)
set or negotiate rates with fiscal support entities;
(2)
limit the number of fiscal support entities;
(3)
identify a process to certify and recertify fiscal support entities and assure
fiscal support entities are available to recipients throughout the state; and
(4)
establish a uniform format and protocol to be used by eligible fiscal support
entities.
Subd.
11. Stakeholder consultation. The
commissioner shall consult with a statewide consumer-directed services
stakeholder group, including representatives of all types of consumer-directed
service users, advocacy organizations, counties, and consumer-directed service
providers. The commissioner shall seek recommendations from this stakeholder
group in developing:
(1)
the self-directed plan format;
(2)
requirements and guidelines for the person-centered plan assessment and
planning process;
(3)
implementation of the option and the quality assurance and risk management
techniques; and
(4)
standards and requirements, including rates for the personal support plan
development provider and the fiscal support entity; policies; training; and
implementation. The stakeholder group shall provide recommendations on the
repeal of the personal care assistant choice option, transition issues, and
whether the consumer support grant program under section 256.476 should be
modified. The stakeholder group shall meet at least three times each year to
provide advice on policy, implementation, and other aspects of consumer and
self-directed services.
EFFECTIVE DATE. Subdivisions 1 to 10 are
effective upon federal approval of the state Medicaid plan amendment. The
commissioner of human services shall inform the Office of the Revisor of
Statutes when federal approval is obtained. Subdivision 11 is effective July 1,
2007.
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Sec. 27. Minnesota Statutes
2006, section 256B.0911, subdivision 3a, is amended to read:
Subd. 3a. Assessment and support planning. (a)
Persons requesting assessment, services planning, or other assistance intended
to support community-based living, including persons who need assessment in
order to determine waiver or alternative care program eligibility, must be
visited by a long-term care consultation team within ten working days after the
date on which an assessment was requested or recommended. Assessments must be
conducted according to paragraphs (b) to (g) (i).
(b) The county may utilize a
team of either the social worker or public health nurse, or both, to conduct
the assessment in a face-to-face interview. The consultation team members must
confer regarding the most appropriate care for each individual screened or
assessed.
(c) The long-term care
consultation team must assess the health and social needs of the person, using
an assessment form provided by the commissioner.
(d) The team must conduct
the assessment in a face-to-face interview with the person being assessed and
the person's legal representative, if applicable.
(e) The team must provide
the person, or the person's legal representative, with written recommendations
for facility- or community-based services. The team must document that the most
cost-effective alternatives available were offered to the individual. For
purposes of this requirement, "cost-effective alternatives" means
community services and living arrangements that cost the same as or less than
nursing facility care.
(f) If the person chooses to
use community-based services, the team must provide the person or the person's
legal representative with a written community support plan, regardless of
whether the individual is eligible for Minnesota health care programs. The
person may request assistance in developing a community support plan without
participating in a complete assessment.
(g) The person has the
right to make the final decision between nursing facility placement and community
placement after the screening team's recommendation, except as provided in
subdivision 4a, paragraph (c).
(h) The team must give the
person receiving assessment or support planning, or the person's legal
representative, materials, and forms supplied by the commissioner
containing the following information:
(1) the need for and purpose
of preadmission screening and assessment if the person selects
nursing facility placement;
(2) the role of the
long-term care consultation assessment and support planning in waiver and
alternative care program eligibility determination;
(2) (3) information about Minnesota
health care programs;
(3) (4) the person's freedom to
accept or reject the recommendations of the team;
(4) (5) the person's right to confidentiality
under the Minnesota Government Data Practices Act, chapter 13; and
(6) the long-term care
consultant's decision regarding the person's need for nursing facility level of
care;
(5) (7) the person's right to
appeal the decision regarding the need for nursing facility level of care or
the county's final decisions regarding public programs eligibility according to
section 256.045, subdivision 3.
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(i) Face-to-face assessment
completed as part of eligibility determination for the alternative care,
elderly waiver, community alternatives for disabled individuals, community
alternative care, and traumatic brain injury waiver programs under sections
256B.0915, 256B.0917, and 256B.49 is valid to establish service eligibility for
no more than 60 calendar days after the date of assessment. The effective
eligibility start date for these programs can never be prior to the date of
assessment. If an assessment was completed more than 60 days before the
effective waiver or alternative care program eligibility start date, assessment
and support plan information must be updated in a face‑to‑face
visit and documented in the department's Medicaid Management Information System
(MMIS). The effective date of program eligibility in this case cannot be prior
to the date the updated assessment is completed.
Sec. 28. Minnesota Statutes
2006, section 256B.0911, subdivision 3b, is amended to read:
Subd. 3b. Transition assistance. (a) A long-term
care consultation team shall provide assistance to persons residing in a
nursing facility, hospital, regional treatment center, or intermediate care
facility for persons with developmental disabilities who request or are
referred for assistance. Transition assistance must include assessment,
community support plan development, referrals to Minnesota health care
programs, and referrals to programs that provide assistance with housing. Transition
assistance must also include information about the Centers for Independent
Living and about other organizations that can provide assistance with
relocation efforts, and information about contacting these organizations to
obtain their assistance and support.
(b) The county shall develop
transition processes with institutional social workers and discharge planners
to ensure that:
(1) persons admitted to
facilities receive information about transition assistance that is available;
(2) the assessment is
completed for persons within ten working days of the date of request or
recommendation for assessment; and
(3) there is a plan for
transition and follow-up for the individual's return to the community. The plan
must require notification of other local agencies when a person who may require
assistance is screened by one county for admission to a facility located in
another county.
(c) If a person who is
eligible for a Minnesota health care program is admitted to a nursing facility,
the nursing facility must include a consultation team member or the case manager
in the discharge planning process.
Sec. 29. Minnesota Statutes
2006, section 256B.0911, is amended by adding a subdivision to read:
Subd. 3c. Transition to housing with services. (a) Transitional
consultation shall be offered to all prospective residents 65 years of age or
older regardless of income, assets, or funding sources before housing with
services establishments offering or providing assisted living execute a lease
or contract with the prospective resident. The purpose of transitional long-term
care consultation is to support persons with current or anticipated long-term
care needs in making informed choices among options that include the most
cost-effective and least restrictive settings, and to delay spenddown to
eligibility for publicly funded programs by connecting people to alternative
services in their homes before transition to housing with services.
(b) Transitional
consultation services are provided as determined by the commissioner of human
services in partnership with county long-term care consultation units, and the
Area Agencies on Aging, and are a combination of telephone-based and in-person
assistance provided under models developed by the commissioner. The
consultation is to be performed in a manner which provides objective and
complete information. Transitional consultation must be provided within five
working days of the request of the prospective resident as follows:
(1) the consultation must be
provided by a qualified professional as determined by the commissioner;
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(2)
the consultation must include a review of the prospective resident's reasons
for considering assisted living, the prospective resident's personal goals, a
discussion of the prospective resident's immediate and projected long-term care
needs, and alternative community services or assisted living settings that may
meet the prospective resident's needs; and
(3)
the prospective resident will be informed of the availability of long-term care
consultation services described in subdivision 3a that are available at no
charge to the prospective resident to assist the prospective resident in
assessment and planning to meet the prospective resident's long-term care
needs. Regardless of the consultation, prospective residents maintain the right
to choose housing with services or assisted living, if that is their choice.
EFFECTIVE DATE. This section is
effective October 1, 2008.
Sec.
30. Minnesota Statutes 2006, section 256B.0911, subdivision 4b, is amended to
read:
Subd.
4b. Exemptions and emergency admissions.
(a) Exemptions from the federal screening requirements outlined in subdivision
4a, paragraphs (b) and (c), are limited to:
(1)
a person who, having entered an acute care facility from a certified nursing
facility, is returning to a certified nursing facility;
(2)
a person transferring from one certified nursing facility in Minnesota to
another certified nursing facility in Minnesota; and
(3)
a person, 21 years of age or older, who satisfies the following criteria, as
specified in Code of Federal Regulations, title 42, section 483.106(b)(2):
(i)
the person is admitted to a nursing facility directly from a hospital after
receiving acute inpatient care at the hospital;
(ii)
the person requires nursing facility services for the same condition for which
care was provided in the hospital; and
(iii)
the attending physician has certified before the nursing facility admission
that the person is likely to receive less than 30 days of nursing facility
services.
(b)
Persons who are exempt from preadmission screening for purposes of level of
care determination include:
(1)
persons described in paragraph (a);
(2)
an individual who has a contractual right to have nursing facility care paid
for indefinitely by the veterans' administration;
(3)
an individual enrolled in a demonstration project under section 256B.69,
subdivision 8, at the time of application to a nursing facility; and
(4)
an individual currently being served under the alternative care program or
under a home and community-based services waiver authorized under section
1915(c) of the federal Social Security Act; and.
(5) individuals admitted to
a certified nursing facility for a short-term stay, which is expected to be 14
days or less in duration based upon a physician's certification, and who have
been assessed and approved for nursing facility admission within the previous
six months. This exemption applies only if the consultation team member
determines at the time of the initial assessment of the six-month period that
it is appropriate to use the nursing facility for short-
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term stays and that there is
an adequate plan of care for return to the home or community-based setting. If
a stay exceeds 14 days, the individual must be referred no later than the first
county working day following the 14th resident day for a screening, which must
be completed within five working days of the referral. The payment limitations
in subdivision 7 apply to an individual found at screening to not meet the
level of care criteria for admission to a certified nursing facility.
(c) Persons admitted to a
Medicaid-certified nursing facility from the community on an emergency basis as
described in paragraph (d) or from an acute care facility on a nonworking day
must be screened the first working day after admission.
(d) Emergency admission to a
nursing facility prior to screening is permitted when all of the following
conditions are met:
(1) a person is admitted
from the community to a certified nursing or certified boarding care facility
during county nonworking hours;
(2) a physician has
determined that delaying admission until preadmission screening is completed
would adversely affect the person's health and safety;
(3) there is a recent
precipitating event that precludes the client from living safely in the
community, such as sustaining an injury, sudden onset of acute illness, or a
caregiver's inability to continue to provide care;
(4) the attending physician
has authorized the emergency placement and has documented the reason that the
emergency placement is recommended; and
(5) the county is contacted
on the first working day following the emergency admission.
Transfer of a patient from
an acute care hospital to a nursing facility is not considered an emergency
except for a person who has received hospital services in the following
situations: hospital admission for observation, care in an emergency room
without hospital admission, or following hospital 24-hour bed care.
(e) A nursing facility must
provide a written notice to persons who satisfy the criteria in
paragraph (a), clause (3), information to all persons admitted regarding
the person's right to request and receive long-term care consultation services
as defined in subdivision 1a. The notice information must be
provided prior to the person's discharge from the facility and in a format
specified by the commissioner.
Sec. 31. Minnesota Statutes
2006, section 256B.0911, subdivision 4c, is amended to read:
Subd. 4c. Screening requirements. (a) A person
may be screened for nursing facility admission by telephone or in a face-to-face
screening interview. Consultation team members shall identify each individual's
needs using the following categories:
(1) the person needs no
face-to-face screening interview to determine the need for nursing facility
level of care based on information obtained from other health care
professionals;
(2) the person needs an
immediate face-to-face screening interview to determine the need for nursing
facility level of care and complete activities required under subdivision 4a;
or
(3) the person may be exempt
from screening requirements as outlined in subdivision 4b, but will need
transitional assistance after admission or in-person follow-along after a
return home.
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(b) Persons admitted on a
nonemergency basis to a Medicaid-certified nursing facility must be screened
prior to admission.
(c) The long-term care
consultation team shall recommend a case mix classification for persons
admitted to a certified nursing facility when sufficient information is
received to make that classification. The nursing facility is authorized to
conduct all case mix assessments for persons who have been screened prior to
admission for whom the county did not recommend a case mix classification. The
nursing facility is authorized to conduct all case mix assessments for persons
admitted to the facility prior to a preadmission screening. The county retains
the responsibility of distributing appropriate case mix forms to the nursing facility.
(d) (c) The county screening or
intake activity must include processes to identify persons who may require
transition assistance as described in subdivision 3b.
Sec. 32. Minnesota Statutes
2006, section 256B.0911, subdivision 6, is amended to read:
Subd. 6. Payment for long-term care consultation
services. (a) The total payment for each county must be paid monthly by
certified nursing facilities in the county. The monthly amount to be paid by
each nursing facility for each fiscal year must be determined by dividing the
county's annual allocation for long-term care consultation services by 12 to
determine the monthly payment and allocating the monthly payment to each
nursing facility based on the number of licensed beds in the nursing facility.
Payments to counties in which there is no certified nursing facility must be
made by increasing the payment rate of the two facilities located nearest to
the county seat.
(b) The commissioner shall
include the total annual payment determined under paragraph (a) for each
nursing facility reimbursed under section 256B.431 or 256B.434 according to
section 256B.431, subdivision 2b, paragraph (g), or 256B.435.
(c) In the event of the
layaway, delicensure and decertification, or removal from layaway of 25 percent
or more of the beds in a facility, the commissioner may adjust the per diem
payment amount in paragraph (b) and may adjust the monthly payment amount in
paragraph (a). The effective date of an adjustment made under this paragraph
shall be on or after the first day of the month following the effective date of
the layaway, delicensure and decertification, or removal from layaway.
(d) Payments for long-term
care consultation services are available to the county or counties to cover
staff salaries and expenses to provide the services described in subdivision
1a. The county shall employ, or contract with other agencies to employ, within
the limits of available funding, sufficient personnel to provide long-term care
consultation services while meeting the state's long-term care outcomes and
objectives as defined in section 256B.0917, subdivision 1. The county shall be
accountable for meeting local objectives as approved by the commissioner in the
biennial home and community-based services quality assurance plan on a form
provided by the commissioner.
(e) Notwithstanding section
256B.0641, overpayments attributable to payment of the screening costs under
the medical assistance program may not be recovered from a facility.
(f) The commissioner of
human services shall amend the Minnesota medical assistance plan to include
reimbursement for the local consultation teams.
(g) The county may bill, as
case management services, assessments, support planning, and follow-along
provided to persons determined to be eligible for case management under
Minnesota health care programs. No individual or family member shall be charged
for an initial assessment or initial support plan development provided under subdivision
3a or 3b.
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Sec. 33. Minnesota Statutes
2006, section 256B.0911, is amended by adding a subdivision to read:
Subd. 6a. Withholding. If any provider obligated to pay the
long-term care consultation amount as described in subdivision 6 is more than
two months delinquent in the timely payment of the monthly installment, the
commissioner may withhold payments, penalties, and interest in accordance with
the methods outlined in section 256.9657, subdivision 7a. Any amount withheld
under this provision must be returned to the county to whom the delinquent
payments were due.
Sec. 34. Minnesota Statutes
2006, 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 county 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 OBRA evaluation as required under the federal Omnibus Budget
Reconciliation Act of 1987 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 developmental disability is approved by the state
developmental disability authority.
(b) The nursing facility
must not bill a person who is not a medical assistance recipient for resident
days that preceded the date of completion of screening activities as required
under subdivisions 4a, 4b, and 4c. The nursing facility must include
unreimbursed resident days in the nursing facility resident day totals reported
to the commissioner.
(c) The commissioner shall
make a request to the Centers for Medicare and Medicaid Services for a waiver
allowing 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 subdivision 4a, paragraph (c).
Sec. 35. Minnesota Statutes
2006, section 256B.0913, subdivision 4, is amended to read:
Subd. 4. Eligibility for funding for services for
nonmedical assistance recipients. (a) Funding for services under the
alternative care program is available to persons who meet the following
criteria:
(1) the person has been
determined by a community assessment under section 256B.0911 to be a person who
would require the level of care provided in a nursing facility, but for the
provision of services under the alternative care program;
(2) the person is age 65 or
older;
(3) the person would be
eligible for medical assistance within 135 days of admission to a nursing
facility;
(4) the person is not ineligible
for the payment of long-term care services by the medical assistance
program due to an asset transfer penalty under section 256B.0595 or equity
interest in the home exceeding $500,000 as stated in section 256B.056;
(5) the person needs
long-term care services that are not funded through other state or federal
funding;
(6)
the monthly cost of the alternative care services funded by the program for
this person does not exceed 75 percent of the monthly limit described under
section 256B.0915, subdivision 3a. This monthly limit does not prohibit the
alternative care client from payment for additional services, but in no case
may the cost of additional
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services purchased under
this section exceed the difference between the client's monthly service limit
defined under section 256B.0915, subdivision 3, and the alternative care
program monthly service limit defined in this paragraph. If medical
care-related supplies and equipment or environmental modifications and
adaptations are or will be purchased for an alternative care services
recipient, the costs may be prorated on a monthly basis for up to 12
consecutive months beginning with the month of purchase. If the monthly cost of
a recipient's other alternative care services exceeds the monthly limit
established in this paragraph, the annual cost of the alternative care services
shall be determined. In this event, the annual cost of alternative care
services shall not exceed 12 times the monthly limit described in this
paragraph; and
(7)
the person is making timely payments of the assessed monthly fee.
A person is ineligible if
payment of the fee is over 60 days past due, unless the person agrees to:
(i)
the appointment of a representative payee;
(ii)
automatic payment from a financial account;
(iii)
the establishment of greater family involvement in the financial management of
payments; or
(iv)
another method acceptable to the county lead agency to ensure
prompt fee payments.
The
county shall lead agency may extend the client's eligibility as
necessary while making arrangements to facilitate payment of past-due amounts
and future premium payments. Following disenrollment due to nonpayment of a monthly
fee, eligibility shall not be reinstated for a period of 30 days.
(b)
Alternative care funding under this subdivision is not available for a person
who is a medical assistance recipient or who would be eligible for medical
assistance without a spenddown or waiver obligation. A person whose initial
application for medical assistance and the elderly waiver program is being
processed may be served under the alternative care program for a period up to
60 days. If the individual is found to be eligible for medical assistance,
medical assistance must be billed for services payable under the federally
approved elderly waiver plan and delivered from the date the individual was
found eligible for the federally approved elderly waiver plan. Notwithstanding this
provision, alternative care funds may not be used to pay for any service the
cost of which: (i) is payable by medical assistance; (ii) is used by a
recipient to meet a waiver obligation; or (iii) is used to pay a medical
assistance income spenddown for a person who is eligible to participate in the
federally approved elderly waiver program under the special income standard
provision.
(c)
Alternative care funding is not available for a person who resides in a
licensed nursing home, certified boarding care home, hospital, or intermediate
care facility, except for case management services which are provided in
support of the discharge planning process for a nursing home resident or
certified boarding care home resident to assist with a relocation process to a
community-based setting.
(d)
Alternative care funding is not available for a person whose income is greater
than the maintenance needs allowance under section 256B.0915, subdivision 1d,
but equal to or less than 120 percent of the federal poverty guideline
effective July 1 in the fiscal year for which alternative care
eligibility is determined, who would be eligible for the elderly waiver with a
waiver obligation.
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Sec.
36. Minnesota Statutes 2006, section 256B.0913, subdivision 5, is amended to
read:
Subd.
5. Services covered under alternative
care. Alternative care funding may be used for payment of costs of:
(1)
adult day care;
(2)
home health aide;
(3)
homemaker services;
(4)
personal care;
(5)
case management;
(6)
respite care;
(7)
care-related supplies and equipment;
(8)
meals delivered to the home;
(9)
nonmedical transportation;
(10)
nursing services;
(11)
chore services;
(12)
companion services;
(13)
nutrition services;
(14)
training for direct informal caregivers;
(15)
telehome care to provide services in their own homes in conjunction with
in-home visits;
(16)
discretionary services, for which counties may make payment from their
alternative care program allocation or services not otherwise defined in this
section or section 256B.0625, following approval by the commissioner
consumer-directed community services under the alternative care programs which
are available statewide and limited to the average monthly expenditures
representative of all alternative care program participants for the same case
mix resident class assigned in the most recent fiscal year for which complete
expenditure data is available;
(17)
environmental modifications and adaptations; and
(18)
direct cash payments for which counties may make payment from their
alternative care program allocation to clients for the purpose of purchasing
services, following approval by the commissioner, and subject to the provisions
of subdivision 5h, until approval and implementation of consumer-directed
services through the federally approved elderly waiver plan. Upon
implementation, consumer-directed services under the alternative care program
are available statewide and limited to the average monthly expenditures
representative of all alternative care program participants for the same case
mix resident class assigned in the most recent fiscal year for which complete
expenditure data is available discretionary services, for which lead
agencies may make payment from their alternative care program allocation for
services not otherwise defined in this section or section 256B.0625, following
approval by the commissioner.
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Total annual payments for
discretionary services and direct cash payments, until the federally
approved consumer-directed service option is implemented statewide, for all
clients within a county may served by a lead agency must not
exceed 25 percent of that county's lead agency's annual
alternative care program base allocation. Thereafter, discretionary services
are limited to 25 percent of the county's annual alternative care program base
allocation.
Sec. 37. Minnesota Statutes
2006, section 256B.0913, subdivision 5a, is amended to read:
Subd. 5a. Services; service definitions; service
standards. (a) Unless specified in statute, the services, service
definitions, and standards for alternative care services shall be the same as
the services, service definitions, and standards specified in the federally
approved elderly waiver plan, except for alternative care does not
cover transitional support services, assisted living services, adult foster
care services, and residential care services and benefits defined
under section 256B.0625 that meet primary and acute health care needs.
(b) The county
lead agency must ensure that the funds are not used to supplant or
supplement services available through other public assistance or services
programs., including supplementation of client co-pays, deductibles,
premiums, or other cost-sharing arrangements for health-related benefits and
services or entitlement programs and services that are available to the person,
but in which they have elected not to enroll. For a provider of supplies
and equipment when the monthly cost of the supplies and equipment is less than
$250, persons or agencies must be employed by or under a contract with the county
lead agency or the public health nursing agency of the local board of
health in order to receive funding under the alternative care program. Supplies
and equipment may be purchased from a vendor not certified to participate in
the Medicaid program if the cost for the item is less than that of a Medicaid
vendor.
(c) Personal care services
must meet the service standards defined in the federally approved elderly
waiver plan, except that a county lead agency may contract with a
client's relative who meets the relative hardship waiver requirements or a
relative who meets the criteria and is also the responsible party under an
individual service plan that ensures the client's health and safety and
supervision of the personal care services by a qualified professional as
defined in section 256B.0625, subdivision 19c. Relative hardship is established
by the county lead agency when the client's care causes a
relative caregiver to do any of the following: resign from a paying job, reduce
work hours resulting in lost wages, obtain a leave of absence resulting in lost
wages, incur substantial client-related expenses, provide services to address
authorized, unstaffed direct care time, or meet special needs of the client
unmet in the formal service plan.
Sec. 38. Minnesota Statutes
2006, section 256B.0913, subdivision 8, is amended to read:
Subd. 8. Requirements for individual care plan.
(a) The case manager shall implement the plan of care for each alternative care
client and ensure that a client's service needs and eligibility are reassessed
at least every 12 months. The plan shall include any services prescribed by the
individual's attending physician as necessary to allow the individual to remain
in a community setting. In developing the individual's care plan, the case
manager should include the use of volunteers from families and neighbors,
religious organizations, social clubs, and civic and service organizations to
support the formal home care services. The county lead agency
shall be held harmless for damages or injuries sustained through the use of
volunteers under this subdivision including workers' compensation liability.
The county of service case manager shall provide documentation in
each individual's plan of care and, if requested, to the commissioner that the
most cost-effective alternatives available have been offered to the individual
and that the individual was free to choose among available qualified providers,
both public and private, including qualified case management or service
coordination providers other than those employed by any county; however, the
county or tribe maintains responsibility for prior authorizing services in
accordance with statutory and administrative requirements. The case manager
must give the individual a ten-day written notice of any denial, termination,
or reduction of alternative care services.
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(b) The county of service
or tribe must provide access to and arrange for case management services,
including assuring implementation of the plan. "County of service"
has the meaning given it in Minnesota Rules, part 9505.0015, subpart 11. The
county of service must notify the county of financial responsibility of the
approved care plan and the amount of encumbered funds.
Sec. 39. Minnesota Statutes 2006,
section 256B.0913, subdivision 9, is amended to read:
Subd. 9. Contracting provisions for providers.
Alternative care funds paid to service providers are subject to audit by the
commissioner for fiscal and utilization control.
The lead agency must select
providers for contracts or agreements using the following criteria and other
criteria established by the county lead agency:
(1) the need for the
particular services offered by the provider;
(2) the population to be
served, including the number of clients, the length of time services will be
provided, and the medical condition of clients;
(3) the geographic area to
be served;
(4) quality assurance
methods, including appropriate licensure, certification, or standards, and
supervision of employees when needed;
(5) rates for each service
and unit of service exclusive of county lead agency
administrative costs;
(6) evaluation of services
previously delivered by the provider; and
(7) contract or agreement
conditions, including billing requirements, cancellation, and indemnification.
The county lead
agency must evaluate its own agency services under the criteria established
for other providers.
Sec. 40. Minnesota Statutes
2006, section 256B.0913, subdivision 10, is amended to read:
Subd. 10. Allocation formula. (a) The
alternative care appropriation for fiscal years 1992 and beyond shall cover
only alternative care eligible clients. By July 1 15 of each
year, the commissioner shall allocate to county agencies the state funds
available for alternative care for persons eligible under subdivision 2.
(b) The adjusted base for
each county lead agency is the county's lead agency's
current fiscal year base allocation plus any targeted funds approved during the
current fiscal year. Calculations for paragraphs (c) and (d) are to be made as
follows: for each county lead agency, the determination of
alternative care program expenditures shall be based on payments for services
rendered from April 1 through March 31 in the base year, to the extent that
claims have been submitted and paid by June 1 of that year.
(c) If the alternative care
program expenditures as defined in paragraph (b) are 95 percent or more of the county's
lead agency's adjusted base allocation, the allocation for the next fiscal
year is 100 percent of the adjusted base, plus inflation to the extent that
inflation is included in the state budget.
(d) If the alternative care
program expenditures as defined in paragraph (b) are less than 95 percent of
the county's lead agency's adjusted base allocation, the
allocation for the next fiscal year is the adjusted base allocation less the
amount of unspent funds below the 95 percent level.
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(e)
If the annual legislative appropriation for the alternative care program is
inadequate to fund the combined county lead agency allocations
for a biennium, the commissioner shall distribute to each county lead
agency the entire annual appropriation as that county's lead agency's
percentage of the computed base as calculated in paragraphs (c) and (d).
(f)
On agreement between the commissioner and the lead agency, the commissioner may
have discretion to reallocate alternative care base allocations distributed to
lead agencies in which the base amount exceeds program expenditures.
Sec.
41. Minnesota Statutes 2006, section 256B.0913, subdivision 11, is amended to
read:
Subd.
11. Targeted funding. (a) The
purpose of targeted funding is to make additional money available to counties
lead agencies with the greatest need. Targeted funds are not intended to be
distributed equitably among all counties lead agencies, but
rather, allocated to those with long-term care strategies that meet state
goals.
(b)
The funds available for targeted funding shall be the total appropriation for
each fiscal year minus county lead agency allocations determined
under subdivision 10 as adjusted for any inflation increases provided in
appropriations for the biennium.
(c)
The commissioner shall allocate targeted funds to counties lead
agencies that demonstrate to the satisfaction of the commissioner that they
have developed feasible plans to increase alternative care spending. In making
targeted funding allocations, the commissioner shall use the following
priorities:
(1)
counties lead agencies that received a lower allocation in fiscal
year 1991 than in fiscal year 1990. Counties remain in this priority until they
have been restored to their fiscal year 1990 level plus inflation;
(2)
counties lead agencies that sustain a base allocation reduction
for failure to spend 95 percent of the allocation if they demonstrate that the
base reduction should be restored;
(3)
counties lead agencies that propose projects to divert community
residents from nursing home placement or convert nursing home residents to
community living; and
(4)
counties lead agencies that can otherwise justify program growth
by demonstrating the existence of waiting lists, demographically justified
needs, or other unmet needs.
(d)
Counties Lead agencies that would receive targeted funds
according to paragraph (c) must demonstrate to the commissioner's satisfaction
that the funds would be appropriately spent by showing how the funds would be
used to further the state's alternative care goals as described in subdivision
1, and that the county has the administrative and service delivery capability
to use them.
(e)
The commissioner shall request applications make applications
available for targeted funds by November 1 of each year. The counties
lead agencies selected for targeted funds shall be notified of the amount
of their additional funding. Targeted funds allocated to a county
lead agency in one year shall be treated as part of the county's
lead agency's base allocation for that year in determining allocations for
subsequent years. No reallocations between counties lead agencies
shall be made.
Sec.
42. Minnesota Statutes 2006, section 256B.0913, subdivision 12, is amended to
read:
Subd.
12. Client fees. (a) A fee is
required for all alternative care eligible clients to help pay for the cost of
participating in the program. The amount of the fee for the alternative care
client shall be determined as follows:
(1)
when the alternative care client's income less recurring and predictable
medical expenses is less than 100 percent of the federal poverty guideline
effective on July 1 of the state fiscal year in which the fee is being
computed, and total assets are less than $10,000, the fee is zero;
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(2) when the alternative
care client's income less recurring and predictable medical expenses is equal
to or greater than 100 percent but less than 150 percent of the federal poverty
guideline effective on July 1 of the state fiscal year in which the fee is
being computed, and total assets are less than $10,000, the fee is five percent
of the cost of alternative care services;
(3) when the alternative
care client's income less recurring and predictable medical expenses is equal
to or greater than 150 percent but less than 200 percent of the federal poverty
guidelines effective on July 1 of the state fiscal year in which the fee is
being computed and assets are less than $10,000, the fee is 15 percent of the
cost of alternative care services;
(4) when the alternative
care client's income less recurring and predictable medical expenses is equal
to or greater than 200 percent of the federal poverty guidelines effective on
July 1 of the state fiscal year in which the fee is being computed and assets
are less than $10,000, the fee is 30 percent of the cost of alternative care
services; and
(5) when the alternative
care client's assets are equal to or greater than $10,000, the fee is 30
percent of the cost of alternative care services.
For married persons, total
assets are defined as the total marital assets less the estimated community
spouse asset allowance, under section 256B.059, if applicable. For married
persons, total income is defined as the client's income less the monthly
spousal allotment, under section 256B.058.
All alternative care
services shall be included in the estimated costs for the purpose of
determining the fee.
Fees are due and payable
each month alternative care services are received unless the actual cost of the
services is less than the fee, in which case the fee is the lesser amount.
(b) The fee shall be waived
by the commissioner when:
(1) a person who is
residing in a nursing facility is receiving case management only;
(2) a married couple is
requesting an asset assessment under the spousal impoverishment provisions;
(3) a person is found
eligible for alternative care, but is not yet receiving alternative care
services including case management services; or
(4) a person has chosen to
participate in a consumer-directed service plan for which the cost is no
greater than the total cost of the person's alternative care service plan less
the monthly fee amount that would otherwise be assessed.
(c) The county agency
must record in the state's receivable system the client's assessed fee amount
or the reason the fee has been waived. The commissioner will bill and
collect the fee from the client. Money collected must be deposited in the
general fund and is appropriated to the commissioner for the alternative care
program. The client must supply the county lead agency with the
client's Social Security number at the time of application. The county
lead agency shall supply the commissioner with the client's Social Security
number and other information the commissioner requires to collect the fee from
the client. The commissioner shall collect unpaid fees using the Revenue
Recapture Act in chapter 270A and other methods available to the commissioner.
The commissioner may require counties lead agencies to inform
clients of the collection procedures that may be used by the state if a fee is
not paid. This paragraph does not apply to alternative care pilot projects
authorized in Laws 1993, First Special Session chapter 1, article 5, section
133, if a county operating under the pilot project reports the following dollar
amounts to the commissioner quarterly:
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(1) total fees billed to
clients;
(2) total collections of
fees billed; and
(3) balance of fees owed by
clients.
If a county lead
agency does not adhere to these reporting requirements, the commissioner
may terminate the billing, collecting, and remitting portions of the pilot
project and require the county lead agency involved to operate
under the procedures set forth in this paragraph.
Sec. 43. Minnesota Statutes
2006, section 256B.0913, subdivision 13, is amended to read:
Subd. 13. County Lead agency biennial
plan. The county lead agency biennial plan for long-term care
consultation services under section 256B.0911, the alternative care program
under this section, and waivers for the elderly under section 256B.0915, shall
be submitted by the lead agency as the home and community-based services
quality assurance plan on a form provided by the commissioner.
Sec. 44. Minnesota Statutes
2006, section 256B.0913, subdivision 14, is amended to read:
Subd. 14. Provider requirements, payment, and rate
adjustments. (a) Unless otherwise specified in statute, providers must be
enrolled as Minnesota health care program providers and abide by the
requirements for provider participation according to Minnesota Rules, part
9505.0195.
(b) Payment for provided
alternative care services as approved by the client's case manager shall occur
through the invoice processing procedures of the department's Medicaid
Management Information System (MMIS). To receive payment, the county
lead agency or vendor must submit invoices within 12 months following the
date of service. The county lead agency and its vendors under
contract shall not be reimbursed for services which exceed the county
allocation.
(c) The county
lead agency shall negotiate individual rates with vendors and may authorize
service payment for actual costs up to the county's current approved rate.
Notwithstanding any other rule or statutory provision to the contrary, the
commissioner shall not be authorized to increase rates by an annual inflation
factor, unless so authorized by the legislature. To improve access to community
services and eliminate payment disparities between the alternative care program
and the elderly waiver program, the commissioner shall establish statewide
maximum service rate limits and eliminate county-specific service rate limits.
(1) Effective July 1, 2001,
for service rate limits, except those in subdivision 5, paragraphs (d) and (i),
the rate limit for each service shall be the greater of the alternative care
statewide maximum rate or the elderly waiver statewide maximum rate.
(2) Counties Lead
agencies may negotiate individual service rates with vendors for actual
costs up to the statewide maximum service rate limit.
Sec. 45. Minnesota Statutes
2006, section 256B.0915, is amended to read:
256B.0915 MEDICAID WAIVER FOR ELDERLY SERVICES.
Subdivision
1. Authority. The commissioner is
authorized to apply for a home and community-based services waiver for the
elderly, authorized under section 1915(c) of the Social Security Act, in order
to obtain federal financial participation to expand the availability of
services for persons who are eligible for medical assistance. The commissioner
may apply for additional waivers or pursue other federal financial
participation which is advantageous
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to the state for funding
home care services for the frail elderly who are eligible for medical
assistance. The provision of waivered services to elderly and disabled medical
assistance recipients must comply with the criteria for service definitions
and provider standards approved in the waiver.
Subd.
1a. Elderly waiver case management
services. (a) Elderly case management services under the home and community-based
services waiver for elderly individuals are available from providers meeting
qualification requirements and the standards specified in subdivision 1b.
Eligible recipients may choose any qualified provider of elderly case
management services.
Case
management services assist individuals who receive waiver services in gaining
access to needed waiver and other state plan services, as well as needed
medical, social, educational, and other services regardless of the funding
source for the services to which access is gained.
A
case aide shall provide assistance to the case manager in carrying out
administrative activities of the case management function. The case aide may
not assume responsibilities that require professional judgment including assessments,
reassessments, and care plan development. The case manager is responsible for
providing oversight of the case aide.
Case
managers shall be responsible for ongoing monitoring of the provision of
services included in the individual's plan of care. Case managers shall
initiate and oversee the process of assessment and reassessment of the
individual's care and review plan of care at intervals specified in the
federally approved waiver plan.
(b)
The county of service or tribe must provide access to and arrange for case
management services. County of service has the meaning given it in Minnesota
Rules, part 9505.0015, subpart 11.
Subd.
1b. Provider qualifications and
standards. The commissioner must enroll qualified providers of elderly case
management services under the home and community-based waiver for the elderly
under section 1915(c) of the Social Security Act. The enrollment process shall
ensure the provider's ability to meet the qualification requirements and
standards in this subdivision and other federal and state requirements of this
service. An elderly case management provider is an enrolled medical assistance
provider who is determined by the commissioner to have all of the following
characteristics:
(1)
the demonstrated capacity and experience to provide the components of case
management to coordinate and link community resources needed by the eligible
population;
(2)
administrative capacity and experience in serving the target population for
whom it will provide services and in ensuring quality of services under state
and federal requirements;
(3)
a financial management system that provides accurate documentation of services
and costs under state and federal requirements;
(4)
the capacity to document and maintain individual case records under state and
federal requirements; and
(5)
the county lead agency may allow a case manager employed by the county
lead agency to delegate certain aspects of the case management activity
to another individual employed by the county lead agency provided
there is oversight of the individual by the case manager. The case manager may
not delegate those aspects which require professional judgment including
assessments, reassessments, and care plan development. Lead agencies include
counties, health plans, and federally recognized tribes who authorize services
under this section.
Subd. 1c. Case management activities under the state plan. The
commissioner shall seek an amendment to the home and community-based services
waiver for the elderly to implement the provisions of subdivisions 1a and 1b.
If the commissioner is unable to secure the approval of the secretary of health
and human services for the requested waiver amendment by December 31, 1993, the
commissioner shall amend the medical assistance state
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plan to provide that case
management provided under the home and community-based services waiver for the
elderly is performed by counties as an administrative function for the proper
and effective administration of the state medical assistance plan. The state
shall reimburse counties for the nonfederal share of costs for case management
performed as an administrative function under the home and community-based
services waiver for the elderly.
Subd.
1d. Posteligibility treatment of income
and resources for elderly waiver. Notwithstanding the provisions of section
256B.056, the commissioner shall make the following amendment to the medical
assistance elderly waiver program effective July 1, 1999, or upon federal
approval, whichever is later.
A
recipient's maintenance needs will be an amount equal to the Minnesota
supplemental aid equivalent rate as defined in section 256I.03, subdivision 5,
plus the medical assistance personal needs allowance as defined in section
256B.35, subdivision 1, paragraph (a), when applying posteligibility treatment
of income rules to the gross income of elderly waiver recipients, except for
individuals whose income is in excess of the special income standard according
to Code of Federal Regulations, title 42, section 435.236. Recipient
maintenance needs shall be adjusted under this provision each July 1.
Subd.
2. Spousal impoverishment policies.
The commissioner shall seek to amend the federal waiver and the medical
assistance state plan to allow apply:
(1)
the spousal
impoverishment criteria as authorized under United States Code, title 42,
section 1396r-5, and as implemented in sections 256B.0575, 256B.058, and
256B.059, except that the amendment shall seek to add to;
(2)
the
personal needs allowance permitted in section 256B.0575,; and
(3)
an amount
equivalent to the group residential housing rate as set by section 256I.03,
subdivision 5, and according to the approved federal waiver and medical
assistance state plan.
Subd.
3. Limits of cases. The number of
medical assistance waiver recipients that a county lead agency may
serve must be allocated according to the number of medical assistance waiver
cases open on July 1 of each fiscal year. Additional recipients may be served
with the approval of the commissioner.
Subd.
3a. Elderly waiver cost limits. (a)
The monthly limit for the cost of waivered services to an individual elderly
waiver client shall be the weighted average monthly nursing facility rate of
the case mix resident class to which the elderly waiver client would be
assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, less the
recipient's maintenance needs allowance as described in subdivision 1d,
paragraph (a), until the first day of the state fiscal year in which the
resident assessment system as described in section 256B.437 for nursing home
rate determination is implemented. Effective on the first day of the state
fiscal year in which the resident assessment system as described in section
256B.437 for nursing home rate determination is implemented and the first day
of each subsequent state fiscal year, the monthly limit for the cost of
waivered services to an individual elderly waiver client shall be the rate of
the case mix resident class to which the waiver client would be assigned under
Minnesota Rules, parts 9549.0050 to 9549.0059, in effect on the last day of the
previous state fiscal year, adjusted by the greater of any legislatively
adopted home and community-based services percentage rate increase or the
average statewide percentage increase in nursing facility payment rates.
(b)
If extended medical supplies and equipment or environmental modifications are
or will be purchased for an elderly waiver client, the costs may be prorated
for up to 12 consecutive months beginning with the month of purchase. If the
monthly cost of a recipient's waivered services exceeds the monthly limit
established in paragraph (a), the annual cost of all waivered services shall be
determined. In this event, the annual cost of all waivered services shall not
exceed 12 times the monthly limit of waivered services as described in
paragraph (a).
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Subd.
3b. Cost limits for elderly waiver
applicants who reside in a nursing facility. (a) For a person who is a
nursing facility resident at the time of requesting a determination of
eligibility for elderly waivered services, a monthly conversion limit for the
cost of elderly waivered services may be requested. The monthly conversion
limit for the cost of elderly waiver services shall be the resident class
assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, for that resident
in the nursing facility where the resident currently resides until July 1 of
the state fiscal year in which the resident assessment system as described in
section 256B.437 for nursing home rate determination is implemented. Effective
on July 1 of the state fiscal year in which the resident assessment system as
described in section 256B.437 for nursing home rate determination is
implemented, the monthly conversion limit for the cost of elderly waiver
services shall be the per diem nursing facility rate as determined by the
resident assessment system as described in section 256B.437 for that resident
in the nursing facility where the resident currently resides multiplied by 365
and divided by 12, less the recipient's maintenance needs allowance as
described in subdivision 1d. The initially approved conversion rate may be
adjusted by the greater of any subsequent legislatively adopted home and
community-based services percentage rate increase or the average statewide
percentage increase in nursing facility payment rates. The limit under this subdivision
only applies to persons discharged from a nursing facility after a minimum
30-day stay and found eligible for waivered services on or after July 1, 1997. For
conversions from the nursing home to the elderly waiver with consumer directed
community support services, the conversion rate limit is equal to the nursing
facility rate reduced by a percentage equal to the percentage difference
between the consumer directed services budget limit that would be assigned
according to the federally approved waiver plan and the corresponding community
case mix cap, but not to exceed 50 percent.
(b)
The following costs must be included in determining the total monthly costs for
the waiver client:
(1)
cost of all waivered services, including extended medical supplies and
equipment and environmental modifications and adaptations; and
(2)
cost of skilled nursing, home health aide, and personal care services
reimbursable by medical assistance.
Subd. 3c. Service approval and contracting
provisions. (a) Medical assistance funding for skilled nursing services,
private duty nursing, home health aide, and personal care services for waiver
recipients must be approved by the case manager and included in the individual
care plan.
(b) A county lead
agency is not required to contract with a provider of supplies and
equipment if the monthly cost of the supplies and equipment is less than $250.
Subd. 3d. Adult foster care rate. The adult
foster care rate shall be considered a difficulty of care payment and shall not
include room and board. The adult foster care service rate shall be negotiated
between the county lead agency and the foster care provider. The
elderly waiver payment for the foster care service in combination with the
payment for all other elderly waiver services, including case management, must
not exceed the limit specified in subdivision 3a, paragraph (a).
Subd. 3e. Assisted living Customized living
service rate. (a) Payment for assisted living service customize
living services shall be a monthly rate negotiated and authorized by the county
agency based on an individualized service plan for each resident and may not
cover direct rent or food costs. lead agency within the parameters
established by the commissioner. The payment agreement must delineate the
services that have been customized for each recipient and specify the amount of
each service to be provided. The lead agency shall ensure that there is a
documented need for all services authorized. Customized living services must
not include rent or raw food costs. The negotiated payment rate must be based
on services to be provided. Negotiated rates must not exceed payment rates for
comparable elderly waiver or medical assistance services and must reflect
economies of scale.
(b) The individualized
monthly negotiated payment for assisted living customized living services
as described in section 256B.0913, subdivisions 5d to 5f, and residential
care services as described in section 256B.0913, subdivision 5c, shall not
exceed the nonfederal share, in effect on July 1 of the state fiscal year for
which the rate
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limit is being calculated,
of the greater of either the statewide or any of the geographic groups'
weighted average monthly nursing facility rate of the case mix resident class
to which the elderly waiver eligible client would be assigned under Minnesota
Rules, parts 9549.0050 to 9549.0059, less the maintenance needs allowance as
described in subdivision 1d, paragraph (a), until the July 1 of the state
fiscal year in which the resident assessment system as described in section
256B.437 for nursing home rate determination is implemented. Effective on July
1 of the state fiscal year in which the resident assessment system as described
in section 256B.437 for nursing home rate determination is implemented and July
1 of each subsequent state fiscal year, the individualized monthly negotiated
payment for the services described in this clause shall not exceed the limit
described in this clause which was in effect on June 30 of the previous state
fiscal year and which has been adjusted by the greater of any legislatively
adopted home and community-based services cost-of-living percentage increase or
any legislatively adopted statewide percent rate increase for nursing
facilities.
(c) The individualized
monthly negotiated payment for assisted Customized living services described
in section 144A.4605 and are delivered by a provider licensed by the
Department of Health as a class A or class F home care provider or an
assisted living home care provider and provided in a building that is
registered as a housing with services establishment under chapter 144D and
that provides 24-hour supervision in combination with the payment for other
elderly waiver services, including case management, must not exceed the limit
specified in subdivision 3a.
Subd. 3f. Individual service rates; expenditure
forecasts. (a) The county lead agency shall negotiate
individual service rates with vendors and may authorize payment for actual
costs up to the county's lead agency's current approved rate.
Persons or agencies must be employed by or under a contract with the county
lead agency or the public health nursing agency of the local board of
health in order to receive funding under the elderly waiver program, except as
a provider of supplies and equipment when the monthly cost of the supplies and
equipment is less than $250.
(b) Reimbursement for the
medical assistance recipients under the approved waiver shall be made from the
medical assistance account through the invoice processing procedures of the
department's Medicaid Management Information System (MMIS), only with the
approval of the client's case manager. The budget for the state share of the
Medicaid expenditures shall be forecasted with the medical assistance budget,
and shall be consistent with the approved waiver.
Subd. 3g. Service rate limits; state assumption of
costs. (a) To improve access to community services and eliminate payment
disparities between the alternative care program and the elderly waiver, the
commissioner shall establish statewide maximum service rate limits and
eliminate county-specific lead agency-specific service rate
limits.
(b) Effective July 1, 2001,
for service rate limits, except those described or defined in subdivisions 3d
and 3e, the rate limit for each service shall be the greater of the alternative
care statewide maximum rate or the elderly waiver statewide maximum rate.
(c) Counties Lead
agencies may negotiate individual service rates with vendors for actual
costs up to the statewide maximum service rate limit.
Subd. 3h. Service rate limits; 24-hour customized living services. The
payment rates for 24-hour customized living services is a monthly rate
negotiated and authorized by the lead agency within the parameters established
by the commissioner of human services. The payment agreement must delineate the
services that have been customized for each recipient and specify the amount of
each service to be provided. The lead agency shall ensure that there is a
documented need for all services authorized. The lead agency shall not
authorize 24-hour customized living services unless there is a documented need
for 24-hour supervision. For purposes of this section, "24-hour
supervision" means that the recipient requires assistance due to needs
related to one or more of the following:
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(1) intermittent assistance
with toileting or transferring;
(2) cognitive or behavioral
issues;
(3) a medical condition that
requires clinical monitoring; or
(4) other conditions or
needs as defined by the commissioner of human services. The lead agency shall
ensure that the frequency and mode of supervision of the recipient and the
qualifications of staff providing supervision are described and meet the needs
of the recipient. Customized living services must not include rent or raw food
costs. The negotiated payment rate for 24-hour customized living services must
be based on services to be provided. Negotiated rates must not exceed payment
rates for comparable elderly waiver or medical assistance services and must
reflect economies of scale. The individually negotiated 24-hour customized
living payments, in combination with the payment for other elderly waiver
services, including case management, must not exceed the recipient's community
budget cap specified in subdivision 3a.
Subd. 4. Termination notice. The case manager
must give the individual a ten-day written notice of any denial, reduction, or
termination of waivered services.
Subd. 5. Assessments and reassessments for waiver
clients. Each client shall receive an initial assessment of strengths,
informal supports, and need for services in accordance with section 256B.0911,
subdivisions 3, 3a, and 3b. A reassessment of a client served under the elderly
waiver must be conducted at least every 12 months and at other times when the
case manager determines that there has been significant change in the client's
functioning. This may include instances where the client is discharged from the
hospital.
Subd. 6. Implementation of care plan. Each elderly
waiver client shall be provided a copy of a written care plan that meets the
requirements outlined in section 256B.0913, subdivision 8. The care plan must
be implemented by the county administering waivered services of
service when it is different than the county of financial responsibility.
The county of service administering waivered services must notify the
county of financial responsibility of the approved care plan.
Subd. 7. Prepaid elderly waiver services. An
individual for whom a prepaid health plan is liable for nursing home services
or elderly waiver services according to section 256B.69, subdivision 6a, is not
eligible to also receive county-administered elderly waiver services under
this section.
Subd. 8. Services and supports. (a) Services and
supports shall meet the requirements set out in United States Code, title 42,
section 1396n.
(b) Services and supports
shall promote consumer choice and be arranged and provided consistent with
individualized, written care plans.
(c) The state of Minnesota,
county, managed care organization, or tribal government under contract
to administer the elderly waiver shall not be liable for damages, injuries, or
liabilities sustained through the purchase of direct supports or goods by the
person, the person's family, or the authorized representatives with funds
received through consumer-directed community support services under the
federally approved waiver plan. Liabilities include, but are not limited to,
workers' compensation liability, the Federal Insurance Contributions Act
(FICA), or the Federal Unemployment Tax Act (FUTA).
Subd.
9. Tribal management of elderly waiver.
Notwithstanding contrary provisions of this section, or those in other state
laws or rules, the commissioner may develop a model for tribal management of
the elderly waiver program and implement this model through a contract between
the state and any of the state's federally recognized
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tribal governments. The
model shall include the provision of tribal waiver case management, assessment
for personal care assistance, and administrative requirements otherwise carried
out by counties lead agencies but shall not include tribal
financial eligibility determination for medical assistance.
EFFECTIVE DATE. Subdivision 3h is
effective the day following final enactment.
Sec.
46. Minnesota Statutes 2006, section 256B.0917, subdivision 8, is amended to
read:
Subd.
8. Living-at-home/block nurse program
grant. (a) The organization awarded the contract under subdivision 7, shall
develop and administer a grant program to establish or expand up to 33 51
community-based organizations that will implement living-at-home/block
nurse programs that are designed to enable senior citizens to live as
independently as possible in their homes and in their communities. At least
one-half of the programs must be in counties outside the seven-county
metropolitan area. Nonprofit organizations and units of local government are
eligible to apply for grants to establish the community organizations that will
implement living-at-home/block nurse programs. In awarding grants, the
organization awarded the contract under subdivision 7 shall give preference to
nonprofit organizations and units of local government from communities that:
(1)
have high nursing home occupancy rates;
(2)
have a shortage of health care professionals;
(3)
are located in counties adjacent to, or are located in, counties with existing
living-at-home/block nurse programs; and
(4)
meet other criteria established by LAH/BN, Inc., in consultation with the
commissioner.
(b)
Grant applicants must also meet the following criteria:
(1)
the local community demonstrates a readiness to establish a community model of
care, including the formation of a board of directors, advisory committee, or
similar group, of which at least two-thirds is comprised of community citizens
interested in community-based care for older persons;
(2)
the program has sponsorship by a credible, representative organization within
the community;
(3)
the program has defined specific geographic boundaries and defined its
organization, staffing and coordination/delivery of services;
(4)
the program demonstrates a team approach to coordination and care, ensuring
that the older adult participants, their families, the formal and informal
providers are all part of the effort to plan and provide services; and
(5)
the program provides assurances that all community resources and funding will
be coordinated and that other funding sources will be maximized, including a
person's own resources.
(c)
Grant applicants must provide a minimum of five percent of total estimated
development costs from local community funding. Grants shall be awarded for
four-year periods, and the base amount shall not exceed $80,000
$100,000 per applicant for the grant period. The organization under
contract may increase the grant amount for applicants from communities that
have socioeconomic characteristics that indicate a higher level of need for
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assistance. Subject to the
availability of funding, grants and grant renewals awarded or entered into on
or after July 1, 1997, shall be renewed by LAH/BN, Inc. every four years,
unless LAH/BN, Inc. determines that the grant recipient has not satisfactorily
operated the living-at-home/block nurse program in compliance with the
requirements of paragraphs (b) and (d). Grants provided to living-at-home/block
nurse programs under this paragraph may be used for both program development
and the delivery of services.
(d)
Each living-at-home/block nurse program shall be designed by representatives of
the communities being served to ensure that the program addresses the specific
needs of the community residents. The programs must be designed to:
(1)
incorporate the basic community, organizational, and service delivery
principles of the living-at-home/block nurse program model;
(2)
provide senior citizens with registered nurse directed assessment, provision
and coordination of health and personal care services on a sliding fee basis as
an alternative to expensive nursing home care;
(3)
provide information, support services, homemaking services, counseling, and
training for the client and family caregivers;
(4)
encourage the development and use of respite care, caregiver support, and
in-home support programs, such as adult foster care and in-home adult day care;
(5)
encourage neighborhood residents and local organizations to collaborate in
meeting the needs of senior citizens in their communities;
(6)
recruit, train, and direct the use of volunteers to provide informal services
and other appropriate support to senior citizens and their caregivers; and
(7)
provide coordination and management of formal and informal services to senior
citizens and their families using less expensive alternatives.
Sec.
47. Minnesota Statutes 2006, section 256B.0919, subdivision 3, is amended to
read:
Subd.
3. County certification of persons
providing adult foster care to related persons. A person exempt from
licensure under section 245A.03, subdivision 2, who provides adult foster care
to a related individual age 65 and older, and who meets the requirements in
Minnesota Rules, parts 9555.5105 to 9555.6265, may be certified by the county
to provide adult foster care. A person certified by the county to provide adult
foster care may be reimbursed for services provided and eligible for funding
under sections 256B.0913 and section 256B.0915, if the relative
would suffer a financial hardship as a result of providing care. For purposes
of this subdivision, financial hardship refers to a situation in which a
relative incurs a substantial reduction in income as a result of resigning from
a full-time job or taking a leave of absence without pay from a full-time job
to care for the client.
Sec.
48. Minnesota Statutes 2006, section 256B.095, is amended to read:
256B.095 QUALITY ASSURANCE
SYSTEM ESTABLISHED.
(a)
Effective July 1, 1998, a quality assurance system for persons with
developmental disabilities, which includes an alternative quality assurance licensing
system for programs, is established in Dodge, Fillmore, Freeborn, Goodhue,
Houston, Mower, Olmsted, Rice, Steele, Wabasha, and Winona Counties for the
purpose of improving the quality of services provided to persons with
developmental disabilities. A county, at its option, may choose to have all
programs for persons with developmental disabilities located within the county
licensed under chapter 245A using standards determined under the alternative
quality assurance licensing system or may continue regulation of these programs
under the licensing system operated by the commissioner. The project expires on
June 30, 2009 2014.
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(b) Effective July 1, 2003, a
county not listed in paragraph (a) may apply to participate in the quality
assurance system established under paragraph (a). The commission established
under section 256B.0951 may, at its option, allow additional counties to
participate in the system.
(c) Effective July 1, 2003,
any county or group of counties not listed in paragraph (a) may establish a
quality assurance system under this section. A new system established under
this section shall have the same rights and duties as the system established under
paragraph (a). A new system shall be governed by a commission under section
256B.0951. The commissioner shall appoint the initial commission members based
on recommendations from advocates, families, service providers, and counties in
the geographic area included in the new system. Counties that choose to
participate in a new system shall have the duties assigned under section
256B.0952. The new system shall establish a quality assurance process under
section 256B.0953. The provisions of section 256B.0954 shall apply to a new
system established under this paragraph. The commissioner shall delegate
authority to a new system established under this paragraph according to section
256B.0955.
(d) Effective July 1, 2007,
the quality assurance system may be expanded to include programs for persons
with disabilities and older adults.
Sec. 49. Minnesota Statutes
2006, section 256B.0951, subdivision 1, is amended to read:
Subdivision 1. Membership. The Quality Assurance
Commission is established. The commission consists of at least 14 but not more
than 21 members as follows: at least three but not more than five members
representing advocacy organizations; at least three but not more than five
members representing consumers, families, and their legal representatives; at
least three but not more than five members representing service providers; at
least three but not more than five members representing counties; and the
commissioner of human services or the commissioner's designee. The first
commission shall establish membership guidelines for the transition and
recruitment of membership for the commission's ongoing existence. Members of
the commission who do not receive a salary or wages from an employer for time
spent on commission duties may receive a per diem payment when performing
commission duties and functions. All members may be reimbursed for expenses
related to commission activities. Notwithstanding the provisions of section
15.059, subdivision 5, the commission expires on June 30, 2009 2014.
Sec. 50. [256B.096] QUALITY MANAGEMENT;
ASSURANCE; AND IMPROVEMENT SYSTEM FOR MINNESOTANS RECEIVING DISABILITY
SERVICES.
Subdivision 1. Scope. In order to improve the quality of services
provided to Minnesotans with disabilities and to meet the requirements of the federally
approved home and community-based waivers under section 1915c of the Social
Security Act, a statewide quality assurance and improvement system for
Minnesotans receiving disability services shall be developed. The disability
services included are the home and community-based services waiver programs for
persons with developmental disabilities under section 256B.092, subdivision 4,
and persons with disabilities under section 256B.49.
Subd. 2. Stakeholder advisory group. The commissioner shall consult
with a stakeholder advisory group on the development and implementation of the
state quality management, assurance, and improvement system, including
representatives from: disability service recipients, disability service
providers, disability advocacy groups, county human service agencies, and state
agency staff from the Departments of Human Services and Health and ombudsman
for mental health and developmental disabilities on the development of a
statewide quality assurance and improvement system.
Subd. 3. Annual survey of service recipients. The commissioner, in
consultation with the stakeholder advisory group, shall develop and conduct an
annual independent random statewide survey of between five and ten percent of
service recipients to determine the effectiveness and quality of disability
services. The survey shall be consistent with the system performance
expectations of the Centers for Medicare and Medicaid Services quality
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management requirements and
framework. The survey shall analyze whether desired outcomes have been achieved
for persons with different demographic, diagnostic, health, and functional needs
and receiving different types of services, in different settings, with
different costs. The survey shall be field tested during 2008 and implemented
by February 1, 2009. Annual statewide and regional reports of the results shall
be published for use by regions, counties, and providers to plan and measure
the impact of quality improvement activities.
Subd. 4. Improvements for incident reporting, investigation, analysis, and
follow-up. In consultation with the stakeholder advisory group, the
commissioner shall identify the information, data sources, and technology
needed to improve the system of incident reporting, including:
(1) reports made under the
Maltreatment of Minors and Vulnerable Adults Acts; and
(2) investigation, analysis,
and follow-up for disability services.
The commissioner must ensure
that the federal home and community-based waiver requirements are met and that
incidents that may have jeopardized safety; health; or violated service-related
assurances, civil and human rights, and other protections designed to prevent
abuse, neglect, and exploitation are reviewed, investigated, and acted upon in
a timely manner.
Subd. 5. Biennial report. The commissioner shall provide a
biennial report to the chairs of the legislative committees with jurisdiction
over health and human services policy and funding beginning January 15, 2009,
on the development and activities of the quality management, assurance, and
improvement system designed to meet the federal requirements under the home and
community-based services waiver programs for persons with disabilities. By
January 15, 2008, the commissioner shall provide a preliminary report on the
priorities for meeting the federal requirements, progress on the annual survey,
recommendations for improvements in the incident reporting system, and a plan
for incorporating the quality assurance efforts under section 256B.095 and
other regional efforts into the statewide system.
Sec. 51. Minnesota Statutes
2006, section 256B.431, subdivision 1, is amended to read:
Subdivision 1. In general. The commissioner shall
determine prospective payment rates for resident care costs. For rates
established on or after July 1, 1985, the commissioner shall develop procedures
for determining operating cost payment rates that take into account the mix of
resident needs, geographic location, and other factors as determined by the
commissioner. The commissioner shall consider whether the fact that a facility
is attached to a hospital or has an average length of stay of 180 days or less
should be taken into account in determining rates. The commissioner shall
consider the use of the standard metropolitan statistical areas when developing
groups by geographic location. The commissioner shall provide notice to each
nursing facility on or before May 1 August 15 of the rates
effective for the following rate year except that if legislation is pending on May
1 August 15 that may affect rates for nursing facilities, the
commissioner shall set the rates after the legislation is enacted and provide
notice to each facility as soon as possible.
Compensation for top
management personnel shall continue to be categorized as a general and
administrative cost and is subject to any limits imposed on that cost category.
Sec. 52. Minnesota Statutes
2006, section 256B.431, subdivision 2e, is amended to read:
Subd. 2e. Contracts for services for
ventilator-dependent persons. (a) The commissioner may negotiate
with a nursing facility eligible to receive medical assistance payments to provide
services to a ventilator-dependent person identified by the commissioner
according to criteria developed by the commissioner, including:
(1) nursing facility care
has been recommended for the person by a preadmission screening team;
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(2) the person has been
hospitalized and no longer requires inpatient acute care hospital services; and
(3) the commissioner has determined
that necessary services for the person cannot be provided under existing
nursing facility rates.
The commissioner may
negotiate an adjustment to the operating cost payment rate for a nursing
facility with a resident who is ventilator-dependent, for that resident. The
negotiated adjustment must reflect only the actual additional cost of meeting
the specialized care needs of a ventilator-dependent person identified by the
commissioner for whom necessary services cannot be provided under existing nursing
facility rates and which are not otherwise covered under Minnesota Rules, parts
9549.0010 to 9549.0080 or 9505.0170 to 9505.0475. For persons who are initially
admitted to a nursing facility before July 1, 2001, and have their payment rate
under this subdivision negotiated after July 1, 2001, the negotiated payment
rate must not exceed 200 percent of the highest multiple bedroom payment rate
for the facility, as initially established by the commissioner for the rate
year for case mix classification K; or, upon implementation of the RUG's-based
case mix system, 200 percent of the highest RUG's rate. For persons initially
admitted to a nursing facility on or after July 1, 2001, the negotiated payment
rate must not exceed 300 percent of the facility's multiple bedroom payment
rate for case mix classification K; or, upon implementation of the RUG's-based
case mix system, 300 percent of the highest RUG's rate. The negotiated
adjustment shall not affect the payment rate charged to private paying
residents under the provisions of section 256B.48, subdivision 1.
(b) Effective July 1, 2007,
or upon opening a unit of at least ten beds dedicated to care of
ventilator-dependent persons in partnership with Mayo Health Systems, whichever
is later, the operating payment rates for residents determined eligible under
paragraph (a) of a nursing facility in Waseca County that on February 1, 2007,
was licensed for 70 beds and reimbursed under this section, section 256B.434,
or section 256B.441, shall be 300 percent of the facility's highest RUG rate.
Sec. 53. Minnesota Statutes
2006, section 256B.431, subdivision 3f, is amended to read:
Subd. 3f. Property costs after July 1, 1988. (a) Investment per bed limit. For the rate
year beginning July 1, 1988, the replacement-cost-new per bed limit must be
$32,571 per licensed bed in multiple bedrooms and $48,857 per licensed bed in a
single bedroom. For the rate year beginning July 1, 1989, the
replacement-cost-new per bed limit for a single bedroom must be $49,907
adjusted according to Minnesota Rules, part 9549.0060, subpart 4, item A,
subitem (1). Beginning January 1, 1990, the replacement-cost-new per bed limits
must be adjusted annually as specified in Minnesota Rules, part 9549.0060,
subpart 4, item A, subitem (1). Beginning January 1, 1991, the
replacement-cost-new per bed limits will be adjusted annually as specified in
Minnesota Rules, part 9549.0060, subpart 4, item A, subitem (1), except that
the index utilized will be the Bureau of the Census: Composite
fixed-weighted price index as published in the C30 Report, Value of New
Construction Put in Place Economic Analysis: Price Indexes for Private
Fixed Investments in Structures; Special Care.
(b) Rental factor. For the rate year beginning July 1, 1988, the
commissioner shall increase the rental factor as established in Minnesota
Rules, part 9549.0060, subpart 8, item A, by 6.2 percent rounded to the nearest
100th percent for the purpose of reimbursing nursing facilities for soft costs
and entrepreneurial profits not included in the cost valuation services used by
the state's contracted appraisers. For rate years beginning on or after July 1,
1989, the rental factor is the amount determined under this paragraph for the
rate year beginning July 1, 1988.
(c) Occupancy factor. For rate years beginning on or after July 1,
1988, in order to determine property-related payment rates under Minnesota
Rules, part 9549.0060, for all nursing facilities except those whose average
length of stay in a skilled level of care within a nursing facility is 180 days
or less, the commissioner shall use 95 percent of capacity days. For a nursing
facility whose average length of stay in a skilled level of care within a
nursing facility is 180 days or less, the commissioner shall use the greater of
resident days or 80 percent of capacity days but in no event shall the divisor
exceed 95 percent of capacity days.
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(d) Equipment allowance. For rate years beginning on July 1, 1988, and
July 1, 1989, the commissioner shall add ten cents per resident per day to each
nursing facility's property-related payment rate. The ten-cent property-related
payment rate increase is not cumulative from rate year to rate year. For the
rate year beginning July 1, 1990, the commissioner shall increase each nursing
facility's equipment allowance as established in Minnesota Rules, part
9549.0060, subpart 10, by ten cents per resident per day. For rate years
beginning on or after July 1, 1991, the adjusted equipment allowance must be
adjusted annually for inflation as in Minnesota Rules, part 9549.0060, subpart
10, item E. For the rate period beginning October 1, 1992, the equipment
allowance for each nursing facility shall be increased by 28 percent. For rate
years beginning after June 30, 1993, the allowance must be adjusted annually
for inflation.
(e) Post chapter 199 related-organization debts and interest expense. For
rate years beginning on or after July 1, 1990, Minnesota Rules, part 9549.0060,
subpart 5, item E, shall not apply to outstanding related organization debt
incurred prior to May 23, 1983, provided that the debt was an allowable debt
under Minnesota Rules, parts 9510.0010 to 9510.0480, the debt is subject to
repayment through annual principal payments, and the nursing facility
demonstrates to the commissioner's satisfaction that the interest rate on the
debt was less than market interest rates for similar arm's-length transactions
at the time the debt was incurred. If the debt was incurred due to a sale
between family members, the nursing facility must also demonstrate that the
seller no longer participates in the management or operation of the nursing
facility. Debts meeting the conditions of this paragraph are subject to all
other provisions of Minnesota Rules, parts 9549.0010 to 9549.0080.
(f) Building capital allowance for nursing facilities with operating
leases. For rate years beginning on or after July 1, 1990, a nursing
facility with operating lease costs incurred for the nursing facility's
buildings shall receive its building capital allowance computed in accordance
with Minnesota Rules, part 9549.0060, subpart 8. If an operating lease provides
that the lessee's rent is adjusted to recognize improvements made by the lessor
and related debt, the costs for capital improvements and related debt shall be
allowed in the computation of the lessee's building capital allowance, provided
that reimbursement for these costs under an operating lease shall not exceed
the rate otherwise paid.
Sec. 54. Minnesota Statutes
2006, section 256B.431, subdivision 17e, is amended to read:
Subd. 17e. Replacement-costs-new per bed limit
effective July 1, 2001. Notwithstanding Minnesota Rules, part 9549.0060,
subpart 11, item C, subitem (2), for a total replacement, as defined in paragraph
(f) subdivision 17d, authorized under section 144A.071 or 144A.073
after July 1, 1999, or any building project that is a relocation, renovation,
upgrading, or conversion completed on or after July 1, 2001, the
replacement-costs-new per bed limit shall be $74,280 per licensed bed in
multiple-bed rooms, $92,850 per licensed bed in semiprivate rooms with a fixed
partition separating the resident beds, and $111,420 per licensed bed in single
rooms. Minnesota Rules, part 9549.0060, subpart 11, item C, subitem (2), does
not apply. These amounts must be adjusted annually as specified in subdivision
3f, paragraph (a), beginning January 1, 2000.
Sec. 55. Minnesota Statutes
2006, section 256B.434, subdivision 4, is amended to read:
Subd. 4. Alternate rates for nursing facilities.
(a) For nursing facilities which have their payment rates determined under this
section rather than section 256B.431, the commissioner shall establish a rate
under this subdivision. The nursing facility must enter into a written contract
with the commissioner.
(b) A nursing facility's
case mix payment rate for the first rate year of a facility's contract under
this section is the payment rate the facility would have received under section
256B.431.
(c) A nursing facility's
case mix payment rates for the second and subsequent years of a facility's
contract under this section are the previous rate year's contract payment rates
plus an inflation adjustment and, for facilities reimbursed under this section
or section 256B.431, an adjustment to include the cost of any increase in
Health
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Department licensing fees
for the facility taking effect on or after July 1, 2001. The index for the
inflation adjustment must be based on the change in the Consumer Price
Index-all items (United States City average) (CPI-U) forecasted by the
commissioner of finance's national economic consultant, as forecasted in the
fourth quarter of the calendar year preceding the rate year. The inflation
adjustment must be based on the 12-month period from the midpoint of the
previous rate year to the midpoint of the rate year for which the rate is being
determined. For the rate years beginning on July 1, 1999, July 1, 2000, July 1,
2001, July 1, 2002, July 1, 2003, July 1, 2004, July 1, 2005, July 1, 2006,
July 1, 2007, and July 1, 2008, July 1, 2009, and July 1, 2010,
this paragraph shall apply only to the property-related payment rate, except
that adjustments to include the cost of any increase in Health Department
licensing fees taking effect on or after July 1, 2001, shall be provided.
Beginning in 2005, adjustment to the property payment rate under this section
and section 256B.431 shall be effective on October 1. In determining the amount
of the property-related payment rate adjustment under this paragraph, the
commissioner shall determine the proportion of the facility's rates that are
property-related based on the facility's most recent cost report.
(d) The commissioner shall
develop additional incentive-based payments of up to five percent above a
facility's operating payment rate for achieving outcomes specified in a
contract. The commissioner may solicit contract amendments and implement those
which, on a competitive basis, best meet the state's policy objectives. The
commissioner shall limit the amount of any incentive payment and the number of
contract amendments under this paragraph to operate the incentive payments
within funds appropriated for this purpose. The contract amendments may specify
various levels of payment for various levels of performance. Incentive payments
to facilities under this paragraph may be in the form of time-limited rate
adjustments or onetime supplemental payments. In establishing the specified
outcomes and related criteria, the commissioner shall consider the following
state policy objectives:
(1) successful diversion or
discharge of residents to the residents' prior home or other community-based
alternatives;
(2) adoption of new
technology to improve quality or efficiency;
(3) improved quality as
measured in the Nursing Home Report Card;
(4) reduced acute care
costs; and
(5) any additional outcomes
proposed by a nursing facility that the commissioner finds desirable.
(e) Notwithstanding the
threshold in section 256B.431, subdivision 16, facilities that take action to
come into compliance with existing or pending requirements of the life safety code
provisions or other federal regulations governing sprinkler systems shall
receive reimbursement for the costs associated with compliance if all of the
following conditions are met:
(1) the expenses associated
with compliance occurred on or after January 1, 2005, and before December 31,
2008;
(2) the costs were not
otherwise reimbursed under section 144A.071, 144A.073, or 256B.434, subdivision
4f; and
(3) the total allowable
costs reported under this paragraph are less than the minimum threshold established
under section 256B.431, subdivisions 15, paragraph (e), and 16.
The commissioner shall use
funds appropriated for this purpose to provide to qualifying nursing facilities
a rate adjustment beginning October 1, 2007, and ending September 30, 2008. Nursing
facilities that have expended funds or anticipate the need to expend funds to
satisfy the most recent life safety code requirements by (1) installing a
sprinkler system or (2) replacing all or portions of an existing sprinkler
system may submit to the commissioner by
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June 30, 2007, on a form
provided by the commissioner the actual costs of a completed project or the
estimated costs, based on a project bid, of a planned project. The commissioner
shall calculate a rate adjustment equal to the allowable costs of the project
divided by the resident days reported for the report year ending September 30,
2006. If the costs from all projects exceed the appropriation for this purpose,
the commissioner shall allocate the funds appropriated on a pro rata basis to
the qualifying facilities by reducing the rate adjustment determined for each
facility by an equal percentage. If the rate adjustments under this subdivision
are reduced to fit the appropriation, facilities may include the portion of the
costs that are not reimbursed by the rate adjustment as part of a project that
meets the requirements of subdivision 4f. If the commissioner determines that
there are any unexpended funds for the purposes of this paragraph, the
commissioner may allocate the remainder of the funds to the qualifying
facilities on a pro rata basis for other physical plant changes required by the
nursing facility in order to meet the most recent life safety code compliance
standards. Facilities that used estimated costs when requesting the rate
adjustment shall report to the commissioner by January 31, 2009, on the use of
these funds on a form provided by the commissioner. If the nursing facility
fails to provide the report, the commissioner shall recoup the funds
appropriated to the facility for this purpose. If the facility reports
expenditures allowable under this subdivision that are less than the amount
received in the facility's annualized rate adjustment, the commissioner shall
recoup the difference.
Sec.
56. Minnesota Statutes 2006, section 256B.434, is amended by adding a
subdivision to read:
Subd.
4i. Nursing facility rate increase effective
October 1, 2007; Hennepin County. For the rate year beginning October
1, 2007, the commissioner shall provide to a nursing facility in Hennepin
County licensed for 268 beds as of February 1, 2007, an increase in the
property payment rate of $6.52 per resident per day. The increase under this
subdivision must be added following the determination under this chapter of the
payment rate for the rate year beginning October 1, 2007, and must be included
in the facility's total payment rate for purposes of determining future rates
under this section or any other section.
Sec.
57. Minnesota Statutes 2006, section 256B.434, is amended by adding a
subdivision to read:
Subd.
4j. Rate increase for facilities in Chisago
County. Effective October 1, 2007, operating payment rates of all
nursing facilities in Chisago County that are reimbursed under this section or
section 256B.441 shall be increased to be equal, for a RUG's rate with a weight
of 1.00, to the geographic group III median rate for the same RUG's weight. The
percentage of the operating payment rate for each facility to be case-mix
adjusted shall be equal to the percentage that is case-mix adjusted in that
facility's September 30, 2007, operating payment rate. This subdivision applies
only if it results in a rate increase. Increases provided by this subdivision
shall be added to the rate determined under any new reimbursement system
established under section 256B.441.
Sec.
58. Minnesota Statutes 2006, section 256B.434, is amended by adding a
subdivision to read:
Subd.
4k. Nursing facility rate increase effective
January 1, 2008; Hennepin County. Effective January 1, 2008, a
nursing facility in Hennepin County licensed for 137 beds as of February 1,
2007, shall receive an increase of $2.81 in each case mix payment rate to
offset property tax payments due as a result of the facility's conversion from
nonprofit to for-profit status. The increase under this subdivision must be
added following the determination under this chapter of the payment rate for
the rate year beginning October 1, 2007, and must be included in the facility's
total payment rate for the purposes of determining future rates under this
section or any other section.
Sec.
59. Minnesota Statutes 2006, section 256B.434, is amended by adding a
subdivision to read:
Subd.
4l. Property rate adjustment; Kanabec
County. The commissioner shall allow a property rate adjustment for
a facility located in Kanabec County that was approved for a moratorium
exception project in 2001, but experienced a delay and additional costs
associated with the project, and completed the project in 2005. The
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property payment rate for
the rate years beginning October 1, 2007, and ending September 30, 2009, must
be $22.73 per resident day. For subsequent years, the property rate of $22.73
per resident day shall be adjusted as provided in subdivision 4, paragraph (c),
as long as the facility has a contract under this section.
Sec.
60. Minnesota Statutes 2006, section 256B.434, is amended by adding a subdivision
to read:
Subd.
4m. Rate increase for facilities in Rice
County. Effective July 1, 2007, operating payment rates of nursing
facilities in Rice County located within two miles of Scott County or Dakota
County that are reimbursed under this section or section 256B.441 must be
increased to be equal, for a RUG's rate with a weight of 1.00, to the
geographic group III median rate for the same RUG's weight. The percentage of
the operating payment rate for each facility to be case-mix adjusted must be
equal to the percentage that is case-mix adjusted in that facility's June 30,
2006, operating payment rate. This subdivision applies only if it results in a
rate increase.
Sec.
61. Minnesota Statutes 2006, section 256B.434, is amended by adding a
subdivision to read:
Subd.
4n. Facility rate increase. For
the rate year beginning October 1, 2007, a nursing facility in Faribault County
licensed for 50 beds as of April 19, 2006, shall receive a rate increase of
$2.64 in each case mix payment rate to offset property tax payments due as a
result of the facility's conversion from nonprofit to for-profit status. The
increase under this subdivision shall be added to the payment rates in effect
for the facility on September 30, 2007, and shall be included in the facility's
total payment rates for the purposes of determining future rates under this
section or any other section.
Sec.
62. Minnesota Statutes 2006, section 256B.434, is amended by adding a
subdivision to read:
Subd.
19. Nursing facility rate increases beginning
October 1, 2007, and October 1, 2008. (a) For the rate year
beginning October 1, 2007, the commissioner shall make available to each
nursing facility reimbursed under this section operating payment rate
adjustments equal to three percent of the operating payment rates in effect on
September 30, 2007. For the rate year beginning October 1, 2008, the
commissioner shall make available to each nursing facility reimbursed under
this section operating payment rate adjustments equal to three percent of the
operating payment rates in effect on September 30, 2008.
(b)
Seventy-five percent of the money resulting from the rate adjustments under
paragraph (a) must be used for increases in compensation-related costs of
eligible employees.
(c)
For purposes of this subdivision, eligible employees includes all persons
directly employed by the nursing facility on or after the effective date of the
rate adjustments, except:
(1)
persons employed in the central office of a corporation that has an ownership
interest in the nursing facility or exercises control over the nursing
facility; and
(2)
persons paid by the nursing facility under a management contract.
(d)
The commissioner shall allow as compensation-related costs all costs for:
(1)
wages and salaries;
(2)
FICA taxes, Medicare taxes, state and federal unemployment taxes, and workers'
compensation;
(3)
the employer's share of health and dental insurance, life insurance, disability
insurance, long-term care insurance, uniform allowance, and pensions; and
(4)
other benefits provided, subject to the approval of the commissioner.
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(e)
The portion of the rate adjustments under paragraph (a) that is not subject to
the requirements in paragraph (b) shall be provided to nursing facilities
effective October 1 of each year.
(f)
Nursing facilities may apply for the portion of the rate adjustments under
paragraph (a) that is subject to the requirements in paragraph (b). The
application must be submitted to the commissioner within six months of the
effective date of the rate adjustments, and the nursing facility must provide
additional information required by the commissioner within nine months of the
effective date of the rate adjustments. The commissioner must respond to all
applications within three weeks of receipt. The commissioner may waive the
deadlines in this paragraph under extraordinary circumstances, to be determined
at the sole discretion of the commissioner. The application must contain:
(1)
an estimate of the amounts of money that must be used as specified in paragraph
(b);
(2)
a detailed distribution plan specifying the allowable compensation-related
increases the nursing facility will implement to use the funds available in
clause (1);
(3)
a description of how the nursing facility will notify eligible employees of the
contents of the approved application, which must provide for giving each
eligible employee a copy of the approved application, excluding the information
required in clause (1), or posting a copy of the approved application,
excluding the information required in clause (1), for a period of at least six
weeks in an area of the nursing facility to which all eligible employees have
access; and
(4)
instructions for employees who believe they have not received the
compensation-related increases specified in clause (2), as approved by the
commissioner, and which must include a mailing address, e-mail address, and the
telephone number that may be used by the employee to contact the commissioner
or the commissioner's representative.
(g)
The commissioner shall ensure that cost increases in distribution plans under
paragraph (f), clause (2), that may be included in approved applications,
comply with requirements in clauses (1) to (4):
(1)
costs to be incurred during the applicable rate year resulting from wage and
salary increases implemented prior to the first day of the nursing facility's
payroll period that includes October 1 of each year shall be allowed if they
were not used in a prior year's application;
(2)
a portion of the costs resulting from tenure-related wage or salary increases
may be considered to be allowable compensation-related increases, in accordance
with existing formulas that the commissioner shall provide;
(3)
the annualized amount of increases in costs for the employer's share of health
and dental insurance, life insurance, disability insurance, and workers'
compensation shall be allowable compensation-related increases if they are
effective on or after April 1 of the year in which the rate adjustments are
effective and prior to April 1 of the following year; and
(4)
for nursing facilities in which employees are represented by an exclusive
bargaining representative, an agreement negotiated and agreed to by the
employer and the exclusive bargaining representative constitutes the plan. The
commissioner shall not review and shall not require changes to the portions of
the plan covered by collective bargaining agreements. A negotiated agreement
may constitute the plan only if the agreement is finalized after the date of
enactment of all increases for the rate year and signed by both parties prior
to submission to the commissioner.
(h)
The commissioner shall review applications received under paragraph (f) and
shall provide the portion of the rate adjustments under paragraph (b) if the
requirements of this subdivision have been met. The rate adjustments shall be
effective October 1 of each year. Notwithstanding paragraph (a), if the
approved application distributes less money than is available, the amount of
the rate adjustment shall be reduced so that the amount of money made available
is equal to the amount to be distributed.
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Sec. 63. Minnesota Statutes
2006, section 256B.434, is amended by adding a subdivision to read:
Subd. 20. Payment of Public Employees Retirement Association costs. Nursing
facilities that participate in the Public Employees Retirement Association
(PERA) shall have the component of their payment rate associated with the costs
of PERA determined for each rate year. Effective for rate years beginning on
and after October 1, 2007, the commissioner shall determine the portion of the
payment rate in effect on September 30 each year and shall subtract that amount
from the payment rate to be effective on the following October 1. The portion
that shall be deemed to be included in the September 30, 2007, rate that is
associated with PERA costs shall be the allowed costs in the facility's base
for determining rates under this section, divided by the resident days reported
for that year. The commissioner shall add to the payment rate to be effective
on October 1 each year an amount equal to the reported costs associated with
PERA, for the year ended on the most recent September 30 for which data is
available, divided by total resident days for that year, as reported by the
facility and audited under section 256B.441.
Sec. 64. Minnesota Statutes
2006, section 256B.437, is amended by adding a subdivision to read:
Subd. 11. Big Stone County rate adjustment. Notwithstanding the
time period specified in subdivision 3, the commissioner shall approve a
planned closure rate adjustment in Big Stone County for an eight-bed facility
in Clinton for reassignment to a 50-bed facility in Graceville. The adjustment
shall be calculated according to subdivisions 3 and 6.
Sec. 65. Minnesota Statutes
2006, section 256B.438, subdivision 3, is amended to read:
Subd. 3. Case mix indices. (a) The commissioner
of human services shall assign a case mix index to each resident class based on
the Centers for Medicare and Medicaid Services staff time measurement study and
adjusted for Minnesota-specific wage indices. The case mix indices assigned to
each resident class shall be published in the Minnesota State Register at least
120 days prior to the implementation of the 34 group, RUG-III resident
classification system.
(b) An index maximization
approach shall be used to classify residents.
(c) After implementation of
the revised case mix system, the commissioner of human services may annually
rebase case mix indices and base rates using more current data on average wage
rates and staff time measurement studies. This rebasing shall be calculated
under subdivision 7, paragraph (b). The commissioner shall publish in the
Minnesota State Register adjusted case mix indices at least 45 days prior to
the effective date of the adjusted case mix indices.
Sec. 66. Minnesota Statutes
2006, section 256B.439, subdivision 1, is amended to read:
Subdivision 1. Development and implementation of quality
profiles. (a) The commissioner of human services, in cooperation with the
commissioner of health, shall develop and implement a quality profile system
for nursing facilities and, beginning not later than July 1, 2004, other
providers of long-term care services, except when the quality profile system
would duplicate requirements under section 256B.5011, 256B.5012, or 256B.5013. Beginning
July 1, 2008, the commissioners shall include quality profiles of nursing homes
that are not medical assistance certified in the Minnesota Nursing Home Report
Card. The nonmedical assistance certified nursing homes may provide to the
commissioners information necessary to conduct consumer satisfaction surveys
and to determine other quality measures. The system must be developed and
implemented to the extent possible without the collection of significant amounts
of new data. To the extent possible, the system must incorporate or be
coordinated with information on quality maintained by area agencies on aging,
long-term care trade associations, and other entities. The system must be
designed to provide information on quality to:
(1) consumers and their
families to facilitate informed choices of service providers;
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(2) providers to enable them
to measure the results of their quality improvement efforts and compare quality
achievements with other service providers; and
(3) public and private
purchasers of long-term care services to enable them to purchase high-quality
care.
(b) The system must be developed
in consultation with the long-term care task force, area agencies on aging, and
representatives of consumers, providers, and labor unions. Within the limits of
available appropriations, the commissioners may employ consultants to assist
with this project.
Sec. 67. Minnesota Statutes
2006, section 256B.441, subdivision 1, is amended to read:
Subdivision 1. Rate determination Rebasing of
nursing facility operating cost payment rates. (a) The commissioner
shall establish a value-based nursing facility reimbursement system which will
provide facility-specific, prospective rates for nursing facilities
participating in the medical assistance program. The rates shall be determined
using an annual statistical and cost report filed by each nursing facility. The
total payment rate shall be composed of four rate components: direct care
services, support services, external fixed, and property-related rate
components. The payment rate shall be derived from statistical measures of
actual costs incurred in facility operation of nursing facilities. From this
cost basis, the components of the total payment rate shall be adjusted for
quality of services provided, recognition of staffing levels, geographic
variation in labor costs, and resident acuity. The commissioner shall
rebase nursing facility operating cost payment rates to align payments to
facilities with the cost of providing care. The rebased operating cost payment
rates shall be calculated using the statistical and cost report filed by each
nursing facility for the report period ending one year prior to the rate year.
(b) Rates shall be
rebased annually. The new operating cost payment rates based on this
section shall take effect beginning with the rate year beginning October 1,
2009, and shall be phased in over three rate years through October 1, 2011.
(c) Operating cost payment
rates shall be rebased on October 1, 2012, and every two years after that date.
(d) Operating cost payment rates
for rate years in which rebasing does not occur shall be increased by the
Global Insight SNF Market Basket inflation factor from the midpoint of the
previous rate year to the midpoint of the next rate year.
(e) Each cost reporting year
shall begin on October 1 and end on the following September 30. Beginning in
2006, a statistical and cost report shall be filed by each nursing facility by
January 15. Notice of rates shall be distributed by August 15 and the rates
shall go into effect on October 1 for one year.
(c) The commissioner shall
begin to phase in the new reimbursement system beginning October 1, 2007. Full
phase-in shall be completed by October 1, 2011.
Sec. 68. Minnesota Statutes
2006, section 256B.441, subdivision 2, is amended to read:
Subd. 2. Definitions. For purposes of this
section, the terms in subdivisions 3 to 42 42a have the meanings
given unless otherwise provided for in this section.
Sec. 69. Minnesota Statutes
2006, section 256B.441, subdivision 5, is amended to read:
Subd. 5. Administrative costs.
"Administrative costs" means the direct costs for administering the
overall activities of the nursing home. These costs include salaries and wages
of the administrator, assistant administrator, business office employees,
security guards, and associated fringe benefits and payroll taxes, fees,
contracts, or purchases related to business office functions, licenses, and
permits except as provided in the external fixed costs
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category, employee
recognition, travel including meals and lodging, training, voice and data
communication or transmission, office supplies, liability insurance and other
forms of insurance not designated to other areas, personnel recruitment, legal
services, accounting services, management or business consultants, data
processing, information technology, Web site, central or home office
costs, business meetings and seminars, postage, fees for professional
organizations, subscriptions, security services, advertising, board of
director's fees, working capital interest expense, and bad debts and bad debt
collection fees.
Sec. 70. Minnesota Statutes
2006, section 256B.441, subdivision 6, is amended to read:
Subd. 6. Allowed costs. "Allowed
costs" means the amounts reported by the facility which are necessary for
the operation of the facility and the care of residents and which are reviewed
by the department for accuracy, reasonableness, and compliance with this
section and generally accepted accounting principles. All references to
costs in this section shall be assumed to refer to allowed costs.
Sec. 71. Minnesota Statutes
2006, section 256B.441, subdivision 10, is amended to read:
Subd. 10. Dietary costs. "Dietary
costs" means the costs for the salaries and wages of the dietary
supervisor, dietitians, chefs, cooks, dishwashers, and other employees assigned
to the kitchen and dining room, and associated fringe benefits and payroll
taxes. Dietary costs also includes the salaries or fees of dietary consultants,
direct costs of raw food (both normal and special diet food), dietary
supplies, and food preparation and serving. Also included are special
dietary supplements used for tube feeding or oral feeding, such as elemental
high nitrogen diet, even if written as a prescription item by a physician.
Sec. 72. Minnesota Statutes
2006, section 256B.441, subdivision 11, is amended to read:
Subd. 11. Direct care costs category. "Direct
care costs category" "Direct care costs" means costs
for nursing services, activities, and social services the wages of
nursing administration, staff education, direct care registered nurses,
licensed practical nurses, certified nursing assistants, trained medication
aides, and associated fringe benefits and payroll taxes; services from a
supplemental nursing services agency; supplies that are stocked at nursing
stations or on the floor and distributed or used individually, including, but
not limited to: alcohol, applicators, cotton balls, incontinence pads,
disposable ice bags, dressings, bandages, water pitchers, tongue depressors,
disposable gloves, enemas, enema equipment, soap, medication cups, diapers,
plastic waste bags, sanitary products, thermometers, hypodermic needles and
syringes, clinical reagents or similar diagnostic agents, drugs that are not
paid for on a separate fee schedule by the medical assistance program or any
other payer, and technology related to the provision of nursing care to
residents, such as electronic charting systems.
Sec. 73. Minnesota Statutes
2006, section 256B.441, subdivision 13, is amended to read:
Subd. 13. External fixed costs category. "External
fixed costs category" "External fixed costs" means
costs related to the nursing home surcharge under section 256.9657, subdivision
1; licensure fees under section 144.122; long-term care consultation fees under
section 256B.0911, subdivision 6; family advisory council fee under section
144A.33; scholarships under section 256B.431, subdivision 36; planned closure
rate adjustments under section 256B.436 or 256B.437; or single bed
room incentives under section 256B.431, subdivision 42; property taxes and
property insurance; and PERA.
Sec. 74. Minnesota Statutes
2006, section 256B.441, subdivision 14, is amended to read:
Subd.
14. Facility average case mix index.
"Facility average case mix index" or "CMI" means a
numerical value score that describes the relative resource use for all
residents within the groups under the resource utilization group (RUG-III)
classification system prescribed by the commissioner based on an assessment of
each resident. The facility average CMI shall be computed as the standardized
days divided by total days for all residents in the facility.
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The
RUG's weights used in this section shall be as follows for each RUG's class:
SE3 1.605; SE2 1.247; SE1 1.081; RAD 1.509; RAC 1.259; RAB 1.109; RAA 0.957; SSC
1.453; SSB 1.254; SSA 1.047; CC2 1.292; CC1 1.200; CB2 1.086; CB1 1.017; CA2
0.908; CA1 0.834; IB2 0.877; IB1 0.817; IA2 0.720; IA1 0.676; BB2 0.956; BB1
0.885; BA2 0.716; BA1 0.673; PE2 1.199; PE1 1.104; PD2 1.023; PD1 0.948; PC2
0.926; PC1 0.860; PB2 0.786; PB1 0.734; PA2 0.691; PA1 0.651; BC1 0.651; and
DDF 1.000
Sec.
75. Minnesota Statutes 2006, section 256B.441, is amended by adding a
subdivision to read:
Subd.
14a. Facility type groups. Facilities
shall be classified into two groups, called "facility type groups,"
which shall consist of:
(1)
C&NC/R80: facilities that are hospital-attached, or are licensed under
Minnesota Rules, parts 9570.2000 to 9570.3400; and
(2)
freestanding: all other facilities.
Sec.
76. Minnesota Statutes 2006, section 256B.441, subdivision 17, is amended to
read:
Subd.
17. Fringe benefit costs.
"Fringe benefit costs" means the costs for group life, health,
dental, workers' compensation, and other employee insurances and pension,
profit-sharing, and retirement plans for which the employer pays all or a
portion of the costs and that are available to at least all employees who
work at least 20 hours per week.
Sec.
77. Minnesota Statutes 2006, section 256B.441, subdivision 20, is amended to
read:
Subd.
20. Housekeeping costs.
"Housekeeping costs" means the costs for the salaries and wages of
the housekeeping supervisor, housekeepers, and other cleaning employees and
associated fringe benefits and payroll taxes. It also includes the cost of
housekeeping supplies, including, but not limited to, cleaning and
lavatory supplies and contract services.
Sec.
78. Minnesota Statutes 2006, section 256B.441, subdivision 24, is amended to
read:
Subd.
24. Maintenance and plant operations
costs. "Maintenance and plant operations costs" means the costs
for the salaries and wages of the maintenance supervisor, engineers,
heating-plant employees, and other maintenance employees and associated fringe
benefits and payroll taxes. It also includes direct costs for maintenance and
operation of the building and grounds, including, but not limited to, fuel,
electricity, medical waste and garbage removal, water, sewer, supplies, tools,
and repairs.
Sec.
79. Minnesota Statutes 2006, section 256B.441, is amended by adding a
subdivision to read:
Subd.
28a. Other direct care costs. "Other
direct care costs" means the costs for the salaries and wages and
associated fringe benefits and payroll taxes of mental health workers,
religious personnel, and other direct care employees not specified in the
definition of direct care costs.
Sec.
80. Minnesota Statutes 2006, section 256B.441, subdivision 30, is amended to
read:
Subd.
30. Peer groups. Facilities shall be
classified into three groups, called "peer groups," which
by county. The groups shall consist of:
(1)
C&NC/Short Stay/R80 - facilities that have three or more admissions per
bed per year, are hospital-attached, or are licensed under Minnesota Rules,
parts 9570.2000 to 9570.3600 group one: facilities in Anoka, Benton,
Carlton, Carver, Chisago, Dakota, Dodge, Goodhue, Hennepin, Isanti, Mille Lacs,
Morrison, Olmsted, Ramsey, Rice, Scott, Sherburne, St. Louis, Stearns, Steele,
Wabasha, Washington, Winona, or Wright County;
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(2)
boarding care homes - facilities that have more than 50 percent of their
beds licensed as boarding care homes group two: facilities in Aitkin,
Beltrami, Blue Earth, Brown, Cass, Clay, Cook, Crow Wing, Faribault, Fillmore,
Freeborn, Houston, Hubbard, Itasca, Kanabec, Koochiching, Lake, Lake of the
Woods, Le Sueur, Martin, McLeod, Meeker, Mower, Nicollet, Norman, Pine, Roseau,
Sibley, Todd, Wadena, Waseca, Watonwan, or Wilkin County; and
(3)
standard - all other facilities group three: facilities in all other
counties.
Sec.
81. Minnesota Statutes 2006, section 256B.441, subdivision 31, is amended to
read:
Subd.
31. Prior rate-setting method
system operating cost payment rate. "Prior rate-setting
method" "Prior system operating cost payment rate"
means the operating cost payment rate determination process in
effect prior to October 1, 2006 on September 30, 2009, under
Minnesota Rules and Minnesota Statutes, not including planned closure rate
adjustments under section 256B.436 or 256B.437, or single bed room incentives
under section 256B.431, subdivision 42.
Sec.
82. Minnesota Statutes 2006, section 256B.441, is amended by adding a
subdivision to read:
Subd.
33a. Raw food costs. "Raw
food costs" means the cost of food provided to nursing facility residents.
Also included are special dietary supplements used for tube feeding or oral
feeding, such as elemental high nitrogen diet.
Sec.
83. Minnesota Statutes 2006, section 256B.441, subdivision 34, is amended to
read:
Subd.
34. Related organization.
"Related organization" means a person that furnishes goods or
services to a nursing facility and that is a close relative of a nursing
facility, an affiliate of a nursing facility, a close relative of an affiliate
of a nursing facility, or an affiliate of a close relative of an affiliate of a
nursing facility. As used in this subdivision, paragraphs (a) to (d) apply:
(a)
"Affiliate" means a person that directly, or indirectly through one
or more intermediaries, controls or is controlled by, or is under common
control with another person.
(b)
"Person" means an individual, a corporation, a partnership, an
association, a trust, an unincorporated organization, or a government or
political subdivision.
(c)
"Close relative of an affiliate of a nursing facility" means an
individual whose relationship by blood, marriage, or adoption to an individual
who is an affiliate of a nursing facility is no more remote than first cousin.
(d)
"Control" including the terms "controlling,"
"controlled by," and "under common control with" means the
possession, direct or indirect, of the power to direct or cause the direction
of the management, operations, or policies of a person, whether through the
ownership of voting securities, by contract, or otherwise, or to influence
in any manner other than through an arms length, legal transaction.
Sec.
84. Minnesota Statutes 2006, section 256B.441, subdivision 38, is amended to
read:
Subd.
38. Social services costs.
"Social services costs" means the costs for the salaries and wages of
the supervisor and other social work employees, associated fringe benefits and
payroll taxes, supplies, services, and consultants. This category includes
the cost of those employees who manage and process admission to the nursing
facility.
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Sec.
85. Minnesota Statutes 2006, section 256B.441, is amended by adding a
subdivision to read:
Subd.
42a. Therapy costs. "Therapy
costs" means any costs related to medical assistance therapy services
provided to residents that are not billed separately from the daily operating
rate.
Sec.
86. Minnesota Statutes 2006, section 256B.441, is amended by adding a
subdivision to read:
Subd.
48. Calculation of operating per diems.
The direct care per diem for each facility shall be the facility's direct
care costs divided by its standardized days. The other care-related per diem
shall be the sum of the facility's activities costs, other direct care costs,
raw food costs, therapy costs, and social services costs, divided by the
facility's resident days. The other operating per diem shall be the sum of the
facility's administrative costs, dietary costs, housekeeping costs, laundry
costs, and maintenance and plant operations costs divided by the facility's
resident days.
Sec.
87. Minnesota Statutes 2006, section 256B.441, is amended by adding a
subdivision to read:
Subd.
49. Determination of total care-related per
diem. The total care-related per diem for each facility shall be the
sum of the direct care per diem and the other care-related per diem.
Sec.
88. Minnesota Statutes 2006, section 256B.441, is amended by adding a
subdivision to read:
Subd.
50. Determination of total care-related
limit. The limit on the total care-related per diem shall be
determined for each peer group and facility type group combination. A
facility's total care-related per diems shall be limited to 120 percent of the
median for the facility's peer and facility type group. The facility-specific
direct care costs used in making this comparison and in the calculation of the
median shall be based on a RUG's weight of 1.00. A facility that is above that
limit shall have its total care-related per diem reduced to the limit. If a
reduction of the total care-related per diem is necessary because of this
limit, the reduction shall be made proportionally to both the direct care per
diem and the other care-related per diem.
Sec.
89. Minnesota Statutes 2006, section 256B.441, is amended by adding a
subdivision to read:
Subd.
51. Determination of other operating limit.
The limit on the other operating per diem shall be determined for each peer
group. A facility's other operating per diem shall be limited to 105 percent of
the median for its peer group. A facility that is above that limit shall have
its other operating per diem reduced to the limit.
Sec.
90. Minnesota Statutes 2006, section 256B.441, is amended by adding a
subdivision to read:
Subd.
52. Determination of efficiency incentive.
Each facility shall be eligible for an efficiency incentive based on its
other operating per diem. A facility with an other operating per diem that
exceeds the limit in subdivision 51 shall receive no efficiency incentive. All
other facilities shall receive an incentive calculated as 50 percent times the
difference between the facility's other operating per diem and its other
operating per diem limit, up to a maximum incentive of $3.
Sec.
91. Minnesota Statutes 2006, section 256B.441, is amended by adding a
subdivision to read:
Subd.
53. Calculation of payment rate for external
fixed costs. The commissioner shall calculate a payment rate for
external fixed costs.
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(a)
For a facility licensed as a nursing home, the portion related to section
256.9657 shall be equal to $8.86. For a facility licensed as both a nursing
home and a boarding care home, the portion related to section 256.9657 shall be
equal to $8.86 multiplied by the result of its number of nursing home beds
divided by its total number of licensed beds.
(b)
The portion related to the licensure fee under section 144.122, paragraph (d),
shall be the amount of the fee divided by actual resident days.
(c)
The portion related to scholarships shall be determined under section 256B.431,
subdivision 36.
(d)
The portion related to long-term care consultation shall be determined
according to section 256B.0911, subdivision 6.
(e)
The portion related to development and education of resident and family
advisory councils under section 144A.33 shall be $5 divided by 365.
(f)
The portion related to planned closure rate adjustments shall be as determined
under sections 256B.436 and 256B.437, subdivision 6.
(g)
The portions related to property insurance, real estate taxes, special
assessments, and payments made in lieu of real estate taxes directly identified
or allocated to the nursing facility shall be the actual amounts divided by
actual resident days.
(h)
The portion related to the Public Employees Retirement Association shall be
actual costs divided by resident days.
(i)
The single bed room incentives shall be as determined under section 256B.431,
subdivision 42.
(j)
The payment rate for external fixed costs shall be the sum of the amounts in
paragraphs (a) to (i).
Sec.
92. Minnesota Statutes 2006, section 256B.441, is amended by adding a
subdivision to read:
Subd.
54. Adjustment of per diem for inflation.
The total care-related per diem and other operating per diem calculated
under this section shall be adjusted for inflation to adjust for the delay
between the reporting year and the rate year. The total care-related payment
rate and other operating payment rate shall be calculated as the per diem
increased by the Global Insight Consumer Price Index urban inflation factor for
the period from the midpoint of the reporting year to the midpoint of the rate
year.
Sec.
93. Minnesota Statutes 2006, section 256B.441, is amended by adding a
subdivision to read:
Subd.
55. Determination of total payment rates.
In rate years when rates are rebased, the total payment rate for a RUG's
weight of 1.00 shall be the sum of the total care-related payment rate, other
operating payment rate, efficiency incentive, external fixed cost rate, and the
property rate determined under section 256B.434. To determine a total payment
rate for each RUG's level, the total care-related payment rate shall be divided
into the direct care payment rate and the other care-related payment rate, and
the direct care payment rate multiplied by the RUG's weight for each RUG's
level using the weights in subdivision 14.
Sec.
94. Minnesota Statutes 2006, section 256B.441, is amended by adding a
subdivision to read:
Subd.
56. Phase-in of rebased operating cost
payment rates. For the rate years beginning October 1, 2009, October
1, 2010, and October 1, 2011, the operating cost payment rate calculated under
this section shall be phased in by blending it with the operating cost payment
rate determined under section 256B.434. For the rate year beginning October 1,
2009, the operating cost payment rate for each facility shall be 25 percent of
the operating cost
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payment rate from this
section, and 75 percent of the operating cost payment rate from section
256B.434. For the rate year beginning October 1, 2010, the operating cost
payment rate for each facility shall be 35 percent of the operating cost
payment rate from this section, and 65 percent of the operating cost payment
rate from section 256B.434. For the rate year beginning October 1, 2011, the
operating cost payment rate for each facility shall be the operating cost
payment rate determined under this section. The blending of operating cost
payment rates under this section shall be performed separately for each RUG's
class.
Sec.
95. Minnesota Statutes 2006, section 256B.441, is amended by adding a
subdivision to read:
Subd.
57. Adjustment for inflation during phase-in
of rebased operating cost payment rates. During the phase-in of
operating cost payment rates under subdivision 56, both the operating costs per
diem under this section and the operating cost payment rate under section
256B.434 shall be adjusted for inflation. The adjustment for each year for the
operating cost per diems shall be the Global Insight Consumer Price Index urban
inflation factor from the midpoint of the reporting year to the midpoint of the
current rate year. The adjustment for each year for the operating cost payment
rate under section 256B.434 shall be the Global Insight Consumer Price Index
urban inflation factor from the midpoint of the October 1, 2007, rate year to
the midpoint of the current rate year.
Sec.
96. Minnesota Statutes 2006, section 256B.441, is amended by adding a
subdivision to read:
Subd.
58. Hold harmless. For the rate
years beginning October 1, 2009, October 1, 2010, and October 1, 2011, no
nursing facility shall receive an operating cost payment rate less than its
operating cost payment rate under section 256B.434. The comparison of operating
cost payment rates under this section shall be made for each of the RUG's
classes separately, and the operating cost payment rates under section 256B.434
used under this section shall not include the inflation increases described in
subdivision 57.
Sec.
97. Minnesota Statutes 2006, section 256B.441, is amended by adding a
subdivision to read:
Subd.
59. Appeals. Nursing facilities
may appeal, as defined under section 256B.50, the determination of a payment
rate established under this chapter.
Sec.
98. Minnesota Statutes 2006, section 256B.49, subdivision 11, is amended to
read:
Subd.
11. Authority. (a) The commissioner
is authorized to apply for home and community-based service waivers, as
authorized under section 1915(c) of the Social Security Act to serve persons
under the age of 65 who are determined to require the level of care provided in
a nursing home and persons who require the level of care provided in a hospital.
The commissioner shall apply for the home and community-based waivers in order
to:
(i)
promote the support of persons with disabilities in the most integrated
settings;
(ii)
expand the availability of services for persons who are eligible for medical
assistance;
(iii)
promote cost-effective options to institutional care; and
(iv)
obtain federal financial participation.
(b)
The provision of waivered services to medical assistance recipients with
disabilities shall comply with the requirements outlined in the federally
approved applications for home and community-based services and subsequent
amendments, including provision of services according to a service plan
designed to meet the needs of the individual. For purposes of this section, the
approved home and community-based application is considered the necessary
federal requirement.
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(c) The commissioner shall
provide interested persons serving on agency advisory committees and,
task forces, the Centers for Independent Living, and others upon
who request, with to be on a list to receive, notice of, and
an opportunity to comment on, at least 30 days before any effective dates,
(1) any substantive changes to the state's disability services program
manual, or (2) changes or amendments to the federally approved applications
for home and community-based waivers, prior to their submission to the federal
Centers for Medicare and Medicaid Services.
(d) The commissioner shall
seek approval, as authorized under section 1915(c) of the Social Security Act,
to allow medical assistance eligibility under this section for children under
age 21 without deeming of parental income or assets.
(e) The commissioner shall
seek approval, as authorized under section 1915(c) of the Social Act, to allow
medical assistance eligibility under this section for individuals under age 65
without deeming the spouse's income or assets.
Sec. 99. Minnesota Statutes
2006, section 256B.49, is amended by adding a subdivision to read:
Subd. 16a. Medical assistance reimbursement. (a) The commissioner
shall seek federal approval for medical assistance reimbursement of independent
living skills services, foster care waiver service, supported employment,
prevocational service, structured day service, and adult day care under the
home and community-based waiver for persons with a traumatic brain injury, the
community alternatives for disabled individuals waivers, and the community
alternative care waivers.
(b) Medical reimbursement
shall be made only when the provider demonstrates evidence of its capacity to
meet basic health, safety, and protection standards through one of the methods
in paragraphs (c) to (e).
(c) The provider is licensed
to provide services under chapter 245B and agrees to apply these standards to
services funded through the traumatic brain injury, community alternatives for
disabled, or community alternative care home and community-based waivers.
(d) The local agency
contracting for the services certifies on a form provided by the commissioner
that the provider has the capacity to meet the individual needs as identified
in each person's individual service plan. When certifying that the service
provider meets the necessary provider qualifications, the local agency shall
verify that the provider has policies and procedures governing the following:
(1) protection of the
consumer's rights and privacy;
(2) risk assessment and
planning;
(3) record keeping and
reporting of incidents and emergencies with documentation of corrective action
if needed;
(4) service outcomes,
regular reviews of progress, and periodic reports;
(5) complaint and grievance
procedures;
(6) service termination or
suspension;
(7) necessary training and
supervision of direct care staff that includes:
(i) documentation in
personnel files of 20 hours of orientation training in providing training
related to service provision;
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(ii) training in recognizing
the symptoms and effects of certain disabilities, health conditions, and
positive behavioral supports and interventions; and
(iii) a minimum of five
hours of related training annually; and
(8) when applicable, the
local agency shall verify that the provider has policies and procedures in
place governing the following:
(i) safe medication
administration;
(ii) proper handling of
consumer funds; and
(iii) behavioral
interventions that are in compliance with prohibitions and standards developed
by the commissioner to meet federal requirements regarding the use of
restraints and restrictive interventions.
(e) For foster care waiver
services or independent living skills services, the local agency contracting
for the services certifies on a form provided by the commissioner that the
provider meets the following:
(1) the provider of foster
care waiver services is licensed to provide adult foster care under Minnesota
Rules, parts 9555.5105 to 9555.6265, or child foster care under Minnesota
Rules, parts 2960.3000 to 2960.3230;
(2) the provider of
independent living skills services also provides licensed foster care services
and agrees to apply the foster care standards under Minnesota Rules, parts
9555.5105; 9555.5705, subpart 2; 9555.6167; 9555.6185; 9555.6195; 9555.6225,
subpart 8; 9555.6245; 9555.6255; and 9555.6265, or parts 2960.3010; 2960.3080,
subparts 10 and 11; 2960.3210; 2960.3220, subparts 5 to 7; and 2960.3230, for
the provision of those services; and
(3) the provider has
policies and procedures applying to the provision of foster care waiver
services or independent living skills services that govern (i) behavioral
interventions that are in compliance with prohibitions and standards developed
by the commissioner to meet federal requirements regarding the use of
restraints and restrictive interventions and (ii) documentation of service
needs and outcomes, regular reviews of progress, and periodic reports.
(f) The local agency shall
review each provider's continued compliance with the basic health, safety, and
protection standards on a regular basis. For the review of paragraph (e), the
local agency shall coordinate the review with the county review of foster care
licensure.
EFFECTIVE DATE. This section is
effective the day following final enactment.
Sec. 100. Minnesota Statutes
2006, section 256B.5012, is amended by adding a subdivision to read:
Subd. 7. ICF/MR rate increases October 1, 2007, and October 1, 2008. (a)
For the rate periods beginning October 1, 2007, and October 1, 2008, the
commissioner shall make available to each facility reimbursed under this
section an adjustment to the total operating payment rate of three percent.
(b) Seventy-five percent of
the money resulting from the rate adjustment under paragraph (a) must be used
to increase wages and benefits and pay associated costs for employees, except
for administrative and central office employees. Seventy-five percent of the
money received by a facility as a result of the rate adjustment provided in
paragraph (a) must be used only for wage, benefit, and staff increases
implemented on or after the effective date of the rate increase each year, and
must not be used for increases implemented prior to that date. The wage
adjustment eligible employees may receive may vary based on merit, seniority,
or other factors determined by the provider.
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(c) For each facility, the
commissioner shall make available an adjustment, based on occupied beds, using
the percentage specified in paragraph (a) multiplied by the total payment rate,
including variable rate but excluding the property-related payment rate, in
effect on the preceding day. The total payment rate must include the adjustment
provided in section 256B.501, subdivision 12.
(d) A facility whose payment
rates are governed by closure agreements, receivership agreements, or Minnesota
Rules, part 9553.0075, is not eligible for an adjustment otherwise granted
under this subdivision.
(e) A facility may apply for
the portion of the payment rate adjustment provided under paragraph (a) for
employee wages and benefits and associated costs. The application must be made
to the commissioner and contain a plan by which the facility will distribute
the funds according to paragraph (b). For facilities in which the employees are
represented by an exclusive bargaining representative, an agreement negotiated
and agreed to by the employer and the exclusive bargaining representative
constitutes the plan. The commissioner shall not review, and shall not require
changes, to the portion or portions of the plan covered by collective
bargaining agreements. A negotiated agreement may constitute the plan only if
the agreement is finalized after the date of enactment of all rate increases
for the rate year. The commissioner shall review the plan to ensure that the
payment rate adjustment per diem is used as provided in this subdivision. To be
eligible, a facility must submit its plan by March 31, 2008, and December 31,
2008, respectively. If a facility's plan is effective for its employees after
the first day of the applicable rate period that the funds are available, the
payment rate adjustment per diem is effective the same date as its plan.
(f) A copy of the approved
distribution plan must be made available to all employees by giving each
employee a copy or by posting it in an area of the facility to which all
employees have access. If an employee does not receive the wage and benefit
adjustment described in the facility's approved plan and is unable to resolve
the problem with the facility's management or through the employee's union
representative, the employee may contact the commissioner at an address or
telephone number provided by the commissioner and included in the approved
plan.
Sec. 101. Minnesota Statutes
2006, section 256B.69, subdivision 23, is amended to read:
Subd. 23. Alternative services; elderly and disabled
persons. (a) The commissioner may implement demonstration projects to
create alternative integrated delivery systems for acute and long-term care
services to elderly persons and persons with disabilities as defined in section
256B.77, subdivision 7a, that provide increased coordination, improve access to
quality services, and mitigate future cost increases. The commissioner may seek
federal authority to combine Medicare and Medicaid capitation payments for the
purpose of such demonstrations and may contract with Medicare-approved special
needs plans to provide Medicaid services. Medicare funds and services shall be
administered according to the terms and conditions of the federal contract and
demonstration provisions. For the purpose of administering medical assistance
funds, demonstrations under this subdivision are subject to subdivisions 1 to
22. The provisions of Minnesota Rules, parts 9500.1450 to 9500.1464, apply to
these demonstrations, with the exceptions of parts 9500.1452, subpart 2, item
B; and 9500.1457, subpart 1, items B and C, which do not apply to persons
enrolling in demonstrations under this section. An initial open enrollment
period may be provided. Persons who disenroll from demonstrations under this
subdivision remain subject to Minnesota Rules, parts 9500.1450 to 9500.1464.
When a person is enrolled in a health plan under these demonstrations and the
health plan's participation is subsequently terminated for any reason, the
person shall be provided an opportunity to select a new health plan and shall
have the right to change health plans within the first 60 days of enrollment in
the second health plan. Persons required to participate in health plans under
this section who fail to make a choice of health plan shall not be randomly
assigned to health plans under these demonstrations. Notwithstanding section
256L.12, subdivision 5, and Minnesota Rules, part 9505.5220, subpart 1, item A,
if adopted, for the purpose of demonstrations under this subdivision, the
commissioner may contract with managed care organizations, including counties,
to serve only elderly persons eligible for medical assistance, elderly and
disabled persons, or disabled persons only. For persons with a primary
diagnosis of developmental disability, serious and persistent mental illness,
or serious emotional disturbance, the commissioner must ensure that the county
authority has approved the demonstration and contracting design. Enrollment in
these projects for persons with disabilities shall be voluntary.
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The commissioner shall not
implement any demonstration project under this subdivision for persons with a
primary diagnosis of developmental disabilities, serious and persistent mental
illness, or serious emotional disturbance, without approval of the county board
of the county in which the demonstration is being implemented.
(b) Notwithstanding chapter
245B, sections 252.40 to 252.46, 256B.092, 256B.501 to 256B.5015, and Minnesota
Rules, parts 9525.0004 to 9525.0036, 9525.1200 to 9525.1330, 9525.1580, and
9525.1800 to 9525.1930, the commissioner may implement under this section
projects for persons with developmental disabilities. The commissioner may capitate
payments for ICF/MR services, waivered services for developmental disabilities,
including case management services, day training and habilitation and
alternative active treatment services, and other services as approved by the
state and by the federal government. Case management and active treatment must
be individualized and developed in accordance with a person-centered plan.
Costs under these projects may not exceed costs that would have been incurred
under fee-for-service. Beginning July 1, 2003, and until two four years
after the pilot project implementation date, subcontractor participation in the
long-term care developmental disability pilot is limited to a nonprofit
long-term care system providing ICF/MR services, home and community-based waiver
services, and in-home services to no more than 120 consumers with developmental
disabilities in Carver, Hennepin, and Scott Counties. The commissioner shall
report to the legislature prior to expansion of the developmental disability
pilot project. This paragraph expires two four years after the
implementation date of the pilot project.
(c) Before implementation of
a demonstration project for disabled persons, the commissioner must provide
information to appropriate committees of the house of representatives and
senate and must involve representatives of affected disability groups in the
design of the demonstration projects.
(d) A nursing facility
reimbursed under the alternative reimbursement methodology in section 256B.434
may, in collaboration with a hospital, clinic, or other health care entity
provide services under paragraph (a). The commissioner shall amend the state
plan and seek any federal waivers necessary to implement this paragraph.
(e) The commissioner, in
consultation with the commissioners of commerce and health, may approve and
implement programs for all-inclusive care for the elderly (PACE) according to
federal laws and regulations governing that program and state laws or rules
applicable to participating providers. The process for approval of these
programs shall begin only after the commissioner receives grant money in an
amount sufficient to cover the state share of the administrative and actuarial
costs to implement the programs during state fiscal years 2006 and 2007. Grant
amounts for this purpose shall be deposited in an account in the special
revenue fund and are appropriated to the commissioner to be used solely for the
purpose of PACE administrative and actuarial costs. A PACE provider is not
required to be licensed or certified as a health plan company as defined in
section 62Q.01, subdivision 4. Persons age 55 and older who have been screened
by the county and found to be eligible for services under the elderly waiver or
community alternatives for disabled individuals or who are already eligible for
Medicaid but meet level of care criteria for receipt of waiver services may
choose to enroll in the PACE program. Medicare and Medicaid services will be
provided according to this subdivision and federal Medicare and Medicaid requirements
governing PACE providers and programs. PACE enrollees will receive Medicaid
home and community-based services through the PACE provider as an alternative
to services for which they would otherwise be eligible through home and
community-based waiver programs and Medicaid State Plan Services. The
commissioner shall establish Medicaid rates for PACE providers that do not
exceed costs that would have been incurred under fee-for-service or other
relevant managed care programs operated by the state.
(f)
The commissioner shall seek federal approval to expand the Minnesota disability
health options (MnDHO) program established under this subdivision in stages,
first to regional population centers outside the seven-county metro area and
then to all areas of the state. Until January 1, 2008 July 1, 2009,
expansion for MnDHO projects that include home and community-based services is
limited to the two projects and service areas in effect on March 1, 2006.
Enrollment in integrated MnDHO programs that include home and community-based
services shall remain voluntary. Costs for home and community-based services
included under MnDHO must not exceed costs that would
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have been incurred under the
fee-for-service program. In developing program specifications for expansion of
integrated programs, the commissioner shall involve and consult the state-level
stakeholder group established in subdivision 28, paragraph (d), including
consultation on whether and how to include home and community-based waiver
programs. Plans for further expansion of MnDHO projects shall be presented to
the chairs of the house and senate committees with jurisdiction over health and
human services policy and finance by February 1, 2007.
(g)
Notwithstanding section 256B.0261, health plans providing services under this
section are responsible for home care targeted case management and relocation
targeted case management. Services must be provided according to the terms of
the waivers and contracts approved by the federal government.
Sec.
102. Minnesota Statutes 2006, section 256B.69, subdivision 28, is amended to
read:
Subd.
28. Medicare special needs plans;
medical assistance basic health care. (a) The commissioner may contract
with qualified Medicare-approved special needs plans to provide medical
assistance basic health care services to persons with disabilities, including
those with developmental disabilities. Basic health care services include:
(1)
those services covered by the medical assistance state plan except for ICF/MR
services, home and community-based waiver services, case management for persons
with developmental disabilities under section 256B.0625, subdivision 20a, and
personal care and certain home care services defined by the commissioner in
consultation with the stakeholder group established under paragraph (d); and
(2)
basic health care services may also include risk for up to 100 days of nursing
facility services for persons who reside in a noninstitutional setting and home
health services related to rehabilitation as defined by the commissioner after
consultation with the stakeholder group.
The
commissioner may exclude other medical assistance services from the basic
health care benefit set. Enrollees in these plans can access any excluded
services on the same basis as other medical assistance recipients who have not
enrolled.
Unless
a person is otherwise required to enroll in managed care, enrollment in these
plans for Medicaid services must be voluntary. For purposes of this
subdivision, automatic enrollment with an option to opt out is not voluntary
enrollment.
(b)
Beginning January 1, 2007, the commissioner may contract with qualified
Medicare special needs plans to provide basic health care services under
medical assistance to persons who are dually eligible for both Medicare and
Medicaid and those Social Security beneficiaries eligible for Medicaid but in
the waiting period for Medicare. The commissioner shall consult with the
stakeholder group under paragraph (d) (e) in developing program
specifications for these services. The commissioner shall report to the chairs
of the house and senate committees with jurisdiction over health and human services
policy and finance by February 1, 2007, on implementation of these programs and
the need for increased funding for the ombudsman for managed care and other
consumer assistance and protections needed due to enrollment in managed care of
persons with disabilities. Payment for Medicaid services provided under this
subdivision for the months of May and June will be made no earlier than July 1
of the same calendar year.
(c)
Beginning January 1, 2008, the commissioner may expand contracting under this subdivision
to all persons with disabilities not otherwise required to enroll in managed
care.
(d)
By February 1, 2009, the commissioner shall report to the chairs of the
house and senate committees with jurisdiction over health and human services policy
and finance on the initial results of implementation of contracts with
qualified Medicare special needs plans to provide basic health care services
under medical assistance to persons who are dually eligible for both Medicare
and Medicaid. This report shall include an overall assessment of the impact on
quality of care including actual costs and benefits.
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(e) The commissioner shall
establish a state-level stakeholder group to provide advice on managed care
programs for persons with disabilities, including both MnDHO and contracts with
special needs plans that provide basic health care services as described in
paragraphs (a) and (b). The stakeholder group shall include representatives
of the counties and labor organizations representing county social service
workers, members, consumer advocates, and providers, and provide advice on
program expansions under this subdivision and subdivision 23, including:
(1)
implementation efforts;
(2)
consumer protections; and
(3)
program specifications such as quality assurance measures, data collection and
reporting, and evaluation of costs, quality, and results.; and
(4)
county safety net protections for persons with disabilities.
(e) (f) Each plan under contract to
provide medical assistance basic health care services shall establish a local
or regional stakeholder group, including representatives of the counties
covered by the plan and labor organizations representing county social service
workers, members, consumer advocates, and current providers, for
advice on issues that arise in the local or regional area.
Sec.
103. [256C.261] SERVICES FOR
DEAF-BLIND PERSONS.
(a)
The commissioner of human services shall combine the existing biennial base
level funding for deaf-blind services into a single grant program. At least 35
percent of the total funding is awarded for services and other supports to
deaf-blind children and their families and at least 25 percent is awarded for
services and other supports to deaf-blind adults.
The
commissioner shall award grants for the purposes of:
(1)
providing services and supports to individuals who are deaf-blind; and
(2)
developing and providing training to counties and the network of senior citizen
service providers. The purpose of the training grants is to teach counties how
to use existing programs that capture federal financial participation to meet
the needs of eligible deaf-blind persons and to build capacity of senior
service programs to meet the needs of seniors with a dual sensory hearing and
vision loss.
(b)
The commissioner may make grants:
(1)
for services and training provided by organizations; and
(2)
to develop and administer consumer-directed services.
(c)
Any entity that is able to satisfy the grant criteria is eligible to receive a
grant under paragraph (a).
(d)
Deaf-blind service providers are not required to, but may, provide intervenor
services as part of the service package provided with grant funds under this
section.
Sec.
104. Minnesota Statutes 2006, section 256D.44, subdivision 2, is amended to
read:
Subd.
2. Standard of assistance for persons
eligible for medical assistance waivers or at risk of placement in a group
residential housing facility. The state standard of assistance for a person
(1) who is eligible for a medical assistance home and community-based
services waiver or a person, (2) who has been determined by the
local agency to meet the plan requirements for placement in a group residential
housing facility under section 256I.04, subdivision 1a, or (3) who is
eligible for a shelter needy payment under subdivision 5, paragraph (f), is
the standard established in subdivision 3, paragraph (a) or (b).
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Sec.
105. Minnesota Statutes 2006, section 256D.44, subdivision 5, is amended to
read:
Subd.
5. Special needs. In addition to the
state standards of assistance established in subdivisions 1 to 4, payments are
allowed for the following special needs of recipients of Minnesota supplemental
aid who are not residents of a nursing home, a regional treatment center, or a
group residential housing facility.
(a)
The county agency shall pay a monthly allowance for medically prescribed diets
if the cost of those additional dietary needs cannot be met through some other
maintenance benefit. The need for special diets or dietary items must be prescribed
by a licensed physician. Costs for special diets shall be determined as
percentages of the allotment for a one-person household under the thrifty food
plan as defined by the United States Department of Agriculture. The types of
diets and the percentages of the thrifty food plan that are covered are as
follows:
(1)
high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;
(2)
controlled protein diet, 40 to 60 grams and requires special products, 100
percent of thrifty food plan;
(3)
controlled protein diet, less than 40 grams and requires special products, 125
percent of thrifty food plan;
(4)
low cholesterol diet, 25 percent of thrifty food plan;
(5)
high residue diet, 20 percent of thrifty food plan;
(6)
pregnancy and lactation diet, 35 percent of thrifty food plan;
(7)
gluten-free diet, 25 percent of thrifty food plan;
(8)
lactose-free diet, 25 percent of thrifty food plan;
(9)
antidumping diet, 15 percent of thrifty food plan;
(10)
hypoglycemic diet, 15 percent of thrifty food plan; or
(11)
ketogenic diet, 25 percent of thrifty food plan.
(b)
Payment for nonrecurring special needs must be allowed for necessary home
repairs or necessary repairs or replacement of household furniture and appliances
using the payment standard of the AFDC program in effect on July 16, 1996, for
these expenses, as long as other funding sources are not available.
(c)
A fee for guardian or conservator service is allowed at a reasonable rate
negotiated by the county or approved by the court. This rate shall not exceed
five percent of the assistance unit's gross monthly income up to a maximum of
$100 per month. If the guardian or conservator is a member of the county agency
staff, no fee is allowed.
(d)
The county agency shall continue to pay a monthly allowance of $68 for
restaurant meals for a person who was receiving a restaurant meal allowance on
June 1, 1990, and who eats two or more meals in a restaurant daily. The
allowance must continue until the person has not received Minnesota
supplemental aid for one full calendar month or until the person's living
arrangement changes and the person no longer meets the criteria for the
restaurant meal allowance, whichever occurs first.
(e)
A fee of ten percent of the recipient's gross income or $25, whichever is less,
is allowed for representative payee services provided by an agency that meets
the requirements under SSI regulations to charge a fee for representative payee
services. This special need is available to all recipients of Minnesota
supplemental aid regardless of their living arrangement.
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(f)
Notwithstanding the language in this subdivision, an amount equal to the
maximum allotment authorized by the federal Food Stamp Program for a single
individual which is in effect on the first day of January July of
the previous each year will be added to the standards of
assistance established in subdivisions 1 to 4 for individuals adults
under the age of 65 who qualify as shelter needy and are: (1)
relocating from an institution, or an adult mental health residential treatment
program under section 256B.0622, and who are shelter needy; (2)
self-directed supports option participants defined under section 256B.0657 if
enacted in the 2007 legislative session; or (3) home and community-based waiver
recipients living in their own rented, leased, or owned apartment or home not
owned, operated, or controlled by a provider of service not related by blood or
marriage. Notwithstanding subdivision 3, paragraph (c), an individual
eligible for the shelter needy benefit under subdivision 5, paragraph (f), is
considered a household of one. An eligible individual who receives this
benefit prior to age 65 may continue to receive the benefit after the age of
65.
(g)(1)
Persons eligible for shelter needy funding under paragraph (f), who are not
receiving medial assistance home and community-based waiver services, are
eligible for a state-funded transitional supports allowance under section
256B.49, subdivision 16, paragraph (e), to establish their own residence not
owned, operated, or controlled by a provider of service not related by blood or
marriage.
(2)
"Shelter
needy" means that the assistance unit incurs monthly shelter costs that
exceed 40 percent of the assistance unit's gross income before the application
of this special needs standard. "Gross income" for the purposes of
this section is the applicant's or recipient's income as defined in section
256D.35, subdivision 10, or the standard specified in subdivision 3, paragraph
(a) or (b), whichever is greater. A recipient of a federal or state housing
subsidy, that limits shelter costs to a percentage of gross income, shall not
be considered shelter needy for purposes of this paragraph.
Sec.
106. Minnesota Statutes 2006, section 256I.04, subdivision 3, is amended to
read:
Subd.
3. Moratorium on the development of
group residential housing beds. (a) County agencies shall not enter into
agreements for new group residential housing beds with total rates in excess of
the MSA equivalent rate except: (1) for group residential housing
establishments licensed under Minnesota Rules, parts 9525.0215 to 9525.0355,
provided the facility is needed to meet the census reduction targets for
persons with developmental disabilities at regional treatment centers; (2) to
ensure compliance with the federal Omnibus Budget Reconciliation Act
alternative disposition plan requirements for inappropriately placed persons
with developmental disabilities or mental illness; (3) up to 80 beds in a
single, specialized facility located in Hennepin County that will provide
housing for chronic inebriates who are repetitive users of detoxification
centers and are refused placement in emergency shelters because of their state
of intoxication, and planning for the specialized facility must have been
initiated before July 1, 1991, in anticipation of receiving a grant from the
Housing Finance Agency under section 462A.05, subdivision 20a, paragraph (b); (4)
notwithstanding the provisions of subdivision 2a, for up to 190 supportive
housing units in Anoka, Dakota, Hennepin, or Ramsey County for homeless adults
with a mental illness, a history of substance abuse, or human immunodeficiency
virus or acquired immunodeficiency syndrome. For purposes of this section,
"homeless adult" means a person who is living on the street or in a
shelter or discharged from a regional treatment center, community hospital, or
residential treatment program and has no appropriate housing available and
lacks the resources and support necessary to access appropriate housing. At
least 70 percent of the supportive housing units must serve homeless adults
with mental illness, substance abuse problems, or human immunodeficiency virus
or acquired immunodeficiency syndrome who are about to be or, within the
previous six months, has been discharged from a regional treatment center, or a
state-contracted psychiatric bed in a community hospital, or a residential
mental health or chemical dependency treatment program. If a person meets the
requirements of subdivision 1, paragraph (a), and receives a federal or state
housing subsidy, the group residential housing rate for that person is limited
to the supplementary rate under section 256I.05, subdivision 1a, and is
determined by subtracting the amount of the person's countable income that
exceeds the MSA equivalent rate from the group residential housing
supplementary rate. A resident in a demonstration project site who no longer
participates in the demonstration program shall retain eligibility for a group
residential housing payment in an amount determined under section 256I.06,
subdivision 8, using the MSA equivalent rate. Service funding under section
256I.05, subdivision 1a, will end June 30, 1997, if federal matching funds are
available and the services can
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be provided through a
managed care entity. If federal matching funds are not available, then service
funding will continue under section 256I.05, subdivision 1a; or (6)
(5) for group residential housing beds in settings meeting the requirements
of subdivision 2a, clauses (1) and (3), which are used exclusively for
recipients receiving home and community-based waiver services under sections
256B.0915, 256B.092, subdivision 5, 256B.093, and 256B.49, and who resided in a
nursing facility for the six months immediately prior to the month of entry
into the group residential housing setting. The group residential housing rate
for these beds must be set so that the monthly group residential housing
payment for an individual occupying the bed when combined with the nonfederal
share of services delivered under the waiver for that person does not exceed
the nonfederal share of the monthly medical assistance payment made for the
person to the nursing facility in which the person resided prior to entry into
the group residential housing establishment. The rate may not exceed the MSA
equivalent rate plus $426.37 for any case.; or (6) for an additional
two beds, resulting in a total of 32 beds, for a facility located in Hennepin
County providing services for recovering and chemically dependent men that has
had a group residential housing contract with the county and has been licensed
as a board and lodge facility with special services since 1980; (7) for a group
residential housing provider located in Stearns County that operates a 40-bed
facility, that received financing through the Minnesota Housing Finance Agency
Ending Long-Term Homelessness Initiative and serves chemically dependent
clientele, providing 24-hour-a-day supervision; (8) for a group residential
housing provider located in Crow Wing County that serves a chemically dependent
clientele, providing 24-hour-a-day supervision and limiting a resident's
maximum length of stay to 13 months out of a consecutive 24-month period; (9)
for a 60-bed facility in St. Louis County which opened in January 2006 that
will serve chemically dependent persons operated by a group residential housing
provider that currently operates a 304-bed facility in Minneapolis; and (10)
for a group residential housing provider that operates two ten-bed facilities,
one located in Hennepin County and one located in Ramsey County, which provide
community support and serve the mental health needs of individuals who have
chronically lived unsheltered, providing 24-hour-a-day supervision.
(b) A county agency may
enter into a group residential housing agreement for beds with rates in excess
of the MSA equivalent rate in addition to those currently covered under a group
residential housing agreement if the additional beds are only a replacement of
beds with rates in excess of the MSA equivalent rate which have been made
available due to closure of a setting, a change of licensure or certification
which removes the beds from group residential housing payment, or as a result
of the downsizing of a group residential housing setting. The transfer of
available beds from one county to another can only occur by the agreement of
both counties.
Sec. 107. Minnesota Statutes
2006, section 256I.05, is amended by adding a subdivision to read:
Subd. 1h. Supplementary rate for certain facilities serving chemically
dependent males. Notwithstanding subdivisions 1a and 1c, beginning
July 1, 2007, a county agency shall negotiate a supplementary rate in addition
to the rate specified in subdivision 1, not to exceed $737.87 per month,
including any legislatively authorized inflationary adjustments, for a group
residential housing provider that:
(1) is located in Ramsey
County and has had a group residential housing contract with the county since
1982 and has been licensed as a board and lodge facility with special services
since 1979; and
(2) serves recovering and
chemically dependent males, providing 24-hour-a-day supervision.
Sec. 108. Minnesota Statutes
2006, section 256I.05, is amended by adding a subdivision to read:
Subd. 1i. Supplementary rate for certain facilities; Hennepin County. Notwithstanding
the provisions of subdivisions 1a and 1c, a county agency shall negotiate a
supplementary rate in addition to the rate specified in subdivision 1, not to
exceed $700 per month, including any legislatively authorized inflationary
adjustments, for a facility located in Hennepin County with a capacity of up to
48 beds that has been licensed since 1978 as a board and lodging facility and
that until August 1, 2007, operated as a licensed chemical dependency treatment
program.
EFFECTIVE DATE. This section is
effective the day following final enactment.
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Sec.
109. Minnesota Statutes 2006, section 256I.05, is amended by adding a
subdivision to read:
Subd.
1j. Supplementary rate for certain
facilities; St. Louis County. (a) Notwithstanding the provisions of
subdivisions 1a and 1c, beginning July 1, 2007, a county agency shall negotiate
a supplementary rate in addition to the rate specified in subdivision 1, not to
exceed $700 per month, including any legislatively authorized inflationary
adjustments, for a 60-bed facility in St. Louis County which opened in January
2006 that will serve chemically dependent persons operated by a group
residential housing provider that currently operates a 304-bed facility in
Minneapolis.
(b)
The supplementary rate in paragraph (a) applies to the 48 beds which do not
already receive a supplementary rate.
Sec.
110. Minnesota Statutes 2006, section 256I.05, is amended by adding a
subdivision to read:
Subd.
1k. Supplementary rate for certain
facilities; Crow Wing County. Notwithstanding the provisions of
subdivisions 1a and 1c, beginning July 1, 2007, a county agency shall negotiate
a supplementary rate in addition to the rate specified in subdivision 1, not to
exceed $700 per month, including any legislatively authorized inflationary
adjustments, for a new 65-bed facility in Crow Wing County that will serve chemically
dependent persons operated by a group residential housing provider that
currently operates a 304-bed facility in Minneapolis and a 44-bed facility in
Duluth which opened in January of 2006.
Sec.
111. Minnesota Statutes 2006, section 256I.05, is amended by adding a
subdivision to read:
Subd.
1l. Supplementary rate for certain
facilities; Stearns County. Notwithstanding the provisions of this
section, beginning July 1, 2007, a county agency shall negotiate a
supplementary service rate in addition to the rate specified in subdivision 1,
not to exceed $700 per month, including any legislatively authorized
inflationary adjustments, for a group residential housing provider located in
Stearns County that operates a 40-bed facility, that received financing through
the Minnesota Housing Finance Agency Ending Long-Term Homelessness Initiative
and serves chemically dependent clientele, providing 24-hour-a-day supervision.
Sec.
112. Minnesota Statutes 2006, section 256I.05, is amended by adding a
subdivision to read:
Subd.
1m. Supplementary rate for certain
facilities; St. Louis County. Notwithstanding the provisions of this
section, beginning July 1, 2007, a county agency shall negotiate a
supplementary service rate in addition to the rate specified in subdivision 1,
not to exceed $700 per month, including any legislatively authorized
inflationary adjustments, for a group residential housing provider located in
St. Louis County that operates a 30-bed facility, that received financing
through the Minnesota Housing Finance Agency Ending Long-Term Homelessness
Initiative and serves chemically dependent clientele, providing 24-hour-a-day
supervision.
Sec.
113. Minnesota Statutes 2006, section 256I.05, is amended by adding a
subdivision to read:
Subd.
1n. Supplemental rate for certain
facilities; Hennepin and Ramsey Counties. Notwithstanding the
provisions of this section, beginning July 1, 2007, a county agency shall
negotiate a supplemental service rate in addition to the rate specified in
subdivision 1, not to exceed $715.78 per month, including any legislatively
authorized inflationary adjustments, for a group residential housing provider
that operates two ten-bed facilities, one located in Hennepin County and one
located in Ramsey County, which provide community support and serve the mental
health needs of individuals who have chronically lived unsheltered, providing
24-hour-a-day supervision.
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Sec. 114. Laws 2000, chapter
340, section 19, is amended to read:
Sec. 19. ALTERNATIVE CARE PILOT PROJECTS.
(a) Expenditures for housing
with services and adult foster care shall be excluded when determining average
monthly expenditures per client for alternative care pilot projects authorized
in Laws 1993, First Special Session chapter 1, article 5, section 133.
(b) Alternative care pilot
projects shall not expire on June 30, 2001, but shall continue until June 30, 2005
2007.
EFFECTIVE DATE. This section is
effective retroactively from June 29, 2005, for activities related to
discontinuing pilot projects under this section.
Sec. 115. Laws 2006, chapter
282, article 20, section 37, is amended to read:
Sec. 37. REPAYMENT DELAY.
A county that overspent its
allowed amounts in calendar year 2004 or 2005 under the waivered services
program for persons with developmental disabilities shall not be required to
pay back the amount of overspending until May 31, 2007.
EFFECTIVE DATE. This section is
effective the day following final enactment.
Sec. 116. LICENSURE; SERVICES FOR YOUTH WITH
DISABILITIES.
(a) Notwithstanding the
requirements of Minnesota Statutes, chapter 245A, upon the recommendation of a
county agency, the commissioner of human services shall grant a license with any
necessary variances to a nonresidential program for youth which provides
services to youth with disabilities under age 21 during nonschool hours
established to ensure health and safety, prevent out-of-home placement, and
increase community inclusion of youth with disabilities. The nonresidential
youth program is subject to the conditions of any variances granted and with
consumer rights under Minnesota Statutes, section 245B.04, consumer protection
standards under Minnesota Statutes, section 245B.05, service standards under
Minnesota Statutes, section 245B.06, management standards under Minnesota
Statutes, section 245B.07, and fire marshal inspections under Minnesota
Statutes, section 245A.151, until the commissioner develops other licensure
requirements for this type of program.
(b) By February 1, 2008, the
commissioner shall recommend amendments to licensure requirements in Minnesota
Statutes, chapter 245A, to allow licensure of appropriate services for
school-age youth with disabilities under age 21 who need supervision and
services to develop skills necessary to maintain personal safety and increase
their independence, productivity, and participation in their communities during
nonschool hours. As part of developing the recommendations, the commissioner
shall survey county agencies to determine how the needs of youth with
disabilities under age 21 who require supervision and support services are
being met and the funding sources used. The recommendations must be provided to
the house and senate chairs of the committees with jurisdiction over licensing
of programs for youth with disabilities.
Sec. 117. INDEPENDENT LIVING.
An individual who has lived
in one of the facilities under Minnesota Statutes, section 256I.05, subdivision
1n, who is being transitioned to independent living as part of the program plan
continues to be eligible for group residential housing and the supplemental
service rate negotiated with the county under Minnesota Statutes, section
256I.05, subdivision 1n.
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Sec. 118. ASSISTIVE TECHNOLOGY STUDY AND REPORT.
Subdivision 1. Study. (a) During the biennium ending June 30, 2009, the
Council on Disability shall facilitate a statewide study of the assistive
technology needs of people with disabling conditions, and seniors. As part of
the study, the council shall identify community-based service providers, state
agencies, and other entities involved in providing assistive technology
supports. The study shall also examine the creation of an assistive technology
pretax savings account to allow disabled persons to set aside pretax and
unearned income to purchase assistive technology devices, equipment, and
services.
(b) The council shall
provide oversight and direction to the Minnesota Regions Assistive Technology
Collaborative during the biennium ending June 30, 2009.
Subd. 2. Report. The council shall present to the chairs of the
house and senate committees having jurisdiction over human services, by January
1, 2009, a report of the findings of the study, including proposed legislation
creating a statewide comprehensive plan to meet the assistive technology needs
of people with disabling conditions and seniors. The statewide plan must
include steps to coordinate and streamline assistive technology services and
the creation of an assistive technology pretax savings account.
Sec. 119. COMMUNITY SERVICES PROVIDER RATE
INCREASES.
(a) The commissioner of
human services shall increase allocations, reimbursement rates, or rate limits,
as applicable, by three percent for the rate period beginning October 1, 2007,
and the rate period beginning October 1, 2008, effective for services rendered
on or after those dates.
(b) The three percent annual
rate increase described in this section must be provided to:
(1) home and community-based
waivered services for persons with developmental disabilities or related
conditions under Minnesota Statutes, section 256B.501;
(2) home and community-based
waivered services for the elderly under Minnesota Statutes, section 256B.0915;
(3) waivered services under
community alternatives for disabled individuals under Minnesota Statutes,
section 256B.49;
(4) community alternative
care waivered services under Minnesota Statutes, section 256B.49;
(5) traumatic brain injury
waivered services under Minnesota Statutes, section 256B.49;
(6) nursing services and
home health services under Minnesota Statutes, section 256B.0625, subdivision
6a;
(7) personal care services
and nursing supervision of personal care services under Minnesota Statutes,
section 256B.0625, subdivision 19a;
(8) private duty nursing
services under Minnesota Statutes, section 256B.0625, subdivision 7;
(9) day training and habilitation
services for adults with developmental disabilities or related conditions under
Minnesota Statutes, sections 252.40 to 252.46, including the additional cost of
rate adjustments on day training and habilitation service, provided as a social
service under Minnesota Statutes, section 256M.60;
(10) alternative care
services under Minnesota Statutes, section 256B.0913;
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(11) adult residential
program grants under Minnesota Statutes, section 245.73;
(12) adult and children's
mental health grants under Minnesota Rules, parts 9535.1700 to 9535.1760;
(13) the group residential
housing supplementary service rate under Minnesota Statutes, section 256I.05,
subdivision 1a;
(14) adult mental health
integrated fund grants under Minnesota Statutes, section 245.4661;
(15) semi-independent living
services (SILS) under Minnesota Statutes, section 252.275, including SILS
funding under county social services grants formerly funded under Minnesota
Statutes, chapter 256I;
(16) community support
services for deaf and hard-of-hearing adults with mental illness who use or
wish to use sign language as their primary means of communication under
Minnesota Statutes, section 256.01, subdivision 2;
(17) living skills training
programs for persons with intractable epilepsy who need assistance in the
transition to independent living under Laws 1988, chapter 689;
(18) physical therapy
services under Minnesota Statutes, sections 256B.0625, subdivision 8, and
256D.03, subdivision 4;
(19) occupational therapy
services under Minnesota Statutes, sections 256B.0625, subdivision 8a, and
256D.03, subdivision 4;
(20) speech-language therapy
services under Minnesota Statutes, section 256D.03, subdivision 4, and
Minnesota Rules, part 9505.0390;
(21) respiratory therapy
services under Minnesota Statutes, section 256D.03, subdivision 4, and
Minnesota Rules, part 9505.0295;
(22) aging grants under
Minnesota Statutes, sections 256.975 to 256.977, 256B.0917, and 256B.0928;
(23) deaf and
hard-of-hearing grants under Minnesota Statutes, sections 256C.233; 256C.25;
Laws 1985, chapter 9, article 1; and Laws 1997, First Special Session chapter
5, section 20;
(24) children's therapeutic
services and supports under Minnesota Statutes, section 256B.0943;
(25) tier I chemical health
services under Minnesota Statutes, chapter 254B;
(26) consumer support grants
under Minnesota Statutes, section 256.476;
(27) family support grants
under Minnesota Statutes, section 252.32;
(28) case management
services to persons with HIV or AIDS under Minnesota Statutes, section 256.01,
subdivision 19; and
(29) adult rehabilitative
mental health services under Minnesota Statutes, section 256B.0623.
(c) Providers that receive a
rate increase under this section shall use 75 percent of the additional revenue
to increase wages and benefits and pay associated costs for all employees,
except for management fees, the administrator, and central office staff.
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(d) For public employees,
the increase for wages and benefits for certain staff is available and pay
rates must be increased only to the extent that they comply with laws governing
public employees' collective bargaining. Money received by a provider for pay
increases under this section may be used only for increases implemented on or
after the first day of the rate period in which the increase is available and
must not be used for increases implemented prior to that date.
(e) A copy of the provider's
plan for complying with paragraph (c) must be made available to all employees
by giving each employee a copy or by posting a copy in an area of the
provider's operation to which all employees have access. If an employee does
not receive the adjustment, if any, described in the plan and is unable to
resolve the problem with the provider, the employee may contact the employee's
union representative. If the employee is not covered by a collective bargaining
agreement, the employee may contact the commissioner at a telephone number
provided by the commissioner and included in the provider's plan.
(f) The commissioner and
each county agency shall take steps necessary to implement the increases
required by this section on the dates specified, and the increases must be
effective on the dates specified, regardless of the client's service
authorization date and notwithstanding the terms of any provider contract,
service agreement, or schedule that limits when a county may increase payment
rates.
Sec. 120. DENTAL ACCESS FOR PERSONS WITH
DISABILITIES.
The commissioner of human
services shall study access to dental services for persons with disabilities, and
shall present recommendations for improving access to dental services to the
legislature by January 15, 2008. The study must examine physical and geographic
access, the willingness of dentists to serve persons with disabilities enrolled
in state health care programs, reimbursement rates for dental service
providers, and other factors identified by the commissioner.
Sec. 121. COMMISSIONER REQUIRED TO SEEK FEDERAL
APPROVAL.
By October 1, 2007, the
commissioner shall seek federal approval to allow persons who have been
eligible for medical assistance for employed persons with disabilities (MA-EPD)
under Minnesota Statutes, section 256B.057, subdivision 9, for each of the 24
consecutive months prior to becoming age 65 to continue using the MA-EPD eligibility
rules as long as they qualify.
Sec. 122. MINNESOTA RULES.
The Department of
Administration shall publish adopted rules in the State Register making the
terminology changes specified in section 92 in Minnesota Rules. Upon
publication in the State Register, the terminology changes for Minnesota Rules
are adopted without further administrative action.
Sec. 123. REVISOR'S INSTRUCTION.
The revisor of statutes
shall change the terms in column A to the terms in column B wherever they
appear in Minnesota Statutes:
Column A Column
B
"Office of Ombudsman for Older "Office
of Ombudsman for
Minnesotans"and "Office of the Long-
Term Care"
Ombudsman for Older Minnesotans"
"ombudsman for older Minnesotans" "ombudsman
for long-term care"
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Sec. 124. REPEALER.
Minnesota Statutes 2006,
sections 252.21; 252.22; 252.23; 252.24; 252.25; 252.261; 252.275, subdivision
5; 256.9743; 256B.0913, subdivisions 5b, 5c, 5d, 5e, 5f, 5g, and 5h; and
256B.441, subdivisions 12, 16, 21, 26, 28, 42, and 45, are repealed.
ARTICLE 5
MENTAL HEALTH
Section 1. Minnesota
Statutes 2006, section 245.462, subdivision 20, is amended to read:
Subd. 20. Mental illness. (a) "Mental
illness" means an organic disorder of the brain or a clinically
significant disorder of thought, mood, perception, orientation, memory, or
behavior that is listed in the clinical manual of the International
Classification of Diseases (ICD-9-CM), current edition, code range 290.0 to
302.99 or 306.0 to 316.0 or the corresponding code in the American Psychiatric
Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-MD),
current edition, Axes I, II, or III, and that seriously limits a person's capacity
to function in primary aspects of daily living such as personal relations,
living arrangements, work, and recreation.
(b) An "adult with
acute mental illness" means an adult who has a mental illness that is
serious enough to require prompt intervention.
(c) For purposes of case
management and community support services, a "person with serious and
persistent mental illness" means an adult who has a mental illness and
meets at least one of the following criteria:
(1) the adult has undergone
two or more episodes of inpatient care for a mental illness within the
preceding 24 months;
(2) the adult has
experienced a continuous psychiatric hospitalization or residential treatment
exceeding six months' duration within the preceding 12 months;
(3) the adult has been
treated by a crisis team two or more times within the preceding 24 months;
(4) the adult:
(i) has a diagnosis of
schizophrenia, bipolar disorder, major depression, or borderline personality
disorder;
(ii) indicates a significant
impairment in functioning; and
(iii) has a written opinion
from a mental health professional, in the last three years, stating that the
adult is reasonably likely to have future episodes requiring inpatient or
residential treatment, of a frequency described in clause (1) or (2), unless
ongoing case management or community support services are provided;
(4) (5) the adult has, in the last
three years, been committed by a court as a person who is mentally ill under
chapter 253B, or the adult's commitment has been stayed or continued; or
(5) (6) the adult (i) was eligible
under clauses (1) to (4) (5), but the specified time period has
expired or the adult was eligible as a child under section 245.4871,
subdivision 6; and (ii) has a written opinion from a mental health professional,
in the last three years, stating that the adult is reasonably likely to have
future episodes requiring inpatient or residential treatment, of a frequency
described in clause (1) or (2), unless ongoing case management or community
support services are provided.
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Sec. 2. Minnesota Statutes 2006, section 245.465, is amended by adding
a subdivision to read:
Subd. 3. Responsibility not
duplicated. For individuals who have health care coverage, the
county board is not responsible for providing mental health services which are
within the limits of the individual's health care coverage.
Sec. 3. Minnesota Statutes 2006, section 245.4874, is amended to read:
245.4874 DUTIES OF COUNTY
BOARD.
Subdivision 1. Duties of the county board.
(a) The county board must:
(1) develop a system of affordable and locally available children's
mental health services according to sections 245.487 to 245.4887;
(2) establish a mechanism providing for
interagency coordination as specified in section 245.4875, subdivision 6;
(3) consider the assessment of unmet needs in the county as reported by
the local children's mental health advisory council under section 245.4875, subdivision
5, paragraph (b), clause (3). The county shall provide, upon request of the
local children's mental health advisory council, readily available data to
assist in the determination of unmet needs;
(4) assure that parents and providers in the county receive information
about how to gain access to services provided according to sections 245.487 to
245.4887;
(5) coordinate the delivery of children's mental health services with
services provided by social services, education, corrections, health, and
vocational agencies to improve the availability of mental health services to
children and the cost-effectiveness of their delivery;
(6) assure that mental health services delivered according to sections
245.487 to 245.4887 are delivered expeditiously and are appropriate to the
child's diagnostic assessment and individual treatment plan;
(7) provide the community with information about predictors and
symptoms of emotional disturbances and how to access children's mental health
services according to sections 245.4877 and 245.4878;
(8) provide for case management services to each child with severe
emotional disturbance according to sections 245.486; 245.4871, subdivisions 3
and 4; and 245.4881, subdivisions 1, 3, and 5;
(9) provide for screening of each child under section 245.4885 upon
admission to a residential treatment facility, acute care hospital inpatient
treatment, or informal admission to a regional treatment center;
(10) prudently administer grants and purchase-of-service contracts that
the county board determines are necessary to fulfill its responsibilities under
sections 245.487 to 245.4887;
(11) assure that mental health professionals, mental health
practitioners, and case managers employed by or under contract to the county to
provide mental health services are qualified under section 245.4871;
(12) assure that children's mental health services are coordinated with
adult mental health services specified in sections 245.461 to 245.486 so that a
continuum of mental health services is available to serve persons with mental
illness, regardless of the person's age;
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(13) assure that culturally
informed mental health consultants are used as necessary to assist the county
board in assessing and providing appropriate treatment for children of cultural
or racial minority heritage; and
(14) consistent with section
245.486, arrange for or provide a children's mental health screening to a child
receiving child protective services or a child in out-of-home placement, a
child for whom parental rights have been terminated, a child found to be
delinquent, and a child found to have committed a juvenile petty offense for
the third or subsequent time, unless a screening has been performed within the
previous 180 days, or the child is currently under the care of a mental health
professional. The court or county agency must notify a parent or guardian whose
parental rights have not been terminated of the potential mental health screening
and the option to prevent the screening by notifying the court or county agency
in writing. The screening shall be conducted with a screening instrument
approved by the commissioner of human services according to criteria that are
updated and issued annually to ensure that approved screening instruments are
valid and useful for child welfare and juvenile justice populations, and shall
be conducted by a mental health practitioner as defined in section 245.4871,
subdivision 26, or a probation officer or local social services agency staff
person who is trained in the use of the screening instrument. Training in the
use of the instrument shall include training in the administration of the
instrument, the interpretation of its validity given the child's current
circumstances, the state and federal data practices laws and confidentiality
standards, the parental consent requirement, and providing respect for families
and cultural values. If the screen indicates a need for assessment, the child's
family, or if the family lacks mental health insurance, the local social
services agency, in consultation with the child's family, shall have conducted
a diagnostic assessment, including a functional assessment, as defined in
section 245.4871. The administration of the screening shall safeguard the
privacy of children receiving the screening and their families and shall comply
with the Minnesota Government Data Practices Act, chapter 13, and the federal
Health Insurance Portability and Accountability Act of 1996, Public Law
104-191. Screening results shall be considered private data and the
commissioner shall not collect individual screening results.
(b) When the county board
refers clients to providers of children's therapeutic services and supports
under section 256B.0943, the county board must clearly identify the desired
services components not covered under section 256B.0943 and identify the
reimbursement source for those requested services, the method of payment, and
the payment rate to the provider.
Subd. 2. Responsibility not duplicated. For individuals who have
health care coverage, the county board is not responsible for providing mental
health services which are within the limits of the individual's health care
coverage.
Sec. 4. Minnesota Statutes
2006, section 245.50, subdivision 5, is amended to read:
Subd. 5. Special contracts; bordering states.
(a) An individual who is detained, committed, or placed on an involuntary basis
under chapter 253B may be confined or treated in a bordering state pursuant to
a contract under this section. An individual who is detained, committed, or
placed on an involuntary basis under the civil law of a bordering state may be
confined or treated in Minnesota pursuant to a contract under this section. A
peace or health officer who is acting under the authority of the sending state
may transport an individual to a receiving agency that provides services
pursuant to a contract under this section and may transport the individual back
to the sending state under the laws of the sending state. Court orders valid
under the law of the sending state are granted recognition and reciprocity in
the receiving state for individuals covered by a contract under this section to
the extent that the court orders relate to confinement for treatment or care of
mental illness or chemical dependency. Such treatment or care may address other
conditions that may be co-occurring with the mental illness or chemical
dependency. These court orders are not subject to legal challenge in the courts
of the receiving state. Individuals who are detained, committed, or placed
under the law of a sending state and who are transferred to a receiving state
under this section continue to be in the legal custody of the authority
responsible for them under the law of the sending state. Except in emergencies,
those individuals may not be transferred, removed, or furloughed from a
receiving agency without the specific approval of the authority responsible for
them under the law of the sending state.
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(b) While in the receiving state pursuant to a contract under this
section, an individual shall be subject to the sending state's laws and rules relating
to length of confinement, reexaminations, and extensions of confinement. No
individual may be sent to another state pursuant to a contract under this
section until the receiving state has enacted a law recognizing the validity
and applicability of this section.
(c) If an individual receiving services pursuant to a contract under
this section leaves the receiving agency without permission and the individual
is subject to involuntary confinement under the law of the sending state, the
receiving agency shall use all reasonable means to return the individual to the
receiving agency. The receiving agency shall immediately report the absence to
the sending agency. The receiving state has the primary responsibility for, and
the authority to direct, the return of these individuals within its borders and
is liable for the cost of the action to the extent that it would be liable for
costs of its own resident.
(d) Responsibility for payment for the cost of care remains with the
sending agency.
(e) This subdivision also applies to county contracts under subdivision
2 which include emergency care and treatment provided to a county resident in a
bordering state.
(f) If a Minnesota resident is admitted to a facility in a bordering
state under this chapter, a physician, licensed psychologist who has a doctoral
degree in psychology, or an advance practice registered nurse certified in
mental health, who is licensed in the bordering state, may act as an examiner
under sections 253B.07, 253B.08, 253B.092, 253B.12, and 253B.17 subject to the
same requirements and limitations in section 253B.02, subdivision 7.
Sec. 5. Minnesota Statutes 2006, section 245.98, subdivision 2, is
amended to read:
Subd. 2. Program. The
commissioner of human services shall establish a program for the treatment of
compulsive gamblers. The commissioner may contract with an entity with
expertise regarding the treatment of compulsive gambling to operate the
program. The program may include the establishment of a statewide toll-free
number, resource library, public education programs; regional in-service
training programs and conferences for health care professionals, educators,
treatment providers, employee assistance programs, and criminal justice
representatives; and the establishment of certification standards for programs
and service providers. The commissioner may enter into agreements with other
entities and may employ or contract with consultants to facilitate the
provision of these services or the training of individuals to qualify them to
provide these services. The program may also include inpatient and outpatient
treatment and rehabilitation services and for residents in a
temporary or permanent residential setting for mental health or chemical
dependency, and individuals in jails or correctional facilities. The program
may also include research studies. The research studies must include
baseline and prevalence studies for adolescents and adults to identify those at
the highest risk. The program must be approved by the commissioner before it is
established.
Sec. 6. Minnesota Statutes 2006, section 245.98, subdivision 5, is
amended to read:
Subd. 5. Standards. The
commissioner shall create standards for treatment and provider qualifications
for the treatment component of the compulsive gambling program. The
commissioner, in coordination with the commissioner of corrections, shall
create standards for the assessment and treatment of compulsive gamblers in
programs operated by the commissioner of corrections.
Sec. 7. [245A.175] MENTAL
HEALTH TRAINING REQUIREMENT.
Prior to placement of a child in a foster care home, the child foster
care provider, if required to be licensed, must complete two hours of training
that addresses the causes, symptoms, and key warning signs of mental health
disorders; cultural considerations; and effective approaches for dealing with a
child's behaviors. At least one hour of the annual 12-hour training requirement
for foster parents must be on children's mental health issues and treatment.
Training curriculum shall be approved by the commissioner of human services.
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Sec. 8. Minnesota Statutes 2006, section 246.54, subdivision 1, is
amended to read:
Subdivision 1. County portion
for cost of care. Except for chemical dependency services provided under
sections 254B.01 to 254B.09, the client's county shall pay to the state of
Minnesota a portion of the cost of care provided in a regional treatment center
or a state nursing facility to a client legally settled in that county. A
county's payment shall be made from the county's own sources of revenue and
payments shall be paid as follows: payments to the state from the county
shall equal 20 percent a percentage of the cost of care, as
determined by the commissioner, for each day, or the portion thereof, that the
client spends at a regional treatment center or a state nursing facility.
according to the following schedule for each admission:
(1) for the first 30 days: 20 percent until January 1, 2008, ten
percent from January 1, 2008, to June 30, 2009, and zero percent thereafter;
(2) 20 percent for days 31 to 60; and
(3) for any days over 60: 20 percent until January 1, 2008, 30 percent
from January 1, 2008, to June 30, 2009, 40 percent from July 1, 2009, to June
30, 2010, and 50 percent thereafter.
If payments received by the
state under sections 246.50 to 246.53 exceed 80 percent the noncounty
portion of the cost of care, the county shall be responsible for paying the
state only the remaining amount. The county shall not be entitled to
reimbursement from the client, the client's estate, or from the client's
relatives, except as provided in section 246.53. No such payments shall be
made for any client who was last committed prior to July 1, 1947.
Sec. 9. Minnesota Statutes 2006, section 256B.0625, subdivision 20, is
amended to read:
Subd. 20. Mental health case
management. (a) To the extent authorized by rule of the state agency,
medical assistance covers case management services to persons with serious and
persistent mental illness and children with severe emotional disturbance.
Services provided under this section must meet the relevant standards in
sections 245.461 to 245.4887, the Comprehensive Adult and Children's Mental
Health Acts, Minnesota Rules, parts 9520.0900 to 9520.0926, and 9505.0322,
excluding subpart 10.
(b) Entities meeting program standards set out in rules governing
family community support services as defined in section 245.4871, subdivision
17, are eligible for medical assistance reimbursement for case management
services for children with severe emotional disturbance when these services
meet the program standards in Minnesota Rules, parts 9520.0900 to 9520.0926 and
9505.0322, excluding subparts 6 and 10.
(c) Medical assistance and MinnesotaCare payment for mental health case
management shall be made on a monthly basis. In order to receive payment for an
eligible child, the provider must document at least a face-to-face contact with
the child, the child's parents, or the child's legal representative. To receive
payment for an eligible adult, the provider must document:
(1) at least a face-to-face contact with the adult or the adult's legal
representative; or
(2) at least a telephone contact with the adult or the adult's legal
representative and document a face-to-face contact with the adult or the
adult's legal representative within the preceding two months.
(d) Payment for mental health case management provided by county or
state staff shall be based on the monthly rate methodology under section
256B.094, subdivision 6, paragraph (b), with separate rates calculated for
child welfare and mental health, and within mental health, separate rates for
children and adults.
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(e) Payment for mental health case management provided by Indian health
services or by agencies operated by Indian tribes may be made according to this
section or other relevant federally approved rate setting methodology.
(f) Payment for mental health case management provided by vendors who
contract with a county or Indian tribe shall be based on a monthly rate
negotiated by the host county or tribe. The negotiated rate must not exceed the
rate charged by the vendor for the same service to other payers. If the service
is provided by a team of contracted vendors, the county or tribe may negotiate
a team rate with a vendor who is a member of the team. The team shall determine
how to distribute the rate among its members. No reimbursement received by
contracted vendors shall be returned to the county or tribe, except to
reimburse the county or tribe for advance funding provided by the county or
tribe to the vendor.
(g) If the service is provided by a team which includes contracted
vendors, tribal staff, and county or state staff, the costs for county or state
staff participation in the team shall be included in the rate for
county-provided services. In this case, the contracted vendor, the tribal
agency, and the county may each receive separate payment for services provided
by each entity in the same month. In order to prevent duplication of services,
each entity must document, in the recipient's file, the need for team case
management and a description of the roles of the team members.
(h) The commissioner shall calculate the nonfederal share of actual
medical assistance and general assistance medical care payments for each
county, based on the higher of calendar year 1995 or 1996, by service date,
project that amount forward to 1999, and transfer one-half of the result from
medical assistance and general assistance medical care to each county's mental
health grants under section 256E.12 for calendar year 1999. The annualized
minimum amount added to each county's mental health grant shall be $3,000 per
year for children and $5,000 per year for adults. The commissioner may reduce
the statewide growth factor in order to fund these minimums. The annualized
total amount transferred shall become part of the base for future mental health
grants for each county.
(i) Notwithstanding section 256B.19, subdivision 1, the nonfederal
share of costs for mental health case management shall be provided by the
recipient's county of responsibility, as defined in sections 256G.01 to
256G.12, from sources other than federal funds or funds used to match other
federal funds. If the service is provided by a tribal agency, the nonfederal
share, if any, shall be provided by the recipient's tribe. When this service
is paid by the state without a federal share through fee-for-service, 50
percent of the cost shall be provided by the recipient's county of
responsibility.
(j) Notwithstanding any administrative rule to the contrary, prepaid
medical assistance, general assistance medical care, and MinnesotaCare include
mental health case management. When the service is provided through prepaid
capitation, the nonfederal share is paid by the state and the county pays no
share.
(j)
(k) The commissioner may suspend, reduce, or terminate the reimbursement
to a provider that does not meet the reporting or other requirements of this
section. The county of responsibility, as defined in sections 256G.01 to
256G.12, or, if applicable, the tribal agency, is responsible for any federal
disallowances. The county or tribe may share this responsibility with its
contracted vendors.
(k)
(l) The commissioner shall set aside a portion of the federal funds
earned for county expenditures under this section to repay the special
revenue maximization account under section 256.01, subdivision 2, clause (15).
The repayment is limited to:
(1) the costs of developing and implementing this section; and
(2) programming the information systems.
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(l)
(m) Payments to counties and tribal agencies for case management
expenditures under this section shall only be made from federal earnings from
services provided under this section. When this service is paid by the state
without a federal share through fee-for-service, 50 percent of the cost shall
be provided by the state. Payments to county-contracted vendors shall
include both the federal earnings, the state share, and the
county share.
(m)
(n) Notwithstanding section 256B.041, county payments for the cost of
mental health case management services provided by county or state staff shall
not be made to the commissioner of finance. For the purposes of mental health
case management services provided by county or state staff under this section,
the centralized disbursement of payments to counties under section 256B.041
consists only of federal earnings from services provided under this section.
(n)
(o) Case management services under this subdivision do not include
therapy, treatment, legal, or outreach services.
(o)
(p) If the recipient is a resident of a nursing facility, intermediate
care facility, or hospital, and the recipient's institutional care is paid by
medical assistance, payment for case management services under this subdivision
is limited to the last 180 days of the recipient's residency in that facility
and may not exceed more than six months in a calendar year.
(p)
(q) Payment for case management services under this subdivision shall
not duplicate payments made under other program authorities for the same
purpose.
(q)
(r) By July 1, 2000, the commissioner shall evaluate the effectiveness
of the changes required by this section, including changes in number of persons
receiving mental health case management, changes in hours of service per
person, and changes in caseload size.
(r)
(s) For each calendar year beginning with the calendar year 2001, the
annualized amount of state funds for each county determined under paragraph (h)
shall be adjusted by the county's percentage change in the average number of
clients per month who received case management under this section during the
fiscal year that ended six months prior to the calendar year in question, in
comparison to the prior fiscal year.
(s)
(t) For counties receiving the minimum allocation of $3,000 or $5,000
described in paragraph (h), the adjustment in paragraph (s) shall be determined
so that the county receives the higher of the following amounts:
(1) a continuation of the minimum allocation in paragraph (h); or
(2) an amount based on that county's average number of clients per
month who received case management under this section during the fiscal year
that ended six months prior to the calendar year in question, times the average
statewide grant per person per month for counties not receiving the minimum
allocation.
(t)
(u) The adjustments in paragraphs (s) and (t) shall be calculated
separately for children and adults.
EFFECTIVE DATE. This section is
effective January 1, 2009, except the amendment to paragraph (i) is effective
January 1, 2008.
Sec. 10. Minnesota Statutes 2006, section 256B.0625, subdivision 47, is
amended to read:
Subd. 47. Treatment foster care
services. Effective July 1, 2006 2009, and subject to federal
approval, medical assistance covers treatment foster care services according to
section 256B.0946.
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Sec. 11. Minnesota Statutes 2006, section 256B.0945, subdivision 4, is
amended to read:
Subd. 4. Payment rates. (a)
Notwithstanding sections 256B.19 and 256B.041, payments to counties for
residential services provided by a residential facility shall only be made of
federal earnings for services provided under this section, and the nonfederal
share of costs for services provided under this section shall be paid by the
county from sources other than federal funds or funds used to match other
federal funds. Payment to counties for services provided according to this
section shall be a proportion of the per day contract rate that relates to
rehabilitative mental health services and shall not include payment for costs
or services that are billed to the IV-E program as room and board.
(b) Per diem rates paid to providers under this section by prepaid
plans shall be the proportion of the per-day contract rate that relates to
rehabilitative mental health services and shall not include payment for group
foster care costs or services that are billed to the county of financial
responsibility.
(c) The
commissioner shall set aside a portion not to exceed five percent of the
federal funds earned for county expenditures under this section to cover
the state costs of administering this section. Any unexpended funds from the
set-aside shall be distributed to the counties in proportion to their earnings
under this section.
EFFECTIVE DATE. This section is
effective January 1, 2009.
Sec. 12. Minnesota Statutes 2006, section 256B.69, subdivision 5g, is
amended to read:
Subd. 5g. Payment for covered services.
For services rendered on or after January 1, 2003, the total payment made to
managed care plans for providing covered services under the medical assistance
and general assistance medical care programs is reduced by .5 percent from
their current statutory rates. This provision excludes payments for nursing
home services, home and community-based waivers, and payments to
demonstration projects for persons with disabilities, and mental health
services added as covered benefits after December 31, 2007.
Sec. 13. Minnesota Statutes 2006, section 256B.69, subdivision 5h, is
amended to read:
Subd. 5h. Payment reduction.
In addition to the reduction in subdivision 5g, the total payment made to
managed care plans under the medical assistance program is reduced 1.0 percent
for services provided on or after October 1, 2003, and an additional 1.0
percent for services provided on or after January 1, 2004. This provision
excludes payments for nursing home services, home and community-based waivers, and
payments to demonstration projects for persons with disabilities, and mental
health services added as covered benefits after December 1, 2007.
Sec. 14. Minnesota Statutes 2006, section 256B.763, is amended to read:
256B.763 CRITICAL ACCESS MENTAL
HEALTH RATE INCREASE.
(a) For services defined in paragraph (b) and rendered on or after July
1, 2007, payment rates shall be increased by 23.7 percent over the rates in
effect on January 1, 2006, for:
(1) psychiatrists and advanced practice registered nurses with a
psychiatric specialty;
(2) community mental health centers under section 256B.0625,
subdivision 5; and
(3) mental health clinics and centers certified under Minnesota Rules,
parts 9520.0750 to 9520.0870, or hospital outpatient psychiatric departments
that are designated as essential community providers under section 62Q.19.
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(b) This increase applies to group skills training when provided as a
component of children's therapeutic services and support, psychotherapy,
medication management, evaluation and management, diagnostic assessment,
explanation of findings, psychological testing, neuropsychological services,
direction of behavioral aides, and inpatient consultation.
(c) This increase does not apply to rates that are governed by section
256B.0625, subdivision 30, or 256B.761, paragraph (b), other cost-based rates,
rates that are negotiated with the county, rates that are established by the
federal government, or rates that increased between January 1, 2004, and
January 1, 2005.
(d) The commissioner shall adjust rates paid to prepaid health plans
under contract with the commissioner to reflect the rate increases provided in
paragraph (a). The prepaid health plan must pass this rate increase to the
providers identified in paragraph (a) paragraphs (a), (e), and (f).
The prepaid plan must pass this rate increase to the providers identified in
paragraphs (a), (e), and (f).
(e) For MinnesotaCare only, payment rates shall be increased by 23.7
percent over the rates in effect on December 31, 2007, for:
(1) medication education services provided on or after January 1, 2008,
by adult rehabilitative mental health services providers certified under
section 256B.0623; and
(2) mental health behavioral aide services provided on or after January
1, 2008, by children's therapeutic services and support providers certified
under section 256B.0943.
(f) For services defined in paragraph (b) and rendered on or after January
1, 2008, by children's therapeutic services and support providers certified
under section 256B.0943 and not already included in paragraph (a), payment
rates for MinnesotaCare shall be increased by 23.7 percent over the rates in
effect on December 31, 2007.
Sec. 15. Minnesota Statutes 2006, section 256L.03, subdivision 1, is
amended to read:
Subdivision 1. Covered health
services. For individuals under section 256L.04, subdivision 7, with income
no greater than 75 percent of the federal poverty guidelines or for families
with children under section 256L.04, subdivision 1, all subdivisions of this
section apply. "Covered health services" means the health services
reimbursed under chapter 256B, with the exception of inpatient hospital services,
special education services, private duty nursing services, adult dental care
services other than services covered under section 256B.0625, subdivision 9,
orthodontic services, nonemergency medical transportation services, personal
care assistant and case management services, nursing home or intermediate care
facilities services, inpatient mental health services, and chemical dependency
services. Outpatient mental health services covered under the MinnesotaCare
program are limited to diagnostic assessments, psychological testing,
explanation of findings, mental health telemedicine, psychiatric consultation,
medication management by a physician, day treatment, partial hospitalization,
and individual, family, and group psychotherapy.
"Covered health services" also includes intensive mental
health outpatient treatment for dialectical behavioral therapy for adults.
No public funds shall be used for coverage of abortion under
MinnesotaCare except where the life of the female would be endangered or
substantial and irreversible impairment of a major bodily function would result
if the fetus were carried to term; or where the pregnancy is the result of rape
or incest.
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Covered health services shall
be expanded as provided in this section.
EFFECTIVE DATE. This section is
effective January 1, 2008, except coverage for mental health case management is
effective January 1, 2009.
Sec. 16. Minnesota Statutes
2006, section 256L.03, subdivision 5, is amended to read:
Subd. 5. Co-payments and coinsurance. (a) Except
as provided in paragraphs (b) and (c), the MinnesotaCare benefit plan shall
include the following co-payments and coinsurance requirements for all
enrollees:
(1) ten percent of the paid
charges for inpatient hospital services for adult enrollees, subject to an
annual inpatient out-of-pocket maximum of $1,000 per individual and $3,000 per
family;
(2) $3 per prescription for
adult enrollees;
(3) $25 for eyeglasses for
adult enrollees;
(4) $3 per nonpreventive
visit. For purposes of this subdivision, a "visit" means an episode
of service which is required because of a recipient's symptoms, diagnosis, or
established illness, and which is delivered in an ambulatory setting by a
physician or physician ancillary, chiropractor, podiatrist, nurse midwife,
advanced practice nurse, audiologist, optician, or optometrist; and
(5) $6 for nonemergency
visits to a hospital-based emergency room.
(b) Paragraph (a), clause
(1), does not apply to parents and relative caretakers of children under the
age of 21 in households with family income equal to or less than 175 percent of
the federal poverty guidelines. Paragraph (a), clause (1), does not apply to
parents and relative caretakers of children under the age of 21 in households
with family income greater than 175 percent of the federal poverty guidelines
for inpatient hospital admissions occurring on or after January 1, 2001.
(c) Paragraph (a), clauses
(1) to (4), do not apply to pregnant women and children under the age of 21.
(d) Paragraph (a), clause
(4), does not apply to mental health services.
(e) Adult enrollees with family
gross income that exceeds 175 percent of the federal poverty guidelines and who
are not pregnant shall be financially responsible for the coinsurance amount,
if applicable, and amounts which exceed the $10,000 inpatient hospital benefit
limit.
(e) (f) When a MinnesotaCare
enrollee becomes a member of a prepaid health plan, or changes from one prepaid
health plan to another during a calendar year, any charges submitted towards
the $10,000 annual inpatient benefit limit, and any out-of-pocket expenses
incurred by the enrollee for inpatient services, that were submitted or
incurred prior to enrollment, or prior to the change in health plans, shall be
disregarded.
Sec. 17. Minnesota Statutes
2006, section 256L.035, is amended to read:
256L.035 LIMITED BENEFITS COVERAGE FOR CERTAIN SINGLE ADULTS AND
HOUSEHOLDS WITHOUT CHILDREN.
(a) "Covered health
services" for individuals under section 256L.04, subdivision 7, with
income above 75 percent, but not exceeding 175 percent, of the federal poverty
guideline means:
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(1) inpatient hospitalization benefits with a ten percent co-payment up
to $1,000 and subject to an annual limitation of $10,000;
(2) physician services provided during an inpatient stay; and
(3) physician services not provided during an inpatient stay; outpatient
hospital services; freestanding ambulatory surgical center services;
chiropractic services; lab and diagnostic services; diabetic supplies and
equipment; mental health services as covered under chapter 256B; and
prescription drugs; subject to the following co-payments:
(i) $50 co-pay per emergency room visit;
(ii) $3 co-pay per prescription drug; and
(iii) $5 co-pay per nonpreventive visit; except this co-pay does not
apply to mental health services or community mental health services.
The services covered under
this section may be provided by a physician, physician ancillary, chiropractor,
psychologist, or licensed independent clinical social worker, or
other mental health providers covered under chapter 256B if the services
are within the scope of practice of that health care professional.
For purposes of this section, "a visit" means an episode of
service which is required because of a recipient's symptoms, diagnosis, or
established illness, and which is delivered in an ambulatory setting by any
health care provider identified in this paragraph.
Enrollees are responsible for all co-payments in this section.
(b) Reimbursement to the providers shall be reduced by the amount of
the co-payment, except that reimbursement for prescription drugs shall not be
reduced once a recipient has reached the $20 per month maximum for prescription
drug co-payments. The provider collects the co-payment from the recipient.
Providers may not deny services to recipients who are unable to pay the
co-payment, except as provided in paragraph (c).
(c) If it is the routine business practice of a provider to refuse
service to an individual with uncollected debt, the provider may include
uncollected co-payments under this section. A provider must give advance notice
to a recipient with uncollected debt before services can be denied.
EFFECTIVE DATE. This section is
effective January 1, 2008, except coverage for mental health case management
under paragraph (a), clause (3), is effective January 1, 2009.
Sec. 18. Minnesota Statutes 2006, section 256L.12, subdivision 9a, is
amended to read:
Subd. 9a. Rate setting; ratable
reduction. For services rendered on or after October 1, 2003, the total payment
made to managed care plans under the MinnesotaCare program is reduced 1.0
percent. This provision excludes payments for mental health services added
as covered benefits after December 31, 2007.
Sec. 19. Minnesota Statutes 2006, section 609.115, subdivision 9, is
amended to read:
Subd. 9. Compulsive gambling
assessment required. (a) If a person is convicted of theft under section
609.52, embezzlement of public funds under section 609.54, or forgery under
section 609.625, 609.63, or 609.631, the probation officer shall determine in
the report prepared under subdivision 1 whether or not compulsive gambling
contributed to the commission of the offense. If so, the report shall contain
the results of a compulsive gambling assessment conducted in accordance with
this subdivision. The probation officer shall make an appointment for the
offender to undergo the assessment if so indicated.
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(b) The compulsive gambling
assessment report must include a recommended level of treatment for the
offender if the assessor concludes that the offender is in need of compulsive
gambling treatment. The assessment must be conducted by an assessor qualified
under section 245.98, subdivision 2a, to perform these assessments or to
provide compulsive gambling treatment. An assessor providing a compulsive
gambling assessment may not have any direct or shared financial interest or
referral relationship resulting in shared financial gain with a treatment provider.
If an independent assessor is not available, the probation officer may use the
services of an assessor with a financial interest or referral relationship as
authorized under rules adopted by the commissioner of human services under
section 245.98, subdivision 2a.
(c) The commissioner of
human services shall reimburse the assessor for the costs associated with a
compulsive gambling assessment at a rate established by the commissioner up to
a maximum of $100 for each assessment. To the extent practicable, the
commissioner shall standardize reimbursement rates for assessments. The
commissioner shall reimburse these costs after receiving written verification
from the probation officer that the assessment was performed and found
acceptable.
(d) The commissioner shall
make a report to the legislature by January 15, 2008, regarding the transfer of
funds to counties for state registered nurses employed in community mental
health pilot projects as part of the assertive community treatment teams under
section 245.4661. The report shall address the impact of the nursing shortage
on replacing these positions, continuity of patient care if these positions
cannot be filled, and ways to maintain state registered nurses in these
positions until the nurse retires or leaves employment. No funds for state
registered nurse positions may be transferred before the report date.
Sec. 20. CASE MANAGEMENT; BEST PRACTICES.
The commissioner of human
services, in consultation with consumers, families, counties, and other interested
stakeholders, will develop recommendations for changes in the adult mental
health act related to case management, consistent with evidence-based and best
practices.
Sec. 21. REGIONAL CHILDREN'S MENTAL HEALTH
INITIATIVE.
Subdivision 1. Pilot project authorized; purpose. A two-year Regional
Children's Mental Health Initiative pilot project is established to improve
children's mental health service coordination, communication, and processes in
Blue Earth, Brown, Faribault, Freeborn, Le Sueur, Martin, Nicollet, Rice,
Sibley, Waseca, and Watonwan Counties. The purpose of the Regional Children's
Mental Health Initiative will be to plan and develop new programs and services
related to children's mental health in south central Minnesota.
Subd. 2. Goals. To accomplish its purpose, the Regional Children's
Mental Health Initiative shall have the following goals:
(1) work to streamline
delivery and regional access to services;
(2) share strategies and
resources for the management of out-of-home placements;
(3) establish standard
protocols and operating procedures for functions that are performed across all
counties;
(4) share information to
improve resource allocation and service delivery across counties;
(5) evaluate outcomes of
various treatment alternatives;
(6) create a network for and
provide support to service delivery groups;
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(7) establish a regional process to match children in need of
out-of-home placement with foster homes that can meet their needs; and
(8) recruit and retain foster homes.
Subd. 3. Director's Council. The
Director's Council shall govern the operations of the Regional Children's
Mental Health Initiative. Members of the Director's Council shall represent
each of the 11 counties participating in the pilot project.
Subd. 4. Regional Children's Mental
Health Initiative Team. The members of the Regional Children's
Mental Health Initiative Team shall conduct planning and development of new and
modified children's mental health programs and services in the region. Members
of the team shall reflect the cultural, demographic, and geographic diversity
of the region and shall be composed of representatives from each of the
following:
(1) the medical community;
(2) human services;
(3) corrections;
(4) education;
(5) mental health providers and vendors;
(6) advocacy organizations;
(7) parents; and
(8) children and youth.
Subd. 5. Authority. The
regional children's mental health initiative shall have the authority to
develop and implement the following programs:
(1) Flexible funding payments. This program will make funds available
to respond to the unique and unpredictable needs of children with mental health
issues such as the need for prescription drugs, transportation, clothing, and
assessments not otherwise available.
(2) Transition to self-sufficiency. This program will help youths
between the ages of 14 and 21 establish professional relationships, find jobs,
build financial foundations, and learn to fulfill their roles as productive
citizens.
(3) Crisis response. This program will establish public and private
partnerships to offer a range of options to meet the needs of children in
crisis. Methods to meet these needs may include accessible local services,
holistic assessments, urgent care and stabilization services, and telehealth
for specialized diagnosis and therapeutic sessions.
(4) Integrated services for complex conditions. This program will design,
develop, and implement packages of integrated services to meet the needs of
children with specific, complex conditions.
Subd. 6. Evaluation and report.
The regional children's mental health initiative shall develop a method for evaluating
the effectiveness of this pilot project focusing on identifiable goals and
outcomes. An interim report on the pilot project's effectiveness shall be
submitted to the house and senate finance committees having jurisdiction over
mental health, the commissioner of human services, and the Minnesota
Association of County Social Service Administrators no later than December 31,
2008. A final report is due no later than December 31, 2009.
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Sec. 22. TRAUMA-FOCUSED EVIDENCE-BASED PRACTICES
TO CHILDREN.
Organizations that are
certified to provide children's therapeutic services and supports under
Minnesota Statutes, section 256B.0943, are eligible to apply for a grant.
Grants are to be used to provide trauma-focused evidence-based practices to
children who are living in a battered women's shelter, homeless shelter,
transitional housing, or supported housing. Children served must have been
exposed to or witnessed domestic violence, have been exposed to or witnessed
community violence, or be a refugee. Priority shall be given to organizations
that demonstrate collaboration with battered women's shelters, homeless
shelters, or providers of transitional housing or supported housing. The
commissioner shall specify which constitutes evidence-based practice.
Organizations shall use all available funding streams.
Sec. 23. DUAL DIAGNOSIS; DEMONSTRATION PROJECT.
(a) The commissioner of
human services shall fund demonstration projects for high risk adults with
serious mental illness and co-occurring substance abuse problems. The projects
must include, but not be limited to, the following:
(1) housing services,
including rent or housing subsidies, housing with clinical staff, or housing
support;
(2) assertive outreach
services; and
(3) intensive direct
therapeutic, rehabilitative, and care management services oriented to harm
reduction.
(b) The commissioner shall
work with providers to ensure proper licensure or certification to meet medical
assistance or third-party payor reimbursement requirements.
Sec. 24. MINNESOTA FAMILY INVESTMENT PROGRAM AND
CHILDREN'S MENTAL HEALTH PILOT PROJECT.
Subdivision 1. Pilot project authorized. The commissioner of human
services shall fund a three-year pilot project to measure the effect of
children's identified mental health needs, including social and emotional
needs, on Minnesota family investment program (MFIP) participants' ability to
obtain and retain employment. The project shall also measure the effect on work
activity of MFIP participants' needs to address their children's identified
mental health needs.
Subd. 2. Provider and agency proposals. (a) Interested MFIP
providers and agencies shall:
(1) submit proposals
defining how they will identify participants whose children have mental health
needs that hinder the employment process;
(2) connect families with
appropriate developmental, social, and emotional screenings and services; and
(3) incorporate those
services into the participant's employment plan.
Each proposal under this
paragraph must include an evaluation component.
(b) Interested MFIP
providers and agencies shall develop a protocol to inform MFIP participants of
the following:
(1) the availability of
developmental, social, and emotional screening tools for children and youth;
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(2) the purpose of the screenings;
(3) how the information will be used to assist the participants in
identifying and addressing potential barriers to employment; and
(4) that their employment plan may be modified based on the screening
results.
Subd. 3. Program components. (a)
MFIP providers shall obtain the participant's written consent for participation
in the pilot project, including consent for developmental, social, and
emotional screening.
(b) MFIP providers shall coordinate with county social service agencies
and health plans to assist recipients in arranging referrals indicated by the
screening results.
(c) Tools used for developmental, social, and emotional screenings
shall be approved by the commissioner of human services.
Subd. 4. Program evaluation. The
commissioner of human services shall conduct an evaluation of the pilot project
to determine:
(1) the number of participants who took part in the screening;
(2) the number of children who were screened and what screening tools
were used;
(3) the number of children who were identified in the screening who
needed referral or follow-up services;
(4) the number of children who received services, what agency provided
the services, and what type of services were provided;
(5) the number of employment plans that were adjusted to include the
activities recommended in the screenings;
(6) the changes in work participation rates;
(7) the changes in earned income;
(8) the changes in sanction rates; and
(9) the participants' report of program effectiveness.
Subd. 5. Work activity. Participant
involvement in screenings and subsequent referral and follow-up services shall
count as work activity under Minnesota Statutes, section 256J.49, subdivision
13.
Sec. 25. SOCIAL AND ECONOMIC
COSTS OF GAMBLING.
Subdivision 1. Report. The
commissioner of human services, in consultation with the state affiliate of the
National Council on Problem Gambling, stakeholders, and licensed vendors, shall
prepare a report that provides a process and funding mechanism to study the
issues in subdivisions 2 and 3. The commissioner, in consultation with the
state affiliate of the National Council on Problem Gambling, stakeholders, and
licensed vendors, shall include in the report potential financial commitments
made by stakeholders and others in order to fund the study. The report is due
to the legislative committees having jurisdiction over compulsive gambling
issues by December 1, 2007.
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Subd. 2. Issues to be addressed. The study must address:
(1) state, local, and tribal
government policies and practices in Minnesota to legalize or prohibit
gambling;
(2) the relationship between
gambling and crime in Minnesota, including: (i) the relationship between
gambling and overall crime rates; (ii) the relationship between gambling and
crimes rates for specific crimes, such as forgery, domestic abuse, child
neglect and abuse, alcohol and drug offenses, and youth crime; and (iii)
enforcement and regulation practices that are intended to address the
relationship between gambling and levels of crime;
(3) the relationship between
expanded gambling and increased rates of problem gambling in Minnesota,
including the impact of pathological or problem gambling on individuals,
families, businesses, social institutions, and the economy;
(4) the social impact of
gambling on individuals, families, businesses, and social institutions in
Minnesota, including an analysis of the relationship between gambling and
depression, abuse, divorce, homelessness, suicide, and bankruptcy;
(5) the economic impact of
gambling on state, local, and tribal economies in Minnesota; and
(6) any other issues deemed
necessary in assessing the social and economic impact of gambling in Minnesota.
Subd. 3. Quantification of social and economic impact. The study
shall quantify the social and economic impact on both (1) state, local, and
tribal governments in Minnesota, and (2) Minnesota's communities and social
institutions, including individuals, families, and businesses within those
communities and institutions.
Sec. 26. REPEALER.
Minnesota Rules, part
9585.0030, is repealed.
ARTICLE 6
DEPARTMENT OF HEALTH
Section 1. Minnesota
Statutes 2006, section 62J.17, subdivision 2, is amended to read:
Subd. 2. Definitions. For purposes of this
section, the terms defined in this subdivision have the meanings given.
(a) "Access" means
the financial, temporal, and geographic availability of health care to
individuals who need it.
(b) (a) "Capital
expenditure" means an expenditure which, under generally accepted
accounting principles, is not properly chargeable as an expense of operation
and maintenance.
(c) "Cost" means
the amount paid by consumers or third party payers for health care services or
products.
(d) "Date of the major
spending commitment" means the date the provider formally obligated itself
to the major spending commitment. The obligation may be incurred by entering
into a contract, making a down payment, issuing bonds or entering a loan agreement
to provide financing for the major spending commitment, or taking some other
formal, tangible action evidencing the provider's intention to make the major
spending commitment.
(e) (b) "Health
care service" means:
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(1) a service or item that
would be covered by the medical assistance program under chapter 256B if
provided in accordance with medical assistance requirements to an eligible
medical assistance recipient; and
(2) a service or item that
would be covered by medical assistance except that it is characterized as
experimental, cosmetic, or voluntary.
"Health care
service" does not include retail, over-the-counter sales of
nonprescription drugs and other retail sales of health-related products that
are not generally paid for by medical assistance and other third-party
coverage.
(f) (c) "Major
spending commitment" means an expenditure in excess of $1,000,000 for:
(1) acquisition of a unit of
medical equipment;
(2) a capital expenditure
for a single project for the purposes of providing health care services, other
than for the acquisition of medical equipment;
(3) offering a new
specialized service not offered before;
(4) planning for an activity
that would qualify as a major spending commitment under this paragraph; or
(5) a project involving a
combination of two or more of the activities in clauses (1) to (4).
The cost of acquisition of
medical equipment, and the amount of a capital expenditure, is the total cost
to the provider regardless of whether the cost is distributed over time through
a lease arrangement or other financing or payment mechanism.
(g) (d) "Medical
equipment" means fixed and movable equipment that is used by a provider in
the provision of a health care service. "Medical equipment" includes,
but is not limited to, the following:
(1) an extracorporeal shock
wave lithotripter;
(2) a computerized axial
tomography (CAT) scanner;
(3) a magnetic resonance
imaging (MRI) unit;
(4) a positron emission
tomography (PET) scanner; and
(5) emergency and
nonemergency medical transportation equipment and vehicles.
(h) (e) "New
specialized service" means a specialized health care procedure or
treatment regimen offered by a provider that was not previously offered by the
provider, including, but not limited to:
(1) cardiac catheterization
services involving high-risk patients as defined in the Guidelines for Coronary
Angiography established by the American Heart Association and the American
College of Cardiology;
(2) heart, heart-lung,
liver, kidney, bowel, or pancreas transplantation service, or any other service
for transplantation of any other organ;
(3) megavoltage radiation
therapy;
(4) open heart surgery;
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(5) neonatal intensive care
services; and
(6) any new medical
technology for which premarket approval has been granted by the United States
Food and Drug Administration, excluding implantable and wearable devices.
(f) "Specialty
care" includes but is not limited to cardiac, neurology, orthopedic,
obstetrics, mental health, chemical dependency, and emergency services.
Sec. 2. Minnesota Statutes 2006,
section 62J.17, subdivision 4a, is amended to read:
Subd. 4a. Expenditure reporting. (a) A
provider making a major spending commitment after April 1, 1992, shall submit
notification of the expenditure to the commissioner and provide the
commissioner with any relevant background information.
(b) Notification must
include a report, submitted within 60 days after the date of the major spending
commitment, using terms conforming to the definitions in section 62J.03 and this
section. Each report is subject to retrospective review and must contain:
(1) a detailed description
of the major spending commitment, including the specific dollar amount of each
expenditure, and its purpose;
(2) the date of the major
spending commitment;
(3) a statement of the
expected impact that the major spending commitment will have on charges by the
provider to patients and third party payers;
(4) a statement of the
expected impact on the clinical effectiveness or quality of care received by
the patients that the provider expects to serve;
(5) a statement of the
extent to which equivalent services or technology are already available to the
provider's actual and potential patient population;
(6) a statement of the
distance from which the nearest equivalent services or technology are already
available to the provider's actual and potential population;
(7) a statement describing
the pursuit of any lawful collaborative arrangements; and
(8) a statement of assurance
that the provider will not use, purchase, or perform health care technologies
and procedures that are not clinically effective and cost-effective, unless the
technology is used for experimental or research purposes to determine whether a
technology or procedure is clinically effective and cost-effective.
The provider may submit any
additional information that it deems relevant.
(c) The commissioner may
request additional information from a provider for the purpose of review of a
report submitted by that provider, and may consider relevant information from
other sources. A provider shall provide any information requested by the
commissioner within the time period stated in the request, or within 30 days
after the date of the request if the request does not state a time.
(d) If the provider fails to
submit a complete and timely expenditure report, including any additional
information requested by the commissioner, the commissioner may make the
provider's subsequent major spending commitments subject to the procedures of
prospective review and approval under subdivision 6a.
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Each hospital, outpatient
surgical center, diagnostic imaging center, and physician clinic shall report
annually to the commissioner on all major spending commitments, in the form and
manner specified by the commissioner. The report shall include the following
information:
(a) a description of major
spending commitments made during the previous year, including the total dollar
amount of major spending commitments and purpose of the expenditures;
(b) the cost of land
acquisition, construction of new facilities, and renovation of existing
facilities;
(c) the cost of purchased or
leased medical equipment, by type of equipment;
(d) expenditures by type for
specialty care and new specialized services;
(e) information on the
amount and types of added capacity for diagnostic imaging services, outpatient
surgical services, and new specialized services; and
(f) information on
investments in electronic medical records systems.
For hospitals and outpatient
surgical centers, this information shall be included in reports to the
commissioner that are required under section 144.698. For diagnostic imaging
centers, this information shall be included in reports to the commissioner that
are required under section 144.565. For physician clinics, this information
shall be included in reports to the commissioner that are required under section
62J.41. For all other health care providers that are subject to this reporting
requirement, reports must be submitted to the commissioner by March 1 each year
for the preceding calendar year.
Sec. 3. Minnesota Statutes
2006, section 62J.17, subdivision 7, is amended to read:
Subd. 7. Exceptions. (a) The retrospective
review process as described in subdivision 5a and the prospective review and
approval process as described in subdivision 6a reporting requirement in
subdivision 4a do does not apply to:
(1) a major spending
commitment to replace existing equipment with comparable equipment used for
direct patient care, upgrades of equipment beyond the current model, or
comparable model must be reported;
(2) (1) a major spending commitment
made by a research and teaching institution for purposes of conducting medical
education, medical research supported or sponsored by a medical school, or by a
federal or foundation grant or clinical trials;
(3) a major spending commitment
to repair, remodel, or replace existing buildings or fixtures if, in the
judgment of the commissioner, the project does not involve a substantial
expansion of service capacity or a substantial change in the nature of health
care services provided;
(4) (2) a major spending commitment
for building maintenance including heating, water, electricity, and other
maintenance-related expenditures; and
(5) (3) a major spending commitment
for activities, not directly related to the delivery of patient care services,
including food service, laundry, housekeeping, and other service-related
activities; and.
(6) a major spending
commitment for computer equipment or data systems not directly related to the
delivery of patient care services, including computer equipment or data systems
related to medical record automation.
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(b) In addition to the exceptions listed in paragraph (a), the prospective
review and approval process described in subdivision 6a reporting
requirement in subdivision 4a does not apply to mergers, acquisitions, and
other changes in ownership or control that, in the judgment of the
commissioner, do not involve a substantial expansion of service capacity or a
substantial change in the nature of health care services provided.
Sec. 4. Minnesota Statutes 2006, section 62J.41, subdivision 1, is
amended to read:
Subdivision 1. Cost containment
data to be collected from providers. The commissioner shall require health
care providers to collect and provide both patient specific information and
descriptive and financial aggregate data on:
(1) the total number of patients served;
(2) the total number of patients served by state of residence and
Minnesota county;
(3) the site or sites where the health care provider provides services;
(4) the number of individuals employed, by type of employee, by the
health care provider;
(5) the services and their costs for which no payment was received;
(6) total revenue by type of payer or by groups of payers, including
but not limited to, revenue from Medicare, medical assistance, MinnesotaCare,
nonprofit health service plan corporations, commercial insurers, health
maintenance organizations, and individual patients;
(7) revenue from research activities;
(8) revenue from educational activities;
(9) revenue from out-of-pocket payments by patients;
(10) revenue from donations; and
(11) a report on health care capital expenditures during the previous
year, as required by section 62J.17; and
(11) (12)
any other data required by the commissioner, including data in unaggregated
form, for the purposes of developing spending estimates, setting spending
limits, monitoring actual spending, and monitoring costs.
The commissioner may, by
rule, modify the data submission categories listed above if the commissioner
determines that this will reduce the reporting burden on providers without
having a significant negative effect on necessary data collection efforts.
Sec. 5. Minnesota Statutes 2006, section 62J.52, subdivision 1, is
amended to read:
Subdivision 1. Uniform billing
form CMS 1450. (a) On and after January 1, 1996, all institutional
inpatient hospital services, ancillary services, institutionally owned or
operated outpatient services rendered by providers in Minnesota, and
institutional or noninstitutional home health services that are not being
billed using an equivalent electronic billing format, must be billed using the
uniform billing form CMS 1450, except as provided in subdivision 5.
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(b) The instructions and
definitions for the use of the uniform billing form CMS 1450 shall be in accordance
with the uniform billing form manual specified by the commissioner. In
promulgating these instructions, the commissioner may utilize the manual
developed by the National Uniform Billing Committee, as adopted and finalized
by the Minnesota Uniform Billing Committee.
(c) Services to be billed
using the uniform billing form CMS 1450 include: institutional inpatient
hospital services and distinct units in the hospital such as psychiatric unit
services, physical therapy unit services, swing bed (SNF) services, inpatient
state psychiatric hospital services, inpatient skilled nursing facility
services, home health services (Medicare part A), and hospice services;
ancillary services, where benefits are exhausted or patient has no Medicare
part A, from hospitals, state psychiatric hospitals, skilled nursing
facilities, and home health (Medicare part B); institutional owned or operated
outpatient services such as waivered services, hospital outpatient services,
including ambulatory surgical center services, hospital referred laboratory
services, hospital-based ambulance services, and other hospital outpatient
services, skilled nursing facilities, home health, freestanding renal dialysis
centers, comprehensive outpatient rehabilitation facilities (CORF), outpatient
rehabilitation facilities (ORF), rural health clinics, and community mental
health centers; home health services such as home health intravenous therapy
providers, waivered services, personal care attendants, and hospice; and any
other health care provider certified by the Medicare program to use this form.
(d) On and after January 1,
1996, a mother and newborn child must be billed separately, and must not be
combined on one claim form.
(e) Services provided by
Medicare Critical Access Hospitals electing Method II billing will be allowed
an exception to this provision to allow the inclusion of the professional fees
on the CMS 1450.
Sec. 6. Minnesota Statutes
2006, section 62J.52, subdivision 2, is amended to read:
Subd. 2. Uniform billing form CMS 1500. (a) On
and after January 1, 1996, all noninstitutional health care services rendered
by providers in Minnesota except dental or pharmacy providers, that are not
currently being billed using an equivalent electronic billing format, must be
billed using the health insurance claim form CMS 1500, except as provided in
subdivision 5.
(b) The instructions and
definitions for the use of the uniform billing form CMS 1500 shall be in
accordance with the manual developed by the Administrative Uniformity Committee
entitled standards for the use of the CMS 1500 form, dated February 1994, as
further defined by the commissioner.
(c) Services to be billed
using the uniform billing form CMS 1500 include physician services and
supplies, durable medical equipment, noninstitutional ambulance services,
independent ancillary services including occupational therapy, physical
therapy, speech therapy and audiology, home infusion therapy, podiatry
services, optometry services, mental health licensed professional services,
substance abuse licensed professional services, nursing practitioner
professional services, certified registered nurse anesthetists, chiropractors,
physician assistants, laboratories, medical suppliers, and other health care
providers such as day activity centers and freestanding ambulatory surgical
centers.
(d) Services provided by
Medicare Critical Access Hospitals electing Method II billing will be allowed
an exception to this provision to allow the inclusion of the professional fees
on the CMS 1450.
Sec. 7. Minnesota Statutes
2006, section 62J.60, subdivision 2, is amended to read:
Subd. 2. General characteristics. (a) The
Minnesota uniform health care identification card must be a preprinted card
constructed of plastic, paper, or any other medium that conforms with ANSI and
ISO 7810 physical characteristics standards. The card dimensions must also
conform to ANSI and ISO 7810 physical characteristics
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standard. The use of a
signature panel is optional. The uniform prescription drug information
contained on the card must conform with the format adopted by the NCPDP and,
except as provided in subdivision 3, paragraph (a), clause (2), must include
all of the fields required to submit a claim in conformance with the most
recent pharmacy identification card implementation guide produced by the NCPDP.
All information required to submit a prescription drug claim, exclusive of
information provided on a prescription that is required by law, must be
included on the card in a clear, readable, and understandable manner. If a
health benefit plan requires a conditional or situational field, as defined by
the NCPDP, the conditional or situational field must conform to the most recent
pharmacy information card implementation guide produced by the NCPDP.
(b) The Minnesota uniform
health care identification card must have an essential information window on
the front side with the following data elements: card issuer name, electronic
transaction routing information, card issuer identification number, cardholder
(insured) identification number, and cardholder (insured) identification name.
No optional data may be interspersed between these data elements.
(c) Standardized labels are
required next to human readable data elements and must come before the human
data elements.
Sec. 8. Minnesota Statutes
2006, section 62J.60, subdivision 3, is amended to read:
Subd. 3. Human readable data elements. (a) The
following are the minimum human readable data elements that must be present on
the front side of the Minnesota uniform health care identification card:
(1) card issuer name or
logo, which is the name or logo that identifies the card issuer. The card
issuer name or logo may be located at the top of the card. No standard label is
required for this data element;
(2) complete electronic
transaction routing information including, at a minimum, the international
identification number. The standardized label of this data element is
"RxBIN." Processor control numbers and group numbers are required if
needed to electronically process a prescription drug claim. The standardized
label for the process control numbers data element is "RxPCN" and the
standardized label for the group numbers data element is "RxGrp,"
except that if the group number data element is a universal element to be used
by all health care providers, the standardized label may be "Grp." To
conserve vertical space on the card, the international identification number
and the processor control number may be printed on the same line;
(3) cardholder (insured)
identification number, which is the unique identification number of the
individual card holder established and defined under this section. The
standardized label for the data element is "ID";
(4) cardholder (insured)
identification name, which is the name of the individual card holder. The
identification name must be formatted as follows: first name, space, optional
middle initial, space, last name, optional space and name suffix. The
standardized label for this data element is "Name";
(5) care type, which is the
description of the group purchaser's plan product under which the beneficiary
is covered. The description shall include the health plan company name and the
plan or product name. The standardized label for this data element is
"Care Type";
(6) service type, which is
the description of coverage provided such as hospital, dental, vision,
prescription, or mental health. The standard label for this data element is
"Svc Type"; and
(7) provider/clinic name,
which is the name of the primary care clinic the card holder is assigned to by
the health plan company. The standard label for this field is "PCP." This
information is mandatory only if the health plan company assigns a specific
primary care provider to the card holder.
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(b) The following human readable data elements shall be present on the
back side of the Minnesota uniform health care identification card. These
elements must be left justified, and no optional data elements may be
interspersed between them:
(1) claims submission names and addresses, which are the names and addresses
of the entity or entities to which claims should be submitted. If different
destinations are required for different types of claims, this must be labeled;
(2) telephone numbers and names that pharmacies and other health care
providers may call for assistance. These telephone numbers and names are
required on the back side of the card only if one of the contacts listed in
clause (3) cannot provide pharmacies or other providers with assistance or with
the telephone numbers and names of contacts for assistance; and
(3) telephone numbers and names; which are the telephone numbers and
names of the following contacts with a standardized label describing the
service function as applicable:
(i) eligibility and benefit information;
(ii) utilization review;
(iii) precertification; or
(iv) customer services.
(c) The following human readable data elements are mandatory on the
back side of the Minnesota uniform health care identification card for health
maintenance organizations:
(1) emergency care authorization telephone number or instruction on how
to receive authorization for emergency care. There is no standard label
required for this information; and
(2) one of the following:
(i) telephone number to call to appeal to or file a complaint with the
commissioner of health; or
(ii) for persons enrolled under section 256B.69, 256D.03, or 256L.12,
the telephone number to call to file a complaint with the ombudsperson
designated by the commissioner of human services under section 256B.69 and the
address to appeal to the commissioner of human services. There is no standard
label required for this information.
(d) All human readable data elements not required under paragraphs (a)
to (c) are optional and may be used at the issuer's discretion.
Sec. 9. Minnesota Statutes 2006, section 62Q.80, is amended by adding a
subdivision to read:
Subd. 1a. Demonstration project.
The commissioner of health shall award a demonstration project grant to a
community-based health care initiative to develop and operate a community-based
health care coverage program to operate within Carlton, Cook, Lake, and St.
Louis Counties. The demonstration project shall extend for five years and must
comply with all the requirements of this section.
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Sec. 10. Minnesota Statutes 2006, section 62Q.80, subdivision 3, is
amended to read:
Subd. 3. Approval. (a) Prior
to the operation of a community-based health care coverage program, a community-based
health initiative shall submit to the commissioner of health for approval the
community-based health care coverage program developed by the initiative. The
commissioner shall only approve a program that has been awarded a community
access program grant from the United States Department of Health and Human
Services. The commissioner shall ensure that the program meets the federal
grant requirements and any requirements described in this section and is
actuarially sound based on a review of appropriate records and methods utilized
by the community-based health initiative in establishing premium rates for the
community-based health care coverage program.
(b) Prior to approval, the commissioner shall also ensure that:
(1) the benefits offered comply with subdivision 8 and that there are
adequate numbers of health care providers participating in the community-based
health network to deliver the benefits offered under the program;
(2) the activities of the program are limited to activities that are exempt
under this section or otherwise from regulation by the commissioner of
commerce;
(3) the complaint resolution process meets the requirements of
subdivision 10; and
(4) the data privacy policies and procedures comply with state and
federal law.
Sec. 11. Minnesota Statutes 2006, section 62Q.80, subdivision 4, is
amended to read:
Subd. 4. Establishment. (a)
The initiative shall establish and operate upon approval by the commissioner of
health a community-based health care coverage program. The operational
structure established by the initiative shall include, but is not limited to:
(1) establishing a process for enrolling eligible individuals and their
dependents;
(2) collecting and coordinating premiums from enrollees and employers
of enrollees;
(3) providing payment to participating providers;
(4) establishing a benefit set according to subdivision 8 and
establishing premium rates and cost-sharing requirements;
(5) creating incentives to encourage primary care and wellness
services; and
(6) initiating disease management services, as appropriate.
(b) The payments collected under paragraph (a), clause (2), may be used
to capture available federal funds.
Sec. 12. Minnesota Statutes 2006, section 62Q.80, subdivision 13, is
amended to read:
Subd. 13. Report. (a) The
initiative shall submit quarterly status reports to the commissioner of health
on January 15, April 15, July 15, and October 15 of each year, with the first
report due January 15, 2007 2008. The status report shall
include:
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(1) the financial status of the program, including the premium rates,
cost per member per month, claims paid out, premiums received, and
administrative expenses;
(2) a description of the health care benefits offered and the services
utilized;
(3) the number of employers participating, the number of employees and
dependents covered under the program, and the number of health care providers
participating;
(4) a description of the health outcomes to be achieved by the program
and a status report on the performance measurements to be used and collected;
and
(5) any other information requested by the commissioner of health or
commerce or the legislature.
(b) The initiative shall contract with an independent entity to conduct
an evaluation of the program to be submitted to the commissioners of health and
commerce and the legislature by January 15, 2009 2010. The
evaluation shall include:
(1) an analysis of the health outcomes established by the initiative
and the performance measurements to determine whether the outcomes are being
achieved;
(2) an analysis of the financial status of the program, including the
claims to premiums loss ratio and utilization and cost experience;
(3) the demographics of the enrollees, including their age, gender,
family income, and the number of dependents;
(4) the number of employers and employees who have been denied access
to the program and the basis for the denial;
(5) specific analysis on enrollees who have aggregate medical claims
totaling over $5,000 per year, including data on the enrollee's main diagnosis
and whether all the medical claims were covered by the program;
(6) number of enrollees referred to state public assistance programs;
(7) a comparison of employer-subsidized health coverage provided in a
comparable geographic area to the designated community-based geographic area
served by the program, including, to the extent available:
(i) the difference in the number of employers with 50 or fewer
employees offering employer-subsidized health coverage;
(ii) the difference in uncompensated care being provided in each area;
and
(iii) a comparison of health care outcomes and measurements established
by the initiative; and
(8) any other information requested by the commissioner of health or
commerce.
Sec. 13. Minnesota Statutes 2006, section 62Q.80, subdivision 14, is
amended to read:
Subd. 14. Sunset. This section
expires December 31, 2011 2012.
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Sec. 14. [144.291] MINNESOTA HEALTH RECORDS ACT.
Subdivision 1. Short title. Sections 144.291 to 144.298 may be cited as
the Minnesota Health Records Act.
Subd. 2. Definitions. For the purposes of sections 144.291 to
144.298, the following terms have the meanings given.
(a) Affiliate. "Affiliate" has the meaning given in section
144.6521, subdivision 3, paragraph (b).
(b) Group purchaser. "Group purchaser" has the meaning given
in section 62J.03, subdivision 6.
(c) Health record. "Health record" means any information,
whether oral or recorded in any form or medium, that relates to the past,
present, or future physical or mental health or condition of a patient; the
provision of health care to a patient; or the past, present, or future payment
for the provision of health care to a patient.
(d) Identifying information. "Identifying information" means
the patient's name, address, date of birth, gender, parent's or guardian's name
regardless of the age of the patient, and other nonclinical data which can be
used to uniquely identify a patient.
(e) Individually identifiable form. "Individually identifiable
form" means a form in which the patient is or can be identified as the
subject of the health records.
(f) Medical emergency. "Medical emergency" means medically
necessary care which is immediately needed to preserve life, prevent serious
impairment to bodily functions, organs, or parts, or prevent placing the
physical or mental health of the patient in serious jeopardy.
(g) Patient. "Patient" means a natural person who has
received health care services from a provider for treatment or examination of a
medical, psychiatric, or mental condition, the surviving spouse and parents of
a deceased patient, or a person the patient appoints in writing as a
representative, including a health care agent acting according to chapter 145C,
unless the authority of the agent has been limited by the principal in the
principal's health care directive. Except for minors who have received health
care services under sections 144.341 to 144.347, in the case of a minor,
patient includes a parent or guardian, or a person acting as a parent or
guardian in the absence of a parent or guardian.
(h) Provider. "Provider" means:
(1) any person who furnishes
health care services and is regulated to furnish the services under chapter
147, 147A, 147B, 147C, 147D, 148, 148B, 148C, 148D, 150A, 151, 153, or 153A;
(2) a home care provider
licensed under section 144A.46;
(3) a health care facility
licensed under this chapter or chapter 144A;
(4) a physician assistant
registered under chapter 147A; and
(5) an unlicensed mental
health practitioner regulated under sections 148B.60 to 148B.71.
(i) Record locator service. "Record locator service" means an
electronic index of patient identifying information that directs providers in a
health information exchange to the location of patient health records held by
providers and group purchasers.
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(j) Related health care entity.
"Related health care entity" means an affiliate of the provider
releasing the health records.
Sec. 15. [144.292] PATIENT
RIGHTS.
Subdivision 1. Scope. Patients
have the rights specified in this section regarding the treatment the patient
receives and the patient's health record.
Subd. 2. Patient access. Upon
request, a provider shall supply to a patient complete and current information
possessed by that provider concerning any diagnosis, treatment, and prognosis
of the patient in terms and language the patient can reasonably be expected to
understand.
Subd. 3. Additional patient rights.
A patient's right specified in this section and sections 144.293 to 144.298
are in addition to the rights specified in sections 144.651 and 144.652 and any
other provision of law relating to the access of a patient to the patient's health
records.
Subd. 4. Notice of rights;
information on release. A provider shall provide to patients, in a
clear and conspicuous manner, a written notice concerning practices and rights
with respect to access to health records. The notice must include an
explanation of:
(1) disclosures of health records that may be made without the written
consent of the patient, including the type of records and to whom the records
may be disclosed; and
(2) the right of the patient to have access to and obtain copies of the
patient's health records and other information about the patient that is
maintained by the provider.
The notice requirements of this subdivision are satisfied if the notice
is included with the notice and copy of the patient and resident bill of rights
under section 144.652 or if it is displayed prominently in the provider's place
of business. The commissioner of health shall develop the notice required in
this subdivision and publish it in the State Register.
Subd. 5. Copies of health records to patients.
Except as provided in section 144.296, upon a patient's written request, a
provider, at a reasonable cost to the patient, shall promptly furnish to the
patient:
(1) copies of the patient's health record, including but not limited to
laboratory reports, x-rays, prescriptions, and other technical information used
in assessing the patient's health conditions; or
(2) the pertinent portion of the record relating to a condition
specified by the patient.
With the consent of the patient, the provider may instead furnish only
a summary of the record. The provider may exclude from the health record
written speculations about the patient's health condition, except that all
information necessary for the patient's informed consent must be provided.
Subd. 6. Cost. (a) When a
patient requests a copy of the patient's record for purposes of reviewing
current medical care, the provider must not charge a fee.
(b) When a provider or its representative makes copies of patient
records upon a patient's request under this section, the provider or its
representative may charge the patient or the patient's representative no more
than 75 cents per page, plus $10 for time spent retrieving and copying the
records, unless other law or a rule or contract provide for a lower maximum
charge. This limitation does not apply to x-rays. The provider may charge a
patient no more than the actual cost of reproducing x-rays, plus no more than
$10 for the time spent retrieving and copying the x‑rays.
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(c) The respective maximum charges of 75 cents per page and $10 for
time provided in this subdivision are in effect for calendar year 1992 and may
be adjusted annually each calendar year as provided in this subdivision. The
permissible maximum charges shall change each year by an amount that reflects
the change, as compared to the previous year, in the Consumer Price Index for
all Urban Consumers, Minneapolis-St. Paul (CPI-U), published by the Department
of Labor.
(d) A provider or its representative must not charge a fee to provide
copies of records requested by a patient or the patient's authorized
representative if the request for copies of records is for purposes of
appealing a denial of Social Security disability income or Social Security
disability benefits under title II or title XVI of the Social Security Act. For
the purpose of further appeals, a patient may receive no more than two medical
record updates without charge, but only for medical record information
previously not provided. For purposes of this paragraph, a patient's authorized
representative does not include units of state government engaged in the
adjudication of Social Security disability claims.
Subd. 7. Withholding health records
from patient. (a) If a provider reasonably determines that the
information is detrimental to the physical or mental health of the patient, or
is likely to cause the patient to inflict self harm, or to harm another, the
provider may withhold the information from the patient and may supply the
information to an appropriate third party or to another provider. The other
provider or third party may release the information to the patient.
(b) A provider shall release information upon written request unless,
prior to the request, a provider has designated and described a specific basis
for withholding the information as authorized by paragraph (a).
Sec. 16. [144.293] RELEASE OR
DISCLOSURE OF HEALTH RECORDS.
Subdivision 1. Release or disclosure of
health records. Health records can be released or disclosed as
specified in subdivisions 2 to 9 and sections 144.294 and 144.295.
Subd. 2. Patient consent to release
of records. A provider, or a person who receives health records from
a provider, may not release a patient's health records to a person without:
(1) a signed and dated consent from the patient or the patient's
legally authorized representative authorizing the release;
(2) specific authorization in law; or
(3) a representation from a provider that the provider holds a consent
from the patient.
Subd. 3. Release from one provider to
another. A patient's health record, including, but not limited to,
laboratory reports, x-rays, prescriptions, and other technical information used
in assessing the patient's condition, or the pertinent portion of the record
relating to a specific condition, or a summary of the record, shall promptly be
furnished to another provider upon the written request of the patient. The
written request shall specify the name of the provider to whom the health
record is to be furnished. The provider who furnishes the health record or
summary may retain a copy of the materials furnished. The patient shall be
responsible for the reasonable costs of furnishing the information.
Subd. 4. Duration of consent.
Except as provided in this section, a consent is valid for one year or for a
lesser period specified in the consent or for a different period provided by
law.
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Subd. 5. Exceptions to consent requirement. This section does not
prohibit the release of health records:
(1) for a medical emergency
when the provider is unable to obtain the patient's consent due to the
patient's condition or the nature of the medical emergency;
(2) to other providers
within related health care entities when necessary for the current treatment of
the patient; or
(3) to a health care
facility licensed by this chapter, chapter 144A, or to the same types of health
care facilities licensed by this chapter and chapter 144A that are licensed in
another state when a patient:
(i) is returning to the
health care facility and unable to provide consent; or
(ii) who resides in the
health care facility, has services provided by an outside resource under Code
of Federal Regulations, title 42, section 483.75(h), and is unable to provide
consent.
Subd. 6. Consent does not expire. Notwithstanding subdivision 4,
if a patient explicitly gives informed consent to the release of health records
for the purposes and restrictions in clauses (1) and (2), the consent does not
expire after one year for:
(1) the release of health
records to a provider who is being advised or consulted with in connection with
the releasing provider's current treatment of the patient;
(2) the release of health
records to an accident and health insurer, health service plan corporation,
health maintenance organization, or third-party administrator for purposes of
payment of claims, fraud investigation, or quality of care review and studies,
provided that:
(i) the use or release of
the records complies with sections 72A.49 to 72A.505;
(ii) further use or release
of the records in individually identifiable form to a person other than the
patient without the patient's consent is prohibited; and
(iii) the recipient
establishes adequate safeguards to protect the records from unauthorized
disclosure, including a procedure for removal or destruction of information
that identifies the patient.
Subd. 7. Exception to consent. Subdivision 2 does not apply to the
release of health records to the commissioner of health or the Health Data
Institute under chapter 62J, provided that the commissioner encrypts the
patient identifier upon receipt of the data.
Subd. 8. Record locator service. (a) A provider or group purchaser
may send patient identifying information and information about the location of
the patient's health records to a record locator service without consent from
the patient. Except in the case of a medical emergency, a provider
participating in a health information exchange using a record locator service
cannot access patient identifying information and information about the
location of the patient's health records until the patient has provided
consent. The Minnesota Department of Health may not access the record locator
service or receive data from the record locator service. Only a provider may
access patient identifying information in a record locator service. The consent
does not expire and may be revoked by the patient at any time by providing
written notice of the revocation to the provider.
(b) A health information
exchange maintaining a record locator service or an entity maintaining a record
locator service for a health information exchange must maintain an audit log of
providers accessing information in a record locator service that minimally
contains information on:
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(1) the identity of the provider accessing the information;
(2) the identity of the patient whose information was accessed by the
provider; and
(3) the date the information was accessed.
(c) No group purchaser may in any way require a provider to participate
in any record locator service as a condition of payment or participation.
(d) A record locator service must provide a mechanism for patients to
opt out of including their identifying information and information about the
location of their health records in a record locator service. At a minimum, any
consent form that permits a provider to access a record locator service must
include a check-box option that allows a patient to completely opt out of the
record locator service which shall be clearly displayed to the patient. A
provider participating in a health information exchange with a record locator
service who receives a patient's request to completely opt out of the record
locator service or to not have a specific provider contact in the record locator
service shall be responsible for removing the patient's information from the
record locator service.
Subd. 9. Documentation of release.
(a) In cases where a provider releases health records without patient consent
as authorized by law, the release must be documented in the patient's health
record. In the case of a release under section 144.294, subdivision 2, the
documentation must include the date and circumstances under which the release
was made, the person or agency to whom the release was made, and the records
that were released.
(b) When a health record is released using a representation from a
provider that holds a consent from the patient, the releasing provider shall
document:
(1) the provider requesting the health records;
(2) the identity of the patient;
(3) the health records requested; and
(4) the date the health records were requested.
Sec. 17. [144.294] RECORDS
RELATING TO MENTAL HEALTH.
Subdivision 1. Provider inquiry. Upon
the written request of a spouse, parent, child, or sibling of a patient being
evaluated for or diagnosed with mental illness, a provider shall inquire of a
patient whether the patient wishes to authorize a specific individual to
receive information regarding the patient's current and proposed course of
treatment. If the patient so authorizes, the provider shall communicate to the
designated individual the patient's current and proposed course of treatment.
Section 144.293, subdivisions 2 and 4, apply to consents given under this
subdivision.
Subd. 2. Disclosure to law
enforcement agency. Notwithstanding section 144.293, subdivisions 2
and 4, a provider must disclose health records relating to a patient's mental
health to a law enforcement agency if the law enforcement agency provides the
name of the patient and communicates that the:
(1) patient is currently involved in an emergency interaction with the
law enforcement agency; and
(2) disclosure of the records is necessary to protect the health or safety
of the patient or of another person.
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The scope of disclosure
under this subdivision is limited to the minimum necessary for law enforcement
to respond to the emergency. A law enforcement agency that obtains health
records under this subdivision shall maintain a record of the requestor, the
provider of the information, and the patient's name. Health records obtained by
a law enforcement agency under this subdivision are private data on individuals
as defined in section 13.02, subdivision 12, and must not be used by law
enforcement for any other purpose.
Subd. 3. Records release for family and caretaker; mental health care.
(a) Notwithstanding section 144.293, a provider providing mental health care
and treatment may disclose health record information described in paragraph (b)
about a patient to a family member of the patient or other person who requests
the information if:
(1) the request for
information is in writing;
(2) the family member or
other person lives with, provides care for, or is directly involved in
monitoring the treatment of the patient;
(3) the involvement under
clause (2) is verified by the patient's mental health care provider, the
patient's attending physician, or a person other than the person requesting the
information, and is documented in the patient's medical record;
(4) before the disclosure,
the patient is informed in writing of the request, the name of the person
requesting the information, the reason for the request, and the specific
information being requested;
(5) the patient agrees to
the disclosure, does not object to the disclosure, or is unable to consent or
object, and the patient's decision or inability to make a decision is documented
in the patient's medical record; and
(6) the disclosure is
necessary to assist in the provision of care or monitoring of the patient's
treatment.
(b) The information
disclosed under this paragraph is limited to diagnosis, admission to or
discharge from treatment, the name and dosage of the medications prescribed,
side effects of the medication, consequences of failure of the patient to take
the prescribed medication, and a summary of the discharge plan.
(c) If a provider reasonably
determines that providing information under this subdivision would be
detrimental to the physical or mental health of the patient or is likely to
cause the patient to inflict self harm or to harm another, the provider must
not disclose the information.
(d) This subdivision does
not apply to disclosures for a medical emergency or to family members as
authorized or required under subdivision 1 or section 144.293, subdivision 5,
clause (1).
Sec. 18. [144.295] DISCLOSURE OF HEALTH RECORDS
FOR EXTERNAL RESEARCH.
Subdivision 1. Methods of release. (a) Notwithstanding section 144.293,
subdivisions 2 and 4, health records may be released to an external researcher
solely for purposes of medical or scientific research only as follows:
(1) health records generated
before January 1, 1997, may be released if the patient has not objected or does
not elect to object after that date;
(2) for health records
generated on or after January 1, 1997, the provider must:
(i) disclose in writing to
patients currently being treated by the provider that health records,
regardless of when generated, may be released and that the patient may object,
in which case the records will not be released; and
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(ii) use reasonable efforts
to obtain the patient's written general authorization that describes the
release of records in item (i), which does not expire but may be revoked or
limited in writing at any time by the patient or the patient's authorized
representative;
(3) the provider must advise
the patient of the rights specified in clause (4); and
(4) the provider must, at
the request of the patient, provide information on how the patient may contact
an external researcher to whom the health record was released and the date it
was released.
(b) Authorization may be
established if an authorization is mailed at least two times to the patient's
last known address with a postage prepaid return envelope and a conspicuous
notice that the patient's medical records may be released if the patient does
not object, and at least 60 days have expired since the second notice was sent.
Subd. 2. Duties of researcher. In making a release for research
purposes, the provider shall make a reasonable effort to determine that:
(1) the use or disclosure
does not violate any limitations under which the record was collected;
(2) the use or disclosure in
individually identifiable form is necessary to accomplish the research or
statistical purpose for which the use or disclosure is to be made;
(3) the recipient has
established and maintains adequate safeguards to protect the records from
unauthorized disclosure, including a procedure for removal or destruction of
information that identifies the patient; and
(4) further use or release
of the records in individually identifiable form to a person other than the
patient without the patient's consent is prohibited.
Sec. 19. [144.296] COPIES OF VIDEOTAPES.
A provider may not release a
copy of a videotape of a child victim or alleged victim of physical or sexual
abuse without a court order under section 13.03, subdivision 6, or as provided
in section 611A.90. This section does not limit the right of a patient to view
the videotape.
Sec. 20. [144.297] INDEPENDENT MEDICAL
EXAMINATION.
This section applies to the
subject and provider of an independent medical examination requested by or paid
for by a third party. Notwithstanding section 144.293, a provider may release
health records created as part of an independent medical examination to the
third party who requested or paid for the examination.
Sec. 21. [144.298] PENALTIES.
Subdivision 1. Licensing action. A violation of sections 144.291 to 144.298
may be grounds for disciplinary action against a provider by the appropriate
licensing board or agency.
Subd. 2. Allocation of liability. In adjudicating a dispute
involving the disclosure of patient health records, a court shall use the
criteria in this subdivision in determining how liability will be allocated.
(a) When requesting health
records using consent, a person warrants that the consent:
(1) contains no information
known to the person to be false; and
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(2) accurately states the patient's desire to have health records
disclosed or that there is specific authorization in law.
(b) When requesting health records using consent or the representation
authorized in section 144.293, subdivision 2, a provider warrants that the
request:
(1) contains no information known to the provider to be false;
(2) accurately states the patient's desire to have health records
disclosed or that there is specific authorization in law; and
(3) does not exceed any limits imposed by the patient in the consent.
(c) When disclosing health records, a person releasing health records
warrants that the person:
(1) has complied with the requirements of this section regarding
disclosure of health records;
(2) knows of no information related to the request that is false; and
(3) has complied with the limits set by the patient in the consent or
as described in the representation of consent.
(d) A court of this state presumes that:
(1) a request made by a person that complies with the provisions of
this section is valid and represents the wishes of the patient;
(2) the information listed in a consent or representation of consent is
accurate;
(3) the recipient of a consent or representation of consent has no
knowledge or notice that the person making the request breached a duty to the
patient or does not rightfully have a consent;
(4) the signature on the consent or representation of consent is not
forged;
(5) the consent or representation of consent was not obtained under
false pretenses; and
(6) the consent or representation of consent was not altered without
the patient's permission.
(e) No person or provider may disclaim or contractually limit the
application of this section, or obtain indemnity for its effects, if the
disclaimer, limitation, or indemnity restricts liability for misrepresentation
against persons reasonably relying on the consent, representation of consent,
or disclosure.
(f) A court of this state shall give effect to liability allocations
between the parties provided by contract that does not allocate liability to
the detriment of the patient and the allocation is consistent with the
requirements of sections 144.291 to 144.298.
(g) A patient is eligible to receive compensatory damages plus costs
and reasonable attorney fees if there is a negligent or intentional violation
of sections 144.293 to 144.295.
Subd. 3. Liability for a record
locator service. A patient is eligible to receive compensatory
damages plus costs and reasonable attorney fees if a health information
exchange maintaining a record locator service, or an entity maintaining a
record locator service for a health information exchange, negligently or
intentionally violates the provisions of section 144.293, subdivision 8.
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Sec. 22. Minnesota Statutes 2006, section 144.3345, is amended to read:
144.3345 INTERCONNECTED
ELECTRONIC HEALTH RECORD GRANTS.
Subdivision 1. Definitions.
The following definitions are used for the purposes of this section.
(a) "Eligible community e-health collaborative" means an
existing or newly established collaborative to support the adoption and use of
interoperable electronic health records. A collaborative must consist of at
least three two or more eligible health care entities in at least
two of the categories listed in paragraph (b) and have a focus on
interconnecting the members of the collaborative for secure and interoperable
exchange of health care information.
(b) "Eligible health care entity" means one of the following:
(1) community clinics, as defined under section 145.9268;
(2) hospitals eligible for rural hospital capital improvement grants,
as defined in section 144.148;
(3) physician clinics located in a community with a population of less
than 50,000 according to United States Census Bureau statistics and outside the
seven-county metropolitan area;
(4) nursing facilities licensed under sections 144A.01 to 144A.27;
(5) community health boards or boards of health as established
under chapter 145A;
(6) nonprofit entities with a purpose to provide health information
exchange coordination governed by a representative, multi-stakeholder board of
directors; and
(7) other providers of health or health care services approved by the
commissioner for which interoperable electronic health record capability would
improve quality of care, patient safety, or community health.
Subd. 2. Grants authorized.
The commissioner of health shall award grants to:
(a)
eligible community e-health collaborative projects to improve the
implementation and use of interoperable electronic health records including but
not limited to the following projects:
(1) collaborative efforts to host and support fully functional
interoperable electronic health records in multiple care settings;
(2) electronic medication history and electronic patient registration
medical history information;
(3) electronic personal health records for persons with chronic
diseases and for prevention services;
(4) rural and underserved community models for electronic prescribing; and
(5) enabling modernize local public health information
systems to rapidly and electronically exchange information needed to
participate in community e-health collaboratives or for public health emergency
preparedness and response.; and
(6) implement regional or community-based health information exchange
organizations;
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(b) community clinics, as
defined under section 145.9268, to implement and use interoperable electronic
health records, including but not limited to the following projects:
(1) efforts to plan for and
implement fully functional, standards-based interoperable electronic health
records; and
(2) purchases and
implementation of computer hardware, software, and technology to fully
implement interoperable electronic health records;
(c) regional or
community-based health information exchange organizations to connect and
facilitate the exchange of health information between eligible health care
entities, including but not limited to the development, testing, and
implementation of:
(1) data exchange standards,
including data, vocabulary, and messaging standards, for the exchange of health
information, provided that such standards are consistent with state and
national standards;
(2) security standards necessary
to ensure the confidentiality and integrity of health records;
(3) computer interfaces and
mechanisms for standardizing health information exchanged between eligible
health care entities;
(4) a record locator service
for identifying the location of patient health records; or
(5) interfaces and
mechanisms for implementing patient consent requirements; and
(d) community health boards
and boards of health as established under chapter 145A to modernize local
public health information systems to be standards-based and interoperable with
other electronic health records and information systems, or for enhanced public
health emergency preparedness and response.
Grant funds may not be used
for construction of health care or other buildings or facilities.
Subd. 3. Allocation of grants. (a) To receive a
grant under this section, an eligible community e-health collaborative,
community clinic, regional or community-based health information exchange, or
community health boards and boards of health must submit an application to
the commissioner of health by the deadline established by the commissioner. A
grant may be awarded upon the signing of a grant contract. In awarding grants,
the commissioner shall give preference to projects benefiting providers located
in rural and underserved areas of Minnesota which the commissioner has
determined have an unmet need for the development and funding of electronic
health records. Applicants may apply for and the commissioner may award grants
for one-year, two-year, or three-year periods.
(b) An application must be
on a form and contain information as specified by the commissioner but at a
minimum must contain:
(1) a description of the
purpose or project for which grant funds will be used;
(2) a description of the problem
or problems the grant funds will be used to address, including an assessment of
the likelihood of the project occurring absent grant funding;
(3) a description of
achievable objectives, a workplan, budget, budget narrative, a project
communications plan, a timeline for implementation and completion of processes
or projects enabled by the grant, and an assessment of privacy and security
issues and a proposed approach to address these issues;
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(4) a description of the health care entities and other groups
participating in the project, including identification of the lead entity
responsible for applying for and receiving grant funds;
(5) a plan for how patients and consumers will be involved in
development of policies and procedures related to the access to and interchange
of information;
(6) evidence of consensus and commitment among the health care entities
and others who developed the proposal and are responsible for its
implementation; and
(7) a plan for documenting and evaluating results of the grant.
; and
(8) a plan for use of data exchange standards, including data and
vocabulary.
(c) The commissioner shall review each application to determine whether
the application is complete and whether the applicant and the project are
eligible for a grant. In evaluating applications, the commissioner shall take
into consideration factors, including but not limited to, the following:
(1) the degree to which the proposal interconnects the various
providers of care with other health care entities in the applicant's
geographic community;
(2) the degree to which the project provides for the interoperability
of electronic health records or related health information technology between
the members of the collaborative, and presence and scope of a description of
how the project intends to interconnect with other providers not part of the
project into the future;
(3) the degree to which the project addresses current unmet needs
pertaining to interoperable electronic health records in a geographic area of
Minnesota and the likelihood that the needs would not be met absent grant
funds;
(4) the applicant's thoroughness and clarity in describing the project,
how the project will improve patient safety, quality of care, and consumer
empowerment, and the role of the various collaborative members;
(5) the recommendations of the Health Information and Technology
Infrastructure Advisory Committee; and
(6) other factors that the commissioner deems relevant.
(d) Grant funds shall be awarded on a three-to-one match basis.
Applicants shall be required to provide $1 in the form of cash or in-kind staff
or services for each $3 provided under the grant program.
(e) Grants shall not exceed $900,000 per grant. The commissioner has
discretion over the size and number of grants awarded.
Subd. 4. Evaluation and report.
The commissioner of health shall evaluate the overall effectiveness of the
grant program. The commissioner shall collect progress and expenditure reports
to evaluate the grant program from the eligible community collaboratives
receiving grants.
Sec. 23. Minnesota Statutes 2006, section 144.565, is amended to read:
144.565 DIAGNOSTIC IMAGING
FACILITIES.
Subdivision 1. Utilization and
services data; economic and financial interests. The commissioner shall
require diagnostic imaging facilities and providers of diagnostic imaging
services in Minnesota to annually report by March 1 each year for
the preceding fiscal year to the commissioner, in the form and manner
specified by the commissioner:
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(1) utilization data for each health plan company and each public program,
including workers' compensation, as follows: of diagnostic imaging
services as defined in subdivision 4, paragraph (b);
(i) the number of computerized tomography (CT) procedures performed;
(ii) the number of magnetic resonance imaging (MRI) procedures
performed; and
(iii) the number of positron emission tomography (PET) procedures
performed; and
(2) the names of all physicians with any financial or economic
interest and all other individuals with a ten percent or greater financial
or economic interest in the facility.;
(3) the location where procedures were performed;
(4) the number of units of each type of fixed, portable, and mobile
scanner used at each location;
(5) the average number of hours per month each mobile scanner was
operated at each location;
(6) the number of hours per month each scanner was leased, if
applicable;
(7) the total number of diagnostic imaging procedures billed for by the
provider at each location, by type of diagnostic imaging service as defined in
subdivision 4, paragraph (b); and
(8) a report on major health care capital expenditures during the
previous year, as required by section 62J.17.
Subd. 2. Commissioner's right to
inspect records. If the report is not filed or the commissioner of health
has reason to believe the report is incomplete or false, the commissioner shall
have the right to inspect diagnostic imaging facility books, audits, and
records.
Subd. 3. Separate reports. For
a diagnostic imaging facility that is not attached or not contiguous to a
hospital or a hospital affiliate, the commissioner shall require the
information in subdivision 1 be reported separately for each detached
diagnostic imaging facility as part of the report required under section
144.702. If any entity owns more than one diagnostic imaging facility, that
entity must report by individual facility. Reports must include only
services that were billed by the provider of diagnostic imaging services
submitting the report. If a diagnostic imaging facility leases capacity,
technical services, or professional services to one or more other providers of
diagnostic imaging services, each provider must submit a separate annual report
to the commissioner for all diagnostic imaging services that it provided and
billed. The owner of the leased capacity must provide a report listing the
names and addresses of providers to whom the diagnostic imaging services and
equipment were leased.
Subd. 4. Definitions. For
purposes of this section, the following terms have the meanings given:
(a) "Diagnostic imaging facility" means a health care
facility that provides is not a hospital or location licensed as a
hospital which offers diagnostic imaging services through the use of
ionizing radiation or other imaging technique including, but not limited to
magnetic resonance imaging (MRI) or computerized tomography (CT) scan on a
freestanding or mobile basis in Minnesota, regardless of whether the
equipment used to provide the service is owned or leased. For the purposes of
this section, diagnostic imaging facility includes, but is not limited to,
facilities such as a physician's office, clinic, mobile transport vehicle,
outpatient imaging center, or surgical center.
(b) "Diagnostic imaging service" means the use of ionizing
radiation or other imaging technique on a human patient including, but not
limited to, magnetic resonance imaging (MRI) or computerized tomography (CT),
positron emission tomography (PET), or single photon emission computerized
tomography (SPECT) scans using fixed, portable, or mobile equipment.
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(b) (c) "Financial
or economic interest" means a direct or indirect:
(1) equity or debt security
issued by an entity, including, but not limited to, shares of stock in a
corporation, membership in a limited liability company, beneficial interest in
a trust, units or other interests in a partnership, bonds, debentures, notes or
other equity interests or debt instruments, or any contractual arrangements;
(2) membership, proprietary
interest, or co-ownership with an individual, group, or organization to which
patients, clients, or customers are referred to; or
(3) employer-employee or
independent contractor relationship, including, but not limited to, those that
may occur in a limited partnership, profit-sharing arrangement, or other
similar arrangement with any facility to which patients are referred, including
any compensation between a facility and a health care provider, the group
practice of which the provider is a member or employee or a related party with
respect to any of them.
(c) (d) "Freestanding
Fixed equipment" means a stationary diagnostic imaging facility
that is not located within a: machine installed in a permanent location.
(1) hospital;
(2) location licensed as a
hospital; or
(3) physician's office or
clinic where the professional practice of medicine by licensed physicians is
the primary purpose and not the provision of ancillary services such as
diagnostic imaging.
(d) (e) "Mobile
equipment" means a diagnostic imaging facility that is transported
to various sites not including movement within a hospital or a physician's
office or clinic machine in a self-contained transport vehicle designed
to be brought to a temporary offsite location to perform diagnostic imaging
services.
(f) "Portable
equipment" means a diagnostic imaging machine designed to be temporarily
transported within a permanent location to perform diagnostic imaging services.
(g) "Provider of
diagnostic imaging services" means a diagnostic imaging facility or an
entity that offers and bills for diagnostic imaging services at a facility
owned or leased by the entity.
Subd. 5. Reports open to public inspection. All reports filed
pursuant to this section shall be open to public inspection.
Sec. 24. [144.585] METHICILLIN-RESISTANT
STAPHYLOCOCCUS AUREUS CONTROL PROGRAMS.
In order to improve the
prevention of hospital-associated bloodstream infections due to
methicillin-resistant Staphylococcus aureus ("MRSA"), every hospital
shall establish an MRSA control program that meets Minnesota Department of
Health best practices standards as published January 15, 2008, including
considerations of:
(1) identification of all
MRSA-colonized patients in all intensive care units, and other at-risk patients
identified by the hospital, through active surveillance testing;
(2) isolation of identified
MRSA-colonized or MRSA-infected patients in an appropriate manner;
(3) monitoring and strict
enforcement of hand hygiene requirements; and
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(4) maintenance of records.
Sec. 25. Minnesota Statutes 2006, section 144.651, subdivision 26, is
amended to read:
Subd. 26. Right to associate.
(a) Residents may meet with and receive visitors and participate
in activities of commercial, religious, political, as defined in section
203B.11 and community groups without interference at their discretion if the
activities do not infringe on the right to privacy of other residents or are
not programmatically contraindicated. This includes:
(1)
the right to join with other individuals within and outside the facility to
work for improvements in long-term care;
(2) the right to visitation by an individual the patient has appointed as
the patient's health care agent under chapter 145C;
(3) the right to visitation and health care decision making by an
individual designated by the patient under paragraph (c).
(b) Upon
admission to a facility where federal law prohibits unauthorized disclosure of
patient or resident identifying information to callers and visitors, the
patient or resident, or the legal guardian or conservator of the patient or
resident, shall be given the opportunity to authorize disclosure of the
patient's or resident's presence in the facility to callers and visitors who
may seek to communicate with the patient or resident. To the extent possible,
the legal guardian or conservator of a patient or resident shall consider the
opinions of the patient or resident regarding the disclosure of the patient's
or resident's presence in the facility.
(c) Upon admission to a facility, the patient or resident, or the legal
guardian or conservator of the patient or resident, must be given the
opportunity to designate a person who is not related who will have the status
of the patient's next of kin with respect to visitation and making a health
care decision. A designation must be included in the patient's health record.
With respect to making a health care decision, a health care directive or
appointment of a health care agent under chapter 145C prevails over a
designation made under this paragraph. The unrelated person may also be
identified as such by the patient or by the patient's family.
Sec. 26. [145.9269] FEDERALLY
QUALIFIED HEALTH CENTERS.
Subdivision 1. Definitions. For
purposes of this section, "federally qualified health center" means
an entity that is receiving a grant under United States Code, title 42, section
254b, or, based on the recommendation of the Health Resources and Services
Administration within the Public Health Service, is determined by the secretary
to meet the requirements for receiving such a grant.
Subd. 2. Allocation of subsidies.
The commissioner of health shall distribute subsidies to federally qualified
health centers operating in Minnesota to continue, expand, and improve
federally qualified health center services to low-income populations. The
commissioner shall distribute the funds appropriated under this section to
federally qualified health centers operating in Minnesota as of January 1,
2007. The amount of each subsidy shall be in proportion to each federally
qualified health center's amount of discounts granted to patients during calendar
year 2006 as reported on the federal Uniform Data System report in conformance
with the Bureau of Primary Health Care Program Expectations Policy Information
Notice 98-23, except that each eligible federally qualified health center shall
receive at least two percent but no more than 30 percent of the total amount of
money available under this section.
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Sec. 27. Minnesota Statutes
2006, section 145C.05, is amended to read:
145C.05 SUGGESTED FORM; PROVISIONS THAT MAY BE INCLUDED.
Subdivision 1. Content. A health care directive
executed pursuant to this chapter may, but need not, be in the form contained
in section 145C.16.
Subd. 2. Provisions that may be included. (a) A
health care directive may include provisions consistent with this chapter,
including, but not limited to:
(1) the designation of one
or more alternate health care agents to act if the named health care agent is
not reasonably available to serve;
(2) directions to joint
health care agents regarding the process or standards by which the health care
agents are to reach a health care decision for the principal, and a statement
whether joint health care agents may act independently of one another;
(3) limitations, if any, on
the right of the health care agent or any alternate health care agents to
receive, review, obtain copies of, and consent to the disclosure of the
principal's medical records or to visit the principal when the principal is
a patient in a health care facility;
(4) limitations, if any, on
the nomination of the health care agent as guardian for purposes of sections
524.5-202, 524.5-211, 524.5-302, and 524.5-303;
(5) a document of gift for
the purpose of making an anatomical gift, as set forth in sections 525.921 to
525.9224, or an amendment to, revocation of, or refusal to make an anatomical
gift;
(6) a declaration regarding
intrusive mental health treatment under section 253B.03, subdivision 6d, or a
statement that the health care agent is authorized to give consent for the
principal under section 253B.04, subdivision 1a;
(7) a funeral directive as
provided in section 149A.80, subdivision 2;
(8) limitations, if any, to
the effect of dissolution or annulment of marriage or termination of domestic
partnership on the appointment of a health care agent under section 145C.09,
subdivision 2;
(9) specific reasons why a
principal wants a health care provider or an employee of a health care provider
attending the principal to be eligible to act as the principal's health care
agent;
(10) health care
instructions by a woman of child bearing age regarding how she would like her
pregnancy, if any, to affect health care decisions made on her behalf; and
(11) health care
instructions regarding artificially administered nutrition or hydration.
(b) A health care directive
may include a statement of the circumstances under which the directive becomes
effective other than upon the judgment of the principal's attending physician
in the following situations:
(1) a principal who in good
faith generally selects and depends upon spiritual means or prayer for the
treatment or care of disease or remedial care and does not have an attending
physician, may include a statement appointing an individual who may determine
the principal's decision-making capacity; and
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(2) a principal who in good faith does not generally select a physician
or a health care facility for the principal's health care needs may include a
statement appointing an individual who may determine the principal's
decision-making capacity, provided that if the need to determine the
principal's capacity arises when the principal is receiving care under the
direction of an attending physician in a health care facility, the
determination must be made by an attending physician after consultation with
the appointed individual.
If a person appointed under clause (1) or (2) is not reasonably
available and the principal is receiving care under the direction of an
attending physician in a health care facility, an attending physician shall
determine the principal's decision-making capacity.
(c) A health care directive may authorize a health care agent to make health
care decisions for a principal even though the principal retains
decision-making capacity.
Sec. 28. Minnesota Statutes 2006, section 145C.07, is amended by adding
a subdivision to read:
Subd. 5. Visitation. A
health care agent may visit the principal when the principal is a patient in a
health care facility regardless of whether the principal retains
decision-making capacity, unless:
(1) the principal has otherwise specified in the health care directive;
(2) a principal who retains decision-making capacity indicates
otherwise; or
(3) a health care provider reasonably determines that the principal
must be isolated from all visitors or that the presence of the health care
agent would endanger the health or safety of the principal, other patients, or
the facility in which the care is being provided.
Sec. 29. Minnesota Statutes 2006, section 157.16, subdivision 1, is
amended to read:
Subdivision 1. License required
annually. A license is required annually for every person, firm, or
corporation engaged in the business of conducting a food and beverage service
establishment, hotel, motel, lodging establishment, or resort. Any person
wishing to operate a place of business licensed in this section shall first
make application, pay the required fee specified in this section, and receive
approval for operation, including plan review approval. Seasonal and temporary
food stands and special event food stands are not required to submit plans. Nonprofit
organizations operating a special event food stand with multiple locations at
an annual one-day event shall be issued only one license. Application shall
be made on forms provided by the commissioner and shall require the applicant
to state the full name and address of the owner of the building, structure, or
enclosure, the lessee and manager of the food and beverage service
establishment, hotel, motel, lodging establishment, or resort; the name under
which the business is to be conducted; and any other information as may be
required by the commissioner to complete the application for license.
Sec. 30. HEALTH PROMOTION
PROGRAM.
The State Community Health Services Advisory Committee established in
Minnesota Statutes, section 145A.10, subdivision 10, shall develop a plan to
fund and implement an ongoing comprehensive health promotion program that can
effect change more effectively and at lower cost at a community level rather
than through individual counseling and change promotion. The program shall use
proven public health strategies to promote healthy lifestyles and behaviors in
order to establish a sustainable, long-term approach to reducing preventable
disability, chronic health conditions, and disease. The focus shall be on
community based initiatives that address childhood and adult obesity, tobacco
and substance abuse, improved activity levels among senior citizens, and other
lifestyle issues that impact health and healthcare costs. Because of its
population health focus, funding shall be related to the size of the population
to be served. The plan shall be completed by September 15, 2007, and shared
with the Legislative Health Care Access Commission.
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Sec. 31. INJUNCTIVE RELIEF REPORT.
The commissioner of health
shall present to the 2008 legislature, by December 15, 2007, recommendations to
fund the cost of bringing actions for injunctive relief under Minnesota
Statutes, section 144G.02, subdivision 2, paragraph (b).
Sec. 32. DIAGNOSTIC IMAGING SERVICES ADVISORY
COMMITTEE; ESTABLISHMENT.
(a) The commissioner of
health shall establish a Diagnostic Imaging Services Advisory Committee to
perform the following duties:
(1) gather and analyze data
to understand the factors driving utilization of diagnostic imaging services,
including computed tomography (CT), magnetic resonance imaging (MRI), positron
emission tomography (PET), magnetic resonance angiography (MRA), and nuclear
cardiology, in the state relative to evidence-based guidelines; and
(2) develop recommendations,
based on the data collected, on how to improve the delivery of evidence-based
diagnostic imaging services. In developing these recommendations, the advisory
committee shall consider the impacts on patient care, premium costs, and
administrative simplicity.
(b) The members of the
Diagnostic Imaging Services Advisory Committee shall include the commissioners
of health and human services or the commissioners' designees and the following:
(1) three physicians
representing speciality and geographic diversity, appointed by the Minnesota
Medical Association;
(2) two hospital
representatives, one from a metropolitan hospital and one from a rural
hospital, appointed by the Minnesota Hospital Association;
(3) three health plan
company representatives appointed by the Minnesota Council of Health Plans;
(4) two representatives
appointed by the Institute for Clinical System Improvement; and
(5) one clinic manager
appointed by the Minnesota Medical Group Management Association.
(c) The Diagnostic Imaging
Services Advisory Committee shall convene no later than September 1, 2007. The
commissioner shall report back to the legislature no later than January 15,
2008. The advisory committee is governed under Minnesota Statutes, section
15.059, except that members shall not receive a per diem and may only be
reimbursed for expenses.
(d) A strategy to improve
the delivery of evidence-based diagnostic imaging services may be developed by
health plans. The commissioner of health shall report the agreement to the
chairs of the senate and house health care committees immediately.
EFFECTIVE DATE. This section is
effective July 1, 2007.
Sec. 33. HEARING AID DISPENSER FEES.
Fees relating to hearing aid
dispensers, as provided in Minnesota Statutes, section 153A.17, may not be
increased until after the Department of Health provides a report to the
legislature regarding the need and reasons for fee increases.
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Sec. 34. REVISOR'S
INSTRUCTION.
In Minnesota Statutes and Minnesota Rules, the revisor shall change the
references in column A with the references in column B.
Column
A Column
B
section
144.335 sections
144.291 to 144.298
section
144.335, subdivision 1 section
144.291, subdivision 2
section
144.335, subdivision 1, paragraph (b) section
144.291, subdivision 2, paragraph (h)
section
144.335, subdivision 2, paragraphs (a) and (b) section 144.292, subdivisions 2 and 5
section
144.335, subdivision 2 section
144.292
section
144.335, subdivision 3a section
144.294, subdivision 2
section
144.335, subdivision 3a, paragraph (d) section
144.295
section
144.335, subdivision 3a, paragraph (f) section
144.294
section
144.335, subdivision 3b section
144.293, subdivision 7
Sec.
35. REPEALER.
(a)
Minnesota Statutes 2006, section 144.335, is repealed.
(b)
Minnesota Statutes 2006, section 62J.17, subdivisions 1, 5a, 6a, and 8, are
repealed, effective the day following final enactment.
ARTICLE
7
MISCELLANEOUS
Section
1. Minnesota Statutes 2006, section 16A.10, is amended by adding a subdivision
to read:
Subd.
2a. Base budget detail. Within
one week of the release of the budget forecasts required in section 16A.102 in
November of an even-numbered year and February of an odd-numbered year, the
commissioner, after consulting with the commissioners of human services and
health, must provide to the legislature information at the program, budget
activity and management activity level for the base level budget of the
Department of Human Services and the Department of Health for the next
biennium. The information must be organized in a manner that explains how base
level budget appropriations are projected to be spent. Within one week of the
release of the budget forecasts required in section 16A.102 in November of an
even-numbered year, the commissioner must also provide the legislature with the
information submitted by the commissioners of human services and health under
subdivision 2, clauses (3) and (4).
Sec.
2. Minnesota Statutes 2006, section 43A.316, is amended to read:
43A.316 PUBLIC EMPLOYEES
INSURANCE PROGRAM.
Subdivision
1. Intent. The legislature finds that
the creation of a statewide program to provide public employees and other
eligible persons with life insurance and hospital, medical, and dental benefit
coverage through provider organizations would result in a greater
utilization more efficient use of government resources and would
advance the health and welfare of the citizens of the state.
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Subd.
2. Definitions. For the purpose of
this section, the terms defined in this subdivision have the meaning given
them.
(a)
Commissioner. "Commissioner"
means the commissioner of employee relations.
(b)
Employee. "Employee"
means:
(1)
a person who is a public employee within the definition of section 179A.03,
subdivision 14, who is insurance eligible and is employed by an eligible
employer;
(2)
an elected public official of an eligible employer who is insurance eligible;
(3)
a person employed by a labor organization or employee association certified as
an exclusive representative of employees of an eligible employer or by another
public employer approved by the commissioner, so long as the plan meets the
requirements of a governmental plan under United States Code, title 29, section
1002(32); or
(4)
a person employed by a county or municipal hospital.
(c)
Eligible employer. "Eligible
employer" means:
(1)
a public employer within the definition of section 179A.03, subdivision 15,
that is a town, county, city, school district as defined in section 120A.05,
service cooperative as defined in section 123A.21, intermediate district as
defined in section 136D.01, Cooperative Center for Vocational Education as
defined in section 123A.22, regional management information center as defined
in section 123A.23, or an education unit organized under the joint powers
action, section 471.59; or
(2)
an exclusive representative of employees, as defined in paragraph (b);
(3)
a county or municipal hospital; or
(4)
another public employer approved by the commissioner; or
(5)
a nursing home as defined in section 144A.01, subdivision 5, located in this
state.
(d)
Exclusive representative. "Exclusive
representative" means an exclusive representative as defined in section
179A.03, subdivision 8.
(e)
Labor-Management Committee. "Labor-Management
Committee" means the committee established by subdivision 4.
(f)
Program. "Program" means
the statewide public employees insurance program created by subdivision 3.
Subd.
3. Public employee insurance program.
The commissioner shall be the administrator of the public employee insurance
program and may determine its funding arrangements. The commissioner may
contract with a qualified entity to perform the administrative functions. The
commissioner shall model the program after the plan established in section
43A.18, subdivision 2, but may modify adopt variations from that
plan, in consultation with the Labor-Management Committee. The variations
may include different deductibles, coinsurance, co-pays, or other enrollee
cost-sharing provisions.
Subd. 4. Labor-Management Committee. (a) The
Labor-Management Committee consists of ten members appointed by the
commissioner. The Labor-Management Committee must comprise five members who
represent employees, including at least one retired employee, and five members
who represent eligible employers. Committee members are eligible for expense
reimbursement in the same manner and amount as authorized by the
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commissioner's plan adopted
under section 43A.18, subdivision 2. The commissioner shall consult with the
labor-management committee in major decisions that affect the program. The
committee shall study issues and make recommendations relating to the
insurance program including, but not limited to, flexible benefits, utilization
review, quality assessment, and cost efficiency. The committee continues to
exist while the program remains in operation.
(b) The five members of the
Labor-Management Committee who represent employees must be chosen by the
commissioner from among persons nominated as provided in this paragraph.
Exclusive representatives of employees of counties, cities, school districts,
and nursing homes are entitled to nominate two candidates for the Labor-Management
Committee from each of those four categories, and the commissioner shall
appoint one of those two nominees from each category. The commissioner shall
choose the fifth employee to represent retired employees.
(c) The five members of the
Labor-Management Committee who represent employers must be chosen by the
commissioner from among persons nominated as provided in this paragraph. The
Association of Minnesota Counties, Minnesota League of Cities, Minnesota School
Boards Association, and the Minnesota Association of Nursing Homes are each
entitled to nominate two candidates for the committee, and the commissioner
shall appoint one of those from each group. The commissioner shall select the
fifth employer member from an employer participating in the program and not
represented by the other four employer members, if any, or if that is not
reasonably possible, the commissioner may appoint any other person as the fifth
employer representative.
Subd.
5. Public employee participation.
(a) Participation in the program is subject to the conditions in this
subdivision.
(b)
Each exclusive representative for an eligible employer determines whether the
employees it represents will participate in the program. The exclusive representative
shall give the employer notice of intent to participate at least 30
60 days before the expiration date of the collective bargaining agreement
preceding the collective bargaining agreement that covers the date of entry
into the program. Either all or none of the employees represented by an
exclusive representative must participate. The exclusive representative and
the eligible employer shall give notice to the commissioner of the
determination to participate in the program at least 30 60 days
before entry into the program. Entry into the program is governed by a schedule
established by the commissioner.
(c)
Employees not represented by exclusive representatives may become members of
the program upon a determination of an eligible employer to include these
employees in the program. Either all or none of the employer's unrepresented
employees must participate. The eligible employer shall give at least 30
60 days' notice to the commissioner before entering the program. Entry into
the program is governed by a schedule established by the commissioner.
(d)
Participation in the program is for a two-year three-year term.
Participation is automatically renewed for an additional two-year
three-year term unless the exclusive representative, or the employer for unrepresented
employees, gives the commissioner notice of withdrawal at least 30 60
days before expiration of the participation period. A group that withdraws must
wait two years before rejoining, except with the approval of the
commissioner. An exclusive representative, or employer for unrepresented
employees, may also withdraw if premiums increase 50 percent by more
than 20 percent in excess of the Consumer Price Index for all urban consumers
or more from one insurance year to the next.
(e)
The exclusive representative shall give the employer notice of intent to
withdraw to the commissioner at least 30 60 days before
the expiration date of a collective bargaining agreement that includes the date
on which the term of participation expires.
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(f)
Each participating eligible employer shall notify the commissioner of the names
of individuals who will be participating within two weeks of after
the commissioner receiving receives notice of the parties' intent
to participate. The employer shall also submit other information as required by
the commissioner for administration of the program.
(g)
An employer that withdraws from the program under circumstances that do not
permit withdrawal under this subdivision is liable to the board for premiums
payable by the employer until the time that the employer is eligible to
withdraw, and the employer shall pay those premiums voluntarily and no later
than their due date. If the premiums are not paid voluntarily, the board has
authority to and shall collect these premiums under any method permitted by law
for a governmental or nongovernmental creditor of the employer.
Subd.
6. Coverage. (a) By January 1,
1989, The commissioner shall announce the benefits of the program. The
program shall include employee hospital, medical, dental, and life insurance
for employees and hospital and medical benefits for dependents. Health
maintenance organization options and other delivery system options may be
provided if they are available, cost-effective, and capable of servicing the
number of people covered in the program. Participation in optional coverages
may be provided by collective bargaining agreements. For employees not represented
by an exclusive representative, the employer may offer the optional coverages
to eligible employees and their dependents provided in the program. Health
coverage must include at least the benefits required of a health plan company
regulated under chapter 62A, 62C, or 62D.
(b)
The commissioner, with the assistance of the Labor-Management Committee, shall
periodically assess whether it is financially feasible for the program to offer
or to continue an individual retiree program that has competitive premium rates
and benefits. If the commissioner determines it to be feasible to offer an
individual retiree program, the commissioner shall announce the applicable
benefits, premium rates, and terms of participation. Eligibility to participate
in the individual retiree program is governed by subdivision 8, but applies to
retirees of eligible employers that do not participate in the program and to
those retirees' dependents and surviving spouses.
Subd.
6a. Chiropractic services
Choice of type of provider. All benefits provided by the program or
a successor program relating to expenses incurred for medical treatment or
services of a physician health care provider must also include chiropractic
treatment and services of a chiropractor any other type of licensed,
certified, or registered health care provider to the extent that the chiropractic
services and treatment are within the scope of chiropractic licensure
the provider's licensure, certification, or registration.
This
subdivision is intended to provide equal access to benefits for program members
who choose to obtain treatment for illness or injury from a doctor of
chiropractic, as long as the treatment falls within the chiropractor's scope of
practice. This subdivision is not intended to change or add to the benefits
provided for in the program.
Subd.
7. Premiums. (a) The
proportion of premium paid by the employer and employee is subject to
collective bargaining or personnel policies. If, at the beginning of the
coverage period, no collective bargaining agreement has been finalized, the
increased dollar costs, if any, from the previous year is the sole
responsibility of the individual participant until a collective bargaining
agreement states otherwise. Premiums, including an administration fee, shall be
established by the commissioner. The commissioner may decide to rate
specific employers separately for premium purposes, if the commissioner
determines that doing so is in the best interests of the program. Each
employer shall pay monthly the amounts due for employee benefits including the
amounts under subdivision 8 to the commissioner no later than the dates
established by the commissioner. If an employer fails to make the payments as
required, the commissioner may shall cancel program benefits and
pursue other civil remedies, as provided in subdivision 5, paragraph (d).
(b)
The premium charged for an employer's first month in the program must be three
times the regular monthly premium charged to that employer, to help establish
and maintain the program's financial resources. The extra two months premium
must be refunded to the employer if the employer leaves the program, if the
refund would not reduce the program's reserves below the level determined to be
appropriate by the commissioner.
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Subd.
8. Continuation of coverage. (a) A
former employee of an employer participating in the program who is receiving a
public pension disability benefit or an annuity or has met the age and service
requirements necessary to receive an annuity under chapter 353, 353C, 354,
354A, 356, 422A, 423, 423A, or 424, and the former employee's dependents, are
eligible to participate in the program. This participation is at the person's
expense unless a collective bargaining agreement or personnel policy provides
otherwise. Premiums for these participants must be established by the
commissioner.
The
commissioner may provide policy exclusions for preexisting conditions only when
there is a break in coverage between a participant's coverage under the
employment-based group insurance program and the participant's coverage under
this section. An employer shall notify an employee of the option to participate
under this paragraph no later than the effective date of retirement. The
retired employee or the employer of a participating group on behalf of a
current or retired employee shall notify the commissioner within 30 days of the
effective date of retirement of intent to participate in the program according
to the rules established by the commissioner.
(b)
The spouse of a deceased employee or former employee may purchase the benefits
provided at premiums established by the commissioner if the spouse was a
dependent under the employee's or former employee's coverage under this section
at the time of the death. The spouse remains eligible to participate in the
program as long as the group that included the deceased employee or former
employee participates in the program. Coverage under this clause must be coordinated
with relevant insurance benefits provided through the federally sponsored
Medicare program.
(c)
The program benefits must continue in the event of strike permitted by section
179A.18, if the exclusive representative chooses to have coverage continue and
the employee pays the total monthly premiums when due.
(d)
A participant who discontinues coverage may not reenroll.
(d)
Persons
participating under these paragraphs this subdivision shall make
appropriate premium payments in the time and manner established by the
commissioner. They are not subject to the payment of the extra payments
required under subdivision 7, paragraph (b).
Subd.
9. Insurance trust fund. The
insurance trust fund in the state treasury consists of deposits of the premiums
received from employers participating in the program and transfers before July
1, 1994, from the excess contributions holding account established by section
353.65, subdivision 7. All money in the fund is appropriated to the
commissioner to pay insurance premiums, approved claims, refunds,
administrative costs, and other related service costs. Premiums paid by
employers to the fund are exempt from the taxes imposed by chapter 297I. The
commissioner shall reserve an amount of money to cover the estimated costs of claims
incurred but unpaid. The State Board of Investment shall invest the money
according to section 11A.24. Investment income and losses attributable to the
fund must be credited to the fund.
Subd.
10. Exemption. The public employee insurance
program and, where applicable, the employers participating in it are exempt
from chapters 60A, 62A, 62C, 62D, 62E, and 62H, section 471.617, subdivisions 2
and 3, and the bidding requirements of section 471.6161, except as otherwise
provided in subdivision 6, paragraph (a).
Subd.
11. Reinsurance. The commissioner
may, on behalf of the program, participate in an insured or self-insured
reinsurance pool.
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Sec. 3. Minnesota Statutes
2006, section 62H.02, is amended to read:
62H.02 REQUIRED PROVISIONS.
(a) A joint self-insurance plan
must include aggregate excess stop-loss coverage and individual excess
stop-loss coverage provided by an insurance company licensed by the state of
Minnesota.
(b) Aggregate excess stop-loss
coverage must include provisions to cover incurred, unpaid claim liability in
the event of plan termination. In addition,
(c) The plan of self-insurance
must have participating employers fund an amount at least equal to the point at
which the excess or stop-loss insurer has contracted to assume 100 percent of
additional liability.
(d) A joint self-insurance plan
must submit its proposed excess or stop-loss insurance contract to the
commissioner of commerce at least 30 days prior to the proposed plan's
effective date and at least 30 days subsequent to any renewal date. The
commissioner shall review the contract to determine if they meet the standards
established by sections 62H.01 to 62H.08 and respond within a 30-day period.
(e) Any excess or stop-loss
insurance plan must contain a provision that the excess or stop-loss insurer
will give the plan and the commissioner of commerce a minimum of 180 days'
notice of termination or nonrenewal. If the plan fails to secure replacement
coverage within 60 days after receipt of the notice of cancellation or
nonrenewal, the commissioner shall issue an order providing for the orderly
termination of the plan.
(f) The commissioner may waive
the requirements of this section and of any rule relating to the requirements
of this section, if the commissioner determines that a joint self-insurance
plan has established alternative arrangements that fully fund the plan's
liability or incurred but unpaid claims. The commissioner may not waive the
requirement that a joint self-insurance plan have excess stop-loss coverage.
EFFECTIVE DATE. This section is
effective the day following final enactment.
Sec. 4. [62Q.40] LANGUAGE INTERPRETER SERVICES.
(a) A health plan must cover
sign language interpreter services provided to deaf and hard-of-hearing
enrollees and language interpreter services provided to enrollees with limited
English proficiency in order to facilitate the provision of health care services
by a provider. For purposes of this section, "provider" has the
meaning given in section 62J.03, subdivision 8, and includes a health care
provider facility; and "health plan" includes coverage excluded under
section 62A.011, subdivision 3, clauses (6), (7), (9), and (10). Interpreter
services may be provided in person, by telephone, facsimile, video or audio
streaming, or by video conference. In accordance with paragraphs (b) and (c), a
health plan company shall reimburse either the party providing interpreter
services directly for the costs of language interpreter services provided to
the enrollee or the provider arranging for the provision of interpreter
services. Providers that employ or contract with interpreters may bill and
shall be reimbursed directly by health plan companies for such services in
accordance with paragraph (b). A health plan company shall provide to
enrollees, upon request, the policies and procedures for addressing the needs
of deaf and hard-of-hearing enrollees and enrollees with limited English
proficiency. All parties providing interpreter services must disclose their
methods for ensuring competency upon request of any health plan company,
provider, or consumer.
(b) A health plan company
shall pay for interpreter services as required in paragraph (a) by establishing
a network of interpreter service providers and requiring use of its own network
of interpreter services providers. The health plan company shall consider, as
part of its interpreter service provider network, entering into an agreement
with a provider for use of an interpreter service provider employed by or under
contract with the provider if:
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(1) the provider accepts as
reimbursement for services rendered by the provider's employed or contracted
interpreter service provider the lesser of either the health plan company's
reimbursement rate for its in-network interpreter service providers or the
provider's fee for services rendered by the provider's interpreter service
provider; and
(2) the interpreter service
provider meets the published quality standards of the health plan company.
(c) If a health plan
company's or a provider's employed or contracted interpreter service provider
is unavailable to provide interpreter services, the health plan company shall
reimburse the interpreter service provider at the lesser of the health plan
company's median reimbursement rate for its in-network interpreter service
providers or the interpreter service provider's fee. An interpreter service
provider not employed or under contract with a health plan company or provider
who fails to meet the quality standards of a health plan company or as required
by law, shall be ineligible for reimbursement under this section.
(d) If the health plan
company pays the interpreter service provider directly, it has no obligation to
pay the provider under this section.
(e) Nothing in this section
requires a health plan company to establish a network of interpreter service
providers.
EFFECTIVE DATE. This section is
effective July 1, 2008, and applies to plans issued or renewed to provide
coverage to Minnesota residents on or after that date unless the legislature
enacts alternative funding sources based on the recommendations of the
commissioner.
Sec. 5. Minnesota Statutes
2006, section 144.05, is amended by adding a subdivision to read:
Subd. 5. Base budget detail. The commissioner shall provide the
commissioner of finance with the information necessary to provide base budget
detail to the legislature under section 16A.10, subdivision 2a.
Sec. 6. Minnesota Statutes
2006, section 148.235, is amended by adding a subdivision to read:
Subd. 11. Dispensing by protocol. A registered nurse in a family
planning agency as defined in Minnesota Rules, part 9505.0280, subpart 3, may
dispense oral contraceptives prescribed by a licensed practitioner as defined
in section 151.01, subdivision 23, pursuant to a dispensing protocol established
by the agency's medical director or under the direction of a physician. The
dispensing protocol must address the requirements of sections 151.01,
subdivision 30, and 151.212, subdivision 1.
Sec. 7. Minnesota Statutes
2006, section 151.37, subdivision 2, is amended to read:
Subd. 2. Prescribing and filing. (a) A licensed
practitioner in the course of professional practice only, may prescribe,
administer, and dispense a legend drug, and may cause the same to be
administered by a nurse, a physician assistant, or medical student or resident
under the practitioner's direction and supervision, and may cause a person who
is an appropriately certified, registered, or licensed health care professional
to prescribe, dispense, and administer the same within the expressed legal
scope of the person's practice as defined in Minnesota Statutes. A licensed
practitioner may prescribe a legend drug, without reference to a specific
patient, by directing a nurse, pursuant to section 148.235, subdivisions 8 and
9, physician assistant, or medical student or resident to adhere to a
particular practice guideline or protocol when treating patients whose
condition falls within such guideline or protocol, and when such guideline or
protocol specifies the circumstances under which the legend drug is to be
prescribed and administered. An individual who verbally, electronically, or
otherwise transmits a written, oral, or electronic order, as an agent of a
prescriber, shall not be deemed to have prescribed the legend drug. This paragraph
applies to a physician assistant only if the physician assistant meets the
requirements of section 147A.18.
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(b)
A licensed practitioner that dispenses for profit a legend drug that is to be
administered orally, is ordinarily dispensed by a pharmacist, and is not a
vaccine, must file with the practitioner's licensing board a statement
indicating that the practitioner dispenses legend drugs for profit, the general
circumstances under which the practitioner dispenses for profit, and the types
of legend drugs generally dispensed. It is unlawful to dispense legend drugs
for profit after July 31, 1990, unless the statement has been filed with the
appropriate licensing board. For purposes of this paragraph, "profit"
means (1) any amount received by the practitioner in excess of the acquisition
cost of a legend drug for legend drugs that are purchased in prepackaged form,
or (2) any amount received by the practitioner in excess of the acquisition
cost of a legend drug plus the cost of making the drug available if the legend
drug requires compounding, packaging, or other treatment. The statement filed
under this paragraph is public data under section 13.03. This paragraph does not
apply to a licensed doctor of veterinary medicine or a registered pharmacist.
Any person other than a licensed practitioner with the authority to prescribe,
dispense, and administer a legend drug under paragraph (a) shall not dispense
for profit. To dispense for profit does not include dispensing by a community
health clinic when the profit from dispensing is used to meet operating
expenses.
(c)
A prescription or drug order for a legend drug is not valid unless it is issued
for a legitimate medical purpose arising from a prescriber-patient relationship
that includes a documented patient evaluation adequate to establish diagnoses
and identify underlying conditions and contraindications to the treatment.
Treatment, including issuing a prescription or drug order, based solely on an
online questionnaire does not constitute a legitimate medical purpose.
Sec.
8. Minnesota Statutes 2006, section 152.11, is amended by adding a subdivision
to read:
Subd.
2d. Identification requirement for schedule
II or III controlled substance. No person may dispense a controlled
substance included in schedule II or III without requiring the person
purchasing the controlled substance, who need not be the person for whom the
controlled substance prescription is written, to present valid photographic
identification, unless the person purchasing the controlled substance, or if
applicable the person for whom the controlled substance prescription is
written, is known to the dispenser.
Sec.
9. [152.126] SCHEDULE II AND III
CONTROLLED SUBSTANCES PRESCRIPTION ELECTRONIC REPORTING SYSTEM.
Subdivision
1. Definitions. For purposes of
this section, the terms defined in this subdivision have the meanings given.
(a)
"Board" means the Minnesota State Board of Pharmacy established under
chapter 151.
(b)
"Controlled substances" means those substances listed in section
152.02, subdivisions 3 and 4, and those substances defined by the board
pursuant to section 152.02, subdivisions 8 and 12.
(c)
"Dispense" or "dispensing" has the meaning given in section
151.01, subdivision 30. Dispensing does not include the direct administering of
a controlled substance to a patient by a licensed health care professional.
(d)
"Dispenser" means a person authorized by law to dispense a controlled
substance, pursuant to a valid prescription. A dispenser does not include a
licensed hospital pharmacy that distributes controlled substances for inpatient
hospital care.
(e)
"Prescriber" means a licensed health care professional who is
authorized to prescribe a controlled substance under section 152.12,
subdivision 1.
(f)
"Prescription" has the meaning given in section 151.01, subdivision
16.
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Subd. 2. Prescription electronic reporting system. (a) By January
1, 2009, or upon enactment of legislation that implements the recommendations
of the Board of Pharmacy under subdivision 3, paragraph (c), whichever is
later, the board shall establish an electronic system for reporting the
information required under subdivision 4 for all controlled substances
dispensed within the state. Data for controlled substance prescriptions that
are dispensed in a quantity small enough to provide treatment to a patient for
a period of 48 hours or less need not be reported.
(b) The board may contract
with a vendor for the purpose of obtaining technical assistance in the design,
implementation, and maintenance of the electronic reporting system. The
vendor's role shall be limited to providing technical support to the board
concerning the software, databases, and computer systems required to interface
with the existing systems currently used by pharmacies to dispense
prescriptions and transmit prescription data to other third parties.
(c) The board may issue a
waiver to a dispenser that is unable to submit dispensing information by
electronic means. The waiver may permit the dispenser to submit dispensing
information by paper form or other means, provided all information required by
subdivision 4 is submitted in this alternative format.
Subd. 3. Prescription Electronic Reporting Advisory Committee. (a)
The board shall convene an advisory committee. The committee must include at
least one representative of:
(1) the Department of
Health;
(2) the Department of Human
Services;
(3) each health-related
licensing board that licenses prescribers;
(4) a professional medical
association, which may include an association of pain management and chemical
dependency specialists;
(5) a professional pharmacy association;
(6) a consumer privacy or
security advocate; and
(7) a consumer or patient
rights organization.
(b) The advisory committee
shall advise the board on the development and operation of the electronic
reporting system, including, but not limited to:
(1) technical standards for
electronic prescription drug reporting;
(2) proper analysis and
interpretation of prescription monitoring data; and
(3) an evaluation process
for the program.
(c) The Board of Pharmacy,
after consultation with the advisory committee, shall present recommendations
and draft legislation on the issues addressed by the advisory committee under
paragraph (b), to the legislature by December 15, 2007.
Subd. 4. Reporting requirements and notice. (a) Each dispenser
must submit the following data to the board or its designated vendor, subject
to the notice required under paragraph (d):
(1) prescriber DEA number;
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(2)
dispenser DEA number;
(3)
name of the patient for whom the prescription was written;
(4)
date of birth of the patient for whom the prescription was written;
(5)
date the prescription was written;
(6)
date the prescription was filled;
(7)
NDC code for drug dispensed; and
(8)
quantity of controlled substance dispensed.
(b)
The dispenser must submit the required information according to the format and
protocols specified in the "ASAP Telecommunications Format for Controlled
Substances," May 1995 edition, published by the American Society for
Automation in Pharmacy, which is hereby adopted by reference, by a procedure
established by the board.
(c)
A dispenser is not required to submit this data for those controlled substance
prescriptions dispensed for:
(1)
individuals residing in licensed skilled nursing or intermediate care
facilities;
(2)
individuals receiving assisted living services under chapter 144G or through a
medical assistance home and community-based waiver;
(3)
individuals receiving medication intravenously;
(4)
individuals receiving hospice and other palliative or end-of-life care; and
(5)
individuals receiving services from a home care provider regulated under
chapter 144A.
(d)
A dispenser must not submit data under this subdivision unless a conspicuous notice
of the reporting requirements of this section is given to the patient for whom
the prescription was written.
Subd.
5. Use of data by board. (a) The
board shall develop and maintain a database of the data reported under
subdivision 4. The board shall maintain data that could identify an individual
prescriber or dispenser in encrypted form. The database may be used by
permissible users identified under subdivision 6 for the identification of:
(1)
individuals receiving prescriptions for controlled substances from prescribers
who subsequently obtain controlled substances from dispensers in quantities or
with a frequency inconsistent with generally recognized standards of dosage for
those controlled substances; and
(2)
individuals presenting forged or otherwise false or altered prescriptions for
controlled substances to dispensers.
(b)
No permissible user identified under subdivision 6 may access the database for
the sole purpose of identifying prescribers of controlled substances for
unusual or excessive prescribing patterns without a valid search warrant or
court order.
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(c) No personnel of a state
or federal occupational licensing board or agency may access the database for
the purpose of obtaining information to be used to initiate or substantiate a
disciplinary action against a prescriber.
(d) Data reported under
subdivision 4 shall be retained by the board in the database for a six-month
period, and shall be removed from the database six months from the date the
data was received.
Subd. 6. Access to reporting system data. (a) Except as indicated
in this subdivision, the data submitted to the board under subdivision 4 is
private data on individuals as defined in section 13.02, subdivision 12, and
not subject to public disclosure.
(b) Except as specified in
subdivision 5, the following persons shall be considered permissible users and
may access the data submitted under subdivision 4 in the same or similar
manner, and for the same or similar purposes, as those persons who are
authorized to access similar private data on individuals under federal and
state law:
(1) a prescriber, to the
extent the information relates specifically to a current patient of the
prescriber, to whom the practitioner is prescribing or considering prescribing
any controlled substance;
(2) a dispenser to the
extent the information relates specifically to a current patient to whom that
dispenser is dispensing or considering dispensing any controlled substance;
(3) an individual who is the
recipient of a controlled substance prescription for which data was submitted
under subdivision 4;
(4) personnel of the board
specifically assigned to conduct a bona fide investigation of a specific board
licensee;
(5) personnel of the board
engaged in the collection of controlled substance prescription information as
part of the assigned duties and responsibilities under this section;
(6) authorized personnel of a
vendor under contract with the board who are engaged in the design,
implementation, and maintenance of the electronic reporting system as part of
the assigned duties and responsibilities of their employment, provided that
access to data is limited to the minimum amount necessary to test and maintain
the system databases;
(7) federal, state, and
local law enforcement authorities engaged in a bona fide investigation of a
specific person; and
(8) personnel of the medical
assistance program assigned to use the data collected under this section to
identify recipients whose usage of controlled substances may warrant
restriction to a single primary care physician, a single outpatient pharmacy,
or a single hospital.
(c) Any permissible user
identified in paragraph (b), who directly accesses the data electronically,
shall implement and maintain a comprehensive information security program that
contains administrative, technical, and physical safeguards that are
appropriate to the user's size and complexity, and the sensitivity of the
personal information obtained. The permissible user shall identify reasonably
foreseeable internal and external risks to the security, confidentiality, and
integrity of personal information that could result in the unauthorized disclosure,
misuse, or other compromise of the information and assess the sufficiency of
any safeguards in place to control the risks.
(d) The board shall not
release data submitted under this section unless it is provided with evidence,
satisfactory to the board, that the person requesting the information is
entitled to receive the data. Access to the data by law enforcement authorities
must be accompanied by a valid search warrant.
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(e)
The board shall not release the name of a prescriber without the written
consent of the prescriber or a valid search warrant or court order. The board
shall provide a mechanism for a prescriber to submit to the board a signed
consent authorizing the release of the prescriber's name when data containing
the prescriber's name is requested.
(f)
The board shall maintain a log of all persons who access the data and shall
ensure that any permissible user complies with paragraph (c) prior to attaining
direct access to the data.
Subd.
7. Disciplinary action. (a) A
dispenser who knowingly fails to submit data to the board as required under
this section is subject to disciplinary action by the appropriate
health-related licensing board.
(b)
A prescriber or dispenser authorized to access the data who knowingly discloses
the data in violation of state or federal laws relating to the privacy of
health care data shall be subject to disciplinary action by the appropriate
health-related licensing board, and appropriate civil penalties.
Subd.
8. Evaluation and reporting. (a)
The board shall evaluate the prescription electronic reporting system to
determine if the system is cost-effective and whether it is negatively
impacting appropriate prescribing practices of controlled substances. The board
may contract with a vendor to design and conduct the evaluation.
(b)
The board shall submit the evaluation of the system to the legislature by
January 15, 2010.
Subd.
9. Immunity from liability; no requirement
to obtain information. (a) A pharmacist, prescriber, or other
dispenser making a report to the program in good faith under this section is
immune from any civil, criminal, or administrative liability, which might
otherwise be incurred or imposed as a result of the report, or on the basis
that the pharmacist or prescriber did or did not seek or obtain or use
information from the program.
(b)
Nothing in this section shall require a pharmacist, prescriber, or other
dispenser to obtain information about a patient from the program, and the
pharmacist, prescriber, or other dispenser, if acting in good faith, is immune
from any civil, criminal, or administrative liability that might otherwise be
incurred or imposed for requesting, receiving, or using information from the
program.
EFFECTIVE DATE. This section is
effective July 1, 2007, or upon receiving sufficient nonstate funds to
implement the prescription electronic reporting program, whichever is later. In
the event that nonstate funds are not secured by the Board of Pharmacy to
adequately fund the implementation of the prescription electronic reporting
program, the board is not required to implement this section without a
subsequent appropriation from the legislature.
Sec.
10. Minnesota Statutes 2006, section 179A.03, subdivision 7, is amended to
read:
Subd.
7. Essential employee.
"Essential employee" means firefighters, peace officers subject to
licensure under sections 626.84 to 626.863, 911 system and police and fire
department public safety dispatchers, guards at correctional facilities,
confidential employees, supervisory employees, assistant county attorneys,
assistant city attorneys, principals, and assistant principals. However, for
state employees, "essential employee" means all employees, except
for nonprofessional employees employed by the Department of Human Services in
mental health facilities for the treatment of psychopathic personalities,
sexual predators, and the criminally insane, in law enforcement, public
safety radio communications operators, health care professionals, correctional
guards, professional engineering, and supervisory collective bargaining units,
irrespective of severance, and no other employees. For University of Minnesota
employees, "essential employee" means all employees in law
enforcement, nursing professional and supervisory units, irrespective of
severance, and no other employees. "Firefighters" means salaried
employees of a fire department whose duties include, directly or indirectly,
controlling, extinguishing, preventing, detecting, or investigating fires.
Employees for whom the state court administrator is the negotiating employer
are not essential employees. For Hennepin Healthcare System, Inc. employees,
"essential employees" means all employees.
EFFECTIVE DATE. This section is
effective the day following final enactment.
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Sec.
11. Minnesota Statutes 2006, section 245.4874, is amended to read:
245.4874 DUTIES OF COUNTY
BOARD.
(a)
The county board must:
(1)
develop a system of affordable and locally available children's mental health
services according to sections 245.487 to 245.4887;
(2) establish a mechanism providing for interagency
coordination as specified in section 245.4875, subdivision 6;
(3)
consider the assessment of unmet needs in the county as reported by the local
children's mental health advisory council under section 245.4875, subdivision
5, paragraph (b), clause (3). The county shall provide, upon request of the local
children's mental health advisory council, readily available data to assist in
the determination of unmet needs;
(4)
assure that parents and providers in the county receive information about how
to gain access to services provided according to sections 245.487 to 245.4887;
(5)
coordinate the delivery of children's mental health services with services
provided by social services, education, corrections, health, and vocational
agencies to improve the availability of mental health services to children and
the cost-effectiveness of their delivery;
(6)
assure that mental health services delivered according to sections 245.487 to
245.4887 are delivered expeditiously and are appropriate to the child's
diagnostic assessment and individual treatment plan;
(7)
provide the community with information about predictors and symptoms of
emotional disturbances and how to access children's mental health services
according to sections 245.4877 and 245.4878;
(8)
provide for case management services to each child with severe emotional
disturbance according to sections 245.486; 245.4871, subdivisions 3 and 4; and
245.4881, subdivisions 1, 3, and 5;
(9)
provide for screening of each child under section 245.4885 upon admission to a
residential treatment facility, acute care hospital inpatient treatment, or
informal admission to a regional treatment center;
(10)
prudently administer grants and purchase-of-service contracts that the county
board determines are necessary to fulfill its responsibilities under sections
245.487 to 245.4887;
(11)
assure that mental health professionals, mental health practitioners, and case
managers employed by or under contract to the county to provide mental health
services are qualified under section 245.4871;
(12)
assure that children's mental health services are coordinated with adult mental
health services specified in sections 245.461 to 245.486 so that a continuum of
mental health services is available to serve persons with mental illness,
regardless of the person's age;
(13)
assure that culturally informed mental health consultants are used as necessary
to assist the county board in assessing and providing appropriate treatment for
children of cultural or racial minority heritage; and
(14)
consistent with section 245.486, arrange for or provide a children's mental
health screening to a child receiving child protective services or a child in
out-of-home placement, a child for whom parental rights have been terminated, a
child found to be delinquent, and a child found to have committed a juvenile
petty offense for the third or subsequent time, unless a screening or
diagnostic assessment has been performed within the previous 180 days, or
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the child is currently under
the care of a mental health professional. The court or county agency must
notify a parent or guardian whose parental rights have not been terminated of
the potential mental health screening and the option to prevent the screening
by notifying the court or county agency in writing. The screening shall be
conducted with a screening instrument approved by the commissioner of human
services according to criteria that are updated and issued annually to ensure
that approved screening instruments are valid and useful for child welfare and
juvenile justice populations, and shall be conducted by a mental health
practitioner as defined in section 245.4871, subdivision 26, or a probation
officer or local social services agency staff person who is trained in the use
of the screening instrument. Training in the use of the instrument shall
include training in the administration of the instrument, the interpretation of
its validity given the child's current circumstances, the state and federal
data practices laws and confidentiality standards, the parental consent
requirement, and providing respect for families and cultural values. If the
screen indicates a need for assessment, the child's family, or if the family
lacks mental health insurance, the local social services agency, in
consultation with the child's family, shall have conducted a diagnostic
assessment, including a functional assessment, as defined in section 245.4871.
The administration of the screening shall safeguard the privacy of children
receiving the screening and their families and shall comply with the Minnesota
Government Data Practices Act, chapter 13, and the federal Health Insurance
Portability and Accountability Act of 1996, Public Law 104-191. Screening
results shall be considered private data and the commissioner shall not collect
individual screening results.
(b)
When the county board refers clients to providers of children's therapeutic
services and supports under section 256B.0943, the county board must clearly
identify the desired services components not covered under section 256B.0943
and identify the reimbursement source for those requested services, the method
of payment, and the payment rate to the provider.
Sec.
12. Minnesota Statutes 2006, section 253B.185, subdivision 2, is amended to
read:
Subd.
2. Transfer to correctional facility.
(a) If a person has been committed under this section and later is committed to
the custody of the commissioner of corrections for any reason, including but
not limited to, being sentenced for a crime or revocation of the person's
supervised release or conditional release under section 244.05, 609.108,
subdivision 6, or 609.109, subdivision 7, the person shall be transferred
to a facility designated by the commissioner of corrections without regard to
the procedures provided in section 253B.18.
(b)
If a person is committed under this section after a commitment to the
commissioner of corrections, the person shall first serve the sentence in a
facility designated by the commissioner of corrections. After the person has
served the sentence, the person shall be transferred to a treatment program
designated by the commissioner of human services.
Sec.
13. Minnesota Statutes 2006, section 254A.03, subdivision 3, is amended to
read:
Subd.
3. Rules for chemical dependency care.
The commissioner of human services shall establish by rule criteria to be used
in determining the appropriate level of chemical dependency care, whether
outpatient, inpatient or short-term treatment programs, for each recipient
of public assistance seeking treatment for alcohol or other drug dependency and
abuse problems. The criteria shall address, at least, the family
relationship, past treatment history, medical or physical problems, arrest
record, and employment situation.
Sec.
14. Minnesota Statutes 2006, section 254A.16, subdivision 2, is amended to
read:
Subd.
2. Program and service guidelines.
(a) The commissioner shall provide program and service guidelines and technical
assistance to the county boards in carrying out services authorized under sections
section 254A.08, 254A.12, 254A.14, and their responsibilities under
chapter 256E.
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(b) The commissioner shall recommend
to the governor means of improving the efficiency and effectiveness of
comprehensive program services in the state and maximizing the use of
nongovernmental funds for providing comprehensive programs.
Sec. 15. [254A.20] CHEMICAL USE ASSESSMENTS;
FINANCIAL CONFLICT OF INTEREST.
(a) Except as provided in
paragraph (b), an assessor conducting a chemical use assessment under Minnesota
Rules, parts 9530.6600 to 9530.6655, may not have any direct or shared
financial interest or referral relationship resulting in shared financial
interest or referral relationship resulting in shared financial gain with a
treatment provider.
(b) A county may contract
with an assessor having a conflict described in paragraph (a) if the county
documents that:
(1) the assessor is employed
by a culturally specific service provider or a service provider with a program
designed to treat individuals of a specific age, sex, or sexual preference;
(2) the county does not
employ a sufficient number of qualified assessors and the only qualified
assessors available in the county have a direct or shared financial interest or
a referral relationship resulting in shared financial gain with a treatment
provider; or
(3) the county social
service agency has an existing relationship with an assessor or service
provider and elects to enter into a contract with that assessor to provide both
assessment and treatment under circumstances specified in the county's
contract, provided the county retains responsibility for making placement
decisions.
EFFECTIVE DATE. This section is
effective the day following final enactment.
Sec. 16. Minnesota Statutes
2006, section 254B.02, subdivision 1, is amended to read:
Subdivision 1. Chemical dependency treatment allocation.
The chemical dependency funds appropriated for allocation shall be placed in a
special revenue account. The commissioner shall annually transfer funds from
the chemical dependency fund to pay for operation of the drug and alcohol abuse
normative evaluation system and to pay for all costs incurred by adding two
positions for licensing of chemical dependency treatment and rehabilitation
programs located in hospitals for which funds are not otherwise appropriated. For
each year of the biennium ending June 30, 1999, the commissioner shall allocate
funds to the American Indian chemical dependency tribal account for treatment
of American Indians by eligible vendors under section 254B.05, equal to the
amount allocated in fiscal year 1997. Six percent of the remaining money
must be reserved for tribal allocation under section 254B.09, subdivisions 4
and 5. The commissioner shall annually divide the money available in the
chemical dependency fund that is not held in reserve by counties from a
previous allocation, or allocated to the American Indian chemical dependency
tribal account. Six percent of the remaining money must be reserved for the
nonreservation American Indian chemical dependency allocation for treatment of
American Indians by eligible vendors under section 254B.05, subdivision 1. The
remainder of the money must be allocated among the counties according to the
following formula, using state demographer data and other data sources
determined by the commissioner:
(a) For purposes of this
formula, American Indians and children under age 14 are subtracted from the
population of each county to determine the restricted population.
(b) The amount of chemical
dependency fund expenditures for entitled persons for services not covered by
prepaid plans governed by section 256B.69 in the previous year is divided by
the amount of chemical dependency fund expenditures for entitled persons for
all services to determine the proportion of exempt service expenditures for
each county.
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(c)
The prepaid plan months of eligibility is multiplied by the proportion of
exempt service expenditures to determine the adjusted prepaid plan months of
eligibility for each county.
(d)
The adjusted prepaid plan months of eligibility is added to the number of
restricted population fee for service months of eligibility for the Minnesota
family investment program, general assistance, and medical assistance and
divided by the county restricted population to determine county per capita
months of covered service eligibility.
(e)
The number of adjusted prepaid plan months of eligibility for the state is
added to the number of fee for service months of eligibility for the Minnesota
family investment program, general assistance, and medical assistance for the
state restricted population and divided by the state restricted population to
determine state per capita months of covered service eligibility.
(f)
The county per capita months of covered service eligibility is divided by the
state per capita months of covered service eligibility to determine the county
welfare caseload factor.
(g)
The median married couple income for the most recent three-year period
available for the state is divided by the median married couple income for the
same period for each county to determine the income factor for each county.
(h)
The county restricted population is multiplied by the sum of the county welfare
caseload factor and the county income factor to determine the adjusted
population.
(i)
$15,000 shall be allocated to each county.
(j)
The remaining funds shall be allocated proportional to the county adjusted
population.
Sec.
17. Minnesota Statutes 2006, section 254B.02, subdivision 5, is amended to
read:
Subd.
5. Administrative adjustment. The
commissioner may make payments to local agencies from money allocated under
this section to support administrative activities under sections 254B.03 and
254B.04. The administrative payment must not exceed five percent of the first
$50,000, four percent of the next $50,000, and three percent of the remaining
payments for services from the allocation. Twenty-five percent of the
administrative allowance shall be advanced at the beginning of each quarter,
based on the payments for services made in the most recent quarter for which
data is available. Adjustment of any overestimate or underestimate based on
actual expenditures shall be made by the state agency by adjusting the
administrative allowance for any succeeding quarter.
Sec.
18. Minnesota Statutes 2006, section 254B.03, subdivision 1, is amended to
read:
Subdivision
1. Local agency duties. (a) Every
local agency shall provide chemical dependency services to persons residing
within its jurisdiction who meet criteria established by the commissioner for
placement in a chemical dependency residential or nonresidential treatment
service. Chemical dependency money must be administered by the local agencies
according to law and rules adopted by the commissioner under sections 14.001 to
14.69.
(b)
In order to contain costs, the county board shall, with the approval of the
commissioner of human services, select eligible vendors of chemical dependency
services who can provide economical and appropriate treatment. Unless the local
agency is a social services department directly administered by a county or
human services board, the local agency shall not be an eligible vendor under
section 254B.05. The commissioner may approve proposals from county boards to
provide services in an economical manner or to control utilization, with
safeguards to ensure that necessary services are provided. If a county
implements a demonstration or experimental medical services funding plan, the
commissioner shall transfer the money as appropriate. If a county selects a
vendor located in another state, the county shall ensure that the vendor is in
compliance with the rules governing licensure of programs located in the state.
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(c)
The calendar year 2002 rate for vendors may not increase more than three
percent above the rate approved in effect on January 1, 2001. The calendar year
2003 rate for vendors may not increase more than three percent above the rate
in effect on January 1, 2002. The calendar years 2004 and 2005 rates may not
exceed the rate in effect on January 1, 2003.
(d) (c) A culturally specific
vendor that provides assessments under a variance under Minnesota Rules, part
9530.6610, shall be allowed to provide assessment services to persons not
covered by the variance.
Sec.
19. Minnesota Statutes 2006, section 254B.03, subdivision 3, is amended to
read:
Subd.
3. Local agencies to pay state for
county share. Local agencies shall submit invoices to the state on forms
supplied by the commissioner and according to procedures established by the
commissioner. Local agencies shall pay the state for the county share of
the invoiced services authorized by the local agency. Payments
shall be made at the beginning of each month for services provided in the
previous month. The commissioner shall bill the county monthly for services,
based on the most recent month for which expenditure information is available.
Adjustment of any overestimate or underestimate based on actual expenditures
shall be made by the state agency by adjusting the estimate for any succeeding
month.
Sec.
20. Minnesota Statutes 2006, section 254B.06, subdivision 3, is amended to
read:
Subd.
3. Payment; denial. The commissioner
shall pay eligible vendors for placements made by local agencies under section
254B.03, subdivision 1, and placements by tribal designated agencies according
to section 254B.09. The commissioner may reduce or deny payment of the state
share when services are not provided according to the placement criteria
established by the commissioner. The commissioner may pay for all or a portion
of improper county chemical dependency placements and bill the county for the
entire payment made when the placement did not comply with criteria established
by the commissioner. The commissioner may make payments to vendors and charge
the county 100 percent of the payments if documentation of a county approved
placement is received more than 30 working days, exclusive of weekends and
holidays, after the date services began; or if the county approved invoice
is received by the commissioner more than 120 days after the last date of
service provided. The commissioner shall not pay vendors until private
insurance company claims have been settled.
Sec.
21. Minnesota Statutes 2006, section 256.01, is amended by adding a subdivision
to read:
Subd.
25. Base budget detail. The
commissioner shall provide the commissioner of finance with the information necessary
to provide base budget detail to the legislature under section 16A.10,
subdivision 2a.
Sec.
22. Minnesota Statutes 2006, section 256B.0625, subdivision 23, is amended to
read:
Subd.
23. Day treatment services. Medical
assistance covers day treatment services as specified in sections 245.462,
subdivision 8, and 245.4871, subdivision 10, that are provided under contract
with the county board. Notwithstanding Minnesota Rules, part 9505.0323, subpart
15, the commissioner may set authorization thresholds for day treatment for
adults according to section 256B.0625, subdivision 25. Notwithstanding
Minnesota Rules, part 9505.0323, subpart 15, effective July 1, 2004,
medical assistance covers day treatment services for children as specified
under section 256B.0943.
Sec.
23. [256B.0636] PRESCRIBING OF
CONTROLLED SUBSTANCES; ABUSE PREVENTION.
The
commissioner shall develop and implement a plan to:
(1)
monitor the prescribing of controlled substances listed in section 152.02,
subdivisions 3 and 4, and those substances defined by the Board of Pharmacy
under section 152.02, subdivisions 8 and 12, by enrolled providers and
providers under contract with participating managed care plans;
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(2)
require enrolled providers and providers under contract with participating
managed care plans to report information related to potential patient abuse of
the controlled substances to the commissioner, and the Board of Pharmacy; and
(3)
provide education to Minnesota health care program enrollees on the proper use
of controlled substances.
Sec.
24. Minnesota Statutes 2006, section 256B.0943, subdivision 6, is amended to
read:
Subd.
6. Provider entity clinical
infrastructure requirements. (a) To be an eligible provider entity under
this section, a provider entity must have a clinical infrastructure that
utilizes diagnostic assessment, an individualized treatment plan, service
delivery, and individual treatment plan review that are culturally competent,
child-centered, and family-driven to achieve maximum benefit for the client.
The provider entity must review and update the clinical policies and procedures
every three years and must distribute the policies and procedures to staff
initially and upon each subsequent update.
(b)
The clinical infrastructure written policies and procedures must include
policies and procedures for:
(1)
providing or obtaining a client's diagnostic assessment that identifies acute and
chronic clinical disorders, co-occurring medical conditions, sources of
psychological and environmental problems, and a functional assessment. The
functional assessment must clearly summarize the client's individual strengths
and needs;
(2)
developing an individual treatment plan that is:
(i)
based on the information in the client's diagnostic assessment;
(ii)
developed no later than the end of the first psychotherapy session after the
completion of the client's diagnostic assessment by the mental health
professional who provides the client's psychotherapy;
(iii)
developed through a child-centered, family-driven planning process that
identifies service needs and individualized, planned, and culturally
appropriate interventions that contain specific treatment goals and objectives
for the client and the client's family or foster family;
(iv)
reviewed at least once every 90 days and revised, if necessary; and
(v)
signed by the client or, if appropriate, by the client's parent or other person
authorized by statute to consent to mental health services for the client;
(3)
developing an individual behavior plan that documents services to be provided
by the mental health behavioral aide. The individual behavior plan must
include:
(i)
detailed instructions on the service to be provided;
(ii)
time allocated to each service;
(iii)
methods of documenting the child's behavior;
(iv)
methods of monitoring the child's progress in reaching objectives; and
(v)
goals to increase or decrease targeted behavior as identified in the individual
treatment plan;
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(4)
clinical supervision of the mental health practitioner and mental health behavioral
aide. A mental health professional must document the clinical supervision the
professional provides by cosigning individual treatment plans and making
entries in the client's record on supervisory activities. Clinical supervision
does not include the authority to make or terminate court-ordered placements of
the child. A clinical supervisor must be available for urgent consultation as
required by the individual client's needs or the situation. Clinical
supervision may occur individually or in a small group to discuss treatment and
review progress toward goals. The focus of clinical supervision must be the
client's treatment needs and progress and the mental health practitioner's or
behavioral aide's ability to provide services;
(4a)
CTSS certified provider entities providing day treatment programs must meet the
conditions in items (i) to (iii):
(i)
the provider supervisor must be present and available on the
premises more than 50 percent of the time in a five-working-day period during
which the supervisee is providing a mental health service;
(ii)
the diagnosis and the client's individual treatment plan or a change in the
diagnosis or individual treatment plan must be made by or reviewed, approved,
and signed by the provider supervisor; and
(iii)
every 30 days, the supervisor must review and sign the record of the client's
care for all activities in the preceding 30-day period;
(4b)
for all other services provided under CTSS, clinical supervision standards
provided in items (i) to (iii) must be used:
(i)
medical assistance shall reimburse a mental health practitioner who maintains a
consulting relationship with a mental health professional who accepts full
professional responsibility and is present on site for at least one observation
during the first 12 hours in which the mental health practitioner provides the
individual, family, or group skills training to the child or the child's
family;
(ii)
thereafter, the mental health professional is required to be present on site
for observation as clinically appropriate when the mental health practitioner
is providing individual, family, or group skills training to the child or the
child's family; and
(iii)
the observation must be a minimum of one clinical unit. The on-site presence of
the mental health professional must be documented in the child's record and
signed by the mental health professional who accepts full professional
responsibility;
(5)
providing direction to a mental health behavioral aide. For entities that
employ mental health behavioral aides, the clinical supervisor must be employed
by the provider entity or other certified children's therapeutic supports and
services provider entity to ensure necessary and appropriate oversight for the
client's treatment and continuity of care. The mental health professional or
mental health practitioner giving direction must begin with the goals on the
individualized treatment plan, and instruct the mental health behavioral aide
on how to construct therapeutic activities and interventions that will lead to
goal attainment. The professional or practitioner giving direction must also
instruct the mental health behavioral aide about the client's diagnosis,
functional status, and other characteristics that are likely to affect service
delivery. Direction must also include determining that the mental health
behavioral aide has the skills to interact with the client and the client's
family in ways that convey personal and cultural respect and that the aide
actively solicits information relevant to treatment from the family. The aide
must be able to clearly explain the activities the aide is doing with the
client and the activities' relationship to
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treatment goals. Direction
is more didactic than is supervision and requires the professional or
practitioner providing it to continuously evaluate the mental health behavioral
aide's ability to carry out the activities of the individualized treatment plan
and the individualized behavior plan. When providing direction, the
professional or practitioner must:
(i) review progress notes
prepared by the mental health behavioral aide for accuracy and consistency with
diagnostic assessment, treatment plan, and behavior goals and the professional
or practitioner must approve and sign the progress notes;
(ii) identify changes in
treatment strategies, revise the individual behavior plan, and communicate
treatment instructions and methodologies as appropriate to ensure that treatment
is implemented correctly;
(iii) demonstrate
family-friendly behaviors that support healthy collaboration among the child,
the child's family, and providers as treatment is planned and implemented;
(iv) ensure that the mental
health behavioral aide is able to effectively communicate with the child, the
child's family, and the provider; and
(v) record the results of
any evaluation and corrective actions taken to modify the work of the mental
health behavioral aide;
(6) providing service
delivery that implements the individual treatment plan and meets the
requirements under subdivision 9; and
(7) individual treatment
plan review. The review must determine the extent to which the services have
met the goals and objectives in the previous treatment plan. The review must
assess the client's progress and ensure that services and treatment goals
continue to be necessary and appropriate to the client and the client's family
or foster family. Revision of the individual treatment plan does not require a
new diagnostic assessment unless the client's mental health status has changed
markedly. The updated treatment plan must be signed by the client, if
appropriate, and by the client's parent or other person authorized by statute
to give consent to the mental health services for the child.
Sec. 25. Minnesota Statutes
2006, section 256B.0943, subdivision 9, is amended to read:
Subd. 9. Service delivery criteria. (a) In
delivering services under this section, a certified provider entity must ensure
that:
(1) each individual
provider's caseload size permits the provider to deliver services to both
clients with severe, complex needs and clients with less intensive needs. The
provider's caseload size should reasonably enable the provider to play an
active role in service planning, monitoring, and delivering services to meet
the client's and client's family's needs, as specified in each client's
individual treatment plan;
(2) site-based programs,
including day treatment and preschool programs, provide staffing and facilities
to ensure the client's health, safety, and protection of rights, and that the
programs are able to implement each client's individual treatment plan;
(3) a day treatment program
is provided to a group of clients by a multidisciplinary team under the
clinical supervision of a mental health professional. The day treatment program
must be provided in and by: (i) an outpatient hospital accredited by the Joint
Commission on Accreditation of Health Organizations and licensed under sections
144.50 to 144.55; (ii) a community mental health center under section 245.62;
and (iii) an entity that is under contract with the county board to operate a
program that meets the requirements of sections 245.4712,
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subdivision 2, and 245.4884,
subdivision 2, and Minnesota Rules, parts 9505.0170 to 9505.0475. The day
treatment program must stabilize the client's mental health status while
developing and improving the client's independent living and socialization
skills. The goal of the day treatment program must be to reduce or relieve the
effects of mental illness and provide training to enable the client to live in
the community. The program must be available at least one day a week for a minimum
three-hour time block. The three-hour time block must include at least one
hour, but no more than two hours, of individual or group psychotherapy. The
remainder of the three-hour time block may include recreation therapy, socialization
therapy, or independent living skills therapy, but only if the therapies are
included in the client's individual treatment plan. Day treatment programs are
not part of inpatient or residential treatment services; and
(4) a preschool program is a
structured treatment program offered to a child who is at least 33 months old,
but who has not yet reached the first day of kindergarten, by a preschool
multidisciplinary team in a day program licensed under Minnesota Rules, parts
9503.0005 to 9503.0175. The program must be available at least one day a week
for a minimum two-hour time block. The structured treatment program may include
individual or group psychotherapy and recreation therapy, socialization
therapy, or independent living skills therapy, if included in the client's
individual treatment plan.
(b) A provider entity must
deliver the service components of children's therapeutic services and supports
in compliance with the following requirements:
(1) individual, family, and
group psychotherapy must be delivered as specified in Minnesota Rules, part
9505.0323;
(2) individual, family, or
group skills training must be provided by a mental health professional or a
mental health practitioner who has a consulting relationship with a mental
health professional who accepts full professional responsibility for the
training;
(3) crisis assistance must
be time-limited and designed to resolve or stabilize crisis through
arrangements for direct intervention and support services to the child and the
child's family. Crisis assistance must utilize resources designed to address
abrupt or substantial changes in the functioning of the child or the child's
family as evidenced by a sudden change in behavior with negative consequences
for well being, a loss of usual coping mechanisms, or the presentation of
danger to self or others;
(4) medically necessary
services that are provided by a mental health behavioral aide must be designed
to improve the functioning of the child and support the family in activities of
daily and community living. A mental health behavioral aide must document the
delivery of services in written progress notes. The mental health behavioral
aide must implement goals in the treatment plan for the child's emotional
disturbance that allow the child to acquire developmentally and therapeutically
appropriate daily living skills, social skills, and leisure and recreational
skills through targeted activities. These activities may include:
(i) assisting a child as
needed with skills development in dressing, eating, and toileting;
(ii) assisting, monitoring,
and guiding the child to complete tasks, including facilitating the child's
participation in medical appointments;
(iii) observing the child
and intervening to redirect the child's inappropriate behavior;
(iv) assisting the child in
using age-appropriate self-management skills as related to the child's
emotional disorder or mental illness, including problem solving, decision
making, communication, conflict resolution, anger management, social skills,
and recreational skills;
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(v)
implementing deescalation techniques as recommended by the mental health
professional;
(vi)
implementing any other mental health service that the mental health
professional has approved as being within the scope of the behavioral aide's
duties; or
(vii)
assisting the parents to develop and use parenting skills that help the child
achieve the goals outlined in the child's individual treatment plan or
individual behavioral plan. Parenting skills must be directed exclusively to
the child's treatment; and
(5)
direction of a mental health behavioral aide must include the following:
(i)
a total of one hour of on-site observation by a mental health professional
during the first 12 hours of service provided to a child;
(ii)
ongoing on-site observation by a mental health professional or mental health
practitioner for at least a total of one hour during every 40 hours of service
provided to a child; and
(iii)
immediate accessibility of the mental health professional or mental health
practitioner to the mental health behavioral aide during service provision.
Sec.
26. Minnesota Statutes 2006, section 256B.0943, subdivision 11, is amended to
read:
Subd.
11. Documentation and billing. (a) A
provider entity must document the services it provides under this section. The
provider entity must ensure that the entity's documentation standards meet the
requirements of federal and state laws. Services billed under this section that
are not documented according to this subdivision shall be subject to monetary
recovery by the commissioner. The provider entity may not bill for anything
other than direct service time.
(b)
An individual mental health provider must promptly document the following in a
client's record after providing services to the client:
(1)
each occurrence of the client's mental health service, including the date,
type, length, and scope of the service;
(2)
the name of the person who gave the service;
(3)
contact made with other persons interested in the client, including
representatives of the courts, corrections systems, or schools. The provider
must document the name and date of each contact;
(4)
any contact made with the client's other mental health providers, case manager,
family members, primary caregiver, legal representative, or the reason the
provider did not contact the client's family members, primary caregiver, or
legal representative, if applicable; and
(5)
required clinical supervision, as appropriate.
Sec.
27. Minnesota Statutes 2006, section 256B.0943, subdivision 12, is amended to
read:
Subd.
12. Excluded services. The following
services are not eligible for medical assistance payment as children's
therapeutic services and supports:
(1)
service components of children's therapeutic services and supports
simultaneously provided by more than one provider entity unless prior
authorization is obtained;
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(2) children's therapeutic
services and supports provided in violation of medical assistance policy in
Minnesota Rules, part 9505.0220;
(3) mental health behavioral
aide services provided by a personal care assistant who is not qualified as a
mental health behavioral aide and employed by a certified children's
therapeutic services and supports provider entity;
(4) service components of
CTSS that are the responsibility of a residential or program license holder,
including foster care providers under the terms of a service agreement or
administrative rules governing licensure; and
(5) adjunctive activities
that may be offered by a provider entity but are not otherwise covered by
medical assistance, including:
(i) a service that is
primarily recreation oriented or that is provided in a setting that is not
medically supervised. This includes sports activities, exercise groups,
activities such as craft hours, leisure time, social hours, meal or snack time,
trips to community activities, and tours;
(ii) a social or educational
service that does not have or cannot reasonably be expected to have a
therapeutic outcome related to the client's emotional disturbance;
(iii) consultation with other
providers or service agency staff about the care or progress of a client;
(iv) prevention or education
programs provided to the community; and
(v) treatment for clients
with primary diagnoses of alcohol or other drug abuse.; and
(6) activities that are not
direct service time.
Sec. 28. [256B.764] REIMBURSEMENT FOR FAMILY
PLANNING SERVICES.
Effective for services
rendered on or after July 1, 2007, payment rates for family planning services
shall be increased by 25 percent over the rates in effect July 30, 2007, when
these services are provided by a community clinic as defined in section
145.9268, subdivision 1.
Sec. 29. Minnesota Statutes
2006, section 256E.35, subdivision 2, is amended to read:
Subd. 2. Definitions. (a) The definitions in
this subdivision apply to this section.
(b) "Family asset
account" means a savings account opened by a household participating in
the Minnesota family assets for independence initiative.
(c) "Fiduciary
organization" means:
(1) a community action
agency that has obtained recognition under section 268.53 256E.31;
(2) a federal community
development credit union serving the seven-county metropolitan area; or
(3) a women-oriented
economic development agency serving the seven-county metropolitan area.
(d) "Financial
institution" means a bank, bank and trust, savings bank, savings
association, or credit union, the deposits of which are insured by the Federal
Deposit Insurance Corporation or the National Credit Union Administration.
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(e) "Permissible
use" means:
(1) postsecondary
educational expenses at an accredited public postsecondary institution
including books, supplies, and equipment required for courses of instruction;
(2) acquisition costs of
acquiring, constructing, or reconstructing a residence, including any usual or
reasonable settlement, financing, or other closing costs;
(3) business capitalization
expenses for expenditures on capital, plant, equipment, working capital, and
inventory expenses of a legitimate business pursuant to a business plan
approved by the fiduciary organization; and
(4) acquisition costs of a
principal residence within the meaning of section 1034 of the Internal Revenue
Code of 1986 which do not exceed 100 percent of the average area purchase price
applicable to the residence determined according to section 143(e)(2) and (3)
of the Internal Revenue Code of 1986.
(f) "Household"
means all individuals who share use of a dwelling unit as primary quarters for
living and eating separate from other individuals.
Sec. 30. [525A.01] SHORT TITLE.
This chapter may be cited as
the "Darlene Luther Revised Uniform Anatomical Gift Act."
Sec. 31. [525A.02] DEFINITIONS.
Subdivision 1. Scope. The definitions in this section apply to this
chapter.
Subd. 2. Adult. "Adult" means an individual who is at
least 18 years of age.
Subd. 3. Agent. "Agent" means an individual who is:
(1) authorized to make
health care decisions on the principal's behalf by a power of attorney for
health care; or
(2) expressly authorized to
make an anatomical gift on the principal's behalf by any other record signed by
the principal.
Subd. 4. Anatomical gift. "Anatomical gift" means a
donation of all or part of a human body to take effect after the donor's death
for the purpose of transplantation, therapy, research, or education.
Subd. 5. Decedent. "Decedent" means a deceased
individual and includes a stillborn infant or an embryo or fetus that has died
of natural causes in utero.
Subd. 6. Disinterested witness. "Disinterested witness"
means a witness other than the spouse, child, parent, sibling, grandchild,
grandparent, or guardian of the individual who makes, amends, revokes, or
refuses to make an anatomical gift, or another adult who exhibited special care
and concern for the individual. The term does not include a person to which an
anatomical gift could pass under section 525A.11.
Subd. 7. Document of gift. "Document of gift" means a
donor card or other record used to make an anatomical gift. The term includes a
statement or symbol on a driver's license, identification card, or donor
registry.
Subd. 8. Donor. "Donor" means an individual whose body
or part is the subject of an anatomical gift.
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Subd. 9. Donor registry. "Donor registry" means a
database that contains records of anatomical gifts and amendments to or
revocations of anatomical gifts.
Subd. 10. Driver's license. "Driver's license" means a
license or permit issued under chapter 171 to operate a vehicle, whether or not
conditions are attached to the license or permit.
Subd. 11. Eye bank. "Eye bank" means a person that is
licensed, accredited, or regulated under federal or state law to engage in the
recovery, screening, testing, processing, storage, or distribution of human
eyes or portions of human eyes.
Subd. 12. Guardian. "Guardian" means a person appointed
by a court to make decisions regarding the support, care, education, health, or
welfare of an individual. The term does not include a guardian ad litem.
Subd. 13. Hospital. "Hospital" means a facility licensed
as a hospital under the law of any state or a facility operated as a hospital
by the United States, a state, or a subdivision of a state.
Subd. 14. Identification card. "Identification card"
means a Minnesota identification card issued under chapter 171.
Subd. 15. Know. "Know" means to have actual knowledge.
Subd. 16. Medical examiner. "Medical examiner" includes
coroner.
Subd. 17. Minor. "Minor" means an individual who is under
18 years of age.
Subd. 18. Organ procurement organization. "Organ procurement
organization" means a person designated by the secretary of the United
States Department of Health and Human Services as an organ procurement
organization.
Subd. 19. Parent. "Parent" means a parent whose parental
rights have not been terminated.
Subd. 20. Part. "Part" means an organ, an eye, or tissue
of a human being. The term does not include the whole body.
Subd. 21. Person. "Person" means an individual,
corporation, business trust, estate, trust, partnership, limited liability
company, association, joint venture, public corporation, government or
governmental subdivision, agency, or instrumentality, or any other legal or
commercial entity.
Subd. 22. Physician. "Physician" means an individual
authorized to practice medicine or osteopathy under the law of any state.
Subd. 23. Procurement organization. "Procurement
organization" means an eye bank, organ procurement organization, or tissue
bank.
Subd. 24. Prospective donor. "Prospective donor" means an
individual who is dead or near death and has been determined by a procurement
organization to have a part that could be medically suitable for
transplantation, therapy, research, or education. The term does not include an
individual who has made a refusal.
Subd. 25. Reasonably available. "Reasonably available"
means able to be contacted by a procurement organization without undue effort
and willing and able to act in a timely manner consistent with existing medical
criteria necessary for the making of an anatomical gift.
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Subd.
26. Recipient. "Recipient"
means an individual into whose body a decedent's part has been or is intended
to be transplanted.
Subd.
27. Record. "Record" means
information that is inscribed on a tangible medium or that is stored in an
electronic or other medium and is retrievable in perceivable form.
Subd.
28. Refusal. "Refusal"
means a record created under section 525A.07 that expressly states an intent to
bar other persons from making an anatomical gift of an individual's body or
part.
Subd.
29. Sign. "Sign" means,
with the present intent to authenticate or adopt a record:
(1)
to execute or adopt a tangible symbol; or
(2)
to attach to or logically associate with the record an electronic symbol,
sound, or process.
Subd.
30. State. "State"
means a state of the United States, the District of Columbia, Puerto Rico, the
United States Virgin Islands, or any territory or insular possession subject to
the jurisdiction of the United States.
Subd.
31. Technician. "Technician"
means an individual determined to be qualified to remove or process parts by an
appropriate organization that is licensed, accredited, or regulated under
federal or state law. The term includes an enucleator.
Subd.
32. Tissue. "Tissue"
means a portion of the human body other than an organ or an eye. The term does
not include blood unless the blood is donated for the purpose of research or
education.
Subd.
33. Tissue bank. "Tissue
bank" means a person that is licensed, accredited, or regulated under
federal or state law to engage in the recovery, screening, testing, processing,
storage, or distribution of tissue.
Subd.
34. Transplant hospital. "Transplant
hospital" means a hospital that furnishes organ transplants and other
medical and surgical specialty services required for the care of transplant
patients.
Sec.
32. [525A.03] APPLICABILITY.
This
chapter applies to an anatomical gift or amendment to, revocation of, or refusal
to make an anatomical gift, whenever made.
Sec.
33. [525A.04] WHO MAY MAKE ANATOMICAL
GIFT BEFORE DONOR'S DEATH.
Subject
to section 525A.08, an anatomical gift of a donor's body or part may be made
during the life of the donor for the purpose of transplantation, therapy,
research, or education in the manner provided in section 525A.05 by:
(1)
the donor, if the donor is an adult or if the donor is a minor and is:
(i)
emancipated; or
(ii)
authorized under state law to apply for a driver's license because the donor is
at least 16 years of age;
(2)
an agent of the donor, unless the power of attorney for health care or other
record prohibits the agent from making an anatomical gift;
(3)
a parent of the donor, if the donor is an unemancipated minor; or
(4)
the donor's guardian.
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Sec. 34. [525A.05] MANNER OF MAKING ANATOMICAL
GIFT BEFORE DONOR'S DEATH.
(a) A donor may make an
anatomical gift:
(1) by authorizing a statement
or symbol indicating that the donor has made an anatomical gift to be imprinted
on the donor's driver's license or identification card;
(2) in a will;
(3) during a terminal
illness or injury of the donor, by any form of communication addressed to at
least two adults, at least one of whom is a disinterested witness; or
(4) as provided in paragraph
(b).
(b) A donor or other person
authorized to make an anatomical gift under section 525A.04 may make a gift by
a donor card or other record signed by the donor or other person making the
gift or by authorizing that a statement or symbol indicating that the donor has
made an anatomical gift be included on a donor registry. If the donor or other
person is physically unable to sign a record, the record may be signed by
another individual at the direction of the donor or other person and must:
(1) be witnessed by at least
two adults, at least one of whom is a disinterested witness, who have signed at
the request of the donor or the other person; and
(2) state that it has been
signed and witnessed as provided in clause (1).
(c) Revocation, suspension,
expiration, or cancellation of a driver's license or identification card upon
which an anatomical gift is indicated does not invalidate the gift.
(d) An anatomical gift made
by will takes effect upon the donor's death whether or not the will is
probated. Invalidation of the will after the donor's death does not invalidate
the gift.
(e) The making of an
anatomical gift shall not itself authorize or direct the denial of health care.
Sec. 35. [525A.06] AMENDING OR REVOKING
ANATOMICAL GIFT BEFORE DONOR'S DEATH.
(a) Subject to section
525A.08, a donor or other person authorized to make an anatomical gift under
section 525A.04 may amend or revoke an anatomical gift by:
(1) a record signed by:
(i) the donor;
(ii) the other person; or
(iii) subject to paragraph
(b), another individual acting at the direction of the donor or the other
person if the donor or other person is physically unable to sign; or
(2) a later-executed
document of gift that amends or revokes a previous anatomical gift or portion
of an anatomical gift, either expressly or by inconsistency.
(b) A record signed pursuant
to paragraph (a), clause (1), item (iii), must:
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(1)
be witnessed by at least two adults, at least one of whom is a disinterested
witness, who have signed at the request of the donor or the other person; and
(2)
state that it has been signed and witnessed as provided in clause (1).
(c)
Subject to section 525A.08, a donor or other person authorized to make an
anatomical gift under section 525A.04 may revoke an anatomical gift by the
destruction or cancellation of the document of gift, or the portion of the
document of gift used to make the gift, with the intent to revoke the gift.
(d)
A donor may amend or revoke an anatomical gift that was not made in a will by
any form of communication during a terminal illness or injury addressed to at
least two adults, at least one of whom is a disinterested witness.
(e)
A donor who makes an anatomical gift in a will may amend or revoke the gift in
the manner provided for amendment or revocation of wills or as provided in
paragraph (a).
Sec.
36. [525A.07] REFUSAL TO MAKE
ANATOMICAL GIFT; EFFECT OF REFUSAL.
(a)
An individual may refuse to make an anatomical gift of the individual's body or
part by:
(1)
a record signed by:
(i)
the individual; or
(ii)
subject to paragraph (b), another individual acting at the direction of the
individual if the individual is physically unable to sign;
(2)
the individual's will, whether or not the will is admitted to probate or
invalidated after the individual's death; or
(3)
any form of communication made by the individual during the individual's
terminal illness or injury addressed to at least two adults, at least one of
whom is a disinterested witness.
(b)
A record signed pursuant to paragraph (a), clause (1), item (ii), must:
(1)
be witnessed by at least two adults, at least one of whom is a disinterested
witness, who have signed at the request of the individual; and
(2)
state that it has been signed and witnessed as provided in clause (1).
(c)
An individual who has made a refusal may amend or revoke the refusal:
(1)
in the manner provided in paragraph (a) for making a refusal;
(2)
by subsequently making an anatomical gift pursuant to section 525A.05 that is
inconsistent with the refusal; or
(3)
by destroying or canceling the record evidencing the refusal, or the portion of
the record used to make the refusal, with the intent to revoke the refusal.
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(d) Except as otherwise
provided in section 525A.08, paragraph (h), in the absence of an express,
contrary indication by the individual set forth in the refusal, an individual's
unrevoked refusal to make an anatomical gift of the individual's body or part
bars all other persons from making an anatomical gift of the individual's body
or part.
Sec. 37. [525A.08] PRECLUSIVE EFFECT OF
ANATOMICAL GIFT, AMENDMENT, OR REVOCATION.
(a) Except as otherwise
provided in paragraph (g) and subject to paragraph (f), in the absence of an
express, contrary indication by the donor, a person other than the donor is
barred from making, amending, or revoking an anatomical gift of a donor's body
or part if the donor made an anatomical gift of the donor's body or part under
section 525A.05 or an amendment to an anatomical gift of the donor's body or
part under section 525A.06. An anatomical gift made in a will, a designation on
a driver's license or identification card, or a health care directive under
chapter 145C, and not revoked, establishes the intent of the person making the
designation and may not be overridden by any other person.
(b) A donor's revocation of
an anatomical gift of the donor's body or part under section 525A.06 is not a
refusal and does not bar another person specified in section 525A.04 or 525A.09
from making an anatomical gift of the donor's body or part under section
525A.05 or 525A.10.
(c) If a person other than
the donor makes an unrevoked anatomical gift of the donor's body or part under
section 525A.05 or an amendment to an anatomical gift of the donor's body or
part under section 525A.06, another person may not make, amend, or revoke the
gift of the donor's body or part under section 525A.10.
(d) A revocation of an
anatomical gift of a donor's body or part under section 525A.06 by a person
other than the donor does not bar another person from making an anatomical gift
of the body or part under section 525A.05 or 525A.10.
(e) In the absence of an
express, contrary indication by the donor or other person authorized to make an
anatomical gift under section 525A.04, an anatomical gift of a part is neither
a refusal to give another part nor a limitation on the making of an anatomical
gift of another part at a later time by the donor or another person.
(f) In the absence of an
express, contrary indication by the donor or other person authorized to make an
anatomical gift under section 525A.04, an anatomical gift of a part for one or
more of the purposes set forth in section 525A.04 is not a limitation on the making
of an anatomical gift of the part for any of the other purposes by the donor or
any other person under section 525A.05 or 525A.10.
(g) If a donor who is an
unemancipated minor dies, a parent of the donor who is reasonably available may
revoke or amend an anatomical gift of the donor's body or part.
(h) If an unemancipated
minor who signed a refusal dies, a parent of the minor who is reasonably
available may revoke the minor's refusal.
Sec. 38. [525A.09] WHO MAY MAKE ANATOMICAL GIFT
OF DECEDENT'S BODY OR PART.
(a) Subject to paragraphs
(b) and (c) and unless barred by section 525A.07 or 525A.08, an anatomical gift
of a decedent's body or part for the purpose of transplantation, therapy,
research, or education may be made by any member of the following classes of
persons who is reasonably available, in the order of priority listed:
(1) an agent of the decedent
at the time of death who could have made an anatomical gift under section
525A.04, clause (2), immediately before the decedent's death;
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(2)
the spouse of the decedent;
(3)
adult children of the decedent;
(4)
parents of the decedent;
(5)
adult siblings of the decedent;
(6)
adult grandchildren of the decedent;
(7)
grandparents of the decedent;
(8)
an adult who exhibited special care and concern for the decedent;
(9)
the persons who were acting as the guardians of the person of the decedent at
the time of death; and
(10)
any other person having the authority to dispose of the decedent's body.
(b)
If there is more than one member of a class listed in paragraph (a), clause
(1), (3), (4), (5), (6), (7), or (9), entitled to make an anatomical gift, an
anatomical gift may be made by a member of the class unless that member or a
person to which the gift may pass under section 525A.11 knows of an objection
by another member of the class. If an objection is known, the gift may be made
only by a majority of the members of the class who are reasonably available.
(c)
A person may not make an anatomical gift if, at the time of the decedent's
death, a person in a prior class under paragraph (a) is reasonably available to
make or to object to the making of an anatomical gift.
Sec.
39. [525A.10] MANNER OF MAKING,
AMENDING, OR REVOKING ANATOMICAL GIFT OF DECEDENT'S BODY OR PART.
(a)
A person authorized to make an anatomical gift under section 525A.09 may make
an anatomical gift by a document of gift signed by the person making the gift or
by that person's oral communication that is electronically recorded or is
contemporaneously reduced to a record and signed by the individual receiving
the oral communication.
(b)
Subject to paragraph (c), an anatomical gift by a person authorized under
section 525A.09 may be amended or revoked orally or in a record by any member
of a prior class who is reasonably available. If more than one member of the
prior class is reasonably available, the gift made by a person authorized under
section 525A.09 may be:
(1)
amended only if a majority of the reasonably available members agree to the
amending of the gift; or
(2)
revoked only if a majority of the reasonably available members agree to the
revoking of the gift or if they are equally divided as to whether to revoke the
gift.
(c)
A revocation under paragraph (b) is effective only if, before an incision has
been made to remove a part from the donor's body or before invasive procedures
have begun to prepare the recipient, the procurement organization, transplant
hospital, or physician or technician knows of the revocation.
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Sec. 40. [525A.11] PERSONS THAT MAY RECEIVE
ANATOMICAL GIFT; PURPOSE OF ANATOMICAL GIFT.
(a) An anatomical gift may
be made to the following persons named in the document of gift:
(1) a hospital; accredited
medical school, dental school, college, or university; organ procurement
organization; or nonprofit organization in medical education or research, for
research or education;
(2) subject to paragraph
(b), an individual designated by the person making the anatomical gift if the
individual is the recipient of the part; and
(3) an eye bank or tissue
bank.
(b) If an anatomical gift to
an individual under paragraph (a), clause (2), cannot be transplanted into the
individual, the part passes in accordance with paragraph (g) in the absence of
an express, contrary indication by the person making the anatomical gift.
(c) If an anatomical gift of
one or more specific parts or of all parts is made in a document of gift that
does not name a person described in paragraph (a) but identifies the purpose
for which an anatomical gift may be used, the following rules apply:
(1) if the part is an eye
and the gift is for the purpose of transplantation or therapy, the gift passes
to the appropriate eye bank;
(2) if the part is tissue
and the gift is for the purpose of transplantation or therapy, the gift passes
to the appropriate tissue bank;
(3) if the part is an organ
and the gift is for the purpose of transplantation or therapy, the gift passes
to the appropriate organ procurement organization as custodian of the organ;
and
(4) if the part is an organ,
an eye, or tissue and the gift is for the purpose of research or education, the
gift passes to the appropriate procurement organization.
(d) For the purpose of
paragraph (c), if there is more than one purpose of an anatomical gift set
forth in the document of gift but the purposes are not set forth in any priority,
the gift must be used for transplantation or therapy, if suitable. If the gift
cannot be used for transplantation or therapy, the gift may be used for
research or education.
(e) If an anatomical gift of
one or more specific parts is made in a document of gift that does not name a
person described in paragraph (a) and does not identify the purpose of the
gift, the gift may be used only for transplantation or therapy, and the gift
passes in accordance with paragraph (g).
(f) If a document of gift
specifies only a general intent to make an anatomical gift by words such as
"donor," "organ donor," or "body donor," or by a
symbol or statement of similar import, the gift may be used only for
transplantation or therapy, and the gift passes in accordance with paragraph
(g).
(g) For purposes of
paragraphs (b), (e), and (f), the following rules apply:
(1) if the part is an eye,
the gift passes to the appropriate eye bank;
(2) if the part is tissue,
the gift passes to the appropriate tissue bank; and
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(3)
if the part is an organ, the gift passes to the appropriate organ procurement
organization as custodian of the organ.
(h)
An anatomical gift of an organ for transplantation or therapy, other than an
anatomical gift under paragraph (a), clause (2), passes to the organ
procurement organization as custodian of the organ.
(i)
If an anatomical gift does not pass pursuant to paragraphs (a) to (h) or the
decedent's body or part is not used for transplantation, therapy, research, or
education, custody of the body or part passes to the person under obligation to
dispose of the body or part.
(j)
A person may not accept an anatomical gift if the person knows that the gift
was not effectively made under section 525A.05 or 525A.10 or if the person
knows that the decedent made a refusal under section 525A.07 that was not
revoked. For purposes of this paragraph, if a person knows that an anatomical
gift was made on a document of gift, the person is deemed to know of any
amendment or revocation of the gift or any refusal to make an anatomical gift
on the same document of gift.
(k)
Except as otherwise provided in paragraph (a), clause (2), nothing in this
chapter affects the allocation of organs for transplantation or therapy.
Sec.
41. [525A.12] SEARCH AND
NOTIFICATION.
(a)
The following persons shall make a reasonable search of an individual who the
person reasonably believes is dead or near death for a document of gift or
other information identifying the individual as a donor or as an individual who
made a refusal:
(1)
a law enforcement officer, firefighter, paramedic, or other emergency rescuer
finding the individual; and
(2)
if no other source of the information is immediately available, a hospital, as
soon as practical after the individual's arrival at the hospital.
(b)
If a document of gift or a refusal to make an anatomical gift is located by the
search required by paragraph (a), clause (1), and the individual or deceased
individual to whom it relates is taken to a hospital, the person responsible
for conducting the search shall send the document of gift or refusal to the
hospital. If a body is transferred to the custody of the medical examiner, the
person who discovered the body must notify the person's dispatcher. A
dispatcher notified under this section must notify the state's federally
designated organ procurement organization and inform the organization of the
deceased's name, donor status, and location.
(c)
A person is not subject to criminal or civil liability for failing to discharge
the duties imposed by this section but may be subject to administrative
sanctions.
Sec.
42. [525A.13] DELIVERY OF DOCUMENT OF
GIFT NOT REQUIRED; RIGHT TO EXAMINE.
(a)
A document of gift need not be delivered during the donor's lifetime to be
effective.
(b)
Upon or after an individual's death, a person in possession of a document of
gift or a refusal to make an anatomical gift with respect to the individual
shall allow examination and copying of the document of gift or refusal by a
person authorized to make or object to the making of an anatomical gift with
respect to the individual or by a person to which the gift could pass under
section 525A.11.
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Sec. 43. [525A.14] RIGHTS AND DUTIES OF
PROCUREMENT ORGANIZATION AND OTHERS.
(a) When a hospital refers
an individual at or near death to a procurement organization, the organization
shall make a reasonable search of the records of the Department of Public
Safety and any donor registry that it knows exists for the geographical area in
which the individual resides to ascertain whether the individual has made an
anatomical gift.
(b) A procurement
organization must be allowed reasonable access to information in the records of
the Department of Public Safety to ascertain whether an individual at or near
death is a donor.
(c) When a hospital refers
an individual at or near death to a procurement organization, the organization
may conduct any reasonable examination necessary to ensure the medical
suitability of a part that is or could be the subject of an anatomical gift for
transplantation, therapy, research, or education from a donor or a prospective
donor. During the examination period, measures necessary to ensure the medical
suitability of the part may not be withdrawn unless the hospital or procurement
organization knows that the individual expressed a contrary intent.
(d) Unless prohibited by law
other than this chapter, at any time after a donor's death, the person to which
a part passes under section 525A.11 may conduct any reasonable examination
necessary to ensure the medical suitability of the body or part for its
intended purpose.
(e) Unless prohibited by law
other than this chapter, an examination under paragraph (c) or (d) may include
an examination of all medical and dental records of the donor or prospective
donor.
(f) Upon the death of a
minor who was a donor or had signed a refusal, unless a procurement
organization knows the minor is emancipated, the procurement organization shall
conduct a reasonable search for the parents of the minor and provide the
parents with an opportunity to revoke or amend the anatomical gift or revoke
the refusal.
(g) Upon referral by a
hospital under paragraph (a), a procurement organization shall make a
reasonable search for any person listed in section 525A.09 having priority to
make an anatomical gift on behalf of a prospective donor. If a procurement
organization receives information that an anatomical gift to any other person
was made, amended, or revoked, it shall promptly advise the other person of all
relevant information.
(h) Subject to sections
525A.11, paragraph (i), and 525A.23, the rights of the person to which a part
passes under section 525A.11 are superior to the rights of all others with
respect to the part. The person may accept or reject an anatomical gift in
whole or in part. Subject to the terms of the document of gift and this
chapter, a person that accepts an anatomical gift of an entire body may allow
embalming, burial, or cremation, and use of remains in a funeral service. If
the gift is of a part, the person to which the part passes under section
525A.11, upon the death of the donor and before embalming, burial, or
cremation, shall cause the part to be removed without unnecessary mutilation.
(i) Neither the physician
who attends the decedent at death nor the physician who determines the time of
the decedent's death may participate in the procedures for removing or
transplanting a part from the decedent.
(j) A physician or
technician may remove a donated part from the body of a donor that the
physician or technician is qualified to remove.
Sec. 44. [525A.15] COORDINATION OF PROCUREMENT
AND USE.
Each hospital in this state
shall enter into agreements or affiliations with procurement organizations for
coordination of procurement and use of anatomical gifts.
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Sec. 45. [525A.16] SALE OR PURCHASE OF PARTS
PROHIBITED; FELONY.
(a) Except as otherwise
provided in paragraph (b), a person that, for valuable consideration, knowingly
purchases or sells a part for transplantation or therapy if removal of a part
from an individual is intended to occur after the individual's death, commits a
felony and upon conviction is subject to a fine not exceeding $10,000 or
imprisonment not exceeding five years, or both.
(b) A person may charge a
reasonable amount for the removal, processing, preservation, quality control,
storage, transportation, implantation, or disposal of a part.
Sec. 46. [525A.17] PROHIBITED ACTS; FELONY.
A person that, in order to
obtain a financial gain, intentionally falsifies, forges, conceals, defaces, or
obliterates a document of gift, an amendment or revocation of a document of
gift, or a refusal commits a felony and upon conviction is subject to a fine
not exceeding $10,000 or imprisonment not exceeding five years, or both.
Sec. 47. [525A.18] IMMUNITY.
(a) A person that acts in
accordance with this chapter or with the applicable anatomical gift law of
another state, or attempts in good faith to do so, is not liable for the act in
a civil action, criminal prosecution, or administrative proceeding.
(b) Neither the person
making an anatomical gift nor the donor's estate is liable for any injury or
damage that results from the making or use of the gift.
(c) In determining whether
an anatomical gift has been made, amended, or revoked under this chapter, a
person may rely upon representations of an individual listed in section
525A.09, paragraph (a), clause (2), (3), (4), (5), (6), (7), or (8), relating
to the individual's relationship to the donor or prospective donor unless the
person knows that the representation is untrue.
(d) An anatomical gift under
this chapter is not a sale of goods as that term is defined in section
336.2-105, paragraph (1), or the sale of a product.
Sec. 48. [525A.19] LAW GOVERNING VALIDITY; CHOICE
OF LAW AS TO EXECUTION OF DOCUMENT OF GIFT; PRESUMPTION OF VALIDITY.
(a) A document of gift is
valid if executed in accordance with:
(1) this chapter;
(2) the laws of the state or
country where it was executed; or
(3) the laws of the state or
country where the person making the anatomical gift was domiciled, has a place
of residence, or was a national at the time the document of gift was executed.
(b) If a document of gift is
valid under this section, the law of this state governs the interpretation of
the document of gift.
(c) A person may presume
that a document of gift or amendment of an anatomical gift is valid unless that
person knows that it was not validly executed or was revoked.
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Sec.
49. [525A.20] DONOR REGISTRY.
(a)
The Department of Health may establish or contract for the establishment of a
donor registry.
(b)
The Department of Public Safety shall cooperate with a person that administers
any donor registry that this state establishes, contracts for, or recognizes
for the purpose of transferring to the donor registry all relevant information
regarding a donor's making, amendment to, or revocation of an anatomical gift.
(c)
A donor registry must:
(1)
allow a donor or other person authorized under section 525A.04 to include on
the donor registry a statement or symbol that the donor has made, amended, or
revoked an anatomical gift;
(2)
be accessible to a procurement organization to allow it to obtain relevant
information on the donor registry to determine, at or near death of the donor
or a prospective donor, whether the donor or prospective donor has made, amended,
or revoked an anatomical gift; and
(3)
be accessible, for purposes of clauses (1) and (2), seven days a week on a
24-hour basis.
(d)
Personally identifiable information on a donor registry about a donor or
prospective donor may not be used or disclosed without the express consent of
the donor, prospective donor, or person that made the anatomical gift for any
purpose other than to determine, at or near death of the donor or prospective
donor, whether the donor or prospective donor has made, amended, or revoked an
anatomical gift.
(e)
This section does not prohibit any person from creating or maintaining a donor
registry that is not established by or under contract with the state. Any such
registry must comply with paragraphs (c) and (d).
Sec.
50. [525A.21] EFFECT OF ANATOMICAL
GIFT ON ADVANCE HEALTH CARE DIRECTIVE.
(a)
In this section:
(1)
"advance health care directive" means a power of attorney for health
care or a record signed by a prospective donor containing the prospective
donor's direction concerning a health care decision for the prospective donor;
(2)
"declaration" means a record signed by a prospective donor specifying
the circumstances under which a life support system may be withheld or
withdrawn from the prospective donor; and
(3)
"health care decision" means any decision made regarding the health
care of the prospective donor.
(b)
If a prospective donor has a declaration or advance health care directive,
measures necessary to ensure the medical suitability of an organ for transplantation
or therapy may not be withheld or withdrawn from the prospective donor, unless
the declaration expressly provides to the contrary.
Sec.
51. [525A.22] COOPERATION BETWEEN
MEDICAL EXAMINER AND PROCUREMENT ORGANIZATION.
(a)
A medical examiner shall cooperate with procurement organizations to maximize
the opportunity to recover anatomical gifts for the purpose of transplantation,
therapy, research, or education.
(b)
If a medical examiner receives notice from a procurement organization that an
anatomical gift might be available or was made with respect to a decedent whose
body is under the jurisdiction of the medical examiner and a postmortem
examination is going to be performed, unless the medical examiner denies
recovery in accordance with section 525A.23, the medical examiner or designee
shall conduct a postmortem examination of the body or the part in a manner and
within a period compatible with its preservation for the purposes of the gift.
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(c)
A part may not be removed from the body of a decedent under the jurisdiction of
a medical examiner for transplantation, therapy, research, or education unless the
part is the subject of an anatomical gift. The body of a decedent under the
jurisdiction of the medical examiner may not be delivered to a person for
research or education unless the body is the subject of an anatomical gift.
This paragraph does not preclude a medical examiner from performing the
medicolegal investigation upon the body or parts of a decedent under the
jurisdiction of the medical examiner.
Sec.
52. [525A.23] FACILITATION OF
ANATOMICAL GIFT FROM DECEDENT WHOSE BODY IS UNDER JURISDICTION OF MEDICAL
EXAMINER.
(a)
Upon request of a procurement organization, a medical examiner shall release to
the procurement organization the name, contact information, and available
medical and social history of a decedent whose body is under the jurisdiction
of the medical examiner. If the decedent's body or part is medically suitable
for transplantation, therapy, research, or education, the medical examiner
shall release postmortem examination results to the procurement organization.
The procurement organization may make a subsequent disclosure of the postmortem
examination results or other information received from the medical examiner
only if relevant to transplantation or therapy.
(b)
The medical examiner may conduct a medicolegal examination by reviewing all
medical records, laboratory test results, x-rays, other diagnostic results, and
other information that any person possesses about a donor or prospective donor
whose body is under the jurisdiction of the medical examiner which the medical
examiner determines may be relevant to the investigation.
(c)
A person that has any information requested by a medical examiner pursuant to
paragraph (b) shall provide that information as expeditiously as possible to
allow the medical examiner to conduct the medicolegal investigation within a
period compatible with the preservation of parts for the purpose of
transplantation, therapy, research, or education.
(d)
If an anatomical gift has been or might be made of a part of a decedent whose
body is under the jurisdiction of the medical examiner and a postmortem
examination is not required, or the medical examiner determines that a
postmortem examination is required but that the recovery of the part that is
the subject of an anatomical gift will not interfere with the examination, the
medical examiner and procurement organization shall cooperate in the timely
removal of the part from the decedent for the purpose of transplantation,
therapy, research, or education.
(e)
If an anatomical gift of a part from the decedent under the jurisdiction of the
medical examiner has been or might be made, but the medical examiner initially
believes that the recovery of the part could interfere with the postmortem
investigation into the decedent's cause or manner of death, the medical examiner
shall consult with the procurement organization or physician or technician
designated by the procurement organization about the proposed recovery. After
consultation, the medical examiner may allow the recovery.
(f)
Following the consultation under paragraph (e), in the absence of mutually
agreed-upon protocols to resolve conflict between the medical examiner and the
procurement organization, if the medical examiner intends to deny recovery of
an organ for transplantation, the medical examiner or designee, at the request
of the procurement organization, shall attend the removal procedure for the
part before making a final determination not to allow the procurement
organization to recover the part. During the removal procedure, the medical
examiner or designee may allow recovery by the procurement organization to
proceed, or, if the medical examiner or designee reasonably believes that the
part may be involved in determining the decedent's cause or manner of death,
deny recovery by the procurement organization.
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(g) If the medical examiner
or designee denies recovery under paragraph (f), the medical examiner or
designee shall:
(1) explain in a record the
specific reasons for not allowing recovery of the part;
(2) include the specific
reasons in the records of the medical examiner; and
(3) provide a record with
the specific reasons to the procurement organization.
(h) If the medical examiner or
designee allows recovery of a part under paragraph (d), (e), or (f), the
procurement organization, upon request, shall cause the physician or technician
who removes the part to provide the medical examiner with a record describing
the condition of the part, a biopsy, a photograph, and any other information
and observations that would assist in the postmortem examination.
(i) If a medical examiner or
designee is required to be present at a removal procedure under paragraph (f),
upon request the procurement organization requesting the recovery of the part
shall reimburse the medical examiner or designee for the additional costs
incurred in complying with paragraph (f).
Sec. 53. [525A.24] RELATION TO ELECTRONIC
SIGNATURES IN GLOBAL AND NATIONAL COMMERCE ACT.
This chapter modifies,
limits, and supersedes the Electronic Signatures in Global and National
Commerce Act, United States Code, title 15, section 7001 et seq., but does not
modify, limit, or supersede section 101(a) of that act, United States Code, title
15, section 7001, or authorize electronic delivery of any of the notices
described in section 103(b) of that act, United States Code, title 15, section
7003(b).
Sec. 54. Laws 2005, chapter
98, article 3, section 25, is amended to read:
Sec. 25. REPEALER.
Minnesota Statutes 2004,
sections 245.713, subdivisions 2 and subdivision 4; 245.716; and
626.5551, subdivision 4, are repealed.
EFFECTIVE DATE. This section is
effective retroactively from August 1, 2005.
Sec. 55. SOBER HOUSES.
Subdivision 1. Sober house defined. For purposes of this section, a
"sober house" means a cooperative living residence that:
(1) provides temporary
housing to persons with alcohol or other drug dependency and abuse problems in
exchange for compensation;
(2) stipulates residents
must abstain from using alcohol or drugs and meet other requirements as a
condition of living in the residence; and
(3) does not provide
counseling or treatment services to those residents within the meaning of Minnesota
Statutes, chapter 148C or 254A.
Subd. 2. Work group creation; membership. The commissioner of
human services shall convene a sober house work group which is comprised of the
following members:
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(1) sober house landlords;
(2) sober house residents;
(3) community members with
knowledge of sober housing;
(4) representatives of
cities and counties;
(5) a representative from
the Department of Human Services, Chemical Health Division;
(6) a representative from
the Department of Human Services, Licensing Division;
(7) a representative of
chemical dependency treatment providers; and
(8) a representative from
the Department of Health.
Subd. 3. Report. The work group created in subdivision 2 is
directed to study the issue of sober houses in the state and determine whether
state licensing or other regulation of sober houses is appropriate. Based on
findings of the work group, the commissioner of human services shall submit a
report of recommendations to the legislature by January 1, 2008.
Sec. 56. INTERPRETER SERVICES WORK GROUP.
(a) The commissioner of
health shall, in consultation with the commissioners of commerce, human
services, and employee relations, convene a work group to study the provision
of interpreter services to patients in medical and dental care settings. The
work group shall include one representative from each of the following groups:
(1) consumers;
(2) interpreters;
(3) interpreter service
providers or agencies;
(4) health plan companies;
(5) self-insured purchasers;
(6) hospitals;
(7) health care providers;
(8) dental providers;
(9) clinic administrators;
(10) state agency staff from
the Departments of Health, Human Services, and Employee Relations;
(11) Minnesota Registry of
Interpreters for the Deaf;
(12) local county social
services agencies;
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(13)
local public health agencies;
(14)
interpreting stakeholders group;
(15)
one interpreter trainer; and
(16)
one interpreter certification examiner.
(b)
The work group shall develop findings and recommendations on the following:
(1)
assuring access to interpreter services;
(2)
compliance with requirements of federal law and guidance;
(3)
developing a quality assurance program to ensure the quality of health care
interpreting services, including requirements for training and establishing a
certification process; and
(4)
identifying broad-based funding mechanisms for interpreter services.
(c)
Based on the discussions of the work group, the commissioner shall make
recommendations to the chairs of the health policy and finance committees in
the house and senate by January 15, 2008, on how to ensure high quality
interpreter services for patients in medical and dental settings, and for a
broad-based funding mechanism for delivering these services.
EFFECTIVE DATE. This section is
effective the day following final enactment.
Sec.
57. FEDERAL GRANTS.
The
Board of Pharmacy shall apply for any applicable federal grants or other
nonstate funds to establish and fully implement the prescription electronic
reporting system.
EFFECTIVE DATE. This section is effective
the day following final enactment.
Sec.
58. BOARD OF PHARMACY.
The
Board of Pharmacy shall not increase the license fees of pharmacists or
pharmacies in order to adequately fund the prescription electronic reporting
system under Minnesota Statutes, section 152.126, without specific authority
from the legislature.
EFFECTIVE DATE. This section is
effective the day following final enactment.
Sec.
59. BOARD OF MEDICAL PRACTICE.
The
Board of Medical Practice shall convene a work group to discuss the appropriate
prescribing of controlled substances listed in Minnesota Statutes, section
152.02, subdivisions 3 and 4, and those substances defined by the Board of
Pharmacy under Minnesota Statutes, section 152.02, subdivisions 7, 8, and 12,
for pain management, and shall report to the legislature by December 15, 2007.
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Sec.
60. AGRICULTURAL COOPERATIVE HEALTH
PLAN FOR FARMERS.
Subdivision
1. Pilot project requirements. The
commissioner of commerce shall authorize a joint self-insurance pilot project
administered by a trust sponsored by one or more agricultural cooperatives
organized under Minnesota Statutes, chapter 308A, or under a federal charter
for the purpose of offering health coverage to members of the cooperatives and
their families, provided the project satisfies the requirements of Minnesota
Statutes, chapter 62H, except as follows:
(1)
Minnesota Statutes, section 62H.02, paragraph (b), does not apply;
(2)
the notice period required under Minnesota Statutes, section 62H.02, paragraph
(e), is 90 days;
(3)
the commissioner shall grant necessary waivers and approve an alternative
arrangement that fully funds the plan's liability or incurred but unpaid claims
under Minnesota Statutes, section 62H.02, paragraph (f), unless the
commissioner provides evidence demonstrating that the insolvency protection
proposed is substantially less than that typically provided by self-insured
group plans of a similar size in Minnesota;
(4)
notwithstanding Minnesota Statutes, section 62H.04, paragraph (a), the joint
self-insurance plan shall be considered a large group and not subject to the
small group insurance requirements in Minnesota Statutes, chapter 62L, even if
some employer groups enrolled in the plan would be defined as small employers,
except that the joint self-insurance plan may elect to treat the sale of a
health plan to or for an employer that has only one eligible employee who has
not waived coverage as the sale of an individual health plan as allowed under
Minnesota Statutes, section 62L.02, subdivision 26;
(5)
Minnesota Statutes, section 297I.05, subdivision 12, paragraph (c), does not
apply; and
(6)
the trust must pay the assessment for the Minnesota comprehensive health
association as provided under Minnesota Statutes, section 62E.11.
Subd.
2. Evaluation and renewal. The
pilot project authorized under this section is for a period of four years from
the date of initial enrollment. The commissioner shall grant an extension of
four additional years if the trust provides evidence that it remains in
compliance with the requirements of this section and other applicable laws and
rules. If the commissioner determines that the operation of the trust has not
improved access, expanded health plan choices, or improved affordability of
health coverage for farm families, or that it has significantly damaged access,
choice, or affordability for other consumers not enrolled in the trust, the
commissioner shall provide at least 180 days' advance written notice to the
trust and to the chairs of the senate and house finance and policy committees
with jurisdiction over health and insurance matters of the commissioner's
intention not to renew the pilot project at the expiration of a four-year
period.
EFFECTIVE DATE. This section is
effective the day following final enactment.
Sec.
61. HEALTH PLAN PURCHASING POOL STUDY
GROUP.
Subdivision
1. Creation; membership. A
health care purchasing pool study group is created to study and make
recommendations regarding the creation of a voluntary, statewide health care
purchasing pool that would contract directly with providers to provide
affordable health coverage to eligible Minnesota residents. The study group is
composed of:
(1)
the chief house and senate authors of this act;
(2)
the chairs of the senate Committee on Health, Housing, and Family Security and
the Health and Human Services Budget Division;
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(3)
the chairs of the house Health Care and Human Services Committee and the Health
Care and Human Services Division;
(4)
the attorney general or the attorney general's designated representative;
(5)
three representatives of health care providers appointed as follows:
(i)
one member appointed by the governor;
(ii)
one member appointed by the speaker of the house; and
(iii)
one member appointed by the Subcommittee on Committees of the senate Committee
on Rules and Administration; and
(6)
two consumers of health care appointed by the governor.
All
appointments to be made under this subdivision must be made within 30 days of
the effective date of this act.
Subd.
2. Study; report. The study
group shall study and make recommendations on the following issues related to
the creation, maintenance, and funding of a voluntary, statewide health plan
purchasing pool to provide comprehensive, cost-effective, and medically
appropriate health coverage to all public and private employees in Minnesota
and all Minnesota residents:
(1)
the creation of an independent public entity to administer the pool;
(2)
eligibility and participation requirements for existing public and private
health care purchasing pools, public and private employers, and residents of
this state;
(3)
how to contract directly with providers to provide comprehensive coverage for
preventive, mental health, dental and other medical services, and comprehensive
drug benefits to enrollees and maximize the cost savings and other efficiencies
that a large purchasing pool would be expected to generate without the need for
a public subsidy;
(4)
provisions that allow the pool to contract directly with health care providers
to provide coverage to enrollees;
(5)
incentives designed to attract and retain the maximum number of enrollees;
(6)
recommendations for the administration of the pool and the plans that will be
available to enrollees including, but not limited to, recommendations to keep the
pool solvent and profitable so that public subsidies are not necessary; and
(7)
other elements the study group concludes are necessary or desirable for the
pool to possess.
The
study group shall submit its report and the draft legislation necessary to
implement its recommendations to the chairs of the legislative committees and
divisions with jurisdiction over health care policy and finance, the Health
Care Access Commission, and the governor by February 1, 2008.
Subd.
3. Staffing. State agencies shall
assist the study group with any requests for information the study group
considers necessary to complete the study and report under subdivision 2.
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Subd.
4. Removal; vacancies; expenses. Removal
of members, vacancies, and expenses for members shall be as provided in
Minnesota Statutes, section 15.059.
Subd.
5. Expiration. This section
expires after the submission of the report as required in subdivision 2.
EFFECTIVE DATE. This section is
effective the day following final enactment.
Sec.
62. REPEALER.
(a)
Minnesota Statutes 2006, sections 254A.02, subdivisions 7, 9, 12, 14, 15, and
16; 254A.085; 254A.086; 254A.12; 254A.14; 254A.15; 254A.16, subdivision 5;
254A.175; 254A.18; 256J.561, subdivision 1; 256J.62, subdivision 9; and
256J.65, are repealed.
(b)
Minnesota Rules, part 9503.0035, subpart 2, is repealed.
(c)
Minnesota Statutes 2006, sections 525.921; 525.9211; 525.9212; 525.9213;
525.9214; 525.9215; 525.9216; 525.9217; 525.9218; 525.9219; 525.9221; 525.9222;
525.9223; and 525.9224, are repealed.
ARTICLE
8
CHILDREN'S
HEALTH SECURITY PROGRAM
Section
1. [16A.726] CHILDREN'S HEALTH
SECURITY ACCOUNT.
A
children's health security account is created in a special revenue fund in the
state treasury. The commissioner shall deposit to the credit of the account
money made available to the account. Notwithstanding section 11A.20, any
investment income attributable to the investment of the children's health
security account not currently needed shall be credited to the children's
health security account.
Sec.
2. Minnesota Statutes 2006, section 256B.057, subdivision 8, is amended 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 275 300 percent of the federal poverty
guidelines for the same size family but less than or equal to 280 305
percent of the federal poverty guidelines for the same size family.
EFFECTIVE DATE. This section is
effective January 1, 2011, or upon federal approval, whichever is later.
Sec.
3. [256N.01] CITATION.
This
chapter may be cited as the "Children's Health Security Act."
Sec.
4. [256N.02] DEFINITIONS.
Subdivision
1. Applicability. The terms used
in this chapter have the following meanings unless otherwise provided for by
text.
Subd.
2. Child. "Child"
means an individual under age 21.
Subd.
3. Commissioner. "Commissioner"
means the commissioner of human services.
Subd.
4. Dependent child. "Dependent
child" means an unmarried child under age 25 who is claimed as a dependent
for federal income tax purposes by a parent, grandparent, foster parent,
relative caretaker, or legal guardian.
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Sec.
5. [256N.03] ESTABLISHMENT.
The
commissioner shall establish the children's health security program. The commissioner
shall begin implementation of the program on October 1, 2008, or upon federal
approval, whichever is later. The children's health security program must
comply with title XIX of the federal Social Security Act, and waivers granted
under title XIX.
Sec.
6. [256N.05] ELIGIBILITY.
Subdivision
1. General requirements. Children
meeting the eligibility requirements of this section are eligible for the
children's health security program.
Subd.
2. Income limit. (a) Effective
October 1, 2008, children in families with gross household incomes equal to or
less than 225 percent of the federal poverty guidelines are eligible for the
children's health security program. In determining gross income, the
commissioner shall use the income methodology applied to children under the
MinnesotaCare program.
(b)
Effective October 1, 2008, a dependent child who meets the program income
limits under paragraph (a) and all other program eligibility requirements is
eligible for state-funded benefits under this section.
(c)
Effective January 1, 2011, or upon federal approval, whichever is later,
children in families with household incomes equal to or less than 300 percent
of the federal poverty guidelines must be included in the children's health
security program.
(d)
The Legislative Task Force On Children's Health Care Coverage established under
section 19 shall develop recommendations on options for extending health
insurance coverage to children in families with household incomes in excess of
300 percent of the federal poverty guidelines.
Subd.
3. Residency. Program
participants must meet the residency requirements of section 256B.056,
subdivision 1.
Subd.
4. Enrollment voluntary. Enrollment
in the children's health security program is voluntary. Parents or guardians
may retain private sector or Medicare coverage for a child as the sole source
of coverage. Parents or guardians who have private sector or Medicare coverage
for children may also enroll children in the children's health security
program. If private sector or Medicare coverage is available, coverage under
the children's health security program is secondary to the private sector or
Medicare coverage.
Subd.
5. Emergency services. Payment
must be made for care and services that are furnished to noncitizens, regardless
of immigration status, who otherwise meet the eligibility requirements of this
chapter, if the 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. For purposes of this subdivision,
"emergency medical condition" means a medical condition that meets
the requirements of United States Code, title 42, section 1396b(v).
Subd.
6. Medical assistance standards and
procedures. (a) Unless otherwise specified in this chapter, the
commissioner shall use medical assistance procedures and methodology when
determining initial eligibility and redetermining eligibility for the
children's health security program.
(b)
The procedures and income standard specified in section 256B.056, subdivisions
5 and 5c, paragraph (a), apply to children who would be eligible for the
children's health security program, except for excess income.
(c)
Retroactive coverage for the children's health security program must be
provided as specified in section 256B.056, subdivision 7.
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Sec.
7. [256N.07] COVERED SERVICES.
Covered
services under the children's health security program must consist of all
covered services under chapter 256B.
Sec.
8. [256N.09] NO ENROLLEE PREMIUMS OR
COST SHARING.
In
order to ensure broad access to coverage, the children's health security
program has no enrollee premium or cost-sharing requirements.
Sec.
9. [256N.11] APPLICATION PROCEDURES;
ELIGIBILITY DETERMINATION.
Subdivision
1. Application procedure. The
application form for the program must be easily understandable and must not
exceed two pages in length. Applications for the program must be made available
to provider offices, local human services agencies, school districts, schools,
community health offices, and other sites willing to cooperate in program
outreach. These sites may accept applications and forward applications to the
commissioner, and counties where applicable. Applications may also be made
directly to the commissioner and to counties that determine eligibility.
Subd.
2. Eligibility determination. Counties
that determine eligibility for MinnesotaCare as of March 1, 2007, shall determine
eligibility for the children's health security program. The commissioner, and
counties where applicable, shall determine an applicant's eligibility for the
program within 30 days of the date the application is received, according to
the procedures in Code of Federal Regulations, title 42, section 435.911.
Subd.
3. Presumptive eligibility. Coverage
under the program is available during a presumptive eligibility period for
children under age 19 whose family income does not exceed the applicable income
standard. The presumptive eligibility period begins on the date on which a
health care provider enrolled in the program, or other entity designated by the
commissioner, determines, based on preliminary information, that the child's
family income does not exceed the applicable income standard. The presumptive
eligibility period ends the earlier of the day on which a determination is made
of eligibility under this section or the last day of the month following the
month presumptive eligibility was determined.
Subd.
4. Renewal of eligibility. The
commissioner shall require enrollees to renew eligibility every 12 months.
Subd.
5. Continuous eligibility. Children
under the age of 19 who are eligible under this section shall be continuously
eligible until the earlier of the next renewal period, or the time that a child
exceeds age 19.
Sec.
10. [256N.12] COUNTY ROLE.
Counties
not required to determine eligibility under section 256N.11, subdivision 2, may
choose to determine eligibility under that section. Counties may also choose to
provide assistance to applicants under section 256N.17, subdivision 1, and
provide ombudsperson services under section 256N.17, subdivision 2. This must
not limit the ability of the commissioner to establish reasonable staffing
standards that relate to the number of persons served, and that provide a
county option to hire part-time staff or pursue multicounty implementation
models. If a county chooses not to deliver these services, they must be
delivered by the commissioner. State and federal funding to support these
services must be the same, whether delivered by the state or by a county or
group of counties.
Sec.
11. [256N.13] SERVICE DELIVERY.
Subdivision 1. Contracts for service delivery. The commissioner, within
each county, may contract with managed care organizations, including health
maintenance organizations licensed under chapter 62D, community integrated
service networks licensed under chapter 62N, accountable provider networks
licensed under chapter 62T, and county-based purchasing plans established under
section 256B.692, to provide covered health care services to
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program enrollees under a
managed care system, and may contract with health care and social service
providers to provide services on a fee-for-service basis. Section 256B.69,
subdivision 26, applies to contracts with managed care organizations. In
determining the method for service delivery, the commissioner shall consider
the cost and quality of health care services; the breadth of services offered,
including medical, dental and mental health services; the breadth of choice of
medical providers for enrollees; the ease of access to quality medical care for
enrollees; the efficiency and cost-effectiveness of service delivery; and the
integration of best medical practice standards into the children's health
security program.
Subd. 2. Managed care organization requirements. (a) Managed care
organizations under contract are responsible for coordinating covered health
care services provided to eligible individuals. Managed care organizations
under contract:
(1) shall authorize and
arrange for the provision of all needed covered health services under chapter
256B, with the exception of services available only under a medical assistance
home and community-based waiver, in order to ensure appropriate health care is
delivered to enrollees;
(2) shall comply with the requirements
of section 256B.69, subdivision 26;
(3) shall accept the
prospective, per capita payment from the commissioner in return for the
provision of comprehensive and coordinated health care services for enrollees;
(4) may contract with health
care and social service providers to provide covered services to enrollees; and
(5) shall institute enrollee
grievance procedures according to the method established by the commissioner,
utilizing applicable requirements of chapter 62D and Code of Federal Regulations,
title 42, section 438, subpart F. Disputes may also be appealed to the
commissioner using the procedures in section 256.045.
(b) Upon implementation of
the children's health security program, the commissioner shall withhold five
percent of managed care organization payments pending completion of performance
targets, including lead screening, well child services, immunizations, vision
screening, and customer service performance targets. Effective January 1, 2011,
the commissioner shall add treatment of asthma and screening for mental health
as new performance targets. Each performance target must apply uniformly to all
managed care organizations, and be qualitative, objective, measurable, and
reasonably attainable, except in the case of a performance target based on
federal or state law or rule. Criteria for assessment of each performance
target must be outlined in writing prior to the contract effective date. The
withhold funds must be returned no sooner than July of the following year if
performance targets in the contract are achieved. The success of each managed
care organization in reaching performance targets must be reported to the
legislature annually.
Subd. 3. Fee-for-service delivery. Disputes related to services
provided under the fee-for-service system may be appealed to the commissioner
using the procedures in section 256.045.
Subd. 4. Contracts for waiver services. The commissioner, when
services are delivered through managed care, may contract with health care and
social service providers on a fee-for-service basis to provide program
enrollees with covered services available only under a medical assistance home
and community-based waiver. The commissioner shall determine eligibility for
home and community-based waiver services using the criteria and procedures in
chapter 256B. Disputes related to services provided on a fee-for-service basis
may be appealed to the commissioner using the procedures in section 256.045.
Subd. 5. Service delivery for Minnesota disabilities health option recipient.
Individuals who voluntarily enroll in the Minnesota Disability Health Option
(MnDHO), established under section 256B.69, subdivision 23, shall continue to
receive their home and community-based waiver services through MnDHO.
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Subd. 6. Disabled or blind children. Children eligible for medical
assistance due to blindness or disability as determined by the Social Security
Administration or the state medical review team are exempt from enrolling in a
managed care organization and shall be provided health benefits on a
fee-for-service basis.
Sec. 12. [256N.15] PAYMENT RATES.
Subdivision 1. Establishment. The commissioner, in consultation with a
health care actuary, shall establish the method and amount of payments for
services. The commissioner shall annually contract with eligible entities to
provide services to program enrollees. The commissioner, in consultation with
the Risk Adjustment Association established under section 62Q.03, subdivision
6, shall develop and implement a risk adjustment system for the program.
Subd. 2. Provider rates. In establishing the payment amount under
subdivision 1, the commissioner shall ensure that fee-for-service payment rates
for preventative care services provided on or after October 1, 2008, are at
least five percent above the medical assistance rates for preventative services
in effect on September 30, 2008, and shall ensure that fee-for-service payment
rates for all other services provided on or after October 1, 2008, are at least
three percent above the medical assistance rates for those services in effect
on September 30, 2008. The commissioner shall adjust managed care capitation
rates to reflect these increases, and shall require managed care organizations,
as a condition of contract, to pass these increases on to providers under
contract.
Sec. 13. [256N.17] CONSUMER ASSISTANCE.
Subdivision 1. Assistance to applicants. The commissioner shall assist applicants
in choosing a managed care organization or fee-for-service provider by:
(1) establishing a Web site
to provide information about managed care organizations and fee-for-service
providers and to allow online enrollment;
(2) make information on managed
care organizations and fee-for-service providers available at the sites
specified in section 256N.11, subdivision 1;
(3) make applications and
information on managed care organizations and fee-for-service providers
available to applicants and enrollees according to Title VI of the Civil Rights
Act and federal regulations adopted under that law or any guidance from the
United States Department of Health and Human Services; and
(4) make benefit educators
available to assist applicants in choosing a managed care organization or
fee-for-service provider.
Subd. 2. Ombudsperson. The commissioner shall designate an
ombudsperson to advocate for children enrolled in the children's health security
program. The ombudsperson shall assist enrollees in understanding and making
use of complaint and appeal procedures and ensure that necessary medical
services are provided to enrollees. At the time of enrollment, the commissioner
shall inform enrollees about the ombudsperson program, the right to a
resolution of the enrollee's complaint by the managed care organization if the
enrollee experiences a problem with the managed care organization or its
providers, and appeal rights under section 256.045.
Sec. 14. [256N.19] MONITORING AND EVALUATION OF
QUALITY AND COSTS.
(a) The commissioner, as a
condition of contract, shall require each participating managed care
organization and participating provider to submit, in the form and manner
specified by the commissioner, data required for assessing enrollee
satisfaction, quality of care, cost, and utilization of services. The
commissioner shall evaluate this data, in order to:
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(1) make summary information
on the quality of care across managed care organizations, medical clinics, and
providers available to consumers;
(2) require managed care
organizations and providers, as a condition of contract, to implement quality
improvement plans; and
(3) compare the cost and
quality of services under the program to the cost and quality of services
provided to private sector enrollees.
(b) The commissioner shall
implement this section to the extent allowed by federal and state laws on data privacy.
Sec. 15. [256N.21] FEDERAL APPROVAL.
The commissioner shall seek
all federal waivers and approvals necessary to implement this chapter
including, but not limited to, waivers and approvals necessary to:
(1) coordinate medical
assistance and MinnesotaCare coverage for children with the children's health
security program;
(2) use federal medical
assistance and MinnesotaCare dollars to pay for health care services under the
children's health security program;
(3) maximize receipt of the
federal medical assistance match for covered children, by increasing income
standards through the use of more liberal income methodologies as provided
under United States Code, title 42, sections 1396a and 1396u-1;
(4) extend presumptive
eligibility and continuous eligibility to children under age 21; and
(5) use federal medical
assistance and MinnesotaCare dollars to provide benefits to dependent children.
Sec. 16. [256N.23] RULEMAKING.
The commissioner shall adopt
rules to implement this chapter.
Sec. 17. [256N.25] CHILDREN'S HEALTH SECURITY
PROGRAM OUTREACH.
Subdivision 1. Grant awards. The commissioner shall award grants to
public or private organizations to:
(1) provide information, in
areas of the state with high uninsured populations, on the importance of
maintaining insurance coverage and on how to obtain coverage through the
children's health security program; and
(2) monitor and provide
ongoing support to ensure enrolled children remain covered.
Subd. 2. Criteria. In awarding the grants, the commissioner shall
consider the following:
(1) geographic areas and
populations with high uninsured rates;
(2) the ability to raise
matching funds;
(3) the ability to contact,
effectively communicate with, or serve eligible populations; and
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(4)
the applicant's plan to monitor and provide support to ensure enrolled children
remain covered.
Subd.
3. Monitoring and termination. The
commissioner shall monitor the grants and may terminate a grant if the outreach
effort does not increase enrollment in the children's health security program.
Sec.
18. IMPLEMENTATION PLAN.
The
commissioner of human services shall develop an implementation plan for the children's
health security program, which includes a health delivery plan based on the
criteria specified in Minnesota Statutes, section 256N.13, subdivision 1. The
commissioner shall present this plan, any necessary draft legislation, and a
draft of proposed rules to the legislature by December 15, 2007. The plan must
include recommendations for any additional legislative changes necessary to
coordinate medical assistance and MinnesotaCare coverage for children with the
children's health security program. The commissioner shall evaluate the
provision of services under the program to children with disabilities and shall
present recommendations to the legislature by December 15, 2009, for any
program changes necessary to ensure the quality and continuity of care.
Sec.
19. LEGISLATIVE TASK FORCE ON
CHILDREN'S HEALTH CARE COVERAGE.
Subdivision
1. Establishment; membership. (a)
The Legislative Task Force on Children's Health Care Coverage is established.
The task force is made up of 12 voting members and six nonvoting members.
(b)
The voting members are:
(1)
six members of the house of representatives appointed by the speaker, three
from the majority party and three from the minority party; and
(2)
six members of the senate appointed by the Subcommittee on Committees of the
senate Committee on Rules and Administration, three from the majority party and
three from the minority party.
(c)
The nonvoting members are one representative selected by each of the following
organizations:
(1)
the American Academy of Pediatrics, Minnesota chapter;
(2)
the Minnesota Nurses Association;
(3)
the Minnesota Council of Health Plans;
(4)
the Minnesota Children's Platform Coalition;
(5)
the Minnesota Universal Health Care Coalition; and
(6)
the Minnesota Business Partnership.
(d)
The task force members must be appointed by September 1, 2007. The majority
leader of the senate and the speaker of the house of representatives must each
designate a chair from their appointments. The chair appointed by the speaker
of the house of representatives shall convene and chair the first meeting of
the task force. The chair appointed by the majority leader of the senate shall
chair the next meeting of the task force. The chairs shall then alternate for
the duration of the task force.
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Subd. 2. Study; staff support. (a) The task force shall study
viable options to extend coverage to all children as provided in Minnesota
Statutes, section 256N.05, subdivision 2, paragraph (d), and provide
recommendations to the legislature. The study must:
(1) evaluate methods to
achieve universal coverage for children, including, but not limited to, changes
to the employer-based coverage system and an expansion of eligibility for the
children's health security program established under Minnesota Statutes,
chapter 256N;
(2) examine health care
reform and cost containment methods that will contain costs and increase access
and improve health outcomes;
(3) examine how to increase
access to preventive care and health care services; and
(4) examine how to reduce
health disparities among minority populations.
(b) The task force, through
the Legislative Coordinating Commission, may hire staff or contract for staff
support for the study.
(c) The task force, in
developing recommendations, shall hold meetings to hear public testimony at
locations throughout the state, including locations outside of the seven-county
metropolitan area.
Subd. 3. Recommendations. The task force shall report its
recommendations to the legislature by December 15, 2009. Recommendations must
be consistent with the following criteria:
(1) health care coverage
must include preventive care and all other medically necessary services;
(2) health care coverage
must be affordable for families, with the family share of premium costs and
cost-sharing in total not exceeding five percent of family income;
(3) the system of coverage
must give priority to ensuring access to and the quality and continuity of
care; and
(4) enrollment must be
simple and seamless for families.
Subd. 4. Expiration. This section expires December 16, 2009.
ARTICLE 9
HEALTH CARE REFORM
Section 1. Minnesota
Statutes 2006, section 62A.65, subdivision 3, is amended to read:
Subd. 3. Premium rate restrictions. No
individual health plan may be offered, sold, issued, or renewed to a Minnesota
resident unless the premium rate charged is determined in accordance with the
following requirements:
(a) Premium rates must be no
more than 25 percent above and no more than 25 percent below the index rate
charged to individuals for the same or similar coverage, adjusted pro rata for
rating periods of less than one year. The premium variations permitted by this
paragraph must be based only upon health status, claims experience, and
occupation. For purposes of this paragraph, health status includes refraining
from tobacco use or other actuarially valid lifestyle factors associated with
good health, provided that the lifestyle factor and its effect upon premium
rates have been determined by the commissioner to be actuarially valid and have
been approved by the commissioner.
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Variations permitted under
this paragraph must not be based upon age or applied differently at different
ages. This paragraph does not prohibit use of a constant percentage adjustment
for factors permitted to be used under this paragraph.
(b) Premium rates may vary
based upon the ages of covered persons only as provided in this paragraph. In
addition to the variation permitted under paragraph (a), each health carrier
may use an additional premium variation based upon age for adults aged 19
and above of up to plus or minus 50 percent of the index rate. Premium
rates for children under the age of 19 may not vary based on age, regardless of
whether the child is covered as a dependent or as a primary insured.
(c) A health carrier may
request approval by the commissioner to establish separate geographic regions
determined by the health carrier and to establish separate index rates for each
such region. The commissioner shall grant approval if the following conditions
are met:
(1) the geographic regions
must be applied uniformly by the health carrier;
(2) each geographic region
must be composed of no fewer than seven counties that create a contiguous
region; and
(3) the health carrier
provides actuarial justification acceptable to the commissioner for the
proposed geographic variations in index rates, establishing that the variations
are based upon differences in the cost to the health carrier of providing
coverage.
(d) Health carriers may use
rate cells and must file with the commissioner the rate cells they use. Rate
cells must be based upon the number of adults or children covered under the
policy and may reflect the availability of Medicare coverage. The rates for
different rate cells must not in any way reflect generalized differences in
expected costs between principal insureds and their spouses.
(e) In developing its index
rates and premiums for a health plan, a health carrier shall take into account
only the following factors:
(1) actuarially valid differences
in rating factors permitted under paragraphs (a) and (b); and
(2) actuarially valid
geographic variations if approved by the commissioner as provided in paragraph
(c).
(f) All premium variations
must be justified in initial rate filings and upon request of the commissioner
in rate revision filings. All rate variations are subject to approval by the
commissioner.
(g) The loss ratio must
comply with the section 62A.021 requirements for individual health plans.
(h) The rates must not be
approved, unless the commissioner has determined that the rates are reasonable.
In determining reasonableness, the commissioner shall consider the growth rates
applied under section 62J.04, subdivision 1, paragraph (b), to the calendar
year or years that the proposed premium rate would be in effect, actuarially
valid changes in risks associated with the enrollee populations, and
actuarially valid changes as a result of statutory changes in Laws 1992,
chapter 549.
(i)
An insurer may, as part of a minimum lifetime loss ratio guarantee filing under
section 62A.02, subdivision 3a, include a rating practices guarantee as
provided in this paragraph. The rating practices guarantee must be in writing
and must guarantee that the policy form will be offered, sold, issued, and
renewed only with premium rates and premium rating practices that comply with
subdivisions 2, 3, 4, and 5. The rating practices guarantee must be accompanied
by an actuarial memorandum that demonstrates that the premium rates and premium
rating system
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used in connection with the
policy form will satisfy the guarantee. The guarantee must guarantee refunds of
any excess premiums to policyholders charged premiums that exceed those
permitted under subdivision 2, 3, 4, or 5. An insurer that complies with this
paragraph in connection with a policy form is exempt from the requirement of
prior approval by the commissioner under paragraphs (c), (f), and (h).
Sec.
2. [62A.67] MINNESOTA HEALTH
INSURANCE EXCHANGE.
Subdivision
1. Title; citation. This section
may be cited as the "Minnesota Health Insurance Exchange."
Subd.
2. Creation; tax exemption. The
Minnesota Health Insurance Exchange is created for the limited purpose of
providing individuals with greater access, choice, portability, and
affordability of health insurance products. The Minnesota Health Insurance
Exchange is a not-for-profit corporation under chapter 317A and section 501(c)
of the Internal Revenue Code.
Subd.
3. Definitions. The following
terms have the meanings given them unless otherwise provided in text.
(a)
"Board" means the board of directors of the Minnesota Health
Insurance Exchange under subdivision 13.
(b)
"Commissioner" means:
(1)
the commissioner of commerce for health insurers subject to the jurisdiction of
the Department of Commerce;
(2)
the commissioner of health for health insurers subject to the jurisdiction of
the Department of Health; or
(3)
either commissioner's designated representative.
(c)
"Exchange" means the Minnesota Health Insurance Exchange.
(d)
"HIPAA" means the Health Insurance Portability and Accountability Act
of 1996.
(e)
"Individual market health plans," unless otherwise specified, means individual
market health plans defined in section 62A.011.
(f)
"Section 125 Plan" means a cafeteria or Premium Only Plan under
section 125 of the Internal Revenue Code that allows employees to pay for
health insurance premiums with pretax dollars.
Subd.
4. Insurer and health plan participation.
All health plans as defined in section 62A.011, subdivision 3, issued or
renewed in the individual market shall participate in the exchange. No health
plans in the individual market may be issued or renewed outside of the
exchange. Group health plans as defined in section 62A.10 shall not be offered
through the exchange. Health plans offered through the Minnesota Comprehensive
Health Association as defined in section 62E.10 are offered through the
exchange to eligible enrollees as determined by the Minnesota Comprehensive
Health Association. Health plans offered through MinnesotaCare under chapter
256L are offered through the exchange to eligible enrollees as determined by
the commissioner of human services.
Subd.
5. Approval of health plans. No
health plan may be offered through the exchange unless the commissioner has
first certified that:
(1)
the insurer seeking to offer the health plan is licensed to issue health
insurance in the state; and
(2)
the health plan meets the requirements of this section, and the health plan and
the insurer are in compliance with all other applicable health insurance laws.
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Subd. 6. Individual market health plans. Individual market health
plans offered through the exchange continue to be regulated by the commissioner
as specified in chapters 62A, 62C, 62D, 62E, 62Q, and 72A, and must include the
following provisions that apply to all health plans issued or renewed through
the exchange:
(1) premiums for children
under the age of 19 shall not vary by age in the exchange; and
(2) premiums for children
under the age of 19 must be excluded from rating factors under section 62A.65,
subdivision 3, paragraph (b).
Subd. 7. Individual participation and eligibility. Individuals are
eligible to purchase health plans directly through the exchange or through an
employer Section 125 Plan under section 62A.68. Nothing in this section
requires guaranteed issue of individual market health plans offered through the
exchange. Individuals are eligible to purchase individual market health plans
through the exchange by meeting one or more of the following qualifications:
(1) the individual is a
Minnesota resident, meaning the individual is physically residing on a
permanent basis in a place that is the person's principal residence and from
which the person is absent only for temporary purposes;
(2) the individual is a
student attending an institution outside of Minnesota and maintains Minnesota
residency;
(3) the individual is not a
Minnesota resident but is employed by an employer physically located within the
state and the individual's employer is required to offer a Section 125 Plan
under section 62A.68;
(4) the individual is not a
Minnesota resident but is self-employed and the individual's principal place of
business is in the state; or
(5) the individual is a
dependent as defined in section 62L.02, of another individual who is eligible
to participate in the exchange.
Subd. 8. Continuation of coverage. Enrollment in a health plan may
be canceled for nonpayment of premiums, fraud, or changes in eligibility for
MinnesotaCare under chapter 256L. Enrollment in an individual market health
plan may not be canceled or nonrenewed because of any change in employer or
employment status, marital status, health status, age, residence, or any other
change that does not affect eligibility as defined in this section.
Subd. 9. Responsibilities of the exchange. The exchange shall
serve as the sole entity for enrollment and collection and transfer of premium
payments for health plans sold to individuals through the exchange. The
exchange shall be responsible for the following functions:
(1) publicize the exchange,
including but not limited to its functions, eligibility rules, and enrollment
procedures;
(2) provide assistance to
employers to establish Section 125 Plans under section 62A.68;
(3) provide education and
assistance to employers to help them understand the requirements of Section 125
Plans and compliance with applicable regulations;
(4) create a system to allow
individuals to compare and enroll in health plans offered through the exchange;
(5) create a system to
collect and transmit to the applicable plans all premium payments made by
individuals, including developing mechanisms to receive and process automatic
payroll deductions for individuals who purchase coverage through employer
Section 125 Plans;
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(6) not accept premium
payments for individual market health plans from an employer Section 125 Plan
if the employer offers a group health plan as defined in section 62A.10, or if
the employer is a self-insurer as defined in section 62E.02;
(7) provide jointly with
health insurers a cancellation notice directly to the primary insured at least
ten days prior to termination of coverage for nonpayment of premium;
(8) bill the employer for
the premiums payable by an employee, provided that the employer is not liable
for payment except from payroll deductions for that purpose;
(9) refer individuals
interested in MinnesotaCare under chapter 256L to the Department of Human
Services to determine eligibility;
(10) establish a mechanism
with the Department of Human Services to transfer premiums and subsidies for
MinnesotaCare to qualify for federal matching payments;
(11) upon request, issue
certificates of previous coverage according to the provisions of HIPAA and as
referenced in section 62Q.181 to all such individuals who cease to be covered
by a participating health plan through the exchange;
(12) establish procedures to
account for all funds received and disbursed by the exchange for individual
participants of the exchange;
(13) make available to the
public, at the end of each calendar year, a report of an independent audit of
the exchange's accounts; and
(14) provide copies of
written and signed statements from employers stating that the employer is not contributing
to the employee's premiums for health plans purchased by an employee through
the exchange to all health insurers with enrolled employees of the employer.
Health insurers may rely on the
employer's statement in clause (4) provided by the Minnesota Health Insurance
Exchange and are not required to guarantee-issue individual health plans to the
employer's employees.
Subd. 10. State not liable. The state of Minnesota shall not be
liable for the actions of the Minnesota Health Insurance Exchange.
Subd. 11. Powers of the exchange. The exchange shall have the power
to:
(1) contract with insurance
producers licensed in accident and health insurance under chapter 60K and
vendors to perform one or more of the functions specified in subdivision 10;
(2) contract with employers
to collect premiums through a Section 125 Plan for eligible individuals who
purchase an individual market health plan through the exchange;
(3) establish and assess
fees on health plan premiums of health plans purchased through the exchange to
fund the cost of administering the exchange;
(4) seek and directly
receive grant funding from government agencies or private philanthropic
organizations to defray the costs of operating the exchange;
(5) establish and administer
rules and procedures governing the operations of the exchange;
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(6) establish one or more
service centers within Minnesota;
(7) sue or be sued or
otherwise take any necessary or proper legal action;
(8) establish bank accounts
and borrow money; and
(9) enter into agreements
with the commissioners of commerce, health, human services, revenue, employment
and economic development, and other state agencies as necessary for the
exchange to implement the provisions of this section.
Subd. 12. Dispute resolution. The exchange shall establish
procedures for resolving disputes with respect to the eligibility of an
individual to participate in the exchange. The exchange does not have the
authority or responsibility to intervene in or resolve disputes between an
individual and a health plan or health insurer. The exchange shall refer complaints
from individuals participating in the exchange to the commissioner to be
resolved according to sections 62Q.68 to 62Q.73.
Subd. 13. Governance. The exchange shall be governed by a board of
directors with 11 members. The board shall convene on or before July 1, 2007,
after the initial board members have been selected. The initial board
membership consists of the following:
(1) the commissioner of
commerce;
(2) the commissioner of
human services;
(3) the commissioner of
health;
(4) four members appointed
by a joint committee of the Minnesota senate and the Minnesota house of
representatives to serve three-year terms; and
(5) four members appointed
by the governor to serve three-year terms.
Subd. 14. Subsequent board membership. Ongoing membership of the
exchange consists of the following effective July 1, 2010:
(1) the commissioner of
commerce;
(2) the commissioner of
human services;
(3) the commissioner of
health;
(4) two members appointed by
the governor with the approval of a joint committee of the senate and house of
representatives to serve two-year terms; and
(5) six members elected by
the membership of the exchange of which three are elected to serve a two-year
term and three are elected to serve a three-year term. Appointed and elected
members may serve more than one term.
Subd. 15. Operations of the board. Officers of the board of
directors are elected by members of the board and serve one-year terms. Six
members of the board constitutes a quorum, and the affirmative vote of six
members of the board is necessary and sufficient for any action taken by the
board. Board members serve without pay, but are reimbursed for actual expenses
incurred in the performance of their duties.
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Subd. 16. Operations of the exchange. The board of directors shall
appoint an exchange director who shall:
(1) be a full-time employee
of the exchange;
(2) administer all of the
activities and contracts of the exchange; and
(3) hire and supervise the
staff of the exchange.
Subd. 17. Insurance producers. An individual has the right to
choose any insurance producer licensed in accident and health insurance under chapter
60K to assist them in purchasing an individual market health plan through the
exchange. When a producer licensed in accident and health insurance under
chapter 60K enrolls an eligible individual in the exchange, the health plan
chosen by an individual may pay the producer a commission.
Subd. 18. Implementation. Health plan coverage through the exchange
begins on January 1, 2009. The exchange must be operational to assist employers
and individuals by September 1, 2008, and be prepared for enrollment by
December 1, 2008. Enrollees of individual market health plans, MinnesotaCare,
and the Minnesota Comprehensive Health Association as of December 2, 2008, are
automatically enrolled in the exchange on January 1, 2009, in the same health
plan and at the same premium that they were enrolled as of December 2, 2008,
subject to the provisions of this section. As of January 1, 2009, all enrollees
of individual market health plans, MinnesotaCare, and the Minnesota
Comprehensive Health Association shall make premium payments to the exchange.
Sec. 3. [62A.68] SECTION 125 PLANS.
Subdivision 1. Definitions. The following terms have the meanings given
unless otherwise provided in text:
(a) "Current
employee" means an employee currently on an employer's payroll other than
a retiree or disabled former employee.
(b) "Employer"
means a person, firm, corporation, partnership, association, business trust, or
other entity employing one or more persons, including a political subdivision
of the state, filing payroll tax information on such employed person or
persons.
(c) "Section 125
Plan" means a cafeteria or Premium Only Plan under section 125 of the
Internal Revenue Code that allows employees to purchase health insurance with
pretax dollars.
(d) "Exchange" means
the Minnesota Health Insurance Exchange under section 62A.67.
(e) "Exchange
director" means the appointed director under section 62A.67, subdivision
16.
Subd. 2. Section 125 Plan requirement. (a) Effective January 1,
2009, all employers with 11 or more current employees shall establish a Section
125 Plan to allow their employees to purchase individual market health plan
coverage with pretax dollars. Nothing in this section requires or mandates
employers to offer or purchase health insurance coverage for their employees.
The following employers are exempt from the Section 125 Plan requirement:
(1) employers that offer a
group health insurance plan as defined in 62A.10;
(2) employers that are
self-insurers as defined in section 62E.02; and
(3) employers with fewer
than 11 current employees, except that employers under this clause may
voluntarily offer a Section 125 Plan.
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(b) Employers that offer a
Section 125 Plan may enter into an agreement with the exchange to administer
the employer's Section 125 Plan.
Subd. 3. Tracking compliance. By July 1, 2008, the exchange, in
consultation with the commissioners of commerce, health, employment and
economic development, and revenue shall establish a method for tracking
employer compliance with the Section 125 Plan requirement.
Subd. 4. Employer requirements. Employers that are required to
offer or choose to offer a Section 125 Plan shall:
(1) allow employees to
purchase any individual market health plan for themselves and their dependents
through the exchange;
(2) allow employees to
choose any insurance producer licensed in accident and health insurance under
chapter 60K to assist them in purchasing an individual market health plan
through the exchange;
(3) provide a written and
signed statement to the exchange stating that the employer is not contributing
to the employee's premiums for health plans purchased by an employee through
the exchange;
(4) upon an employee's request,
deduct premium amounts on a pretax basis in an amount not to exceed an
employee's wages, and remit these employee payments to the exchange; and
(5) provide notice to
employees that individual market health plans purchased through the exchange
are not employer-sponsored or administered. Employers shall be held harmless
from any and all liability claims related to the individual market health plans
purchased through the exchange by employees under a Section 125 Plan.
Subd. 5. Section 125 eligible health plans. Individuals who are
eligible to use an employer Section 125 Plan to pay for health insurance
coverage purchased through the exchange may enroll in any health plan offered
through the exchange for which the individual is eligible including individual
market health plans, MinnesotaCare, and the Minnesota Comprehensive Health
Association.
Sec. 4. Minnesota Statutes
2006, section 62E.141, is amended to read:
62E.141 INCLUSION IN EMPLOYER-SPONSORED PLAN.
No employee of an employer
that offers a group health plan, under which the employee is eligible
for coverage, is eligible to enroll, or continue to be enrolled, in the
comprehensive health association, except for enrollment or continued enrollment
necessary to cover conditions that are subject to an unexpired preexisting
condition limitation, preexisting condition exclusion, or exclusionary rider
under the employer's health plan. This section does not apply to persons
enrolled in the Comprehensive Health Association as of June 30, 1993. With respect
to persons eligible to enroll in the health plan of an employer that has more
than 29 current employees, as defined in section 62L.02, this section does not
apply to persons enrolled in the Comprehensive Health Association as of
December 31, 1994.
Sec. 5. Minnesota Statutes
2006, section 62J.04, subdivision 3, is amended to read:
Subd. 3. Cost containment duties. The
commissioner shall:
(1) establish statewide and
regional cost containment goals for total health care spending under this
section and, collect data as described in sections 62J.38 to
62J.41 to monitor statewide achievement of the cost containment goals, and
annually report to the legislature on whether the goals were achieved and, if
not, what action should be taken to ensure that goals are achieved in the
future;
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(2) divide the state into no
fewer than four regions, with one of those regions being the Minneapolis/St.
Paul metropolitan statistical area but excluding Chisago, Isanti, Wright, and
Sherburne Counties, for purposes of fostering the development of regional
health planning and coordination of health care delivery among regional health
care systems and working to achieve the cost containment goals;
(3) monitor the quality of
health care throughout the state and take action as necessary to ensure an
appropriate level of quality;
(4) issue recommendations
regarding uniform billing forms, uniform electronic billing procedures and data
interchanges, patient identification cards, and other uniform claims and
administrative procedures for health care providers and private and public
sector payers. In developing the recommendations, the commissioner shall review
the work of the work group on electronic data interchange (WEDI) and the
American National Standards Institute (ANSI) at the national level, and the
work being done at the state and local level. The commissioner may adopt rules
requiring the use of the Uniform Bill 82/92 form, the National Council of
Prescription Drug Providers (NCPDP) 3.2 electronic version, the Centers for
Medicare and Medicaid Services 1500 form, or other standardized forms or
procedures;
(5) undertake health
planning responsibilities;
(6) authorize, fund, or promote
research and experimentation on new technologies and health care procedures;
(7) within the limits of
appropriations for these purposes, administer or contract for statewide
consumer education and wellness programs that will improve the health of Minnesotans
and increase individual responsibility relating to personal health and the
delivery of health care services, undertake prevention programs including
initiatives to improve birth outcomes, expand childhood immunization efforts,
and provide start-up grants for worksite wellness programs;
(8) undertake other
activities to monitor and oversee the delivery of health care services in
Minnesota with the goal of improving affordability, quality, and accessibility
of health care for all Minnesotans; and
(9) make the cost
containment goal data available to the public in a consumer-oriented manner.
EFFECTIVE DATE. This section is
effective July 1, 2007.
Sec. 6. Minnesota Statutes
2006, section 62J.495, is amended to read:
62J.495 HEALTH INFORMATION TECHNOLOGY AND INFRASTRUCTURE ADVISORY
COMMITTEE.
Subdivision 1. Establishment; members; duties
Implementation. By January 1, 2012, all hospitals and health care
providers must have in place an interoperable electronic health records system
within their hospital system or clinical practice setting. The commissioner of
health, in consultation with the Health Information Technology and
Infrastructure Advisory Committee, shall develop a statewide plan to meet this
goal, including the adoption of uniform standards to be used for the
interoperable system for sharing and synchronizing patient data across systems.
The standards must be compatible with federal efforts. The uniform standards
must be refined and adopted for use when a standard development organization
accredited by the American National Standards Institute completes the
development of a standard for sharing and synchronizing patient data across
systems.
Subd. 2. Health Information Technology and Infrastructure Advisory Committee.
(a) The commissioner shall establish a Health Information Technology and
Infrastructure Advisory Committee governed by section 15.059 to advise the
commissioner on the following matters:
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(1) assessment of the use of
health information technology by the state, licensed health care providers and
facilities, and local public health agencies;
(2) recommendations for
implementing a statewide interoperable health information infrastructure, to
include estimates of necessary resources, and for determining standards for
administrative data exchange, clinical support programs, patient privacy
requirements, and maintenance of the security and confidentiality of individual
patient data; and
(3) other related issues as
requested by the commissioner.
(b) The members of the
Health Information Technology and Infrastructure Advisory Committee shall
include the commissioners, or commissioners' designees, of health, human
services, administration, and commerce and additional members to be appointed
by the commissioner to include persons representing Minnesota's local public
health agencies, licensed hospitals and other licensed facilities and
providers, private purchasers, the medical and nursing professions, health
insurers and health plans, the state quality improvement organization, academic
and research institutions, consumer advisory organizations with an interest and
expertise in health information technology, and other stakeholders as
identified by the Health Information Technology and Infrastructure Advisory
Committee.
Subd. 2. Annual report. (c) The commissioner shall
prepare and issue an annual report not later than January 30 of each year
outlining progress to date in implementing a statewide health information
infrastructure and recommending future projects.
Subd. 3. Expiration. (d) Notwithstanding section
15.059, this section subdivision expires June 30, 2009
2012.
Sec. 7. [62J.496] ELECTRONIC HEALTH RECORD SYSTEM REVOLVING ACCOUNT AND LOAN
PROGRAM.
Subdivision 1. Account establishment. The commissioner of finance shall
establish and implement a revolving account in the state government special
revenue fund to provide loans to eligible borrowers to assist in financing the
installation or support of an interoperable health record system. The system
must provide for the interoperable exchange of health care information between
the applicant and, at a minimum, a hospital system, pharmacy, and a health care
clinic or other physician group.
Subd. 2. Eligibility. (a) "Eligible borrower" means one
of the following:
(1) community clinics, as
defined under section 145.9268;
(2) hospitals eligible for
rural hospital capital improvement grants, as defined in section 144.148;
(3) physician clinics
located in a community with a population of less than 50,000 according to
United States Census Bureau statistics and outside the seven-county
metropolitan area;
(4) nursing facilities
licensed under sections 144A.01 to 144A.27; and
(5) other providers of
health or health care services approved by the commissioner for which
interoperable electronic health record capability would improve quality of
care, patient safety, or community health.
(b) To be eligible for a
loan under this section, the applicant must submit a loan application to the
commissioner of health on forms prescribed by the commissioner. The application
must include, at a minimum:
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(1)
the amount of the loan requested and a description of the purpose or project
for which the loan proceeds will be used;
(2)
a quote from a vendor;
(3)
a description of the health care entities and other groups participating in the
project;
(4)
evidence of financial stability and a demonstrated ability to repay the loan;
and
(5)
a description of how the system to be financed interconnects or plans in the
future to interconnect with other health care entities and provider groups
located in the same geographical area.
Subd.
3. Loans. (a) The commissioner
of health may make a no interest loan to a provider or provider group who is
eligible under subdivision 2 on a first-come, first-served basis provided that
the applicant is able to comply with this section. The total accumulative loan
principal must not exceed $1,500,000 per loan. The commissioner of health has
discretion over the size and number of loans made.
(b)
The commissioner of health may prescribe forms and establish an application
process and, notwithstanding section 16A.1283, may impose a reasonable
nonrefundable application fee to cover the cost of administering the loan
program.
(c)
The borrower must begin repaying the principal no later than two years from the
date of the loan. Loans must be amortized no later than six years from the date
of the loan.
(d)
Repayments must be credited to the account.
Subd.
4. Data classification. Data
collected by the commissioner of health on the application to determine eligibility
under subdivision 2 and to monitor borrowers' default risk or collect payments
owed under subdivision 3 are (1) private data on individuals as defined in
section 13.02, subdivision 12; and (2) nonpublic data as defined in section
13.02, subdivision 9. The names of borrowers and the amounts of the loans
granted are public data.
Sec.
8. [62J.536] UNIFORM ELECTRONIC
TRANSACTIONS AND IMPLEMENTATION GUIDE STANDARDS.
Subdivision
1. Electronic claims and eligibility
transactions required. (a) Beginning January 15, 2009, all group
purchasers must accept from health care providers the eligibility for a health
plan transaction described under Code of Federal Regulations, title 45, part
162, subpart L. Beginning July 15, 2009, all group purchasers must accept from
health care providers the health care claims or equivalent encounter
information transaction described under Code of Federal Regulations, title 45,
part 162, subpart K.
(b)
Beginning January 15, 2009, all group purchasers must transmit to providers the
eligibility for a health plan transaction described under Code of Federal
Regulations, title 45, part 162, subpart L. Beginning December 1, 2009, all
group purchasers must transmit to providers the health care payment and
remittance advice transaction described under Code of Federal Regulations,
title 45, part 162, subpart P.
(c)
Beginning January 15, 2009, all health care providers must submit to group
purchasers the eligibility for a health plan transaction described under Code
of Federal Regulations, title 45, part 162, subpart L. Beginning July 15, 2009,
all health care providers must submit to group purchasers the health care
claims or equivalent encounter information transaction described under Code of
Federal Regulations, title 45, part 162, subpart K.
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(d) Beginning January 15,
2009, all health care providers must accept from group purchasers the
eligibility for a health plan transaction described under Code of Federal
Regulations, title 45, part 162, subpart L. Beginning December 15, 2009, all
health care providers must accept from group purchasers the health care payment
and remittance advice transaction described under Code of Federal Regulations,
title 45, part 162, subpart P.
(e) Each of the transactions
described in paragraphs (a) to (d) shall require the use of a single, uniform
companion guide to the implementation guides described under Code of Federal
Regulations, title 45, part 162. The companion guides will be developed
pursuant to subdivision 2.
(f) Notwithstanding any
other provisions in sections 62J.50 to 62J.61, all group purchasers and health
care providers must exchange claims and eligibility information electronically
using the transactions, companion guides, implementation guides, and timelines
required under this subdivision. Group purchasers may not impose any fee on
providers for the use of the transactions prescribed in this subdivision.
(g) Nothing in this
subdivision shall prohibit group purchasers and health care providers from
using a direct data entry, Web-based methodology for complying with the
requirements of this subdivision. Any direct data entry method for conducting
the transactions specified in this subdivision must be consistent with the data
content component of the single, uniform companion guides required in paragraph
(e) and the implementation guides described under Code of Federal Regulations,
title 45, part 162.
Subd. 2. Establishing uniform, standard companion guides. (a) At
least 12 months prior to the timelines required in subdivision 1, the
commissioner of health shall promulgate rules pursuant to section 62J.61
establishing and requiring group purchasers and health care providers to use
the transactions and the uniform, standard companion guides required under
subdivision 1, paragraph (e).
(b) The commissioner of
health must consult with the Minnesota Administrative Uniformity Committee on
the development of the single, uniform companion guides required under subdivision
1, paragraph (e), for each of the transactions in subdivision 1. The single
uniform companion guides required under subdivision 1, paragraph (e), must
specify uniform billing and coding standards. The commissioner of health shall
base the companion guides required under subdivision 1, paragraph (e), billing
and coding rules, and standards on the Medicare program, with modifications
that the commissioner deems appropriate after consulting the Minnesota
Administrative Uniformity Committee.
(c) No group purchaser or
health care provider may add to or modify the single, uniform companion guides
defined in subdivision 1, paragraph (e), through additional companion guides or
other requirements.
(d) In promulgating the
rules in paragraph (a), the commissioner shall not require data content that is
not essential to accomplish the purpose of the transactions in subdivision 1.
Sec. 9. Minnesota Statutes
2006, section 62J.692, subdivision 1, is amended to read:
Subdivision 1. Definitions. For purposes of this
section, the following definitions apply:
(a) "Accredited
clinical training" means the clinical training provided by a medical
education program that is accredited through an organization recognized by the
Department of Education, the Centers for Medicare and Medicaid Services, or
another national body who reviews the accrediting organizations for multiple
disciplines and whose standards for recognizing accrediting organizations are
reviewed and approved by the commissioner of health in consultation with the
Medical Education and Research Advisory Committee.
(b) "Commissioner"
means the commissioner of health.
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(c)
"Clinical medical education program" means the accredited clinical
training of physicians (medical students and residents), doctor of pharmacy
practitioners, doctors of chiropractic, dentists, advanced practice nurses
(clinical nurse specialists, certified registered nurse anesthetists, nurse
practitioners, and certified nurse midwives), and physician assistants.
(d)
"Sponsoring institution" means a hospital, school, or consortium
located in Minnesota that sponsors and maintains primary organizational and
financial responsibility for a clinical medical education program in Minnesota
and which is accountable to the accrediting body.
(e)
"Teaching institution" means a hospital, medical center, clinic, or
other organization that conducts a clinical medical education program in
Minnesota.
(f)
"Trainee" means a student or resident involved in a clinical medical
education program.
(g)
"Eligible trainee FTEs" means the number of trainees, as measured by
full-time equivalent counts, that are at training sites located in Minnesota
with a currently active medical assistance provider number
enrollment status and a National Provider Identification (NPI) number where
training occurs in either an inpatient or ambulatory patient care setting and
where the training is funded, in part, by patient care revenues.
Sec.
10. Minnesota Statutes 2006, section 62J.692, subdivision 4, is amended to
read:
Subd.
4. Distribution of funds. (a) The
commissioner shall annually distribute 90 percent of available medical
education funds transferred according to section 256B.69, subdivision
5c, paragraph (a), clause (1), to all qualifying applicants based on a
distribution formula that reflects a summation of two factors:
(1)
an education factor, which is determined by the total number of eligible trainee
FTEs and the total statewide average costs per trainee, by type of trainee, in
each clinical medical education program; and
(2)
a public program volume factor, which is determined by the total volume of
public program revenue received by each training site as a percentage of all
public program revenue received by all training sites in the fund pool.
In
this formula, the education factor is weighted at 67 percent and the public
program volume factor is weighted at 33 percent.
Public
program revenue for the distribution formula includes revenue from medical
assistance, prepaid medical assistance, general assistance medical care, and
prepaid general assistance medical care. Training sites that receive no public
program revenue are ineligible for funds available under this paragraph. Total
statewide average costs per trainee for medical residents is based on audited
clinical training costs per trainee in primary care clinical medical education
programs for medical residents. Total statewide average costs per trainee for
dental residents is based on audited clinical training costs per trainee in
clinical medical education programs for dental students. Total statewide
average costs per trainee for pharmacy residents is based on audited clinical
training costs per trainee in clinical medical education programs for pharmacy
students.
(b)
The commissioner shall annually distribute ten percent of total available
medical education funds transferred according to section 256B.69,
subdivision 5c, paragraph (a), clause (1), to all qualifying applicants
based on the percentage received by each applicant under paragraph (a). These
funds are to be used to offset clinical education costs at eligible clinical
training sites based on criteria developed by the clinical medical education
program. Applicants may choose to distribute funds allocated under this
paragraph based on the distribution formula described in paragraph (a).
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(c) The commissioner shall
annually distribute $5,000,000 of the funds dedicated to the commissioner under
section 297F.10, subdivision 1, clause (2), plus any federal financial
participation on these funds and on funds transferred under subdivision 10, to
all qualifying applicants based on a distribution formula that gives 100
percent weight to a public program volume factor, which is determined by the
total volume of public program revenue received by each training site as a
percentage of all public program revenue received by all training sites in the
fund pool. If federal approval is not obtained for federal financial
participation on any portion of funds distributed under this paragraph, 90
percent of the unmatched funds shall be distributed by the commissioner based on
the formula described in paragraph (a) and ten percent of the unmatched funds
shall be distributed by the commissioner based on the formula described in
paragraph (b).
(d) The commissioner shall
annually distribute $3,060,000 of funds dedicated to the commissioner under
section 297F.10, subdivision 1, clause (2), through a formula giving 100
percent weight to an education factor, which is determined by the total number
of eligible trainee full-time equivalents and the total statewide average costs
per trainee, by type of trainee, in each clinical medical education program. If
no matching funds are received on funds distributed under paragraph (c), funds
distributed under this paragraph shall be distributed by the commissioner based
on the formula described in paragraph (a).
(e) The commissioner shall
annually distribute $340,000 of funds dedicated to the commissioner under
section 297F.10, subdivision 1, clause (2), to all qualifying applicants based
on the percentage received by each applicant under paragraph (a). These funds
are to be used to offset clinical education costs at eligible clinical training
sites based on criteria developed by the clinical medical education program.
Applicants may choose to distribute funds allocated under this paragraph based
on the distribution formula described in paragraph (a). If no matching funds
are received on funds distributed under paragraph (c), funds distributed under
this paragraph shall be distributed by the commissioner based on the formula
described in paragraph (b).
(c) (f) Funds distributed shall not
be used to displace current funding appropriations from federal or state
sources.
(d) (g) Funds shall be distributed
to the sponsoring institutions indicating the amount to be distributed to each
of the sponsor's clinical medical education programs based on the criteria in
this subdivision and in accordance with the commissioner's approval letter.
Each clinical medical education program must distribute funds allocated under
paragraph (a) to the training sites as specified in the commissioner's approval
letter. Sponsoring institutions, which are accredited through an organization
recognized by the Department of Education or the Centers for Medicare and
Medicaid Services, may contract directly with training sites to provide
clinical training. To ensure the quality of clinical training, those accredited
sponsoring institutions must:
(1) develop contracts
specifying the terms, expectations, and outcomes of the clinical training
conducted at sites; and
(2) take necessary action if
the contract requirements are not met. Action may include the withholding of
payments under this section or the removal of students from the site.
(e) (h) Any funds not distributed
in accordance with the commissioner's approval letter must be returned to the
medical education and research fund within 30 days of receiving notice from the
commissioner. The commissioner shall distribute returned funds to the
appropriate training sites in accordance with the commissioner's approval letter.
(f) (i) The commissioner shall
distribute by June 30 of each year an amount equal to the funds transferred
under subdivision 10, plus five percent interest to the University of
Minnesota Board of Regents for the instructional costs of health professional
programs at the Academic Health Center and for interdisciplinary academic
initiatives within the Academic Health Center.
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(g) (j) A maximum of $150,000 of the
funds dedicated to the commissioner under section 297F.10, subdivision 1, paragraph
(b), clause (2), may be used by the commissioner for administrative
expenses associated with implementing this section.
Sec.
11. Minnesota Statutes 2006, section 62J.692, subdivision 7a, is amended to
read:
Subd.
7a. Clinical medical education
innovations grants. (a) The commissioner shall award grants to teaching
institutions and clinical training sites for projects that increase dental
access for underserved populations and promote innovative clinical training of
dental professionals.
(b)
The commissioner shall award grants to teaching institutions and clinical
training sites for projects that increase mental health access for underserved
populations, promote innovative clinical training of mental health
professionals, increase the number of mental health providers in rural or
underserved areas, and promote the incorporation of patient safety principles
into clinical medical education programs.
(c) In awarding the grants, the
commissioner, in consultation with the commissioner of human services, shall
consider the following:
(1)
potential to successfully increase access to an underserved population;
(2)
the long-term viability of the project to improve access beyond the period of
initial funding;
(3)
evidence of collaboration between the applicant and local communities;
(4)
the efficiency in the use of the funding; and
(5)
the priority level of the project in relation to state clinical education,
access, patient safety, and workforce goals.; and
(6)
the potential of the project to impact the number or distribution of the health
care workforce.
(b) (d) The commissioner shall
periodically evaluate the priorities in awarding the innovations grants in
order to ensure that the priorities meet the changing workforce needs of the
state.
Sec.
12. Minnesota Statutes 2006, section 62J.692, subdivision 8, is amended to
read:
Subd.
8. Federal financial participation.
(a) The commissioner of human services shall seek to maximize federal financial
participation in payments for medical education and research costs. If the
commissioner of human services determines that federal financial participation
is available for the medical education and research, the commissioner of health
shall transfer to the commissioner of human services the amount of state funds
necessary to maximize the federal funds available. The amount transferred to
the commissioner of human services, plus the amount of federal financial
participation, shall be distributed to medical assistance providers in
accordance with the distribution methodology described in subdivision 4.
(b)
For the purposes of paragraph (a), the commissioner shall use physician clinic
rates where possible to maximize federal financial participation.
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Sec. 13. Minnesota Statutes
2006, section 62J.692, subdivision 10, is amended to read:
Subd. 10. Transfers from University of Minnesota.
Of the funds dedicated to the Academic Health Center under section 297F.10,
subdivision 1, clause (1), $4,850,000 shall be transferred annually to the
commissioner of health no later than April 15 of each year for distribution
under subdivision 4, paragraph (f) (i).
Sec. 14. Minnesota Statutes
2006, section 62J.81, subdivision 1, is amended to read:
Subdivision 1. Required disclosure of estimated payment.
(a) A health care provider, as defined in section 62J.03, subdivision 8, or the
provider's designee as agreed to by that designee, shall, at the request of a
consumer, provide that consumer with a good faith estimate of the reimbursement
allowable payment the provider expects to receive from the health
plan company in which the consumer is enrolled has agreed to accept from
the consumer's health plan company for the services specified by the consumer,
specifying the amount of the allowable payment due from the health plan company.
Health plan companies must allow contracted providers, or their designee, to
release this information. A good faith estimate must also be made available
at the request of a consumer who is not enrolled in a health plan company. If
a consumer has no applicable public or private coverage, the health care
provider must give the consumer a good faith estimate of the average allowable
reimbursement the provider accepts as payment from private third-party payers
for the services specified by the consumer and the estimated amount the
noncovered consumer will be required to pay. Payment information provided
by a provider, or by the provider's designee as agreed to by that designee, to
a patient pursuant to this subdivision does not constitute a legally binding
estimate of the allowable charge for or cost to the consumer of
services.
(b) A health plan company,
as defined in section 62J.03, subdivision 10, shall, at the request of an
enrollee or the enrollee's designee, provide that enrollee with a good faith
estimate of the reimbursement allowable amount the health plan
company would expect to pay to has contracted for with a
specified provider within the network as total payment for a health care
service specified by the enrollee and the portion of the allowable amount
due from the enrollee and the enrollee's out-of-pocket costs. If requested
by the enrollee, the health plan company shall also provide to the enrollee a
good faith estimate of the enrollee's out-of-pocket cost for the health care
service. An estimate provided to an enrollee under this paragraph is not a
legally binding estimate of the reimbursement allowable amount or
enrollee's out-of-pocket cost.
EFFECTIVE DATE. This section is
effective August 1, 2007.
Sec. 15. Minnesota Statutes
2006, section 62J.82, is amended to read:
62J.82 HOSPITAL CHARGE INFORMATION REPORTING DISCLOSURE.
Subdivision 1. Required information. The Minnesota Hospital Association
shall develop a Web-based system, available to the public free of charge, for
reporting charge information the following, for Minnesota
residents,:
(1) hospital-specific
performance on the measures of care developed under section 256B.072 for acute
myocardial infarction, heart failure, and pneumonia;
(2) by January 1, 2009,
hospital-specific performance on the public reporting measures for
hospital-acquired infections as published by the National Quality Forum and
collected by the Minnesota Hospital Association and Stratis Health in
collaboration with infection control practitioners; and
(3) charge information, including, but not limited
to, number of discharges, average length of stay, average charge, average
charge per day, and median charge, for each of the 50 most common inpatient
diagnosis-related groups and the 25 most common outpatient surgical procedures
as specified by the Minnesota Hospital Association.
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Subd. 2. Web site. The Web site must provide information that
compares hospital-specific data to hospital statewide data. The Web site must
be established by October 1, 2006, and must be updated annually. The
commissioner shall provide a link to this reporting information on the
department's Web site.
Subd. 3. Enforcement. The commissioner shall provide a link to
this information on the department's Web site. If a hospital does not
provide this information to the Minnesota Hospital Association, the
commissioner of health may require the hospital to do so in
accordance with section 144.55, subdivision 6. The commissioner shall
provide a link to this information on the department's Web site.
Sec. 16. [62J.84] HEALTH CARE TRANSFORMATION TASK
FORCE.
Subdivision 1. Task force. The governor shall convene a health care
transformation task force to advise and assist the governor and the Minnesota
legislature. The task force shall consist of:
(1) four legislators from
the house of representatives appointed by the speaker, two from the majority
party and two from the minority party, and four legislators from the senate
appointed by the Subcommittee on Committees of the senate Committee on Rules
and Administration, two from the majority party and two from the minority
party;
(2) four representatives of
the governor and state agencies appointed by the governor;
(3) at least four persons
appointed by the governor who have demonstrated leadership in health care
organizations, health improvement initiatives, health care trade or
professional associations, or other collaborative health system improvement
activities; and
(4) at least two persons
appointed by the governor who have demonstrated leadership in employer and
group purchaser activities related to health system improvement, at least one
of which must be from a labor organization.
Subd. 2. Public input. The commissioner of health shall review
available research, and conduct statewide, regional, and local surveys, focus
groups, and other activities as needed to fill gaps in existing research, to
determine Minnesotans' values, preferences, opinions, and perceptions related
to health care and to the issues confronting the task force, and shall report
the findings to the task force.
Subd. 3. Inventory and assessment of existing activities; action plan.
The task force shall complete an inventory and assessment of all public and
private organized activities, coalitions, and collaboratives working on tasks
relating to health system improvement including, but not limited to, patient
safety, quality measurement and reporting, evidence-based practice, adoption of
health information technology, disease management and chronic care coordination,
medical homes, access to health care, cultural competence, prevention and
public health, consumer incentives, price and cost transparency, nonprofit
organization community benefits, education, research, and health care
workforce.
Subd. 4. Action plan. By December 15, 2007, the governor, with the
advice and assistance of the task force, shall develop and present to the
legislature a statewide action plan for transforming the health care system to
improve affordability, quality, and access. The plan shall include draft
legislation needed to implement the plan. The plan may consist of legislative
actions, administrative actions of governmental entities, collaborative
actions, and actions of individuals and individual organizations. Among other things,
the action plan must include the following, with specific and measurable goals
and deadlines for each:
(1) proposed actions that
will slow the rate of increase in health care costs to a rate that does not
exceed the increase in the Consumer Price Index for urban consumers for the
preceding calendar year plus two percentage points, plus an additional
percentage based on the added costs necessary to implement legislation enacted
in 2007;
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(2)
actions that will increase the affordable health coverage options for uninsured
and underinsured Minnesotans and other strategies that will ensure that all
Minnesotans will have health coverage by January 2011;
(3)
actions to improve the quality and safety of health care and reduce racial and
ethnic disparities in access and quality;
(4)
actions that will reduce the rate of preventable chronic illness through
prevention and public health and wellness initiatives; and
(5)
proposed changes to state health care purchasing and payment strategies used
for state health care programs and state employees that will promote higher
quality, lower cost health care through incentives that reward prevention and
early intervention, use of cost-effective primary care, effective care
coordination, and management of chronic disease;
(6)
actions that will promote the appropriate and cost-effective investment in new
facilities, technologies, and drugs;
(7)
actions to reduce administrative costs; and
(8)
the results of the inventory completed under subdivision 3 and recommendations
for how these activities can be coordinated and improved.
Subd.
5. Options for small employers. The
task force shall study and report back to the legislature by December 15, 2007,
on options for serving small employers and their employees, and self-employed
individuals.
Sec.
17. Minnesota Statutes 2006, section 62L.12, subdivision 2, is amended to read:
Subd.
2. Exceptions. (a) A health carrier
may sell, issue, or renew individual conversion policies to eligible employees
otherwise eligible for conversion coverage under section 62D.104 as a result of
leaving a health maintenance organization's service area.
(b)
A health carrier may sell, issue, or renew individual conversion policies to
eligible employees otherwise eligible for conversion coverage as a result of
the expiration of any continuation of group coverage required under sections
62A.146, 62A.17, 62A.21, 62C.142, 62D.101, and 62D.105.
(c)
A health carrier may sell, issue, or renew conversion policies under section
62E.16 to eligible employees.
(d)
A health carrier may sell, issue, or renew individual continuation policies to
eligible employees as required.
(e)
A health carrier may sell, issue, or renew individual health plans if the
coverage is appropriate due to an unexpired preexisting condition limitation or
exclusion applicable to the person under the employer's group health plan or
due to the person's need for health care services not covered under the
employer's group health plan.
(f)
A health carrier may sell, issue, or renew an individual health plan, if the
individual has elected to buy the individual health plan not as part of a
general plan to substitute individual health plans for a group health plan nor
as a result of any violation of subdivision 3 or 4.
(g)
Nothing in this subdivision relieves a health carrier of any obligation to
provide continuation or conversion coverage otherwise required under federal or
state law.
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(h)
Nothing in this chapter restricts the offer, sale, issuance, or renewal of
coverage issued as a supplement to Medicare under sections 62A.3099 to 62A.44, or
policies or contracts that supplement Medicare issued by health maintenance
organizations, or those contracts governed by sections 1833, 1851 to 1859,
1860D, or 1876 of the federal Social Security Act, United States Code, title
42, section 1395 et seq., as amended.
(i)
Nothing in this chapter restricts the offer, sale, issuance, or renewal of
individual health plans necessary to comply with a court order.
(j)
A health carrier may offer, issue, sell, or renew an individual health plan to
persons eligible for an employer group health plan, if the individual health
plan is a high deductible health plan for use in connection with an existing
health savings account, in compliance with the Internal Revenue Code, section
223. In that situation, the same or a different health carrier may offer,
issue, sell, or renew a group health plan to cover the other eligible employees
in the group.
(k)
A health carrier may offer, sell, issue, or renew an individual health plan to
one or more employees of a small employer if the individual health plan is
marketed directly through the Minnesota Health Insurance Exchange
under section 62A.67 or 62A.68 to all employees of the small employer and
the small employer does not contribute directly or indirectly to the premiums
or facilitate the administration of the individual health plan. The requirement
to market an individual health plan to all employees through the Minnesota
Health Insurance Exchange under section 62A.67 or 62A.68 does not require
the health carrier to offer or issue an individual health plan to any employee.
For purposes of this paragraph, an employer is not contributing to the premiums
or facilitating the administration of the individual health plan if the
employer does not contribute to the premium and merely collects the premiums
from an employee's wages or salary through payroll deductions and submits
payment for the premiums of one or more employees in a lump sum to the
health carrier to the Minnesota Health Insurance Exchange under section
62A.67 or 62A.68. Except for coverage under section 62A.65, subdivision 5,
paragraph (b), or 62E.16, at the request of an employee, the health carrier
Minnesota Health Insurance Exchange under section 62A.67 or 62A.68 may bill
the employer for the premiums payable by the employee, provided that the
employer is not liable for payment except from payroll deductions for that
purpose. If an employer is submitting payments under this paragraph, the health
carrier and the Minnesota Health Insurance Exchange under section 62A.67 or 62A.68
shall jointly provide a cancellation notice directly to the primary
insured at least ten days prior to termination of coverage for nonpayment of
premium. Individual coverage under this paragraph may be offered only if the
small employer has not provided coverage under section 62L.03 to the employees
within the past 12 months.
The
employer must provide a written and signed statement to the health carrier
Minnesota Health Insurance Exchange under section 62A.67 or 62A.68 that the
employer is not contributing directly or indirectly to the employee's premiums.
The Minnesota Health Insurance Exchange under section 62A.67 or 62A.68 shall
provide all health carriers with enrolled employees of the employer with a copy
of the employer's statement. The health carrier may rely on the employer's
statement provided by the Minnesota Health Insurance Exchange under section
62A.67 or 62A.68 and is not required to guarantee-issue individual health
plans to the employer's other current or future employees.
Sec.
18. Minnesota Statutes 2006, section 62L.12, subdivision 4, is amended to read:
Subd.
4. Employer prohibition. A small
employer offering a health benefit plan shall not encourage or direct an
employee or applicant to:
(1)
refrain from filing an application for health coverage when other similarly
situated employees may file an application for health coverage;
(2)
file an application for health coverage during initial eligibility for
coverage, the acceptance of which is contingent on health status, when other similarly
situated employees may apply for health coverage, the acceptance of which is
not contingent on health status;
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(3) seek coverage from
another health carrier, including, but not limited to, MCHA; or
(4) cause coverage to be
issued on different terms because of the health status or claims experience of
that person or the person's dependents.
Sec. 19. Minnesota Statutes 2006,
section 62Q.165, subdivision 1, is amended to read:
Subdivision 1. Definition. It is the commitment of the
state to achieve universal health coverage for all Minnesotans by the year
2011. Universal coverage is achieved when:
(1) every Minnesotan has
access to a full range of quality health care services;
(2) every Minnesotan is able
to obtain affordable health coverage which pays for the full range of services,
including preventive and primary care; and
(3) every Minnesotan pays
into the health care system according to that person's ability.
EFFECTIVE DATE. This section is
effective July 1, 2007.
Sec. 20. Minnesota Statutes
2006, section 62Q.165, subdivision 2, is amended to read:
Subd. 2. Goal. It is the goal of the state to
make continuous progress toward reducing the number of Minnesotans who do not
have health coverage so that by January 1, 2000, fewer than four percent of
the state's population will be without health coverage 2011, all
Minnesota residents have access to affordable health care. The goal will be
achieved by improving access to private health coverage through insurance
reforms and market reforms, by making health coverage more affordable for
low-income Minnesotans through purchasing pools and state subsidies, and by
reducing the cost of health coverage through cost containment programs and
methods of ensuring that all Minnesotans are paying into the system according
to their ability.
EFFECTIVE DATE. This section is
effective July 1, 2007.
Sec. 21. Minnesota Statutes
2006, section 62Q.80, subdivision 3, is amended to read:
Subd. 3. Approval. (a) Prior to the operation of
a community-based health care coverage program, a community-based health
initiative shall submit to the commissioner of health for approval the
community-based health care coverage program developed by the initiative. The
commissioner shall only approve a program that has been awarded a community
access program grant from the United States Department of Health and Human
Services. The commissioner shall ensure that the program meets the federal
grant requirements and any requirements described in this section and is
actuarially sound based on a review of appropriate records and methods utilized
by the community-based health initiative in establishing premium rates for the
community-based health care coverage program.
(b) Prior to approval, the
commissioner shall also ensure that:
(1) the benefits offered
comply with subdivision 8 and that there are adequate numbers of health care
providers participating in the community-based health network to deliver the
benefits offered under the program;
(2) the activities of the
program are limited to activities that are exempt under this section or
otherwise from regulation by the commissioner of commerce;
(3) the complaint resolution
process meets the requirements of subdivision 10; and
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(4) the data privacy
policies and procedures comply with state and federal law.
Sec. 22. Minnesota Statutes
2006, section 62Q.80, subdivision 4, is amended to read:
Subd. 4. Establishment. (a) The
initiative shall establish and operate upon approval by the commissioner of
health a community-based health care coverage program. The operational structure
established by the initiative shall include, but is not limited to:
(1) establishing a process
for enrolling eligible individuals and their dependents;
(2) collecting and
coordinating premiums from enrollees and employers of enrollees;
(3) providing payment to
participating providers;
(4) establishing a benefit
set according to subdivision 8 and establishing premium rates and cost-sharing
requirements;
(5) creating incentives to
encourage primary care and wellness services; and
(6) initiating disease
management services, as appropriate.
(b) The payments collected
under paragraph (a), clause (2), may be used to capture available federal
funds.
Sec. 23. Minnesota Statutes
2006, section 62Q.80, subdivision 13, is amended to read:
Subd. 13. Report. (a) The initiative shall submit
quarterly status reports to the commissioner of health on January 15, April 15,
July 15, and October 15 of each year, with the first report due January 15, 2007
2008. The status report shall include:
(1) the financial status of
the program, including the premium rates, cost per member per month, claims
paid out, premiums received, and administrative expenses;
(2) a description of the
health care benefits offered and the services utilized;
(3) the number of employers
participating, the number of employees and dependents covered under the
program, and the number of health care providers participating;
(4) a description of the
health outcomes to be achieved by the program and a status report on the
performance measurements to be used and collected; and
(5) any other information
requested by the commissioner of health or commerce or the legislature.
(b) The initiative shall
contract with an independent entity to conduct an evaluation of the program to
be submitted to the commissioners of health and commerce and the legislature by
January 15, 2009 2010. The evaluation shall include:
(1) an analysis of the
health outcomes established by the initiative and the performance measurements
to determine whether the outcomes are being achieved;
(2) an analysis of the
financial status of the program, including the claims to premiums loss ratio
and utilization and cost experience;
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(3) the demographics of the
enrollees, including their age, gender, family income, and the number of
dependents;
(4) the number of employers
and employees who have been denied access to the program and the basis for the
denial;
(5) specific analysis on
enrollees who have aggregate medical claims totaling over $5,000 per year,
including data on the enrollee's main diagnosis and whether all the medical
claims were covered by the program;
(6) number of enrollees
referred to state public assistance programs;
(7) a comparison of
employer-subsidized health coverage provided in a comparable geographic area to
the designated community-based geographic area served by the program,
including, to the extent available:
(i) the difference in the
number of employers with 50 or fewer employees offering employer-subsidized
health coverage;
(ii) the difference in
uncompensated care being provided in each area; and
(iii) a comparison of health
care outcomes and measurements established by the initiative; and
(8) any other information
requested by the commissioner of health or commerce.
Sec. 24. Minnesota Statutes
2006, section 62Q.80, subdivision 14, is amended to read:
Subd. 14. Sunset. This section expires December
31, 2011 2012.
Sec. 25. Minnesota Statutes
2006, section 144.698, subdivision 1, is amended to read:
Subdivision 1. Yearly reports. (a) Each
hospital and each outpatient surgical center, which has not filed the financial
information required by this section with a voluntary, nonprofit reporting
organization pursuant to section 144.702, shall file annually with the
commissioner of health after the close of the fiscal year:
(1) a balance sheet
detailing the assets, liabilities, and net worth of the hospital or outpatient
surgical center;
(2) a detailed statement of
income and expenses;
(3) a copy of its most
recent cost report, if any, filed pursuant to requirements of Title XVIII of
the United States Social Security Act;
(4) a copy of all changes to
articles of incorporation or bylaws;
(5) information on services
provided to benefit the community, including services provided at no cost or
for a reduced fee to patients unable to pay, teaching and research activities,
or other community or charitable activities;
(6) information required on
the revenue and expense report form set in effect on July 1, 1989, or as
amended by the commissioner in rule;
(7) information on changes
in ownership or control; and
(8) other information required
by the commissioner in rule.;
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(9) information on the
number of available hospital beds that are dedicated to certain specialized
services, as designated by the commissioner, and annual occupancy rates for
those beds, separately for adult and pediatric care;
(10) from outpatient
surgical centers, the total number of surgeries; and
(11) a report on health care
capital expenditures during the previous year, as required by section 62J.17.
(b) Beginning with hospital
fiscal year 2009, each nonprofit hospital shall report on community benefits
under paragraph (a), clause (5). "Community benefit" means the costs
of community care, underpayment for services provided under state health care
programs, research costs, community health services costs, financial and
in-kind contributions, costs of community building activities, costs of
community benefit operations, education, and the cost of operating subsidized
services. The cost of bad debts and underpayment for Medicare services are not
included in the calculation of community benefit.
Sec. 26. Minnesota Statutes
2006, section 144.699, is amended by adding a subdivision to read:
Subd. 5. Annual reports on community benefit, community care amounts, and
state program underfunding. (a) For each hospital reporting health
care cost information under section 144.698 or 144.702, the commissioner shall
report annually on the hospital's community benefit, community care, and
underpayment for state public health care programs.
(b) For purposes of this
subdivision, "community benefits" has the definition given in section
144.698, paragraph (b).
(c) For purposes of this subdivision,
"community care" means the costs for medical care for which a
hospital has determined is charity care, as defined under Minnesota Rules, part
4650.0115, or for which the hospital determines after billing for the services
that there is a demonstrated inability to pay. Any costs forgiven under a
hospital's community care plan or under section 62J.83 may be counted in the
hospital's calculation of community care. Bad debt expenses and discounted
charges available to the uninsured shall not be included in the calculation of
community care. The amount of community care is the value of costs incurred and
not the charges made for services.
(d) For purposes of this
subdivision, underpayment for services provided by state public health care
programs is the difference between hospital costs and public program payments.
The information shall be reported in terms of total dollars and as a percentage
of total operating costs for each hospital.
Sec. 27. Minnesota Statutes
2006, section 256.01, subdivision 2b, is amended to read:
Subd. 2b. Performance payments. (a) The
commissioner shall develop and implement a pay-for-performance system to
provide performance payments to:
(1) eligible medical groups and
clinics that demonstrate optimum care in serving individuals with chronic
diseases who are enrolled in health care programs administered by the
commissioner under chapters 256B, 256D, and 256L.;
(2) medical groups that
implement effective medical home models of patient care that improve quality
and reduce costs through effective primary and preventive care, care
coordination, and management of chronic conditions; and
(3) eligible medical groups
and clinics that evaluate medical provider usage patterns and provide feedback
to individual medical providers on that provider's practice patterns relative
to peer medical providers.
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(b) The commissioner shall
also develop and implement a patient incentive health program to provide
incentives and rewards to patients who are enrolled in health care programs
administered by the commissioner under chapters 256B, 256D, and 256L, and who
have agreed to and meet personal health goals established with their primary
care provider to manage a chronic disease or condition including, but not
limited to, diabetes, high blood pressure, and coronary artery disease.
(c) The commissioner may
receive any federal matching money that is made available through the medical
assistance program for managed care oversight contracted through vendors
including consumer surveys, studies, and external quality reviews as required
by the Federal Balanced Budget Act of 1997, Code of Federal Regulations, title
42, part 438, subpart E. Any federal money received for managed care oversight
is appropriated to the commissioner for this purpose. The commissioner may
expend the federal money received in either year of the biennium.
EFFECTIVE DATE. This section is
effective July 1, 2007.
Sec. 28. Minnesota Statutes
2006, section 256B.0625, is amended by adding a subdivision to read:
Subd. 49. Provider-directed care coordination services. The
commissioner shall develop and implement a provider-directed care coordination
program for medical assistance recipients who are not enrolled in the prepaid
medical assistance program and who are receiving services on a fee-for-service
basis. This program provides payment to primary care clinics for care
coordination for people who have complex and chronic medical conditions.
Clinics must meet certain criteria such as the capacity to develop care plans;
have a dedicated care coordinator; and have an adequate number of
fee-for-service clients, evaluation mechanisms, and quality improvement
processes to qualify for reimbursement. For purposes of this subdivision, a
primary care clinic is a medical clinic designated as the patient's first point
of contact for medical care, available 24 hours a day, seven days a week, that
provides or arranges for the patient's comprehensive health care needs, and provides
overall integration, coordination and continuity over time and referrals for
specialty care.
Sec. 29. Minnesota Statutes
2006, section 256L.01, subdivision 4, is amended to read:
Subd. 4. Gross individual or gross family income.
(a) "Gross individual or gross family income" for nonfarm
self-employed means income calculated for the six-month period of eligibility
using the net profit or loss reported on the applicant's federal income tax
form for the previous year and using the medical assistance families with
children methodology for determining allowable and nonallowable self-employment
expenses and countable income.
(b) "Gross individual
or gross family income" for farm self-employed means income calculated for
the six-month period of eligibility 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 amounts that apply to the
business in which the family is currently engaged.
(c) "Gross individual
or gross family income" means the total income for all family members,
calculated for the six-month period of eligibility.
EFFECTIVE DATE. This section is
effective July 1, 2007.
Sec. 30. HEALTH CARE PAYMENT SYSTEM REFORM.
Subdivision 1. Payment reform plan. The commissioners of employee
relations, human services, commerce, and health shall develop a plan for
promoting and facilitating changes in payment rates and methods for paying for
health care services, drugs, devices, supplies, and equipment in order to:
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(1) reward the provision of
cost-effective primary and preventive care;
(2) reward the use of
evidence-based care;
(3) discourage
underutilization, overuse, and misuse;
(4) reward the use of the
most cost-effective settings, drugs, devices, providers, and treatments; and
(5) encourage consumers to
maintain good health and use the health care system appropriately.
In developing the plan, the commissioners
shall analyze existing data to determine specific services and health
conditions for which changes in payment rates and methods would lead to
significant improvements in quality of care.
Subd. 2. Report. The commissioners shall submit a report to the
legislature by December 15, 2007, describing the payment reform plan. The
report must include proposed legislation for implementing those components of
the plan requiring legislative action or appropriations of money.
EFFECTIVE DATE. This section is
effective July 1, 2007.
Sec. 31. COMMUNITY COLLABORATIVE PILOT PROJECTS
TO COVER THE UNINSURED.
Subdivision 1. Community collaboratives. The commissioner of human
services shall provide grants to and authorization for up to three community
collaboratives that satisfy the requirements in this section. To be eligible to
receive a grant and authorization under this section, a community collaborative
must include:
(1) one or more counties;
(2) one or more local
hospitals;
(3) one or more local
employers who collectively provide at least 300 jobs in the community;
(4) one or more health care
clinics or physician groups; and
(5) a third-party payer,
which may be a county-based purchasing plan operating under Minnesota Statutes,
section 256B.692, a self-insured employer, or a health plan company as defined
in Minnesota Statutes, section 62Q.01, subdivision 4.
Subd. 2. Pilot project requirements. (a) Community collaborative
pilot projects must:
(1) identify and enroll
persons in the community who are uninsured, and who have, or are at risk of
developing, one of the following chronic conditions: mental illness, diabetes,
asthma, hypertension, or other chronic condition designated by the project;
(2) assist uninsured persons
to obtain private-sector health insurance coverage if possible or to enroll in
any public health care programs for which they are eligible. If the uninsured
individual is unable to obtain health coverage, the community collaborative
must enroll the individual in a local health care assistance program that
provides specified services to prevent or effectively manage the chronic
condition;
(3) include components to
help uninsured persons retain employment or to become employable, if currently
unemployed;
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(4)
ensure that each uninsured person enrolled in the program has a medical home
responsible for providing, or arranging for, health care services and assisting
in the effective management of the chronic condition;
(5)
coordinate services between all providers and agencies serving an enrolled
individual; and
(6)
be coordinated with the state's Q-Care initiative and improve the use of
evidence-based treatments and effective disease management programs in the
broader community, beyond those individuals enrolled in the project.
(b)
Projects established under this section are not insurance and are not subject
to state-mandated benefit requirements or insurance regulations.
Subd.
3. Criteria. Proposals must be
evaluated by actuarial, financial, and clinical experts based on the likelihood
that the project would produce a positive return on investment for the
community. In awarding grants, the commissioner of human services shall give
preference to proposals that:
(1)
have broad community support from local businesses, provider counties, and
other public and private organizations;
(2)
would provide services to uninsured persons who have, or are at risk of
developing, multiple, co-occurring chronic conditions;
(3)
integrate or coordinate resources from multiple sources, such as employer
contributions, county funds, social service programs, and provider financial or
in-kind support;
(4)
provide continuity of treatment and services when uninsured individuals in the
program become eligible for public or private health insurance or when insured
individuals lose their coverage;
(5)
demonstrate how administrative costs for health plan companies and providers
can be reduced through greater simplification, coordination, consolidation,
standardization, reducing billing errors, or other methods; and
(6)
involve local contributions to the cost of the pilot projects.
Subd.
4. Grants. The commissioner of human
services shall provide implementation grants of up to one-half of the community
collaborative's costs for planning, administration, and evaluation. The
commissioner shall also provide grants to community collaboratives to develop a
fund to pay up to 50 percent of the cost of the services provided to uninsured
individuals. The remaining costs must be paid for through other sources or by
agreement of a health care provider to contribute the cost as charity care.
Subd.
5. Evaluation. The commissioner
of human services shall evaluate the effectiveness of each community
collaborative project awarded a grant, by comparing actual costs for serving
the identified uninsured persons to the predicted costs that would have been
incurred in the absence of early intervention and consistent treatment to
manage the chronic condition, including the costs to medical assistance,
MinnesotaCare, and general assistance medical care. The commissioner shall
require community collaborative projects, as a condition of receipt of a grant
award, to provide the commissioner with all information necessary for this
evaluation.
EFFECTIVE DATE. This section is
effective July 1, 2007.
Sec.
32. HEALTH CARE PAYMENT REFORM PILOT
PROJECTS.
Subdivision
1. Pilot projects. (a) The
commissioners of health, human services, and employee relations shall develop
and administer payment reform pilot projects for state employees and persons
enrolled in medical assistance, MinnesotaCare, or general assistance medical
care, to the extent permitted by federal requirements. The purpose of the
projects is to promote and facilitate changes in payment rates and methods for
paying for health care services, drugs, devices, supplies, and equipment in
order to:
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(1)
reward the provision of cost-effective primary and preventive care;
(2)
reward the use of evidence-based care;
(3)
reward coordination of care for patients with chronic conditions;
(4)
discourage overuse and misuse;
(5)
reward the use of the most cost-effective settings, drugs, devices, providers,
and treatments;
(6)
encourage consumers to maintain good health and use the health care system
appropriately.
(b)
The pilot projects must involve the use of designated care professionals or
clinics to serve as a patient's medical home and be responsible for
coordinating health care services across the continuum of care. The pilot
projects must evaluate different payment reform models and must be coordinated
with the Minnesota senior health options program and the Minnesota disability
health options program. To the extent possible, the commissioners shall
coordinate state purchasing activities with other public employers and with
private purchasers, self-insured groups, and health plan companies to promote
the use of pilot projects encompassing both public and private purchasers and
markets.
Subd.
2. Payment methods and incentives. The
commissioners shall modify existing payment methods and rates for those
enrollees and health care providers participating in the pilot project in order
to provide incentives for care management, team-based care, and practice
redesign, and increase resources for primary care, chronic condition care, and
care provided to complex patients. The commissioners may create financial
incentives for patients to select a medical home under the pilot project by
reducing, modifying, or eliminating deductibles and co-payments for certain
services, or through other incentives. The commissioners may require patients
to remain with their designated medical home for a specified period of time.
Alternative payment methods may include complete or partial capitation,
fee-for-service payments, or other payment methodologies. The payment methods
may provide for the payment of bonuses to medical home providers or other
providers, or to patients, for the achievement of performance goals. The
payment methods may include allocating a portion of the payment that would otherwise
be paid to health plans under state prepaid health care programs to the
designated medical home for specified services.
Subd.
3. Requirements. In order to be
designated a medical home under the pilot project, health care professionals or
clinics must demonstrate their ability to:
(1)
be the patient's first point of contact by telephone or other means, 24 hours a
day, seven days a week;
(2)
provide or arrange for patients' comprehensive health care needs, including the
ability to structure planned chronic disease visits and to manage chronic
disease through the use of disease registries;
(3)
coordinate patients' care when care must be provided outside the medical home;
(4)
provide longitudinal care, not just episodic care, including meeting long-term
and unique personal needs;
(5)
utilize an electronic health record and incorporate a plan to develop and make
available to patients that choose a medical home an electronic personal health
record that is prepopulated with the patient's data, consumer-directed,
connected to the provider, 24-hour accessible, and owned and controlled by the
patient;
(6)
systematically improve quality of care using, among other inputs, patient
feedback; and
(7)
create a provider network that provides for increased reimbursement for a
medical home in a cost-neutral manner.
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Subd.
4. Evaluation. Pilot projects
must be evaluated based on patient satisfaction, provider satisfaction,
clinical process and outcome measures, program costs and savings, and economic
impact on health care providers. Pilot projects must be evaluated based on the
extent to which the medical home:
(1)
coordinated health care services across the continuum of care and thereby
reduced duplication of services and enhanced communication across providers;
(2)
provided safe and high-quality care by increasing utilization of effective
treatments, reduced use of ineffective treatments, reduced barriers to
essential care and services, and eliminated barriers to access;
(3)
reduced unnecessary hospitalizations and emergency room visits and increased
use of cost-effective care and settings;
(4)
encouraged long-term patient and provider relationships by shifting from
episodic care to consistent, coordinated communication and care with a
specified team of providers or individual providers;
(5)
engaged and educated consumers by encouraging shared patient and provider
responsibility and accountability for disease prevention, health promotion,
chronic disease management, acute care, and overall well-being, encouraging
informed medical decision-making, ensuring the availability of accurate medical
information, and facilitated the transfer of accurate medical information;
(6)
encouraged innovation in payment methodologies by using patient and provider
incentives to coordinate care and utilize medical home services and fostering
the expansion of a technology infrastructure that supports collaboration; and
(7)
reduced overall health care costs as compared to conventional payment methods
for similar patient populations.
Subd.
5. Rulemaking. The commissioners
are exempt from administrative rulemaking under chapter 14 for purposes of
developing, administering, contracting for, and evaluating pilot projects under
this section. The commissioner shall publish a proposed request for proposals
in the State Register and allow 30 days for comment before issuing the final
request for proposals.
Subd.
6. Regulatory and payment barriers.
The commissioners shall study state and federal statutory and regulatory
barriers to the creation of medical homes and provide a report and
recommendations to the legislature by December 15, 2007.
Sec.
33. HEALTH CARE SYSTEM CONSOLIDATION.
(a)
The commissioner of health shall study the effect of health care provider and
health plan company consolidation in the four metropolitan statistical areas in
Minnesota on: health care costs, including provider payment rates; quality of
care; and access to care. The commissioner shall separately consider hospitals,
specialty groups, and primary care groups. The commissioner shall present
findings and recommendations to the legislature by December 15, 2007.
(b)
For purposes of this study, health carriers, provider networks, and other health
care providers shall provide data on network participation, contracted payment
rates, charges, costs, payments received, patient referrals, and other
information requested by the commissioner, in the form and manner specified by
the commissioner. Provider-level information on contracted payment rates and
payments from health plans provided to the commissioner of
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health for the purposes of
this study are (1) private data on individuals as defined in Minnesota
Statutes, section 13.02, subdivision 12, and (2) nonpublic data as defined in
Minnesota Statutes, section 13.02, subdivision 9. The commissioner may not
collect patient-identified data for purposes of this study. Data collected for
purposes of this study may not be used for any other purposes.
Sec.
34. REPEALER.
Minnesota
Statutes 2006, section 62J.052, subdivision 1, is repealed effective August 1,
2007.
ARTICLE
10
PUBLIC
HEALTH
Section
1. Minnesota Statutes 2006, section 13.3806, is amended by adding a subdivision
to read:
Subd.
21. Birth defects registry system. Data
on individuals collected by the birth defects registry system are private data
on individuals and classified pursuant to section 144.2215.
Sec.
2. Minnesota Statutes 2006, section 16B.61, is amended by adding a subdivision
to read:
Subd.
3b. Window fall prevention device code.
The commissioner of labor and industry shall adopt rules for window fall
prevention devices as part of the state Building Code. Window fall prevention
devices include, but are not limited to, safety screens, hardware, guards, and
other devices that comply with the standards established by the commissioner of
labor and industry. The rules must require compliance with standards for window
fall prevention devices developed by ASTM International, contained in the
International Building Code as the model language with amendments deemed
necessary to coordinate with the other adopted building codes in Minnesota. The
rules must establish a scope that includes the applicable building occupancies,
and the types, locations, and sizes of windows that will require the
installation of fall devices. The rules will be effective July 1, 2009. The
commissioner shall report to the legislature on the status of the rulemaking on
or before February 15, 2008.
Sec.
3. Minnesota Statutes 2006, section 103I.101, subdivision 6, is amended to
read:
Subd.
6. Fees for variances. The commissioner
shall charge a nonrefundable application fee of $175 $215 to
cover the administrative cost of processing a request for a variance or
modification of rules adopted by the commissioner under this chapter.
EFFECTIVE DATE. This section is effective
July 1, 2008.
Sec.
4. Minnesota Statutes 2006, section 103I.208, subdivision 1, is amended to
read:
Subdivision
1. Well notification fee. The well
notification fee to be paid by a property owner is:
(1)
for a new water supply well, $175 $215, which includes the state
core function fee;
(2)
for a well sealing, $35 $50 for each well, which includes the
state core function fee, except that for monitoring wells constructed on a
single property, having depths within a 25 foot range, and sealed within 48
hours of start of construction, a single fee of $35 $50; and
(3)
for construction of a dewatering well, $175 $215, which includes
the state core function fee, for each dewatering well except a dewatering
project comprising five or more dewatering wells shall be assessed a single fee
of $875 $1,075 for the dewatering wells recorded on the
notification.
EFFECTIVE DATE. This section is
effective July 1, 2008.
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Sec.
5. Minnesota Statutes 2006, section 103I.208, subdivision 2, is amended to
read:
Subd.
2. Permit fee. The permit fee to be
paid by a property owner is:
(1)
for a water supply well that is not in use under a maintenance permit, $150
$175 annually;
(2)
for construction of a monitoring well, $175 $215, which includes
the state core function fee;
(3)
for a monitoring well that is unsealed under a maintenance permit, $150
$175 annually;
(4)
for monitoring wells used as a leak detection device at a single motor fuel retail
outlet, a single petroleum bulk storage site excluding tank farms, or a single
agricultural chemical facility site, the construction permit fee is $175
$215, which includes the state core function fee, per site regardless of
the number of wells constructed on the site, and the annual fee for a
maintenance permit for unsealed monitoring wells is $150 $175 per
site regardless of the number of monitoring wells located on site;
(5)
for a groundwater thermal exchange device, in addition to the notification fee
for water supply wells, $175 $215, which includes the state core
function fee;
(6)
for a vertical heat exchanger, $175 $215;
(7)
for a dewatering well that is unsealed under a maintenance permit, $150
$175 annually for each dewatering well, except a dewatering project
comprising more than five dewatering wells shall be issued a single permit for $750
$875 annually for dewatering wells recorded on the permit; and
(8)
for an elevator boring, $175 $215 for each boring.
EFFECTIVE DATE. This section is
effective July 1, 2008.
Sec.
6. Minnesota Statutes 2006, section 103I.235, subdivision 1, is amended to
read:
Subdivision
1. Disclosure of wells to buyer. (a)
Before signing an agreement to sell or transfer real property, the seller must
disclose in writing to the buyer information about the status and location of
all known wells on the property, by delivering to the buyer either a statement
by the seller that the seller does not know of any wells on the property, or a
disclosure statement indicating the legal description and county, and a map
drawn from available information showing the location of each well to the
extent practicable. In the disclosure statement, the seller must indicate, for
each well, whether the well is in use, not in use, or sealed.
(b)
At the time of closing of the sale, the disclosure statement information, name
and mailing address of the buyer, and the quartile, section, township, and
range in which each well is located must be provided on a well disclosure
certificate signed by the seller or a person authorized to act on behalf of the
seller.
(c)
A well disclosure certificate need not be provided if the seller does not know
of any wells on the property and the deed or other instrument of conveyance
contains the statement: "The Seller certifies that the Seller does not
know of any wells on the described real property."
(d)
If a deed is given pursuant to a contract for deed, the well disclosure
certificate required by this subdivision shall be signed by the buyer or a
person authorized to act on behalf of the buyer. If the buyer knows of no wells
on the property, a well disclosure certificate is not required if the following
statement appears on the deed followed by the signature of the grantee or, if
there is more than one grantee, the signature of at least one of the grantees:
"The Grantee certifies that the Grantee does not know of any wells on the
described real property." The statement and signature of the grantee may
be on the front or back of the deed or on an attached sheet and an
acknowledgment of the statement by the grantee is not required for the deed to
be recordable.
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(e) This subdivision does not
apply to the sale, exchange, or transfer of real property:
(1) that consists solely of
a sale or transfer of severed mineral interests; or
(2) that consists of an
individual condominium unit as described in chapters 515 and 515B.
(f) For an area owned in
common under chapter 515 or 515B the association or other responsible person
must report to the commissioner by July 1, 1992, the location and status of all
wells in the common area. The association or other responsible person must
notify the commissioner within 30 days of any change in the reported status of
wells.
(g) For real property sold
by the state under section 92.67, the lessee at the time of the sale is
responsible for compliance with this subdivision.
(h) If the seller fails to
provide a required well disclosure certificate, the buyer, or a person
authorized to act on behalf of the buyer, may sign a well disclosure
certificate based on the information provided on the disclosure statement
required by this section or based on other available information.
(i) A county recorder or
registrar of titles may not record a deed or other instrument of conveyance
dated after October 31, 1990, for which a certificate of value is required
under section 272.115, or any deed or other instrument of conveyance dated
after October 31, 1990, from a governmental body exempt from the payment of
state deed tax, unless the deed or other instrument of conveyance contains the
statement made in accordance with paragraph (c) or (d) or is accompanied by the
well disclosure certificate containing all the information required by
paragraph (b) or (d). The county recorder or registrar of titles must not
accept a certificate unless it contains all the required information. The
county recorder or registrar of titles shall note on each deed or other
instrument of conveyance accompanied by a well disclosure certificate that the
well disclosure certificate was received. The notation must include the
statement "No wells on property" if the disclosure certificate states
there are no wells on the property. The well disclosure certificate shall not
be filed or recorded in the records maintained by the county recorder or
registrar of titles. After noting "No wells on property" on the deed
or other instrument of conveyance, the county recorder or registrar of titles
shall destroy or return to the buyer the well disclosure certificate. The
county recorder or registrar of titles shall collect from the buyer or the
person seeking to record a deed or other instrument of conveyance, a fee of $40
$45 for receipt of a completed well disclosure certificate. By the tenth
day of each month, the county recorder or registrar of titles shall transmit
the well disclosure certificates to the commissioner of health. By the tenth
day after the end of each calendar quarter, the county recorder or registrar of
titles shall transmit to the commissioner of health $32.50 $37.50
of the fee for each well disclosure certificate received during the quarter.
The commissioner shall maintain the well disclosure certificate for at least
six years. The commissioner may store the certificate as an electronic image. A
copy of that image shall be as valid as the original.
(j) No new well disclosure
certificate is required under this subdivision if the buyer or seller, or a
person authorized to act on behalf of the buyer or seller, certifies on the
deed or other instrument of conveyance that the status and number of wells on
the property have not changed since the last previously filed well disclosure
certificate. The following statement, if followed by the signature of the
person making the statement, is sufficient to comply with the certification
requirement of this paragraph: "I am familiar with the property described
in this instrument and I certify that the status and number of wells on the
described real property have not changed since the last previously filed well
disclosure certificate." The certification and signature may be on the
front or back of the deed or on an attached sheet and an acknowledgment of the statement
is not required for the deed or other instrument of conveyance to be
recordable.
(k) The commissioner in
consultation with county recorders shall prescribe the form for a well
disclosure certificate and provide well disclosure certificate forms to county
recorders and registrars of titles and other interested persons.
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(l) Failure to comply with a
requirement of this subdivision does not impair:
(1) the validity of a deed
or other instrument of conveyance as between the parties to the deed or
instrument or as to any other person who otherwise would be bound by the deed
or instrument; or
(2) the record, as notice,
of any deed or other instrument of conveyance accepted for filing or recording
contrary to the provisions of this subdivision.
EFFECTIVE DATE. This section is
effective July 1, 2008.
Sec. 7. Minnesota Statutes
2006, section 144.123, is amended to read:
144.123 FEES FOR DIAGNOSTIC LABORATORY SERVICES; EXCEPTIONS.
Subdivision 1. Who must pay. Except for the limitation
contained in this section, the commissioner of health shall charge a handling
fee for each specimen submitted to the Department of Health for analysis for
diagnostic purposes by any hospital, private laboratory, private clinic, or
physician. No fee shall be charged to any entity which receives direct or
indirect financial assistance from state or federal funds administered by the
Department of Health, including any public health department, nonprofit community
clinic, venereal sexually transmitted disease clinic, family
planning clinic, or similar entity. No fee will be charged for any
biological materials submitted to the Department of Health as a requirement of Minnesota
Rules, part 4605.7040, or for those biological materials requested by the
department to gather information for disease prevention or control purposes. The
commissioner of health may establish by rule other exceptions to the
handling fee as may be necessary to gather information for epidemiologic
purposes protect the public's health. All fees collected pursuant to
this section shall be deposited in the state treasury and credited to the state
government special revenue fund.
Subd. 2. Rules for Fee amounts. The
commissioner of health shall promulgate rules, in accordance with chapter
14, which shall specify the amount of the charge a handling fee
prescribed in subdivision 1. The fee shall approximate the costs to the
department of handling specimens including reporting, postage, specimen kit
preparation, and overhead costs. The fee prescribed in subdivision 1 shall be $15
$25 per specimen until the commissioner promulgates rules pursuant to
this subdivision.
Sec. 8. Minnesota Statutes
2006, section 144.125, is amended to read:
144.125 TESTS OF INFANTS FOR HERITABLE AND CONGENITAL DISORDERS.
Subdivision 1. Duty to perform testing. It is the duty
of (1) the administrative officer or other person in charge of each institution
caring for infants 28 days or less of age, (2) the person required in pursuance
of the provisions of section 144.215, to register the birth of a child, or (3)
the nurse midwife or midwife in attendance at the birth, to arrange to have
administered to every infant or child in its care tests for heritable and
congenital disorders according to subdivision 2 and rules prescribed by the
state commissioner of health. Testing and the recording and reporting of test
results shall be performed at the times and in the manner prescribed by the
commissioner of health. The commissioner shall charge laboratory service
fees a fee so that the total of fees collected will approximate the
costs of conducting the tests and implementing and maintaining a system to
follow-up infants with heritable or congenital disorders. The laboratory
service fee is $61 $101 per specimen. Costs associated with
capital expenditures and the development of new procedures may be prorated over
a three-year period when calculating the amount of the fees.
Subd.
2. Determination of tests to be
administered. The commissioner shall periodically revise the list of tests
to be administered for determining the presence of a heritable or congenital
disorder. Revisions to the list shall reflect advances in medical science, new
and improved testing methods, or other factors that will improve the public
health. In determining whether a test must be administered, the commissioner
shall take into consideration the
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adequacy of laboratory
analytical methods to detect the heritable or congenital disorder, the
ability to treat or prevent medical conditions caused by the heritable or
congenital disorder, and the severity of the medical conditions caused by the
heritable or congenital disorder. The list of tests to be performed may be
revised if the changes are recommended by the advisory committee established
under section 144.1255, approved by the commissioner, and published in the
State Register. The revision is exempt from the rulemaking requirements in
chapter 14, and sections 14.385 and 14.386 do not apply.
Subd.
3. Objection of parents to test.
Persons with a duty to perform testing under subdivision 1 shall advise parents
of infants (1) that the blood or tissue samples used to perform testing
thereunder as well as the results of such testing may be retained by the
Department of Health, (2) the benefit of retaining the blood or tissue sample,
and (3) that the following options are available to them with respect to the
testing: (i) to decline to have the tests, or (ii) to elect to have the tests
but to require that all blood samples and records of test results be destroyed
within 24 months of the testing. If the parents of an infant object in writing
to testing for heritable and congenital disorders or elect to require that
blood samples and test results be destroyed, the objection or election shall be
recorded on a form that is signed by a parent or legal guardian and made part
of the infant's medical record. A written objection exempts an infant from the
requirements of this section and section 144.128.
Sec.
9. Minnesota Statutes 2006, section 144.2215, subdivision 1, is amended to
read:
Subdivision
1. Establishment. Within the limits
of available appropriations, the commissioner of health shall establish and
maintain an information system containing data on the cause, treatment,
prevention, and cure of major birth defects. The commissioner shall consult
with representatives and experts in epidemiology, medicine, insurance, health
maintenance organizations, genetics, consumers, and voluntary organizations in
developing the system and may phase in the implementation of the system. After
the parents have provided informed consent under section 144.2216, subdivision
4, the commissioner shall offer the parents with their informed consent a visit
by a trained health care worker to interview the parents about:
(1)
all previous home addresses, occupations, and places of work including from
childhood;
(2)
the time and place of any military service; and
(3)
known occasions or sites of toxic exposures.
Sec.
10. Minnesota Statutes 2006, section 144.672, subdivision 1, is amended to
read:
Subdivision
1. Rule authority. The commissioner
of health shall collect cancer incidence information, analyze the information,
and conduct special studies designed to determine the potential public health
significance of an increase in cancer incidence.
The
commissioner shall adopt rules to administer the system, collect information,
and distribute data. The rules must include, but not be limited to, the
following:
(1)
the type of data to be reported, which must include current and previous
occupational data;
(2)
standards for reporting specific types of data;
(3)
payments allowed to hospitals, pathologists, and registry systems to defray
their costs in providing information to the system;
(4)
criteria relating to contracts made with outside entities to conduct studies
using data collected by the system. The criteria may include requirements for a
written protocol outlining the purpose and public benefit of the study, the
description, methods, and projected results of the study, peer review by other
scientists, the methods and facilities to protect the privacy of the data, and
the qualifications of the researcher proposing to undertake the study; and
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(5)
specification of fees to be charged under section 13.03, subdivision 3, for all
out-of-pocket expenses for data summaries or specific analyses of data
requested by public and private agencies, organizations, and individuals, and
which are not otherwise included in the commissioner's annual summary reports.
Fees collected are appropriated to the commissioner to offset the cost of
providing the data.
Sec.
11. Minnesota Statutes 2006, section 144.9502, subdivision 3, is amended to
read:
Subd.
3. Reports of blood lead analysis
required. (a) Every hospital, medical clinic, medical laboratory, 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):
(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 ten micrograms of lead per
deciliter of whole blood; or
(2)
within one month in writing or by electronic transmission, for any capillary
result or for a venous blood lead level less than 15 ten
micrograms of lead per deciliter of whole blood.
(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.
12. Minnesota Statutes 2006, section 144.9504, subdivision 2, is amended to
read:
Subd.
2. Lead risk assessment. (a) An
assessing agency shall conduct a lead risk assessment of a residence according
to the venous blood lead level and time frame set forth in clauses (1) to (4)
for purposes of secondary prevention:
(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 60
45 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 15 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 15
ten micrograms of lead per deciliter of whole blood; or
(4)
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 local, state, and federal appropriations, an
assessing agency may also conduct a lead risk assessment for children with any
elevated blood lead level.
(c)
In a building with two or more dwelling units, an assessing agency shall assess
the individual unit in which the conditions of this section are met and shall inspect
all common areas accessible to a child. 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 assessing agency shall also inspect the
other sites. The assessing agency shall have one additional day added to the
time frame set forth in this subdivision to complete the lead risk assessment
for each additional site.
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(d)
Within the limits of appropriations, the 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 15 ten 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 primary prevention information. Within
the limits of appropriations, the assessing agency may perform a risk
assessment and issue corrective orders in the properties, if it is likely that
the previous address contributed to the child's or pregnant female's blood lead
level. The assessing agency shall provide the notice required by this
subdivision without identifying the child or pregnant female with the elevated
blood lead level. The 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.
(e)
The assessing agency shall conduct the lead risk assessment according to rules
adopted by the commissioner under section 144.9508. An assessing agency shall
have lead risk assessments performed by lead risk assessors licensed by the
commissioner according to rules adopted under section 144.9508. If a property
owner refuses to allow a lead risk assessment, the assessing agency shall begin
legal proceedings to gain entry to the property and the time frame for
conducting a lead risk assessment set forth in this subdivision no longer
applies. A lead risk assessor or 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 must be tested with appropriate analytical equipment 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 another
probable source of lead exposure is not identified. 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)
Each 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 assessing agency. Assessing agencies must consider appeals that
propose lower cost methods that make the residence lead safe. The commissioner
shall use the authority and appeal procedure granted under sections 144.989 to
144.993.
(g)
Sections 144.9501 to 144.9509 neither authorize nor prohibit an assessing
agency from charging a property owner for the cost of a lead risk assessment.
Sec.
13. Minnesota Statutes 2006, section 144.9507, is amended by adding a
subdivision to read:
Subd.
6. Medical assistance. Medical
assistance reimbursement for lead risk assessment services under section
256B.0625, subdivision 49, shall not be used to replace or decrease existing state
or local funding for lead services and lead-related activities.
Sec.
14. Minnesota Statutes 2006, section 144.9512, is amended to read:
144.9512 LEAD ABATEMENT
PROGRAM.
Subdivision
1. Definitions. (a) The definitions
in section 144.9501 and in this subdivision apply to this section.
(b)
"Eligible organization" means a lead contractor, city, board of
health, community health department, community action agency as defined in
section 256E.30, or community development corporation.
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(c) "Commissioner"
means the commissioner of health, or the commissioner of the Minnesota
Housing Finance Agency as authorized by section 462A.05, subdivision 15c.
Subd. 2. Grants; administration. Within the
limits of the available appropriation, the commissioner must develop a swab
team services program which may shall make demonstration and
training grants to eligible organizations a nonprofit
organization currently operating the CLEARCorps lead hazard reduction project to
train workers to provide swab team services and swab team services for
residential property. Grants may be awarded to nonprofit organizations to
provide technical assistance and training to ensure quality and consistency
within the statewide program. Grants must be awarded to help ensure full-time
employment to workers providing swab team services and must be awarded for a
two-year period.
Grants awarded under this
section must be made in consultation with the commissioner of the Housing
Finance Agency and representatives of neighborhood groups from areas at high
risk for toxic lead exposure, a labor organization, the lead coalition,
community action agencies, and the legal aid society. The consulting team must
review grant applications and recommend awards to eligible organizations that
meet requirements for receiving a grant under this section.
Subd. 3. Applicants. (a) Interested eligible organizations may
apply to the commissioner for grants under this section. Two or more eligible
organizations may jointly apply for a grant. Priority shall be given to
community action agencies in greater Minnesota and to either community action
agencies or neighborhood based nonprofit organizations in cities of the first class.
Of the total annual appropriation, 12.5 percent may be used for administrative
purposes. The commissioner may deviate from this percentage if a grantee can
justify the need for a larger administrative allowance. Of this amount, up to
five percent may be used by the commissioner for state administrative purposes.
Applications must provide information requested by the commissioner, including
at least the information required to assess the factors listed in paragraph
(d).
(b) The commissioner must
consult with boards of health to provide swab team services for purposes of
secondary prevention. The priority for swab teams created by grants to eligible
organizations under this section must be work assigned by the commissioner of
health, or by a board of health if so designated by the commissioner of health,
to provide secondary prevention swab team services to fulfill the requirements
of section 144.9504, subdivision 6, in response to a lead order. Swab teams
assigned work under this section by the commissioner, that are not engaged
daily in fulfilling the requirements of section 144.9504, subdivision 6, must
deliver swab team services in response to elevated blood lead levels as defined
in section 144.9501, subdivision 9, where lead orders were not issued, and for
purposes of primary prevention in census tracts known to be in areas at high
risk for toxic lead exposure as described in section 144.9503, subdivision 2.
(c) Any additional money
must be used for grants to establish swab teams for primary prevention under
section 144.9503, in census tracts in areas at high risk for toxic lead
exposure as determined under section 144.9503, subdivision 2.
(d) In evaluating grant
applications, the commissioner must consider the following criteria:
(1) the use of lead
contractors and lead workers for residential swab team services;
(2) the participation of
neighborhood groups and individuals, as swab team workers, in areas at high
risk for toxic lead exposure;
(3) plans for the provision
of swab team services for primary and secondary prevention as required under
subdivision 4;
(4) plans for supervision,
training, career development, and postprogram placement of swab team members;
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(5)
plans for resident and property owner education on lead safety;
(6)
plans for distributing cleaning supplies to area residents and educating
residents and property owners on cleaning techniques;
(7)
sources of other funding and cost estimates for training, lead inspections,
swab team services, equipment, monitoring, testing, and administration;
(8)
measures of program effectiveness;
(9)
coordination of program activities with other federal, state, and local public
health, job training, apprenticeship, and housing renovation programs including
programs under sections 116L.86 to 116L.881; and
(10)
prior experience in providing swab team services.
Subd.
4. Lead supervisor or certified firm
Eligible grant activities. (a) Eligible organizations and lead supervisors
or certified firms may participate in the swab team program. An eligible
organization The nonprofit receiving a grant under this section must
assure ensure that all participating lead supervisors or
certified firms are licensed and that all swab team workers are certified by
the Department of Health under section 144.9505. Eligible organizations and
lead supervisors or certified firms may distinguish between interior and
exterior services in assigning duties and The nonprofit organization
may participate in the program by:
(1)
providing on-the-job training for swab team workers;
(2)
providing swab team services to meet the requirements of sections 144.9503,
subdivision 4, and 144.9504, subdivision 6;
(3)
providing a removal and replacement component using skilled craft workers
under subdivision 7 lead hazard reduction to meet the requirements of
section 144.9501, subdivision 17;
(4)
providing lead testing according to subdivision 8;
(5) (4) providing lead dust cleaning
supplies cleanup equipment and materials, as described in section 144.9507
144.9503, subdivision 4, paragraph (c) 1, to residents; or
(6) (5) having a swab team worker
instruct residents and property owners on appropriate lead control techniques,
including the lead-safe directives developed by the commissioner of health.;
(6)
conducting blood lead testing events including screening children and pregnant
women according to Department of Health screening guidelines;
(7)
performing case management services according to Department of Health case
management guidelines; or
(8)
conducting mandated risk assessments under Minnesota Statutes, section
144.9504, subdivision 2.
(b)
Participating lead supervisors or certified firms must:
(1)
demonstrate proof of workers' compensation and general liability insurance
coverage;
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(2) be knowledgeable about
lead abatement requirements established by the Department of Housing and Urban
Development and the Occupational Safety and Health Administration and lead
hazard reduction requirements and lead-safe directives of the commissioner of
health;
(3) demonstrate experience
with on-the-job training programs;
(4) demonstrate an ability
to recruit employees from areas at high risk for toxic lead exposure; and
(5) demonstrate experience
in working with low-income clients.
Subd. 5. Swab team workers. Each worker engaged
in swab team services established under this section must have blood lead concentrations
below 15 micrograms of lead per deciliter of whole blood as determined by a
baseline blood lead screening. Any The nonprofit organization
receiving a grant under this section is responsible for lead screening and must
assure ensure that all swab team workers meet the standards
established in this subdivision. Grantees The nonprofit organization
must use appropriate workplace procedures including following the lead-safe
directives developed by the commissioner of health to reduce risk of elevated
blood lead levels. Grantees The nonprofit organization and
participating contractors must report all employee blood lead levels that
exceed 15 micrograms of lead per deciliter of whole blood to the commissioner
of health.
Subd. 6. On-the-job training component. (a) Programs established
under this section must provide on-the-job training for swab team workers.
(b) Swab team workers must
receive monetary compensation equal to the prevailing wage as defined in
section 177.42, subdivision 6, for comparable jobs in the licensed contractor's
principal business.
Subd. 7. Removal and replacement component. (a) Within the limits
of the available appropriation and if a need is identified by a lead inspector,
the commissioner may establish a component for removal and replacement of
deteriorated paint in residential properties according to the following
criteria:
(1) components within a
residence must have both deteriorated lead-based paint and substrate damage
beyond repair or rotting wooden framework to be eligible for removal and
replacement;
(2) all removal and
replacement must be done using least-cost methods and following lead-safe
directives;
(3) whenever windows and
doors or other components covered with deteriorated lead-based paint have sound
substrate or are not rotting, those components should be repaired, sent out for
stripping, planed down to remove deteriorated lead-based paint, or covered with
protective guards instead of being replaced, provided that such an activity is
the least-cost method of providing the swab team service;
(4) removal and replacement
or repair must be done by lead contractors using skilled craft workers or
trained swab team members; and
(5) all craft work that
requires a state license must be supervised by a person with a state license in
the craft work being supervised. The grant recipient may contract for this
supervision.
(b) The program design must:
(1) identify the need for
on-the-job training of swab team workers to be removal and replacement workers;
and
(2) describe plans to
involve appropriate groups in designing methods to meet the need for training
swab team workers.
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Subd. 8. Testing and evaluation. (a) Testing of the environment is
not necessary by swab teams whose work is assigned by the commissioner of
health or a designated board of health under section 144.9504. The commissioner
of health or designated board of health must share the analytical testing data
collected on each residence for purposes of secondary prevention under section
144.9504 with the swab team workers in order to provide constructive feedback
on their work and to the commissioner for the purposes set forth in paragraph
(c).
(b) For purposes of primary
prevention evaluation, the following samples must be collected: pretesting and
posttesting of one noncarpeted floor dust lead sample and a notation of the
extent and location of bare soil and of deteriorated lead-based paint. The analytical
testing data collected on each residence for purposes of primary prevention
under section 144.9503 must be shared with the swab team workers in order to
provide constructive feedback on their work and to the commissioner for the
purposes set forth in paragraph (c).
(c) The commissioner of
health must establish a program to collect appropriate data as required under
paragraphs (a) and (b), in order to conduct an ongoing evaluation of swab team
services for primary and secondary prevention. Within the limits of available
appropriations, the commissioner of health must conduct on up to 1,000
residences which have received primary or secondary prevention swab team
services, a postremediation evaluation, on at least a quarterly basis for a
period of at least two years for each residence. The evaluation must note the
condition of the paint within the residence, the extent of bare soil on the
grounds, and collect and analyze one noncarpeted floor dust lead sample. The
data collected must be evaluated to determine the efficacy of providing swab
team services as a method of reducing lead exposure in young children. In
evaluating this data, the commissioner of health must consider city size,
community location, historic traffic flow, soil lead level of the property by
area or census tract, distance to industrial point sources that emit lead,
season of the year, age of the housing, age and number of children living at
the residence, the presence of pets that move in and out of the residence, and
other relevant factors as the commissioner of health may determine.
Subd. 9. Program benefits. As a condition of
providing swab team services under this section, an the nonprofit
organization may require a property owner to not increase rents on a property
solely as a result of a substantial improvement made with public funds under
the programs in this section.
Subd. 10. Requirements of organizations receiving
grants the nonprofit organization. An eligible The
nonprofit organization that is awarded a training and demonstration
grant under this section must prepare and submit a quarterly progress report to
the commissioner beginning three months after receipt of the grant.
Sec. 15. [144.966] EARLY HEARING DETECTION AND
INTERVENTION ACT.
Subdivision 1. Definitions. (a) "Child" means a person 18
years of age or younger.
(b) "False positive
rate" means the proportion of infants identified as having a significant
hearing loss by the screening process who are ultimately found to not have a
significant hearing loss.
(c) "False negative
rate" means the proportion of infants not identified as having a
significant hearing loss by the screening process who are ultimately found to
have a significant hearing loss.
(d) "Hearing screening
test" means automated auditory brain stem response, otoacoustic emissions,
or another appropriate screening test approved by the Department of Health.
(e) "Hospital"
means a birthing health care facility or birthing center licensed in this state
that provides obstetrical services.
(f) "Infant" means
a child who is not a newborn and has not attained the age of one year.
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(g)
"Newborn" means an infant 28 days old or younger.
(h)
"Parent" means a natural parent, stepparent, adoptive parent,
guardian, or custodian of a newborn or infant.
Subd.
2. Newborn Hearing Screening Advisory
Committee. (a) The commissioner of health shall appoint a Newborn
Hearing Screening Advisory Committee to advise and assist the Department of
Health and the Department of Education in:
(1)
developing protocols and timelines for screening, rescreening, and diagnostic
audiological assessment and early medical, audiological, and educational
intervention services for children who are deaf or hard-of-hearing;
(2)
designing protocols for tracking children from birth through age three that may
have passed newborn screening but are at risk for delayed or late onset of
permanent hearing loss;
(3)
designing a technical assistance program to support facilities implementing the
screening program and facilities conducting rescreening and diagnostic
audiological assessment;
(4)
designing implementation and evaluation of a system of follow-up and tracking;
and
(5)
evaluating program outcomes to increase effectiveness and efficiency and ensure
culturally appropriate services for children with a confirmed hearing loss and
their families.
(b)
Membership of the committee shall include at least one member from each of the
following groups with no less than two of the members being deaf or
hard-of-hearing:
(1)
a representative from a consumer organization representing culturally deaf
persons;
(2)
a parent with a child with hearing loss representing a parent organization;
(3)
a consumer from an organization representing oral communication options;
(4)
a consumer from an organization representing cued speech communication options;
(5)
an audiologist who has experience in evaluation and intervention of infants and
young children;
(6)
a speech-language pathologist who has experience in evaluation and intervention
of infants and young children;
(7)
two primary care providers who have experience in the care of infants and young
children, one of which shall be a pediatrician;
(8)
a representative from the early hearing detection intervention teams;
(9)
a representative from the Department of Education resource center for the deaf
and hard-of-hearing or their designee;
(10)
a representative of the Minnesota Commission Serving Deaf and Hard of Hearing
People;
(11)
a representative from the Department of Human Services Deaf and Hard of Hearing
Services Division;
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(12) one or more of the Part
C coordinators from the Department of Education, the Department of Health, or
the Department of Human Services or their designee;
(13) the Department of
Health early hearing detection and intervention coordinator;
(14) two birth hospital
representatives from one rural and one urban hospital;
(15) a pediatric geneticist;
(16) an otolaryngologist;
(17) a representative from
the Newborn Screening Advisory Committee under this subdivision; and
(18) a representative of the
Department of Education regional low-incidence facilitators.
The Department of Health
member shall chair the first meeting of the committee. At the first meeting,
the committee shall elect a chairperson from its membership. The committee
shall meet at the call of the chairperson, at least four times a year. The
committee shall adopt written bylaws to govern its activities. The Department
of Health shall provide technical and administrative support services as
required by the committee. These services shall include technical support from
individuals qualified to administer infant hearing screening, rescreening, and
diagnostic audiological assessments.
Members of the committee
shall receive no compensation for their service, but shall be reimbursed for
expenses incurred as a result of their duties as members of the committee.
Subd. 3. Newborn and infant hearing screening programs. All
hospitals shall establish a Universal Newborn Hearing and Infant Screening
(UNHS) program. Each UNHS program shall:
(1) in advance of any
hearing screening testing, provide to the newborn's or infant's parents
information concerning the nature of the screening procedure, applicable costs
of the screening procedure, the potential risks and effects of hearing loss,
and the benefits of early detection and intervention;
(2) comply with parental
consent under section 144.125, subdivision 3;
(3) develop policies and
procedures for screening and rescreening based on Department of Health
recommendations;
(4) provide appropriate
training and monitoring of individuals responsible for performing hearing
screening tests as recommended by the Department of Health;
(5) test the newborn's
hearing prior to discharge, or, if the newborn is expected to remain in the
hospital for a prolonged period, testing shall be performed prior to three
months of age, or when medically feasible;
(6) develop and implement
procedures for documenting the results of all hearing screening tests;
(7) inform the baby's
parents or parent, primary care physician, and the Department of Health
according to recommendations of the Department of Health of the results of the
hearing screening test or rescreening if conducted, or if the newborn or infant
was not successfully tested. The hospital that discharges the baby to home is
responsible for the screening; and
(8) collect performance data
specified by the Department of Health.
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Subd.
4. Notification and information. (a)
Notification to the parents, primary care provider, and Department of Health
shall occur prior to discharge or no later than ten days following the date of
testing. Notification shall include information recommended by the Department
of Health.
(b)
A physician, nurse, midwife, or other health professional attending a birth
outside a hospital or institution shall provide information, orally and in
writing, as established by the Department of Health, to parents regarding
places where the parents may have their infants' hearing screened and the
importance of such screening.
(c)
The professional conducting the diagnostic procedure to confirm the hearing
loss must report the results to the parents, primary care provider, and
Department of Health according to the Department of Health recommendations.
Subd.
5. Oversight responsibility. The
Department of Health shall exercise oversight responsibility for UNHS programs,
including establishing a performance data set and reviewing performance data
collected by each hospital.
Subd.
6. Civil and criminal immunity and
penalties. (a) No physician or hospital shall be civilly or
criminally liable for failure to conduct hearing screening testing.
(b)
No physician, midwife, nurse, other health professional, or hospital acting in
compliance with this section shall be civilly or criminally liable for any acts
conforming with this section, including furnishing information required
according to this section.
Subd.
7. Laboratory service fees. The
commissioner shall charge laboratory service fees according to section 16A.1285
so that the total of fees collected will approximate the costs of implementing
and maintaining a system to follow up infants, provide technical assistance, a
tracking system, data management, and evaluation.
EFFECTIVE DATE. This section is
effective the day following final enactment.
Sec.
16. [144.967] ARSENIC HEALTH RISK
STANDARD.
Subdivision
1. Arsenic health risk standard
established. The commissioner of health in cooperation with the
commissioners of agriculture and the Pollution Control Agency responsible for
monitoring land and water cleanup and soil contamination information shall
determine a health risk standard for human exposure to arsenic. The
commissioner of health shall ensure that the established arsenic health risk
standard is included in all information provided to the public.
Subd.
2. Information. The commissioner
of health, in consultation with the commissioners of agriculture and the Pollution
Control Agency with jurisdiction over soil and water contamination, shall
establish a central information source available to the public to provide
accurate information on arsenic soil and water contamination in residential
areas.
Subd.
3. Testing for arsenic. (a) The
commissioner of health shall ensure access to medical testing for arsenical
pesticide exposure to persons living within one mile of the CMC Heartland Lite
Yard Superfund site who are not covered by health insurance or medical assistance.
(b)
Through an agreement with the United States Environmental Protection Agency,
the commissioner shall ensure soil testing is available to households within
one mile of the CMC Heartland Lite Yard Superfund site at no cost to the
residents.
Subd.
4. Evaluation. The commissioner
of health shall evaluate the cumulative health impact burdens of environmental
toxins in the residential communities impacted by arsenic-contaminated soil
from the CMC Heartland Lite Yard Superfund site. The first priority shall be to
evaluate health burdens to those communities experiencing health disparities as
documented by the Minority and Multicultural Health Division of the Minnesota
Department of Health.
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Sec.
17. [144.995] DEFINITIONS.
(a)
For purposes of sections 144.995 to 144.998, the terms in this section have the
meanings given.
(b)
"Advisory panel" means the Environmental Health Tracking and
Biomonitoring Advisory Panel established under section 144.998.
(c)
"Biomonitoring" means the process by which chemicals and their
metabolites are identified and measured within a biospecimen.
(d)
"Biospecimen" means a sample of human fluid, serum, or tissue that is
reasonably available as a medium to measure the presence and concentration of
chemicals or their metabolites in a human body.
(e)
"Commissioner" means the commissioner of the Department of Health.
(f)
"Community" means geographically or nongeographically-based
populations that may participate in the biomonitoring program. A
"nongeographical community" includes, but is not limited to,
populations that may share a common chemical exposure through similar
occupations, populations experiencing a common health outcome that may be
linked to chemical exposures, or populations that may experience similar
chemical exposures because of comparable consumption, lifestyle, product use,
or subpopulations that share ethnicity, age, or gender.
(g)
"Department" means the Department of Health.
(h)
"Designated chemicals" means those chemicals that are known to, or
strongly suspected of, adversely impacting human health or development, based
upon scientific, peer-reviewed animal, human, or in vitro studies, and baseline
human exposure data, and consists of chemical families or metabolites that are
included in the federal Centers for Disease Control and Prevention studies that
are known collectively as the National Reports on Human Exposure to
Environmental Chemicals program and any substances specified under section
144.998, subdivision 3, clause (6).
(i)
"Environmental hazard" means a chemical, metal, or other substance
for which scientific, peer-reviewed studies of humans, animals, or cells have
demonstrated that the chemical is known or reasonably anticipated to adversely
impact human health.
(j)
"Environmental health tracking" means collection, integration,
analysis, and dissemination of data on human exposures to chemicals in the
environment and on diseases potentially caused or aggravated by those
chemicals.
Sec.
18. [144.996] ENVIRONMENTAL HEALTH
TRACKING; BIOMONITORING.
Subdivision
1. Environmental health tracking. In
cooperation with the commissioner of the Pollution Control Agency, the
commissioner shall establish an environmental health tracking program to:
(1)
coordinate data collection activities with the Pollution Control Agency,
Department of Agriculture, University of Minnesota, and any other relevant
state agency and work to promote the sharing of and access to health and
environmental databases in order to develop an environmental health tracking
system for Minnesota, consistent with applicable data practices laws;
(2)
facilitate the dissemination of public health tracking data to the public and
researchers in accessible format and provide technical assistance on
interpreting the data;
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(3) develop written data
sharing agreements with the Minnesota Pollution Control Agency, Department of
Agriculture, and other relevant state agencies and organizations, and develop
additional procedures as needed to protect individual privacy;
(4) develop a strategic plan
that includes a mission statement, the identification of core priorities for
research and epidemiologic surveillance, the identification of internal and
external stakeholders, and a work plan describing future program development;
(5) organize, analyze, and
interpret available data, in order to:
(i) characterize statewide
and localized trends and geographic patterns of prevalence and incidence of
chronic diseases, including, but not limited to, cancer, respiratory diseases,
reproductive problems, birth defects, neurologic diseases, and developmental disorders;
(ii) recommend to the
commissioner methods to improve data collection on statewide population rates
of chronic diseases and the occurrence of environmental hazards and exposures;
(iii) characterize statewide
and localized trends and geographic patterns in the occurrence of environmental
hazards and exposures;
(iv) assess the level of
correlation with disease rate data and indicators of exposure such as
biomonitoring data, and other health and environmental data;
(v) incorporate newly
collected and existing health tracking and biomonitoring data into efforts to
identify communities with elevated rates of chronic disease, higher likelihood
of exposure to environmental pollutants, or both;
(vi) analyze occurrence of
environmental hazards, exposures, and diseases with relation to socioeconomic
status, race, and ethnicity;
(vii) develop and implement
targeted plans to conduct more intensive health tracking and biomonitoring
among communities;
(viii) work with the
Pollution Control Agency, the Department of Agriculture, and other relevant
state agency personnel and organizations to develop, implement, and evaluate
preventive measures to reduce elevated rates of diseases and exposures
identified through activities performed under sections 144.995 to 144.998; and
(ix) provide baseline data
and present descriptive information relevant to policy formation that are
consistent with existing goals of the department; and
(6) submit a biennial report
to the legislature by January 15, beginning January 15, 2009, on the status of
environmental health tracking activities and related research programs, and
making recommendations regarding the continuation and improvement of the
programs.
Subd. 2. Biomonitoring. The commissioner shall:
(1) conduct biomonitoring of
communities on a voluntary basis by collecting and analyzing biospecimens, as
appropriate, to assess environmental exposures to designated chemicals;
(2) conduct biomonitoring of
pregnant women and minors on a voluntary basis, when scientifically appropriate;
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(3) communicate findings to
the public, and plan ensuing stages of biomonitoring and disease tracking work
to further develop and refine the integrated analysis;
(4) share analytical results
with the advisory panel and work with the panel to interpret results,
communicate findings to the public, and plan ensuing stages of biomonitoring
work; and
(5) submit a biennial report
to the legislature by January 15, beginning January 15, 2009, on the status of
the biomonitoring program and any recommendations for improvement.
Subd. 3. Health data. Data collected under the biomonitoring
program are health data under section 13.3805.
Sec. 19. [144.997] BIOMONITORING PILOT PROGRAM.
Subdivision 1. Pilot program. With advice from the advisory panel, the
commissioner shall develop a biomonitoring pilot program. The program shall
collect one biospecimen from each of the voluntary participants. The
biospecimen selected must be the biospecimen that most accurately represents
body concentration of the chemical of interest. Each biospecimen from the
voluntary participants must be analyzed for one type or class of related
chemicals or metals, based on recommendations from the advisory panel. The
panel shall determine the chemical or class of chemicals that community members
were most likely exposed to. The program shall collect and assess biospecimens
in accordance with the following:
(1) 30 voluntary participants
from each of three communities that the advisory panel identifies as likely to
have been exposed to a designated chemical;
(2) 100 voluntary
participants from each of two communities: (i) that the advisory panel
identifies as likely to have been exposed to arsenic and (ii) that the advisory
panel identifies as likely to have been exposed to mercury; and
(3) 100 voluntary
participants from each of two communities that the advisory panel identifies as
likely to have been exposed to perfluorinated chemicals.
Subd. 2. Base program. Following the conclusion of the pilot
program and within the appropriations available, the program shall:
(1) collect and assess
biospecimens from at least as many voluntary participants and communities as
identified in subdivision 1, clause (1); and
(2) work with the advisory
panel to assess the usefulness of continuing biomonitoring among members of
communities assessed during the initial phase of the program, and to identify
other communities and other designated chemicals to be assessed via
biomonitoring.
Subd. 3. Participation. (a) Participation in the biomonitoring
program by providing biospecimens is voluntary and requires written, informed consent.
Minors may participate in the program if a written consent is signed by the
minor's parent or legal guardian. The written consent must include the
information required to be provided under this subdivision to all voluntary
participants.
(b) All participants shall
be evaluated for the presence of the designated chemical of interest as a
component of the biomonitoring process. Participants shall be provided with
information and fact sheets about the program's activities and its findings.
Individual participants shall, if requested, receive their complete results.
Any results provided to participants shall be subject to the Department of
Health Institutional Review Board protocols and guidelines. When either
physiological or chemical data obtained from a participant indicate a
significant known
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health risk, program staff
experienced in communicating biomonitoring results shall consult with the
individual and recommend follow-up steps, as appropriate. Program
administrators shall receive training in administering the program in an
ethical, culturally sensitive, participatory, and community-based manner.
Subd. 4. Program guidelines. (a) The commissioner, in consultation
with the advisory panel, shall develop:
(1) protocols or program
guidelines that address the science and practice of biomonitoring to be
utilized and procedures for changing those protocols to incorporate new and
more accurate or efficient technologies as they become available. The protocols
shall be developed utilizing a peer-review process in a manner that is
participatory and community-based in design, implementation, and evaluation;
(2) guidelines for ensuring
the privacy of information; informed consent; follow-up counseling and support;
and communicating findings to participants, communities, and the general
public. The informed consent used for the program must meet the informed
consent protocols developed by the National Institutes of Health;
(3) educational and outreach
materials that are culturally appropriate for dissemination to program
participants and communities. Priority shall be given to the development of
materials specifically designed to ensure that parents are informed about all
of the benefits of breastfeeding so that the program does not result in an
unjustified fear of toxins in breast milk, which might inadvertently lead
parents to avoid breastfeeding. The materials shall communicate relevant
scientific findings; data on the accumulation of pollutants to community
health; and the required responses by local, state, and other governmental
entities in regulating toxicant exposures;
(4) a training program that
is culturally sensitive specifically for health care providers, health
educators, and other program administrators;
(5) a designation process
for state and private laboratories that are qualified to analyze biospecimens
and report the findings; and
(6) a method for informing
affected communities and local governments representing those communities
concerning biomonitoring activities and for receiving comments from citizens
concerning those activities.
(b) The commissioner may
enter into contractual agreements with health clinics, community-based
organizations, or experts in a particular field to perform any of the
activities described under this section.
Sec. 20. [144.998] ENVIRONMENTAL HEALTH TRACKING
AND BIOMONITORING ADVISORY PANEL.
Subdivision 1. Creation. The commissioner shall establish the Environmental
Health Tracking and Biomonitoring Advisory Panel. The commissioner shall
appoint, from the panel's membership, a chair. The panel shall meet as often as
it deems necessary but, at a minimum, on a quarterly basis. Members of the
panel shall serve without compensation but shall be reimbursed for travel and
other necessary expenses incurred through performance of their duties. Members
appointed under this subdivision are appointed for a three-year term and may be
reappointed.
Subd. 2. Members. The commissioner shall appoint eight members,
none of whom may be lobbyists registered under chapter 10A, who have
backgrounds or training in designing, implementing, and interpreting health
tracking and biomonitoring studies or in related fields of science, including
epidemiology, biostatistics, environmental health, laboratory sciences,
occupational health, industrial hygiene, toxicology, and public health,
including:
(1) two scientists who
represent nongovernmental organizations with a focus on environmental health,
environmental justice, children's health, or on specific chronic diseases; and
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(2) one scientist who is a
representative of the University of Minnesota.
In addition, the
commissioner shall appoint one member representing each of the following
departments or divisions: the department's health promotion and chronic disease
division, the Pollution Control Agency, and the Department of Agriculture.
Subd. 3. Duties. The advisory panel shall make recommendations to
the commissioner and the legislature on:
(1) priorities for health
tracking;
(2) priorities for
biomonitoring that are based on sound science and practice, and that will
advance the state of public health in Minnesota;
(3) specific chronic
diseases to study under the environmental health tracking system;
(4) specific environmental
pollutant exposures to study under the environmental health tracking system,
with the agreement of at least seven of the advisory panel members;
(5) specific communities and
geographic areas on which to focus environmental health tracking and
biomonitoring efforts;
(6) specific chemicals and
metals to study under the biomonitoring program that meet the following criteria,
with the agreement of at least seven of the advisory panel members:
(i) the degree of potential
exposure to the public or specific subgroups, including, but not limited to,
occupational;
(ii) the likelihood of a chemical
being a carcinogen or toxicant based on peer-reviewed health data, the chemical
structure, or the toxicology of chemically related compounds;
(iii) the limits of
laboratory detection for the chemical, including the ability to detect the
chemical at low enough levels that could be expected in the general population;
(iv) exposure or potential
exposure to the public or specific subgroups;
(v) the known or suspected
health effects resulting from the same level of exposure based on peer-reviewed
scientific studies;
(vi) the need to assess the
efficacy of public health actions to reduce exposure to a chemical;
(vii) the availability of a
biomonitoring analytical method with adequate accuracy, precision, sensitivity,
specificity, and speed;
(viii) the availability of
adequate biospecimen samples; and
(ix) other criteria that the
panel may agree to; and
(7) other aspects of the
design, implementation, and evaluation of the environmental health tracking and
biomonitoring system, including, but not limited to:
(i) identifying possible
community partners and sources of additional public or private funding;
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(ii)
developing outreach and educational methods and materials; and
(iii)
disseminating environmental health tracking and biomonitoring findings to the
public.
Subd.
4. Liability. No member of the
panel shall be held civilly or criminally liable for an act or omission by that
person if the act or omission was in good faith and within the scope of the
member's responsibilities under sections 144.995 to 144.998.
Sec.
21. Minnesota Statutes 2006, section 144E.101, subdivision 6, is amended to
read:
Subd.
6. Basic life support. (a) Except as
provided in paragraph (e), a basic life support ambulance shall be staffed by
at least two ambulance service personnel, at least one of which must be an EMT,
who provide a level of care so as to ensure that:
(1)
life-threatening situations and potentially serious injuries are recognized;
(2)
patients are protected from additional hazards;
(3)
basic treatment to reduce the seriousness of emergency situations is
administered; and
(4)
patients are transported to an appropriate medical facility for treatment.
(b)
A basic life support service shall provide basic airway management.
(c)
By January 1, 2001, a basic life support service shall provide automatic
defibrillation, as provided in section 144E.103, subdivision 1, paragraph (b).
(d)
A basic life support service licensee's medical director may authorize the
ambulance service personnel to carry and to use medical antishock trousers and
to perform intravenous infusion if the ambulance service personnel have been
properly trained.
(e)
Upon application from an ambulance service that includes evidence demonstrating
hardship, the board may grant a temporary variance from the staff
requirements in paragraph (a) and may authorize a basic life support ambulance
to be staffed by one EMT and one first responder. The variance shall apply to
basic life support ambulances operated by the ambulance service for up to
one year from the date of the variance's issuance until the ambulance
service renews its license. When a variance expires, an ambulance service
may apply for a new variance under this paragraph. For purposes of this
paragraph, "ambulance service" means either an ambulance service
whose primary service area is located outside the metropolitan counties listed
in section 473.121, subdivision 4, and outside the cities of Duluth, Mankato,
Moorhead, Rochester, and St. Cloud; or an ambulance service based in a
community with a population of less than 1,000.
Sec.
22. Minnesota Statutes 2006, section 144E.127, is amended to read:
144E.127 INTERHOSPITAL;
INTERFACILITY TRANSFER.
Subdivision
1. Interhospital transfers. When
transporting a patient from one licensed hospital to another, a licensee may
substitute for one of the required ambulance service personnel, a physician, a
registered nurse, or physician's assistant who has been trained to use the
equipment in the ambulance and is knowledgeable of the licensee's ambulance
service protocols.
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Subd.
2. Interfacility transfers. In
an interfacility transport, a licensee whose primary service area is located
outside the metropolitan counties listed in section 473.121, subdivision 4, and
outside the cities of Duluth, Mankato, Moorhead, Rochester, and St. Cloud; or
an ambulance service based in a community with a population of less than 1,000,
may substitute one EMT with a registered first responder if an EMT or
EMT-paramedic, physician, registered nurse, or physician's assistant is in the
patient compartment. If using a physician, registered nurse, or physician's
assistant as the sole provider in the patient compartment, the individual must
be trained to use the equipment in the ambulance and be knowledgeable of the
ambulance service protocols.
Sec.
23. Minnesota Statutes 2006, section 144E.35, subdivision 1, is amended to read:
Subdivision
1. Repayment for volunteer training.
Any political subdivision, or nonprofit hospital or nonprofit corporation
operating A licensed ambulance service shall be reimbursed by the board for
the necessary expense of the initial training of a volunteer ambulance
attendant upon successful completion by the attendant of a basic emergency care
course, or a continuing education course for basic emergency care, or both,
which has been approved by the board, pursuant to section 144E.285. Reimbursement
may include tuition, transportation, food, lodging, hourly payment for the time
spent in the training course, and other necessary expenditures, except that in
no instance shall a volunteer ambulance attendant be reimbursed more than $450
$600 for successful completion of a basic course, and $225 $275
for successful completion of a continuing education course.
Sec.
24. [145.958] BISPHENOL-A IN PRODUCTS
FOR CHILDREN.
Subdivision.
1. Bisphenol-A and phthalates committee.
The commissioner of health shall create a committee under the direction of
the environmental health division of the Department of Health to study the
scientific literature and make recommendations to the legislature on the health
impact of bisphenol-A and phthalates on children in products intended for use
by young children, including, but not limited to, toys, pacifiers, baby
bottles, and teethers, and report back by January 15, 2008. The committee shall
also identify least harmful alternatives. Of the seven committee members at
least one shall be a representative of the Department of Health, one shall be a
representative of environmental health sciences research, one shall be a
representative of the Minnesota Nurses Association, one shall be a
representative of environmental health consumer advocates, one shall be a
member of a children's product manufacturer's association, and one shall be a
representative of the University of Minnesota, chemical plastics research
department.
Subd.
2. Definitions. For the purposes
of this section, the following terms have the meanings given them:
(a)
"Toy" means all products designed or intended by the manufacturer to
be used by children when they play.
(b)
"Child care article" means all products designed or intended by the
manufacturer to facilitate sleep, relaxation, or the feeding of children or to
help children with sucking or teething.
Sec.
25. Minnesota Statutes 2006, section 145A.17, is amended to read:
145A.17 FAMILY HOME VISITING
PROGRAMS.
Subdivision
1. Establishment; goals. The commissioner
shall establish a program to fund family home visiting programs designed to
foster a healthy beginning for children in families at or below 200
percent of the federal poverty guidelines beginnings, improve pregnancy
outcomes, promote school readiness, prevent child abuse and neglect, reduce
juvenile delinquency, promote positive parenting and resiliency in children,
and promote family health and economic self-sufficiency for children and
families. The commissioner shall promote partnerships, collaboration, and
multidisciplinary visiting done by teams of professionals and paraprofessionals
from the fields of public health nursing, social work, and early childhood
education. A program funded under this section must serve families at or
below 200 percent of the federal poverty guidelines, and other families
determined to be at risk, including but not limited to being at risk for child
abuse, child neglect, or juvenile delinquency. Programs must give priority
for services to families considered to be in need of services, including but
not limited to begin prenatally whenever possible and must be targeted
to families with:
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(1) adolescent parents;
(2) a history of alcohol or
other drug abuse;
(3) a history of child
abuse, domestic abuse, or other types of violence;
(4) a history of domestic
abuse, rape, or other forms of victimization;
(5) reduced cognitive
functioning;
(6) a lack of knowledge of
child growth and development stages;
(7) low resiliency to
adversities and environmental stresses; or
(8) insufficient financial
resources to meet family needs;
(9) a history of
homelessness;
(10) a risk of long-term welfare
dependence or family instability due to employment barriers; or
(11) other risk factors as
determined by the commissioner.
Subd. 3. Requirements for programs; process. (a)
Before a community health board or tribal government may receive an allocation
under subdivision 2, a community health board or tribal government must submit
a proposal to the commissioner that includes identification, based on a
community assessment, of the populations at or below 200 percent of the federal
poverty guidelines that will be served and the other populations that will be
served. Each program that receives funds must Community health boards
and tribal governments that receive funding under this section must submit a
plan to the commissioner describing a multidisciplinary approach to targeted
home visiting for families. The plan must be submitted on forms provided by the
commissioner. At a minimum, the plan must include the following:
(1) a description of
outreach strategies to families prenatally or at birth;
(2) provisions for the
seamless delivery of health, safety, and early learning services;
(3) methods to promote
continuity of services when families move within the state;
(4) a description of the
community demographics;
(5) a plan for meeting
outcome measures; and
(6) a proposed work plan
that includes:
(i) coordination to ensure
nonduplication of services for children and families;
(ii) a description of the
strategies to ensure that children and families at greatest risk receive
appropriate services; and
(iii) collaboration with
multidisciplinary partners including public health, ECFE, Head Start, community
health workers, social workers, community home visiting programs, school
districts, and other relevant partners. Letters of intent from multidisciplinary
partners must be submitted with the plan.
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(b)
Each program that receives funds must accomplish the following program
requirements:
(1)
use either a broad community-based or selective
community-based strategy to provide preventive and early intervention home
visiting services;
(2)
offer a home visit by a trained home visitor. If a home visit is accepted, the
first home visit must occur prenatally or as soon after birth as possible and
must include a public health nursing assessment by a public health nurse;
(3)
offer, at a minimum, information on infant care, child growth and development,
positive parenting, preventing diseases, preventing exposure to environmental
hazards, and support services available in the community;
(4)
provide information on and referrals to health care services, if needed,
including information on and assistance in applying for health care
coverage for which the child or family may be eligible; and provide information
on preventive services, developmental assessments, and the availability of
public assistance programs as appropriate;
(5)
provide youth development programs when appropriate;
(6)
recruit home visitors who will represent, to the extent possible, the races,
cultures, and languages spoken by families that may be served;
(7)
train and supervise home visitors in accordance with the requirements
established under subdivision 4;
(8)
maximize resources and minimize duplication by coordinating activities or
contracting with local social and human services organizations, education
organizations, and other appropriate governmental entities and community-based
organizations and agencies; and
(9)
utilize appropriate racial and ethnic approaches to providing home visiting
services; and
(10)
connect eligible families, as needed, to additional resources available in the
community, including, but not limited to, early care and education programs,
health or mental health services, family literacy programs, employment
agencies, social services, and child care resources and referral agencies.
(c)
When available, programs that receive funds under this section must offer or
provide the family with a referral to center-based or group meetings that meet
at least once per month for those families identified with additional needs.
The meetings must focus on further enhancing the information, activities, and
skill-building addressed during home visitation; offering opportunities for
parents to meet with and support each other; and offering infants and toddlers
a safe, nurturing, and stimulating environment for socialization and supervised
play with qualified teachers.
(b) (d) Funds available
under this section shall not be used for medical services. The commissioner
shall establish an administrative cost limit for recipients of funds. The
outcome measures established under subdivision 6 must be specified to
recipients of funds at the time the funds are distributed.
(c) (e) Data collected on
individuals served by the home visiting programs must remain confidential and
must not be disclosed by providers of home visiting services without a specific
informed written consent that identifies disclosures to be made. Upon request,
agencies providing home visiting services must provide recipients with
information on disclosures, including the names of entities and individuals
receiving the information and the general purpose of the disclosure.
Prospective and current recipients of home visiting services must be told and
informed in writing that written consent for disclosure of data is not required
for access to home visiting services.
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Subd. 4. Training. The commissioner shall
establish training requirements for home visitors and minimum requirements for
supervision by a public health nurse. The requirements for nurses must
be consistent with chapter 148. The commissioner must provide training for
home visitors. Training must include child development, positive
parenting techniques, screening and referrals for child abuse and neglect, and
diverse cultural practices in child rearing and family systems the
following:
(1) effective relationships
for engaging and retaining families and ensuring family health, safety, and
early learning;
(2) effective methods of
implementing parent education, conducting home visiting, and promoting quality
early childhood development;
(3) early childhood
development from birth to age five;
(4) diverse cultural
practices in child rearing and family systems;
(5) recruiting, supervising,
and retaining qualified staff;
(6) increasing services for
underserved populations; and
(7) relevant issues related
to child welfare and protective services, with information provided being
consistent with state child welfare agency training.
Subd. 5. Technical assistance. The commissioner
shall provide administrative and technical assistance to each program,
including assistance in data collection and other activities related to
conducting short- and long-term evaluations of the programs as required under
subdivision 7. The commissioner may request research and evaluation support
from the University of Minnesota.
Subd. 6. Outcome and performance measures.
The commissioner shall establish outcomes measures to determine
the impact of family home visiting programs funded under this section on the
following areas:
(1) appropriate utilization
of preventive health care;
(2) rates of substantiated
child abuse and neglect;
(3) rates of unintentional
child injuries;
(4) rates of children who
are screened and who pass early childhood screening; and
(5) rates of children
accessing early care and educational services;
(6) program retention rates;
(7) number of home visits
provided compared to the number of home visits planned;
(8) participant
satisfaction;
(9) rates of at-risk
populations reached; and
(10) any additional qualitative
goals and quantitative measures established by the commissioner.
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Subd.
7. Evaluation. Using the qualitative
goals and quantitative outcome and performance measures established
under subdivisions 1 and 6, the commissioner shall conduct ongoing evaluations
of the programs funded under this section. Community health boards and tribal
governments shall cooperate with the commissioner in the evaluations and shall
provide the commissioner with the information necessary to conduct the
evaluations. As part of the ongoing evaluations, the commissioner shall rate
the impact of the programs on the outcome measures listed in subdivision 6, and
shall periodically determine whether home visiting programs are the best way to
achieve the qualitative goals established under subdivisions 1 and 6. If the
commissioner determines that home visiting programs are not the best way to
achieve these goals, the commissioner shall provide the legislature with
alternative methods for achieving them.
Subd.
8. Report. By January 15, 2002, and
January 15 of each even-numbered year thereafter, the commissioner shall submit
a report to the legislature on the family home visiting programs funded under
this section and on the results of the evaluations conducted under subdivision
7.
Subd.
9. No supplanting of existing funds.
Funding available under this section may be used only to supplement, not to
replace, nonstate funds being used for home visiting services as of July 1,
2001.
Sec.
26. Minnesota Statutes 2006, section 156.001, is amended by adding a
subdivision to read:
Subd.
10a. Program for the Assessment of Veterinary
Education Equivalence; PAVE certificate. A "Program for the
Assessment of Veterinary Education Equivalence" or "PAVE"
certificate is issued by the American Association of Veterinary State Boards,
indicating that the holder has demonstrated knowledge and skill equivalent to
that possessed by a graduate of an accredited or approved college of veterinary
medicine.
Sec.
27. [156.015] FEES.
Subdivision
1. Verification of licensure. The
board may charge a fee of $25 per license verification to a licensee for
verification of licensure status provided to other veterinary licensing boards.
Subd.
2. Continuing education review. The
board may charge a fee of $50 per submission to a sponsor for review and
approval of individual continuing education seminars, courses, wet labs, and
lectures. This fee does not apply to continuing education sponsors that already
meet the criteria for preapproval under Minnesota Rules, part 9100.1000,
subpart 3, item A.
Sec.
28. Minnesota Statutes 2006, section 156.02, subdivision 1, is amended to read:
Subdivision
1. License application. Application
for a license to practice veterinary medicine in this state shall be made in
writing to the Board of Veterinary Medicine upon a form furnished by the board,
accompanied by satisfactory evidence that the applicant is at least 18 years of
age, is of good moral character, and has one of the following:
(1)
a diploma conferring the degree of doctor of veterinary medicine, or an
equivalent degree, from an accredited or approved college of veterinary
medicine;
(2)
an ECFVG or PAVE certificate; or
(3)
a certificate from the dean of an accredited or approved college of veterinary
medicine stating that the applicant is a student in good standing expecting to
be graduated at the completion of the current academic year of the college in
which the applicant is enrolled.
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The application shall
contain the information and material required by subdivision 2 and any other
information that the board may, in its sound judgment, require. The application
shall be filed with the board at least 60 days before the date of the
examination. If the board deems it advisable, it may require that such
application be verified by the oath of the applicant.
Sec. 29. Minnesota Statutes
2006, section 156.02, subdivision 2, is amended to read:
Subd. 2. Required with application. Every
application shall contain the following information and material:
(1) the application fee set
by the board in the form of a check or money order payable to the board, which
fee is not returnable in the event permission to take the examination is denied
for good cause;
(2) a copy of a diploma from
an accredited or approved college of veterinary medicine or a certificate from
the dean or secretary of an accredited or approved college of veterinary
medicine showing the time spent in the school and the date when the applicant
was duly and regularly graduated or will duly and regularly graduate or
verification of ECFVG or PAVE certification;
(3) affidavits of at least
two veterinarians and three adults who are not related to the applicant setting
forth how long a time, when, and under what circumstances they have known the
applicant, and any other facts as may be proper to enable the board to
determine the qualifications of the applicant; and
(4) if the applicant has
served in the armed forces, a copy of discharge papers.
Sec. 30. Minnesota Statutes
2006, section 156.04, is amended to read:
156.04 BOARD TO ISSUE LICENSE.
The Board of Veterinary
Medicine shall issue to every applicant who has successfully passed the
required examination, who has received a diploma conferring the degree of
doctor of veterinary medicine or an equivalent degree from an accredited or
approved college of veterinary medicine or an ECFVG or PAVE certificate,
and who shall have been adjudged to be duly qualified to practice veterinary
medicine, a license to practice.
Sec. 31. Minnesota Statutes
2006, section 156.072, subdivision 2, is amended to read:
Subd. 2. Required with application. Such doctor
of veterinary medicine shall accompany the application by the following:
(1) a copy of a diploma from
an accredited or approved college of veterinary medicine or certification from
the dean, registrar, or secretary of an accredited or approved college of
veterinary medicine attesting to the applicant's graduation from an accredited
or approved college of veterinary medicine, or a certificate of satisfactory
completion of the ECFVG or PAVE program.
(2) affidavits of two
licensed practicing doctors of veterinary medicine residing in the United
States or Canadian licensing jurisdiction in which the applicant is currently
practicing, attesting that they are well acquainted with the applicant, that
the applicant is a person of good moral character, and has been actively
engaged in practicing or teaching in such jurisdiction for the period above
prescribed;
(3) a certificate from the
regulatory agency having jurisdiction over the conduct of practice of
veterinary medicine that such applicant is in good standing and is not the
subject of disciplinary action or pending disciplinary action;
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(4)
a certificate from all other jurisdictions in which the applicant holds a
currently active license or held a license within the past ten years, stating
that the applicant is and was in good standing and has not been subject to
disciplinary action;
(5)
in lieu of clauses (3) and (4), certification from the Veterinary Information
Verification Agency that the applicant's licensure is in good standing;
(6)
a fee as set by the board in form of check or money order payable to the board,
no part of which shall be refunded should the application be denied;
(7)
score reports on previously taken national examinations in veterinary medicine,
certified by the Veterinary Information Verification Agency; and
(8)
if requesting waiver of examination, provide evidence of meeting licensure
requirements in the state of the applicant's original licensure that were
substantially equal to the requirements for licensure in Minnesota in existence
at that time.
Sec.
32. Minnesota Statutes 2006, section 156.073, is amended to read:
156.073 TEMPORARY PERMIT.
The
board may issue without examination a temporary permit to practice veterinary
medicine in this state to a person who has submitted an application approved by
the board for license pending examination, and holds a doctor of veterinary
medicine degree or an equivalent degree from an approved or accredited college
of veterinary medicine or an ECFVG or PAVE certification. The temporary
permit shall expire the day after publication of the notice of results of the
first examination given after the permit is issued. No temporary permit may be
issued to any applicant who has previously failed the national examination and
is currently not licensed in any licensing jurisdiction of the United States or
Canada or to any person whose license has been revoked or suspended or who is
currently subject to a disciplinary order in any licensing jurisdiction of the
United States or Canada.
Sec.
33. Minnesota Statutes 2006, section 156.12, subdivision 2, is amended to read:
Subd.
2. Authorized activities. No
provision of this chapter shall be construed to prohibit:
(a)
a person from rendering necessary gratuitous assistance in the treatment of any
animal when the assistance does not amount to prescribing, testing for, or
diagnosing, operating, or vaccinating and when the attendance of a licensed
veterinarian cannot be procured;
(b)
a person who is a regular student in an accredited or approved college of
veterinary medicine from performing duties or actions assigned by instructors
or preceptors or working under the direct supervision of a licensed
veterinarian;
(c)
a veterinarian regularly licensed in another jurisdiction from consulting with
a licensed veterinarian in this state;
(d)
the owner of an animal and the owner's regular employee from caring for and
administering to the animal belonging to the owner, except where the ownership
of the animal was transferred for purposes of circumventing this chapter;
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(e) veterinarians who are in
compliance with subdivision 6 and who are employed by the University of
Minnesota from performing their duties with the College of Veterinary Medicine,
College of Agriculture, Agricultural Experiment Station, Agricultural Extension
Service, Medical School, School of Public Health, or other unit within the university;
or a person from lecturing or giving instructions or demonstrations at the
university or in connection with a continuing education course or seminar to
veterinarians or pathologists at the University of Minnesota Veterinary
Diagnostic Laboratory;
(f) any person from selling
or applying any pesticide, insecticide or herbicide;
(g) any person from engaging
in bona fide scientific research or investigations which reasonably requires
experimentation involving animals;
(h) any employee of a
licensed veterinarian from performing duties other than diagnosis, prescription
or surgical correction under the direction and supervision of the veterinarian,
who shall be responsible for the performance of the employee;
(i) a graduate of a foreign
college of veterinary medicine from working under the direct personal
instruction, control, or supervision of a veterinarian faculty member of the
College of Veterinary Medicine, University of Minnesota in order to complete
the requirements necessary to obtain an ECFVG or PAVE certificate.
Sec. 34. Minnesota Statutes
2006, section 156.12, subdivision 4, is amended to read:
Subd. 4. Titles. It is unlawful for a person who
has not received a professional degree from an accredited or approved college of
veterinary medicine, or ECFVG or PAVE certification, to use any of the
following titles or designations: Veterinary, veterinarian, animal doctor,
animal surgeon, animal dentist, animal chiropractor, animal acupuncturist, or
any other title, designation, word, letter, abbreviation, sign, card, or device
tending to indicate that the person is qualified to practice veterinary
medicine.
Sec. 35. Minnesota Statutes
2006, section 156.12, subdivision 6, is amended to read:
Subd. 6. Faculty licensure. (a) Veterinary
Medical Center clinicians at the College of Veterinary Medicine, University of
Minnesota, who are engaged in the practice of veterinary medicine as defined in
subdivision 1 and who treat animals owned by clients of the Veterinary Medical
Center must possess the same license required by other veterinary practitioners
in the state of Minnesota except for persons covered by paragraphs (b) and (c).
(b) A specialty practitioner
in a hard-to-fill faculty position who has been employed at the College of Veterinary
Medicine, University of Minnesota, for five years or more prior to 2003 or is
specialty board certified by the American Veterinary Medical Association or
the European Board of Veterinary Specialization may be granted a specialty
faculty Veterinary Medical Center clinician license which will allow the
licensee to practice veterinary medicine in the state of Minnesota in the
specialty area of the licensee's training and only within the scope of
employment at the Veterinary Medical Center.
(c) A specialty practitioner
in a hard-to-fill faculty position at the College of Veterinary Medicine,
University of Minnesota, who has graduated from a board-approved foreign
veterinary school may be granted a temporary faculty Veterinary Medical Center
clinician license. The temporary faculty Veterinary Medical Center clinician
license expires in two years and allows the licensee to practice veterinary
medicine as defined in subdivision 1 and treat animals owned by clients of the
Veterinary Medical Center. The temporary faculty Veterinary Medical Center
clinician license allows the licensee to practice veterinary medicine in the
state of Minnesota in the specialty area of the licensee's training and only
within the scope of employment at the Veterinary Medical Center while under
the direct supervision of a veterinarian currently licensed and actively
practicing veterinary medicine in Minnesota, as defined in section 156.04. The
direct supervising veterinarian shall not have any current or past conditions,
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restrictions, or
probationary status imposed on the veterinarian's license by the board within
the past five years. The holder of a temporary faculty Veterinary Medical Center clinician
license who is enrolled in a PhD program may apply for up to two additional
consecutive two-year extensions of an expiring temporary faculty Veterinary
Medical Center clinician license. Any other holder of a temporary faculty
Veterinary Medical Center clinician license may apply for one two-year
extension of the expiring temporary faculty Veterinary Medical Center clinician
license. Temporary faculty Veterinary Medical Center clinician licenses that
are allowed to expire may not be renewed. The board shall grant an extension to
a licensee who demonstrates suitable progress toward completing the
requirements of their academic program, specialty board certification, or full
licensure in Minnesota by a graduate of a foreign veterinary college.
(d) Temporary and specialty
faculty Veterinary Medical Center clinician licensees must abide by all the
laws governing the practice of veterinary medicine in the state of Minnesota
and are subject to the same disciplinary action as any other veterinarian
licensed in the state of Minnesota.
(e) The fee for a license
issued under this subdivision is the same as for a regular license to practice
veterinary medicine in Minnesota. License payment deadlines, late payment fees,
and other license requirements are also the same as for regular licenses.
Sec. 36. Minnesota Statutes
2006, section 156.15, subdivision 2, is amended to read:
Subd. 2. Service. Service of an order under this
section is effective if the order is served on the person or counsel of record
personally or by certified United States mail to the most recent
address provided to the board for the person or counsel of record.
Sec. 37. Minnesota Statutes
2006, section 156.16, subdivision 3, is amended to read:
Subd. 3. Dispensing. "Dispensing"
means distribution of veterinary prescription drugs or over-the-counter drugs
for extra-label use or human drugs for extra-label use by a person
licensed as a pharmacist by the Board of Pharmacy or a person licensed by the
Board of Veterinary Medicine.
Sec. 38. Minnesota Statutes
2006, section 156.16, subdivision 10, is amended to read:
Subd. 10. Prescription. "Prescription"
means an order from a veterinarian to a pharmacist or another veterinarian
authorizing the dispensing of a veterinary prescription drug
drugs, human drugs for extra-label use, or over-the-counter drugs for
extra-label use to a client for use on or in a patient.
Sec. 39. Minnesota Statutes
2006, section 156.18, subdivision 1, is amended to read:
Subdivision 1. Prescription. (a) A person may not
dispense a veterinary prescription drug to a client without a prescription or
other veterinary authorization. A person may not make extra-label use of an
animal or human drug for an animal without a prescription from a veterinarian.
A veterinarian or the veterinarian's authorized employee may dispense a
veterinary prescription drug to drugs, human drugs for extra-label
use, or an over-the-counter drug for extra-label use by a client or
oversee the extra-label use of a veterinary drug directly by a client
without a separate written prescription, providing there is documentation of
the prescription in the medical record and there is an existing
veterinarian-client-patient relationship. The prescribing veterinarian must
monitor the use of veterinary prescription drugs, human drugs for extra-label
use, or over-the-counter drugs for extra-label use by a client.
(b) A veterinarian may
dispense prescription veterinary drugs and prescribe and dispense extra-label
use drugs to a client without personally examining the animal if a bona fide
veterinarian-client-patient relationship exists and in the judgment of the
veterinarian the client has sufficient knowledge to use the drugs properly.
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(c) A veterinarian may issue
a prescription or other veterinary authorization by oral or written
communication to the dispenser, or by computer connection. If the communication
is oral, the veterinarian must enter it into the patient's record. The dispenser
must record the veterinarian's prescription or other veterinary authorization
within 72 hours.
(d) A prescription or other
veterinary authorization must include:
(1) the name, address, and,
if written, the signature of the prescriber;
(2) the name and address of
the client;
(3) identification of the
species for which the drug is prescribed or ordered;
(4) the name, strength, and
quantity of the drug;
(5) the date of issue;
(6) directions for use; and
(7) withdrawal time.,
if applicable; and
(8) number of authorized
refills.
(e) A veterinarian may, in
the course of professional practice and an existing veterinarian-client-patient
relationship, prepare medicaments that combine drugs approved by the United
States Food and Drug Administration and other legally obtained ingredients with
appropriate vehicles.
(f) A veterinarian or a bona
fide employee of a veterinarian may dispense veterinary prescription drugs to a
person on the basis of a prescription issued by a licensed veterinarian. The
provisions of paragraphs (c) and (d) apply.
(g) This section does not
limit the authority of the Minnesota Racing Commission to regulate
veterinarians providing services at a licensed racetrack.
Sec. 40. Minnesota Statutes
2006, section 156.18, subdivision 2, is amended to read:
Subd. 2. Label of dispensed veterinary drugs.
(a) A veterinarian or the veterinarian's authorized agent or employee dispensing
a veterinary prescription drug or prescribing the extra-label use of an
over-the-counter drug, an over-the-counter drug for extra-label use, or
a human drug for extra-label use must provide written information which
includes the name and address of the veterinarian, date of filling, species of
patient, name or names of drug, strength of drug or drugs, directions for use,
withdrawal time, and cautionary statements, if any, appropriate for the drug.
(b) If the veterinary drug
has been prepared, mixed, formulated, or packaged by the dispenser, all of the
information required in paragraph (a) must be provided on a label affixed to
the container.
(c) If the veterinary drug
is in the manufacturer's original package, the information required in
paragraph (a) must be supplied in writing but need not be affixed to the
container. Information required in paragraph (a) that is provided by the
manufacturer on the original package does not need to be repeated in the
separate written information. Written information required by this paragraph
may be written on the sales invoice.
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Sec.
41. Minnesota Statutes 2006, section 156.19, is amended to read:
156.19 EXTRA-LABEL USE.
A
person, other than a veterinarian or a person working under the control an
employee of a veterinarian, must not make extra-label use of a veterinary
drug in or on a food-producing animal, unless permitted by the prescription of
a veterinarian. A veterinarian may prescribe the extra-label use of a veterinary
drug if:
(1)
the veterinarian makes a careful medical diagnosis within the context of a
valid veterinarian-client-patient relationship;
(2)
the veterinarian determines that there is no marketed drug specifically labeled
to treat the condition diagnosed, or that drug therapy as recommended by the
labeling has, in the judgment of the attending veterinarian, been found to be
clinically ineffective;
(3)
the veterinarian recommends procedures to ensure that the identity of the
treated animal will be carefully maintained; and
(4)
the veterinarian prescribes a significantly extended time period for drug
withdrawal before marketing meat, milk, or eggs.; and
(5)
the veterinarian has met the criteria established in Code of Federal Regulations,
title 21, part 530, which define the extra-label use of medication in or on
animals.
Sec.
42. Minnesota Statutes 2006, section 198.075, is amended to read:
198.075 MINNESOTA VETERANS
HOME EMPLOYEES; EXCLUDED FROM COMMISSARY PRIVILEGES.
Except
as provided in this section, no commissary privileges including food, laundry
service, janitorial service, and household supplies shall be furnished to any
employee of the Minnesota veterans homes. An employee of the Minnesota
veterans homes who works a second shift that is consecutive with a regularly
scheduled shift may be allowed one free meal at the veterans home on the day of
that extra shift.
Sec.
43. Minnesota Statutes 2006, section 256B.0625, subdivision 14, is amended to
read:
Subd.
14. Diagnostic, screening, and
preventive services. (a) Medical assistance covers diagnostic, screening,
and preventive services.
(b)
"Preventive services" include services related to pregnancy,
including:
(1)
services for those conditions which may complicate a pregnancy and which may be
available to a pregnant woman determined to be at risk of poor pregnancy
outcome;
(2)
prenatal HIV risk assessment, education, counseling, and testing; and
(3)
alcohol abuse assessment, education, and counseling on the effects of alcohol
usage while pregnant. Preventive services available to a woman at risk of poor
pregnancy outcome may differ in an amount, duration, or scope from those
available to other individuals eligible for medical assistance.
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(c) "Screening
services" include, but are not limited to, blood lead tests. Screening
services also include, for children with blood lead levels equal to or greater
than five micrograms of lead per deciliter of whole blood, environmental
investigations to determine the source of lead exposure. Reimbursement is
limited to a health professional's time and activities during an on-site
investigation of a child's home or primary residence.
Sec. 44. Minnesota Statutes
2006, section 256B.0625, is amended by adding a subdivision to read:
Subd. 49. Lead risk assessments. (a) Effective October 1, 2007, or
six months after federal approval, whichever is later, medical assistance
covers lead risk assessments provided by a lead risk assessor who is licensed
by the commissioner of health under section 144.9505 and employed by an
assessing agency as defined in section 144.9501. Medical assistance covers a onetime
on-site investigation of a recipient's home or primary residence to determine
the existence of lead so long as the recipient is under the age of 21 and has a
venous blood lead level specified in section 144.9504, subdivision 2, paragraph
(a).
(b) Medical assistance
reimbursement covers the lead risk assessor's time to complete the following
activities:
(1) gathering samples;
(2) interviewing family
members;
(3) gathering data,
including meter readings; and
(4) providing a report with
the results of the investigation and options for reducing lead-based paint
hazards.
Medical assistance coverage
of lead risk assessment does not include testing of environmental substances
such as water, paint, or soil or any other laboratory services. Medical assistance
coverage of lead risk assessments is not included in the capitated services for
children enrolled in health plans through the prepaid medical assistance
program and the MinnesotaCare program.
(c) Payment for lead risk assessment
must be cost-based and must meet the criteria for federal financial
participation under the Medicaid program. The rate must be based on allowable
expenditures from cost information gathered. Under section 144.9507,
subdivision 5, federal medical assistance funds may not replace existing
funding for lead-related activities. The nonfederal share of costs for services
provided under this subdivision must be from state or local funds and is the
responsibility of the agency providing the risk assessment. Eligible
expenditures for the nonfederal share of costs may not be made from federal
funds or funds used to match other federal funds. Any federal disallowances are
the responsibility of the agency providing risk assessment services.
Sec. 45. [325E.385] PRODUCTS CONTAINING
POLYBROMINATED DIPHENYL ETHER.
Subdivision 1. Definitions. For the purposes of sections 325E.386 to
325E.388, the terms in this section have the meanings given them.
Subd. 2. Commercial decabromodiphenyl ether. "Commercial
decabromodiphenyl ether" means the chemical mixture of decabromodiphenyl
ether, including associated polybrominated diphenyl ether impurities not
intentionally added.
Subd. 3. Commissioner. "Commissioner" means the
commissioner of the Pollution Control Agency.
Subd. 4. Manufacturer. "Manufacturer" means any person,
firm, association, partnership, corporation, governmental entity, organization,
or joint venture that produces a product containing polybrominated diphenyl
ethers or an importer or domestic distributor of a noncomestible product
containing polybrominated diphenyl ethers.
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Subd. 5. Polybrominated diphenyl ethers or PBDE's. "Polybrominated
diphenyl ethers" or "PBDE's" means chemical forms that consist
of diphenyl ethers bound with bromine atoms. Polybrominated diphenyl ethers
include, but are not limited to, the three primary forms of the commercial
mixtures known as pentabromodiphenyl ether, octabromodiphenyl ether, and decabromodiphenyl
ether.
Subd. 6. Retailer. "Retailer" means a person who offers
a product for sale at retail through any means, including, but not limited to,
remote offerings such as sales outlets, catalogs, or the Internet, but does not
include a sale that is a wholesale transaction with a distributor or a
retailer.
Subd. 7. Used product. "Used product" means any product
that has been previously owned, purchased, or sold in commerce. Used product
does not include any product manufactured after January 1, 2008.
Sec. 46. [325E.386] PRODUCTS CONTAINING CERTAIN
POLYBROMINATED DIPHENYL ETHERS BANNED; EXEMPTIONS.
Subdivision 1. Penta- and octabromodiphenyl ethers. Except as provided
in subdivision 3, beginning January 1, 2008, a person may not manufacture,
process, or distribute in commerce a product or flame-retardant part of a
product containing more than one-tenth of one percent of pentabromodiphenyl
ether or octabromodiphenyl ether by mass.
Subd. 2. Exemptions. The following products containing polybrominated
diphenyl ethers are exempt from subdivision 1:
(1) the sale or distribution
of any used transportation vehicle with component parts containing
polybrominated diphenyl ethers;
(2) the sale or distribution
of any used transportation vehicle parts or new transportation vehicle parts
manufactured before January 1, 2008, that contain polybrominated diphenyl
ethers;
(3) the manufacture, sale,
repair, distribution, maintenance, refurbishment, or modification of equipment
containing polybrominated diphenyl ethers and used primarily for military or
federally funded space program applications. This exemption does not cover
consumer-based goods with broad applicability;
(4) the sale or distribution
by a business, charity, public entity, or private party of any used product
containing polybrominated diphenyl ethers;
(5) the manufacture, sale,
or distribution of new carpet cushion made from recycled foam containing more
than one-tenth of one percent penta polybrominated diphenyl ether; or
(6) medical devices.
In-state retailers in
possession of products on January 1, 2008, that are banned for sale under
subdivision 1 may exhaust their stock through sales to the public. Nothing in
this section restricts the ability of a manufacturer, importer, or distributor
from transporting products containing polybrominated diphenyl ethers through
the state, or storing such products in the state for later distribution outside
the state.
Sec. 47. [325E.387] REVIEW OF DECABROMODIPHENYL
ETHER.
Subdivision 1. Commissioner duties. The commissioner in consultation
with the commissioners of health and public safety shall review uses of
commercial decabromodiphenyl ether, availability of technically feasible and
safer alternatives, fire safety and any evidence regarding the potential harm
to public health and the environment posed by
Journal of the House - 47th
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commercial decabromodiphenyl
ether and the alternatives. The commissioner must consult with key
stakeholders. The commissioner must also review the findings from similar state
and federal agencies and must report their findings and recommendations to the
appropriate committees of the legislature no later than January 15, 2008.
Subd. 2. State procurement. By January 1, 2008, the commissioner
of administration shall make available for purchase and use by all state
agencies only equipment, supplies, and other products that do not contain
polybrominated diphenyl ethers, unless exempted under section 325E.386,
subdivision 2.
Sec. 48. [325E.388] PENALTIES.
A manufacturer who violates
sections 325E.386 to 325E.388 is subject to a civil penalty not to exceed
$1,000 for each violation in the case of a first offense. A manufacturer is
subject to a civil penalty not to exceed $5,000 for each repeat offense.
Penalties collected under this section must be deposited in an account in the
special revenue fund and are appropriated in fiscal years 2008 and 2009 to the
commissioner to implement and enforce this section.
Sec. 49. Laws 2005, First Special Session chapter 4, article 9,
section 3, subdivision 2, is amended to read:
Subd. 2. Community and
Family Health Improvement
Summary by Fund
General 40,413,000 40,382,000
State Government
Special Revenue 141,000 128,000
Health Care Access 3,510,000 3,516,000
Federal TANF 6,000,000 6,000,000
Family Planning Base
Reduction. Base level funding for the
family planning special projects grant program is reduced by $1,877,000 each
year of the biennium beginning July 1, 2007, provided that this reduction shall
only take place upon full implementation of the family planning project section
of the 1115 waiver. Notwithstanding Minnesota Statutes, section 145.925, the
commissioner shall give priority to community health care clinics providing
family planning services that either serve a high number of women who do not
qualify for medical assistance or are unable to participate in the medical
assistance program as a medical assistance provider when allocating the
remaining appropriations. Notwithstanding section 15, this paragraph shall not
expire.
Shaken Baby Video. Of the state government
special revenue fund appropriation, $13,000 in 2006 is appropriated to the
commissioner of health to provide a video to hospitals on shaken baby syndrome.
The commissioner of health shall assess a fee to hospitals to cover the cost of
the approved shaken baby video and the revenue received is to be deposited in
the state government special revenue fund.
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Sec. 50. FUNDING FOR
ENVIRONMENTAL JUSTICE MAPPING.
The commissioner of health, in conjunction with the commissioner of the
Pollution Control Agency, shall establish an environmental justice mapping
program and shall apply for federal funding to renew and expand the state's
environmental justice mapping capacity in order to promote public health
tracking. The commissioner shall coordinate the project with the Pollution
Control Agency and the Department of Agriculture in order to explore possible
links between environmental health and toxic exposures and to help create a
system for environmental public health tracking. The commissioner shall also
make recommendations to the legislature for additional sources of funding
within the state.
EFFECTIVE DATE. This section is
effective the day following final enactment.
Sec. 51. LEGISLATIVE FINDINGS
AND PURPOSE.
The legislature hereby finds that hearing loss occurs in newborn
infants more frequently than any other health condition for which newborn
infant screening is required. Early detection of hearing loss in a child and
early intervention and treatment has been demonstrated to be highly effective
in facilitating a child's healthy development in a manner consistent with the
child's age, language acquisition, and cognitive ability. Without early hearing
detection and intervention, children with hearing loss experience serious
delays in language acquisition and social and cognitive development. With
appropriate testing and identification of newborn infants, hearing loss
screening will facilitate early intervention and treatment and will serve the
public purpose of promoting the healthy development of children.
For these reasons, the legislature hereby determines that it is
beneficial and in the best interests of the development of the children of the
state of Minnesota that newborn infants' hearing be screened.
Sec. 52. INFORMATION SHARING.
By August 1, 2007, the commissioner of health, the Pollution Control
Agency, the commissioner of agriculture, and the University of Minnesota are
requested to jointly develop and sign a memorandum of understanding declaring
their intent to share new and existing environmental hazard, exposure, and
health outcome data, consistent with applicable data practices laws, and to
cooperate and communicate effectively to ensure sufficient clarity and
understanding of the data between these organizations.
Sec. 53. COMMISSIONER OF
HEALTH REPORT; ROUTINE RADIATION EMISSIONS.
The commissioner of health, within the limits of available
appropriations, in cooperation with the utilities that own the Monticello and
Prairie Island nuclear plants, shall issue a report detailing where routine
radiation releases go and the health impacts of the radiation emissions on
affected communities. By April 1, 2008, the report must be distributed to house
and senate committees having jurisdiction over public health and to all communities
that are part of the emergency response planning.
Sec. 54. FRAGRANCE-FREE
SCHOOLS EDUCATION PILOT PROJECT.
Subdivision 1. Purpose. Recognizing
that scented products may trigger asthma or chemical sensitivity reactions in students
and school staff, which can contribute to learning and breathing problems, the
commissioner of health shall develop a fragrance-free schools education pilot
project.
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Subd. 2. Education. The commissioner of health, in collaboration
with the commissioner of education and the Minneapolis Board of Education,
shall establish a working group composed of at least three students, two teachers,
one school administrator, and one member of the Minneapolis Board of Education
to recommend an education campaign in Minneapolis public schools to inform
students and parents about the potentially harmful effects of the use of
fragrance products on sensitive students and school personnel in Minneapolis
schools. The commissioner shall report findings to the legislature by February
1, 2008.
EFFECTIVE DATE. This section is
effective the day following final enactment.
Sec. 55. LINDANE COMMITTEE.
The commissioner of health
shall create a committee of stakeholders, including at least one environmental
health research scientist and at least one parent consumer advocate, to review
the scientific literature and make recommendations to the legislature on the
health impact of Lindane on children and report back by January 15, 2008.
Sec. 56. MEDICAL ASSISTANCE COVERAGE FOR ARSENIC
TESTING.
The commissioner of human
services shall ensure that testing for arsenic under Minnesota Statutes,
section 144.967, is covered under medical assistance.
Sec. 57. BLOOD LEAD TESTING STUDY.
The commissioner of health,
in consultation with the Department of Human Services; cities of the first
class; health care providers; and other interested parties shall conduct a study
to evaluate blood lead testing methods used to confirm elevated blood lead
status. The study shall examine and/or develop:
(1) the false positive rate
of capillary tests for children less than 72 months old;
(2) current protocols for conducting
capillary testing, including filter paper methodology;
(3) existing guidelines and
regulations from other states and federal agencies regarding lead testing;
(4) recommendations
regarding the use of capillary tests to initiate environmental investigations
and case management, including number and timing of tests and fiscal
implications for state and local lead programs; and
(5) recommendations
regarding reducing the state mandatory intervention to ten micrograms of lead
per deciliter of whole blood.
The commissioner shall
submit the results of the study and any recommendations, including any
necessary legislative changes, to the legislature by February 15, 2008.
Sec. 58. WINDOW SAFETY EDUCATION.
The commissioner of health
shall create in the department's current educational safety program a component
targeted at parents and caregivers of young children to provide awareness of
the need to take precautions to prevent children from falling through open
windows. The commissioner of health shall consult with representatives of the
residential building industry, the window products industry, the child safety
advocacy community, and the Department of Labor and Industry to create the
window safety program component. The program must include the gathering of data
about falls from windows that result in severe injury in order to measure the
effectiveness of the safety program. The commissioner of health may consult
with other child safety advocacy groups, experts, and
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interested parties in the
development and implementation of the window safety program. The commissioner
of health shall prepare and submit a final report on the window safety program
to the legislature by March 1, 2011. The commissioner shall prepare and submit
a yearly progress report to the legislature by March 1 of each year beginning
in 2008 until the submission of the final report. The final report must include
a summary of the safety program, the impact of the program on children falling
from windows, and any recommendations for further study or action.
Sec. 59. REVISOR'S INSTRUCTION.
The revisor of statutes
shall change the range reference "144.9501 to 144.9509" to
"144.9501 to 144.9512" wherever the reference appears in Minnesota
Statutes and Minnesota Rules.
Sec. 60. REPEALER.
Laws 2004, chapter 288,
article 6, section 27, is repealed.
ARTICLE 11
HUMAN SERVICES FORECAST
ADJUSTMENTS
Section 1. SUMMARY OF APPROPRIATIONS; DEPARTMENT OF HUMAN SERVICES
FORECAST ADJUSTMENT.
The dollar amounts shown are added to or, if shown in
parentheses, are subtracted from the appropriations in Laws 2006, chapter 282,
from the general fund, or any other fund named, to the Department of Human
Services for the purposes specified in this article, to be available for the
fiscal year indicated for each purpose. The figure "2007" used in
this article means that the appropriation or appropriations listed are
available for the fiscal year ending June 30, 2007.
2007
General Fund $(25,226,000)
Health Care Access $(53,980,000)
TANF $(24,805,000)
Total $(104,011,000)
Sec. 2. COMMISSIONER
OF HUMAN SERVICES
Subdivision 1. Total
Appropriation $(104,011,000)
Appropriations by Fund
2007
General (25,226,000)
Health Care Access (53,980,000)
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TANF (24,805,000)
Subd. 2. Revenue
and Pass Through
TANF (106,000)
Subd. 3. Children
and Economic Assistance Grants
General 3,221,000
TANF (24,699,000)
The amounts that may be spent from this
appropriation for each purpose are as follows:
(a) MFIP/DWP Grants
General 13,827,000
TANF (24,699,000)
(b) MFIP Child Care Assistance
Grants
General (4,733,000)
(c) General Assistance
Grants
General 1,081,000
(d) Minnesota Supplemental
Aid Grants
General (1,099,000)
(e) Group Residential
Housing Grants
General (5,855,000)
Subd. 4. Basic
Health Care Grants
General 17,592,000
Health Care Access (53,980,000)
The amounts that may be spent from this
appropriation for each purpose are as follows:
(a) MinnesotaCare Health
Care Access (53,980,000)
(b) MA Basic Health Care -
Families and Children
General 15,729,000
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(c) MA Basic Health Care -
Elderly and Disabled
General (4,540,000)
(d) General Assistance
Medical Care
General 6,403,000
Subd. 5. Continuing
Care Grants
General (46,039,000)
The amounts that may be
spent from this appropriation for each purpose are as follows:
(a) MA Long-Term Care
Facilities
General (15,028,000)
(b) MA Long-Term Care
Waivers
General (20,677,000)
(c) Chemical Dependency
Entitlement Grants
General (10,334,000)
Sec. 3. EFFECTIVE DATE.
Sections 1 and 2 are
effective the day following final enactment.
ARTICLE 12
HUMAN SERVICES APPROPRIATIONS
Section 1. SUMMARY OF
APPROPRIATIONS.
The amounts shown in this section summarize direct
appropriations, by fund, made in this article.
2008 2009 Total
General $4,559,985,000 $4,920,502,000 $9,480,487,000
State Government Special
Revenue 13,854,000 13,864,000 27,718,000
Health Care Access 432,115,000 536,076,000 968,191,000
Federal TANF 244,463,000 252,899,000 497,362,000
Lottery Prize Fund 2,184,000 1,787,000 3,971,000
Total $5,252,601,000 $5,730,508,000 $10,983,109,000
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Sec. 2. HEALTH AND
HUMAN SERVICES APPROPRIATIONS.
The sums shown in the columns marked
"Appropriations" are appropriated to the agencies and for the purposes
specified in this article. The appropriations are from the general fund, or
another named fund, and are available for the fiscal years indicated for each
purpose. The figures "2008" and "2009" used in this article
mean that the appropriations listed under them are available for the fiscal
year ending June 30, 2008, or June 30, 2009, respectively. "The first
year" is fiscal year 2008. "The second year" is fiscal year
2009. "The biennium" is fiscal years 2008 and 2009. Appropriations
for the fiscal year ending June 30, 2007, are effective the day following final
enactment.
APPROPRIATIONS
Available for the Year
Ending June 30
2008 2009
Sec. 3. HUMAN
SERVICES
Subdivision 1. Total
Appropriation $5,198,244,000 $5,684,723,000
Appropriations by Fund
2008 2009
General 4,341,800,000 4,904,289,000
State Government
Special Revenue 545,000 555,000
Health Care Access 409,252,000 519,813,000
Federal TANF 244,463,000 252,899,000
Lottery Prize Fund 2,184,000 1,787,000
The amounts that may be
spent for each purpose are specified in the following subdivisions.
Receipts
for Systems Projects. Appropriations and federal
receipts for information system projects for MAXIS, PRISM, MMIS, and SSIS must
be deposited in the state system account authorized in Minnesota Statutes,
section 256.014. Money appropriated for computer projects approved by the
Minnesota Office of Enterprise Technology, funded by the legislature, and
approved by the commissioner of finance, may be transferred from one project to
another and from development to operations as the commissioner of human
services considers necessary. Any unexpended balance in the appropriation for
these projects does not cancel but is available for ongoing development and
operations.
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APPROPRIATIONS
Available for the Year
Ending June 30
2008 2009
Systems
Continuity. In the event of disruption
of technical systems or computer operations, the commissioner may use available
grant appropriations to ensure continuity of payments for maintaining the
health, safety, and well-being of clients served by programs administered by
the Department of Human Services. Grant funds must be used in a manner consistent
with the original intent of the appropriation.
Nonfederal
Share Transfers. The nonfederal share of
activities for which federal administrative reimbursement is appropriated to
the commissioner may be transferred to the special revenue fund.
Gifts. Notwithstanding
Minnesota Statutes, sections 16A.013 to 16A.016, the commissioner may accept,
on behalf of the state, additional funding from sources other than state funds
for the purpose of financing the cost of assistance program grants or nongrant
administration. All additional funding is appropriated to the commissioner for
use as designated by the grantor of funding.
TANF Funds
Appropriated to Other Entities. Any expenditures from the
TANF block grant shall be expended according to the requirements and
limitations of part A of title IV of the Social Security Act, as amended, and
any other applicable federal requirement or limitation. Prior to any
expenditure of these funds, the commissioner shall ensure that funds are
expended in compliance with the requirements and limitations of federal law and
that any reporting requirements of federal law are met. It shall be the
responsibility of any entity to which these funds are appropriated to implement
a memorandum of understanding with the commissioner that provides the necessary
assurance of compliance prior to any expenditure of funds. The commissioner
shall receipt TANF funds appropriated to other state agencies and coordinate
all related interagency accounting transactions necessary to implement these appropriations.
Unexpended TANF funds appropriated to any state, local, or nonprofit entity
cancel at the end of the state fiscal year unless appropriating or statutory
language permits otherwise.
TANF Block
Grant. Of this amount, $750,000 the
first year and $750,000 the second year are onetime appropriations from the
state's federal TANF block grant under Title I of Public Law 104-193. If the
appropriation in either year is insufficient, the appropriation for the other
year is available.
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APPROPRIATIONS
Available for the Year
Ending June 30
2008 2009
TANF
Maintenance of Effort. (a) In order to meet the basic maintenance of effort
(MOE) requirements of the TANF block grant specified under Code of Federal
Regulations, title 45, section 263.1, the commissioner may only report
nonfederal money expended for allowable activities listed in the following
clauses as TANF/MOE expenditures:
(1) MFIP cash, diversionary work
program, and food assistance benefits under Minnesota Statutes, chapter 256J;
(2) the child care
assistance programs under Minnesota Statutes, sections 119B.03 and 119B.05, and
county child care administrative costs under Minnesota Statutes, section 119B.15;
(3) state and county MFIP
administrative costs under Minnesota Statutes, chapters 256J and 256K;
(4) state, county, and
tribal MFIP employment services under Minnesota Statutes, chapters 256J and
256K;
(5) expenditures made on
behalf of noncitizen MFIP recipients who qualify for the medical assistance
without federal financial participation program under Minnesota Statutes,
section 256B.06, subdivision 4, paragraphs (d), (e), and (j); and
(6) qualifying working
family credit expenditures under Minnesota Statutes, section 290.0671.
(b) The commissioner shall
ensure that sufficient qualified nonfederal expenditures are made each year to
meet the state's TANF/MOE requirements. For the activities listed in paragraph
(a), clauses (2) to (6), the commissioner may only report expenditures that are
excluded from the definition of assistance under Code of Federal Regulations,
title 45, section 260.31.
(c) The commissioner shall
ensure that the maintenance of effort used by the commissioner of finance for
the February and November forecasts required under Minnesota Statutes, section
16A.103, contains expenditures under paragraph (a), clause (1), equal to at
least 25 percent of the total required under Code of Federal Regulations, title
45, section 263.1.
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APPROPRIATIONS
Available for the Year
Ending June 30
2008 2009
(d) Minnesota Statutes, section 256.011, subdivision
3, which requires that federal grants or aids secured or obtained under that
subdivision be used to reduce any direct appropriations provided by law, does
not apply if the grants or aids are federal TANF funds.
(e) Notwithstanding section 13, this rider expires
June 30, 2011.
Working Family Credit
Expenditures as TANF/MOE. The commissioner may claim
as TANF maintenance of effort up to $6,707,000 per year for fiscal year 2008
through fiscal year 2011. Notwithstanding section 13, this rider expires June
30, 2011.
Additional Working Family
Credit Expenditures to be Claimed for TANF/MOE. In
addition to the amounts provided in this section, the commissioner may count
the following amounts of working family credit expenditure as TANF/MOE:
(1) fiscal year 2008, $4,269,000; and
(2) fiscal year 2009, $4,889,000.
Notwithstanding section 13, this rider expires June
30, 2011.
Capitation Rate Increase. Of
the health care access fund appropriations to the University of Minnesota in the
higher education omnibus appropriation bill, $2,157,000 in fiscal year 2008 and
$2,157,000 in fiscal year 2009 are to be used to increase the capitation
payments under Minnesota Statutes, section 256B.69.
Health Care Access Fund
Transfer.
Notwithstanding Minnesota Statutes, section 295.581, in addition to the
transfers in Minnesota Statutes, section 16A.724, subdivision 2, the
commissioner of finance shall transfer up to the following amounts from the
health care access fund to the general fund on June 30 of each fiscal year:
(1) fiscal year 2008, $6,416,000;
(2) fiscal year 2009, $5,643,000;
(3) fiscal year 2010, $6,677,000; and
(4) fiscal year 2011, $7,866,000.
Notwithstanding section 13, this rider expires June
30, 2011.
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APPROPRIATIONS
Available for the Year
Ending June 30
2008 2009
Subd. 2. Agency
Management 57,495,000 57,696,000
Appropriations by Fund
General 48,181,000 48,417,000
State Government
Special Revenue 424,000 432,000
Health Care Access 8,018,000 7,975,000
Federal TANF 222,000 222,000
The amounts that may be
spent from the appropriation for each purpose are as follows:
(a) Financial Operations
Appropriations by Fund
General 7,102,000 7,523,000
Health Care Access 889,000 880,000
Federal TANF 122,000 122,000
(b) Legal and Regulation Operations
Appropriations by Fund
General 12,805,000 12,673,000
State Government
Special Revenue 424,000 432,000
Health Care Access 891,000 908,000
Federal TANF 100,000 100,000
Base
Adjustment. The general fund base is
decreased by $177,000 in fiscal year 2010 and $353,000 in fiscal year 2011 for
legal and regulatory.
Journal of the House - 47th
Day - Friday, April 13, 2007 - Top of Page 3731
APPROPRIATIONS
Available for the Year
Ending June 30
2008 2009
Child Care Licensing. $697,000 is appropriated
from the general fund to the commissioner of human services for the biennium
beginning July 1, 2007, for purposes of completing background studies for
family and group family child care providers under Minnesota Statutes, chapter
245C. This appropriation will be $288,000 in fiscal year 2010 and $112,000 in
fiscal year 2011.
(c) Management Operations
Appropriations by Fund
General 4,390,000 4,433,000
Health Care Access 234,000 238,000
(d) Information Technology Operations
Appropriations by Fund
General 23,884,000 23,788,000
Health Care Access 6,004,000 5,949,000
Subd. 3. Revenue
and Pass-Through Expenditures 56,509,000 56,897,000
Federal TANF 56,509,000 56,897,000
TANF Transfer to Federal
Child Care and Development Fund. The following TANF fund
amounts are appropriated to the commissioner for the purposes of MFIP
transition year child care under MFIP, Minnesota Statutes, section 119B.05:
(1) fiscal year 2008, $9,478,000
(2) fiscal year 2009, $13,022,000
(3) fiscal year 2010, $3,332,000 and
(4) fiscal year 2011, $4,668,000.
The commissioner shall authorize transfer of
sufficient TANF funds to the federal child care and development fund to meet
this appropriation and shall ensure that all transferred funds are expended
according the federal child care and development fund regulations.
Journal of the House - 47th
Day - Friday, April 13, 2007 - Top of Page 3732
APPROPRIATIONS
Available for the Year
Ending June 30
2008 2009
Subd. 4. Children
and Economic Assistance Grants 603,305,000 581,714,000
Appropriations by Fund
General 416,519,000 387,330,000
Federal TANF 186,536,000 194,584,000
Health Care Access 250,000 -0-
The amounts that may be
spent from this appropriation for each purpose are as follows:
(a) MFIP/DWP Grants
Appropriations by Fund
General 62,000,000 61,911,000
Federal TANF 82,532,000 90,003,000
(b) Support Services Grants
Appropriations by Fund
General 8,815,000 9,465,000
Federal TANF 103,382,000 103,382,000
TANF Prior
Appropriation Cancellation. Notwithstanding Laws 2001, First
Special Session chapter 9, article 17, section 2, subdivision 11, paragraph
(b), any unexpended TANF funds appropriated to the commissioner to contract
with the Board of Trustees of Minnesota State Colleges and Universities, to
provide tuition waivers to employees of health care and human service providers
that are members of qualifying consortia operating under Minnesota Statutes,
sections 116L.10 to 116L.15, must cancel at the end of fiscal year 2007.
MFIP Pilot
Program.
Of the general fund appropriation, $100,000 in fiscal year 2008 and $750,000
in fiscal year 2009 are for a grant to the Stearns-Benton Employment and
Training Council for the Workforce U pilot program.
Journal of the House - 47th
Day - Friday, April 13, 2007 - Top of Page 3733
APPROPRIATIONS
Available for the Year
Ending June 30
2008 2009
Work Study. $750,000 in fiscal year
2008 and $750,000 in fiscal year 2009 are appropriated from the TANF reserve
account to the Minnesota Office of Higher Education for work study grants under
Minnesota Statutes, section 136A.233, specifically for low-income individuals
who receive assistance under Minnesota Statutes, chapter 256J.
(c) MFIP Child Care Assistance Grants
General 337,000 553,000
Federal TANF 32,000 609,000
(d) Child Support Enforcement Grants
General 11,705,000 3,705,000
Child
Support Enforcement. $8,000,000 for fiscal year 2008 is to make grants to counties for
child support enforcement programs to make up for the loss under the 2006
federal Deficit Reduction Act of federal matching funds for federal incentive
funds passed on to the counties by the state.
This appropriation is
available until spent.
(e) Basic Sliding Fee Child Care Assistance Grants
General 43,012,000 45,432,000
Base
Adjustment. The general fund base is
increased by $3,583,000 in fiscal year 2010 and $1,334,000 in fiscal year 2011
for basic sliding fee child care assistance grants.
(f) Child Care Development Grants
General 5,865,000 5,865,000
Child Care
Services Grants. $5,000,000 is appropriated from the general fund to the
commissioner of human services for the biennium beginning July 1, 2007, for
purposes of providing child care services grants under Minnesota Statutes,
section 119B.21, subdivision 5. This appropriation is for the 2008-2009
biennium only, and does not increase the base funding.
Journal of the House - 47th
Day - Friday, April 13, 2007 - Top of Page 3734
APPROPRIATIONS
Available for the Year
Ending June 30
2008 2009
Early
Childhood Professional Development System. $2,000,000 is
appropriated from the general fund to the commissioner of human services for
the biennium beginning July 1, 2007, for purposes of the early childhood
professional development system, which increases the quality and continuum of
professional development opportunities for child care practitioners. This
appropriation is for the 2008-2009 biennium only, and does not increase the
base funding.
Family,
Friend, and Neighbor Grant Program. $750,000 in fiscal year 2008 and $750,000 in
fiscal year 2009 are appropriated from the general fund to the commissioner of
human services for the family, friend, and neighbor grant program in section
31. Any balance in the first year does not cancel but is available in the
second year. This appropriation is for the 2008-2009 biennium only, and does
not increase the base funding.
(g) Increased Child Care Provider Connections. (1) $200,000
is appropriated from the general fund to the commissioner of human services for
the biennium beginning July 1, 2007, for the following purposes: $100,000 each
year is for a grant to Hennepin County, and $100,000 each year is for a grant
to Ramsey County. The two counties shall each contract with a nonprofit
organization to work with the contracting county and county-based licensed
family child care providers to facilitate county-based information regarding
family and children's resources and to make training and peer support available
to licensed family child care providers consistent with clause (2). These appropriations
are available until June 30, 2009, and shall not become part of base-level
funding for the biennium beginning July 1, 2009.
(2) Programs to improve
child care provider connections to county services shall be established in
Hennepin and Ramsey counties to:
(i) improve county contact
activities with county-licensed family child care providers that facilitate
utilization of county educational, social service, public health, and economic
assistance services by eligible families, parents, and children using licensed
family child care; and
(ii) support licensed family
child care providers to qualify as quality-rated child care providers through
peer support and coaching networks.
Journal of the House - 47th
Day - Friday, April 13, 2007 - Top of Page 3735
APPROPRIATIONS
Available for the Year
Ending June 30
2008 2009
Hennepin and Ramsey Counties shall contract with a
nonprofit organization under clause (1) that utilizes licensed family child
care providers as contacts for families using licensed family child care and to
provide peer support to licensed family child care providers.
(3) Hennepin and Ramsey Counties must report back on
successful strategies for increasing contact with county-based licensed family
child care providers and report their findings to the appropriate legislative
committees by February 15, 2010.
(h) Children's Services Grants
Appropriations by Fund
General 62,745,000 73,133,000
Health Care Access 250,000 -0-
Base Adjustment. The
general fund base is decreased by $673,000 in fiscal year 2010 and $670,000 in
fiscal year 2011 for children's services grants.
Privatized Adoption Grants. Federal
reimbursement for privatized adoption grant and foster care recruitment grant
expenditures is appropriated to the commissioner for adoption grants and foster
care and adoption administrative purposes.
Adoption Assistance
Incentive Grants. Federal funds available
during fiscal year 2008 and fiscal year 2009 for the adoption incentive grants
are appropriated to the commissioner for these purposes.
Adoption Assistance and
Relative Custody Assistance. The commissioner may
transfer unencumbered appropriation balances for adoption assistance and
relative custody assistance between fiscal years and between programs.
Adoption Assistance and
Relative Custody Assistance Subsidy Payment Increase. Notwithstanding
Minnesota Rules, part 9560.0083, subparts 5 and 6, the commissioner shall
increase the payment schedules for basic and supplemental maintenance needs
subsidies by 3.95 percent effective July 1, 2007. The commissioner may make
cost-neutral adjustments between schedules and between brackets within
schedules to allow for whole-dollar bracket
levels and account for differential cost
Journal of the House - 47th
Day - Friday, April 13, 2007 - Top of Page 3736
APPROPRIATIONS
Available for the Year
Ending June 30
2008 2009
increases in caring for children with special needs.
Counties have until December 31, 2007, to implement the relative custody
assistance payment increases and shall make payment adjustments retroactive to
July 1, 2007.
Crisis Nurseries. $1,100,000 in fiscal
year 2008 and $1,100,000 in fiscal year 2009 are appropriated from the general
fund for the crisis nurseries program. Of this amount, $100,000 each year is to
be made available for capacity development and technical support for crisis
nurseries.
Respite Care. Of the general fund
appropriation, $1,250,000 in fiscal year 2008 and $2,500,000 in fiscal year
2009 are to the commissioner of human services to fund respite care for
children who have a diagnosis of emotional disturbance or severe emotional
disturbance.
Childhood Trauma; Grants. Of the general fund
appropriation, $125,000 in fiscal year 2008 and $250,000 in fiscal year 2009
are to the commissioner of human services to make grants for the purpose of
maintaining and expanding evidence-based practices that support children and
youth who have been exposed to violence or who are refugees.
Collaborative Services for
High-Risk Children. Of the general fund appropriation, $2,632,000 in fiscal year 2008
and $6,150,000 in fiscal year 2009 are to the commissioner of human services to
fund early intervention collaborative programs.
Evidence-Based Practice. Of the general fund
appropriation, $2,175,000 in fiscal year 2008 and $4,350,000 in fiscal year
2009 are to the commissioner of human services to develop and implement
evidence-based practice in children's mental health care and treatment.
MFIP and Children's Mental
Health Pilot Project. Of the general fund
appropriation, $100,000 in fiscal year 2008 and $200,000 in fiscal year 2009
are to the commissioner of human services to fund the MFIP and children's mental
health pilot project.
Regional Children's Mental
Health Initiative. $700,000 in fiscal year 2008 and $700,000 in fiscal year 2009 are
appropriated to the commissioner of human services to fund the Regional
Children's Mental Health Initiative pilot project. This is a onetime
appropriation.
Journal of the House - 47th
Day - Friday, April 13, 2007 - Top of Page 3737
APPROPRIATIONS
Available for the Year
Ending June 30
2008 2009
Child Safety Efforts. $1,000,000 in fiscal year
2008 and $1,000,000 in fiscal year 2009 are appropriated to counties based on
their population of residents under age 18. Funds are to be used to maintain
and improve child safety services. By February 1, 2008, each county shall
submit a report regarding current child safety efforts, child safety funding,
and unmet needs including investments needed. The report shall also include
methods and community partners available to ensure early identification of
at-risk families. The Association of Minnesota Counties and county agencies
shall develop a uniform report structure so that statewide data can be easily
summarized. This is a onetime appropriation.
Fetal Alcohol Syndrome. Of the general fund
appropriation, $75,000 in fiscal year 2008 and $75,000 in fiscal year 2009 are
for three programs that provide services to reduce fetal alcohol syndrome under
Minnesota Statutes, section 145.9266. The three program grantees are the
University of Minnesota, the Meeker-McLeod-Sibley Community, and the American
Indian Family Center. This appropriation shall become part of the base
appropriation.
Base Adjustment. The
general fund base is increased by $366,000 in fiscal year 2010 and $369,000 in
fiscal year 2011 for children's services grants.
(i) Children and Community Services Grants
General 110,802,000 69,567,000
Base Adjustment. The
general fund base is increased by $99,000 in each of fiscal years 2010 and 2011
for children and community services grants.
Targeted Case Management
Temporary Funding. Of the general fund
appropriation, $40,000,000 in fiscal year 2008 is allocated to counties and
tribes affected by reductions in targeted case management federal Medicaid
revenue as a result of the provisions in the federal Deficit Reduction Act of
2005, Public Law 109-171. The commissioner shall distribute the funds
proportionate to each affected county or tribe's targeted case management
federal earnings for calendar year 2005. Prior to distribution of funds, the
commissioner shall estimate and certify the amount by which the federal
regulations will reduce case management revenue over the 2008-2009 biennium.
The commissioner may provide grants up to the amount of the estimated reduction, not to exceed $40,000,000 for the biennium.
Journal of the House - 47th
Day - Friday, April 13, 2007 - Top of Page 3738
APPROPRIATIONS
Available for the Year
Ending June 30
2008 2009
The commissioner may
determine the timing and frequency of payments to counties. These funds are available
in either year of the biennium. Counties shall use these funds to pay for
social service-related costs, but the funds are not subject to provisions of
the Children and Community Services Act grant under Minnesota Statutes, chapter
256M.
Child Welfare
Project.
Of the general fund appropriation, $2,000,000 for the biennium beginning
July 1, 2007, is for expanding the American Indian chid welfare project under
Minnesota Statutes, section 256.01, subdivision 14b, to include the Red Lake
Band of Chippewa Indians Tribe, provided the tribe meets the criteria in
Minnesota Statutes, section 256.01, subdivision 14b.
(j) General Assistance Grants
General 37,876,000 38,253,000
General
Assistance Standard. The commissioner shall set
the monthly standard of assistance for general assistance units consisting of
an adult recipient who is childless and unmarried or living apart from parents
or a legal guardian at $203. The commissioner may reduce this amount according
to Laws 1997, chapter 85, article 3, section 54.
Emergency
General Assistance. The amount appropriated for
emergency general assistance funds is limited to no more than $7,889,812 in
fiscal year 2008 and $7,889,812 in fiscal year 2009. Funds to counties must be
allocated by the commissioner using the allocation method specified in
Minnesota Statutes, section 256D.06.
(k) Minnesota Supplemental Aid Grants
General 30,798,000 31,439,000
Emergency
Minnesota Supplemental Aid Funds. The amount appropriated for
emergency Minnesota supplemental aid funds is limited to no more than
$1,100,000 in fiscal year 2008 and $1,100,000 in fiscal year 2009. Funds to
counties must be allocated by the commissioner using the allocation method
specified in Minnesota Statutes, section 256D.46.
Journal of the House - 47th
Day - Friday, April 13, 2007 - Top of Page 3739
APPROPRIATIONS
Available for the Year
Ending June 30
2008 2009
(l) Group Residential Housing Grants
General 91,441,000 99,304,000
Base Adjustment. The
general fund base is increased by $6,665,000 in fiscal year 2010 and
$13,419,000 in fiscal year 2011.
People
Incorporated. $460,000 in fiscal year 2008
and $460,000 in fiscal year 2009 are appropriated from the general fund to the
commissioner of human services to augment community support and mental health
services provided to individuals residing in facilities under Minnesota
Statutes, section 256I.05, subdivision 1h.
(m) Other Children and Economic Assistance Grants
Federal TANF 590,000 590,000
New Chance. $140,000 in fiscal year
2008 and $140,000 in fiscal year 2009 are appropriated from federal TANF funds
to the Hennepin County new chance program.
Mothers First. Of the TANF
appropriation, $450,000 in fiscal year 2008 and $450,000 in fiscal year 2009
are to fund the Ramsey County mothers first program. The appropriations are
available until spent and are a onetime appropriation.
Homeless and Runaway Youth. $3,500,000 in the first year
and $3,500,000 in the second year are for the Runaway and Homeless Youth Act
under Minnesota Statutes, section 256K.45. Funds shall be spent in each area of
the continuum of care to ensure that programs are meeting the greatest need.
The base is decreased by $2,000,000 each year in fiscal year 2010 and fiscal
year 2011.
Transitional Housing and
Emergency Services.
(1) $750,000 each year from the federal TANF fund is
for transitional housing programs under Minnesota Statutes, section 256E.33.
The TANF appropriations are onetime. The general fund base for transitional
housing is increased by $422,000 each year for the fiscal 2010-2011 biennium.
Up to ten percent of this appropriation may be used for housing and services
which extend beyond 24 months. $300,000 in each year of this amount is for
grants for safe housing pilot projects for battered women and families in Anoka
County, Houston County, and Beltrami County; and
Journal of the House - 47th
Day - Friday, April 13, 2007 - Top of Page 3740
APPROPRIATIONS
Available for the Year
Ending June 30
2008 2009
(2) $527,000 each year is added to the base for
emergency services grants under Laws 1997, chapter 162, article 3, section 7.
The base for emergency services grants is decreased each year by $300,000 in
fiscal year 2010 and fiscal year 2011.
Foodshelf Programs. $575,000 each year is
added to the base for foodshelf programs under Minnesota Statutes, section
256E.34. The base is decreased by $250,000 each year in fiscal year 2010 and
fiscal year 2011.
Long-term Homeless Services. $2,440,000 each year is
added to the base for the long-term homeless services under Minnesota Statutes,
section 256K.26. The base is decreased by $1,000,000 each year in fiscal year
2010 and fiscal year 2011.
Minnesota Community Action
Grants.
$1,500,000 each year is added to the base for the purposes of Minnesota
community action grants under Minnesota Statutes, sections 256E.30 to 256E.32.
The base is reduced by $500,000 each year in fiscal year 2010 and fiscal year
2011.
Tenant Hotline Services
Program.
$50,000 each year is added to the base for a grant to HOME Line for the
tenant hotline services program. This is a onetime appropriation.
Subd. 5. Children
and Economic Assistance Management 46,507,000 46,590,000
Appropriations by Fund
General 44,964,000 45,040,000
Health Care Access 347,000 354,000
Federal TANF 1,196,000 1,196,000
The amounts that may be spent from the appropriation
for each purpose are as follows:
(a) Children and Economic Assistance Administration
Appropriations by Fund
General 9,321,000 9,318,000
Federal TANF 1,196,000 1,196,000
Journal of the House - 47th
Day - Friday, April 13, 2007 - Top of Page 3741
APPROPRIATIONS
Available for the Year
Ending June 30
2008 2009
(b) Children and Economic Assistance Operations
Appropriations by Fund
General 35,643,000 35,722,000
Health Care Access 347,000 354,000
Spending
Authority for Food Stamps Bonus Awards. In the event that Minnesota qualifies
for the United States Department of Agriculture Food and Nutrition Services
Food Stamp Program performance bonus awards, the funding is appropriated to the
commissioner. The commissioner shall retain 25 percent of the funding, with the
other 75 percent divided among the counties according to a formula that takes
into account each county's impact on state performance in the applicable bonus
categories.
Child
Support Payment Center. Payments to the commissioner
from other governmental units, private enterprises, and individuals for
services performed by the child support payment center must be deposited in the
state systems account authorized under Minnesota Statutes, section 256.014.
These payments are appropriated to the commissioner for the operation of the
child support payment center or system, according to Minnesota Statutes,
section 256.014.
Financial
Institution Data Match and Payment of Fees. The commissioner is
authorized to allocate up to $310,000 each year in fiscal years 2008 and 2009 from
the PRISM special revenue account to make payments to financial institutions in
exchange for performing data matches between account information held by
financial institutions and the public authority's database of child support
obligors as authorized by Minnesota Statutes, section 13B.06, subdivision 7.
Subd. 6. Basic
Health Care Grants 2,396,290,000 2,738,179,000
Appropriations by Fund
General 2,618,815,000 2,250,170,000
Health Care Access 377,475,000 487,989,000
Journal of the House - 47th
Day - Friday, April 13, 2007 - Top of Page 3742
APPROPRIATIONS
Available for the Year
Ending June 30
2008 2009
The amounts that may be
spent from the appropriation for each purpose are as follows:
(a) MinnesotaCare Grants
Health Care Access 376,588,000 455,429,000
MinnesotaCare
Federal Receipts. Receipts received as a
result of federal participation in administering costs of the Minnesota health
care reform waiver must be deposited as nondedicated revenue in the health care
access fund. Receipts received as a result of federal participation in making
grants must be deposited in the federal fund and must offset health care access
funds for payments to providers.
MinnesotaCare
Funding. The commissioner may expend
money appropriated from the health care access fund for MinnesotaCare in either
fiscal year of the biennium.
HealthMatch
Delay.
Of this
appropriation, $2,560,000 in fiscal year 2008 and $25,508,000 in fiscal year
2009 are for MinnesotaCare program costs related to implementation of the
HealthMatch program.
(b) MA Basic Health Care - Families and Children
Appropriations by Fund
General 759,866,000 853,680,000
Health Care Access -0- 31,661,000
(c) MA Basic Health Care - Elderly and Disabled
General 1,017,023,000 1,142,719,000
Provider-Directed
Care Coordination. In addition to medical assistance reimbursement under Minnesota
Statutes, sections 256B.0625 and 256B.76, clinics participating in provider-directed
care coordination under Minnesota Statutes, section 256B.0625, also receive a
monthly payment per client when the clinic serves an eligible client. The
payments across the program must average $50 per month per client.
Journal of the House - 47th
Day - Friday, April 13, 2007 - Top of Page 3743
APPROPRIATIONS
Available for the Year
Ending June 30
2008 2009
Services
for Developmentally Disabled. The commissioner must serve: an additional 200
persons in the MR/RC waiver program; an additional 200 persons in the family
support grant program under Minnesota Statutes, section 252.32; and an
additional 200 persons in the semi-independent living services program under
Minnesota Statutes, section 252.275.
Transfer of
Funds. (1) The commissioner of
human services shall transfer to qualifying counties medical assistance funds
for fiscal year 2007 equal to the difference between the state allocation for
community alternatives for disabled individuals (CADI) and actual county
spending for persons who have been receiving personal care assistant services
but were transferred to the CADI waivered services program according to Laws
2006, chapter 282, article 20, section 35. The medical assistance funds shall
be transferred from appropriations for personal care assistant services that
went unspent as a result of the provisions of Laws 2006, chapter 282, article
20, section 35.
(2) Counties that qualify
under paragraph (a) shall provide to the commissioner by June 10, 2007, all
necessary information regarding the funding amount to which they are entitled.
The commissioner shall transfer funds to qualifying counties by June 25, 2007.
(3) The amounts provided to
counties under this section shall become part of each county's base level state
allocation for CADI for the biennium beginning July 1, 2007.
(4) The provisions in
paragraphs (a) to (c) shall apply to persons who transferred to the elderly
waiver as a result of Laws 2006, chapter 282, article 20, section 35.
(5) This rider is effective
the day following final enactment.
(d) General Assistance Medical Care Grants
General 238,887,000 251,082,000
(e) Other Health Care Grants
General 3,039,000 2,709,000
Health Care Access 887,000 899,000
Journal of the House - 47th
Day - Friday, April 13, 2007 - Top of Page 3744
APPROPRIATIONS
Available for the Year
Ending June 30
2008 2009
Care
Coordination. Of the general fund appropriation, $500,000 in fiscal year 2008 and
$1,000,000 in fiscal year 2009 are for the commissioner of human services for
contracting for care coordination with the U special kids program under
Minnesota Statutes, section 256B.0751.
Community-Based
Health Care. Of the general fund appropriation, $1,050,000 for the biennium
beginning July 1, 2007, is to the commissioner of human services for the
demonstration project grant described in Minnesota Statutes, section 62Q.80,
subdivision 1a. This is a onetime appropriation and is available until June 30,
2012.
Community
Collaboratives. Of the general fund appropriation, $330,000 in fiscal year 2008 and
$850,000 in fiscal year 2009 are to provide grants to community collaboratives
to cover the uninsured. These are onetime appropriations.
Health Care
Payment Reform Pilot. Of the general fund appropriation, $1,018,000 in fiscal year 2008
and $1,027,000 in fiscal year 2009 are for the health care payment reform pilot
project. These are onetime appropriations.
Patient
Incentive Programs. Of the general fund appropriation, $500,000 in fiscal year 2008 and
$500,000 in fiscal year 2009 are for patient incentive programs.
State
Health Policies Grant. Of the general fund appropriation, $300,000 in fiscal year 2008 is
to provide a grant to a research center associated with a safety net hospital
and county-affiliated health system to develop the capabilities necessary for
evaluating the effects of changes in state health policies on low-income and
uninsured individuals, including the impact on state health care program costs,
health outcomes, cost-shifting to different units and levels of government, and
utilization patterns including use of emergency room care and hospitalization
rates.
Neighborhood
Health Care Network. Of the general fund appropriation, $150,000 in fiscal year 2008 and
$150,000 in fiscal year 2009 are for a grant to the Neighborhood Health Care
Network to maintain and staff a toll-free health care access telephone number.
Journal of the House - 47th
Day - Friday, April 13, 2007 - Top of Page 3745
APPROPRIATIONS
Available for the Year
Ending June 30
2008 2009
Subd. 7. Health
Care Management 54,536,000 58,696,000
Appropriations by Fund
General 32,416,000 30,589,000
Health Care Access 22,120,000 28,125,000
The amounts that may be spent from the appropriation
for each purpose are as follows:
(a) Health Care Policy Administration
Appropriations by Fund
General 10,236,000 8,813,000
Health Care Access 2,323,000 10,074,000
Minnesota Senior Health
Options Reimbursement. Federal administrative reimbursement resulting from the Minnesota
senior health options project is appropriated to the commissioner for this
activity.
Utilization Review. Federal administrative reimbursement
resulting from prior authorization and inpatient admission certification by a
professional review organization is dedicated to the commissioner for these
purposes. A portion of these funds must be used for activities to decrease
unnecessary pharmaceutical costs in medical assistance.
Dental Access for Persons
with Disabilities. Of the general fund appropriation, $82,000 in fiscal year 2008 is
for a study on access to dental services for persons with disabilities.
Base Adjustment. The health care access
fund base is $10,716,000 in fiscal year 2010 and $8,870,000 in fiscal year
2011, for health care administration.
(b) Health Care Operations
Appropriations by Fund
General 22,180,000 21,776,000
Health Care Access 19,797,000 18,051,000
Journal of the House - 47th
Day - Friday, April 13, 2007 - Top of Page 3746
APPROPRIATIONS
Available for the Year
Ending June 30
2008 2009
Base
Adjustment. The general fund base is decreased by $214,000 in fiscal year 2010 for
health care operations.
Subd. 8. Continuing
Care Grants 1,697,359,000 1,858,283,000
Appropriations by Fund
General 1,694,876,000 1,855,900,000
Health Care Access 750,000 750,000
Lottery Prize 1,733,000 1,633,000
The amounts that may be spent
from the appropriation for each purpose are as follows:
(a) Aging and Adult Services Grants
General 15,986,000 16,605,000
Information
and Assistance Reimbursement. Federal administrative reimbursement obtained from
information and assistance services provided by the Senior LinkAge Line to
people who are identified as eligible for medical assistance are appropriated
to the commissioner for this activity.
Senior
Companion Program. Of the general fund appropriation, $191,000 in fiscal year 2008 and
$191,000 in fiscal year 2009 are for the senior companion program under
Minnesota Statutes, section 256.977.
Volunteer
Senior Citizens. Of the general fund appropriation, $192,000 in fiscal year 2008 and
$192,000 in fiscal year 2009 are for the volunteer programs for retired senior
citizens under Minnesota Statutes, section 256.9753.
Foster
Grandparent Program. Of the general fund appropriation, $192,000 in fiscal year 2008 and
$192,000 in fiscal year 2009 are for the foster grandparent program in
Minnesota Statutes, section 256.976.
Senior
Nutrition.
Of the general fund appropriation, $250,000 in fiscal year 2008 and $250,000
in fiscal year 2009 are for the senior nutrition programs under Minnesota Statutes,
section 256.9752. The commissioner shall give priority to increase services to:
(1) persons facing language or cultural barriers, (2) persons with special
diets, (3) persons living in isolated rural areas, and (4) other hard-to-serve
populations.
Journal of the House - 47th
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APPROPRIATIONS
Available for the Year
Ending June 30
2008 2009
Living At
Home/Block Nurse Program. Of the general fund appropriation, $580,000 in
fiscal year 2008 and $655,000 in fiscal year 2009 are for the living at
home/block nurse program. The purpose of the appropriation is to increase base
funding levels to $25,000 per program year, provide base funding for nine
programs currently operating without base funding, provide base funding for
five new programs beginning July 1, 2007, and provide base funding for six
additional programs beginning July 1, 2008.
$76,000 in fiscal year 2008
and $62,000 in fiscal year 2009 are for increased staff for the ombudsman for
older Minnesotans and related costs.
$150,000 in fiscal year 2008
and $150,000 in fiscal year 2009 are to increase the base of the Senior LinkAge
line program.
Minnesota
Kinship Caregivers Association. (1) Of the general fund appropriation, $175,000 in
fiscal year 2008 and $175,000 in fiscal year 2009 are transferred to a
nonprofit organization experienced in kinship caregiver programs, with at least
50 percent of its board composed of kinship caregivers for purposes of
providing support to grandparents or relatives who are raising kinship
children.
(2) The demonstration grant
sites must include the Minnesota Kinship Caregivers Association central site in
the metropolitan area and another site in the Bemidji region. The support must
provide a one-stop services program. The services that may be provided include
but are not limited to legal services, education, information, family
activities, support groups, mental health access, advocacy, mentors, and
information related to foster care licensing. The funds may also be used for a
media campaign to inform kinship families about available information and
services, support sites, and other program development. The general fund base
for the program shall be $160,000 in fiscal year 2010 and $160,000 in fiscal
year 2011.
Base
Adjustment. The general fund base is increased by $72,000 in fiscal year 2010
and $72,000 in fiscal year 2011 for aging and adult services grants.
(b) Alternative Care Grants
General 50,063,000 52,511,000
Journal of the House - 47th
Day - Friday, April 13, 2007 - Top of Page 3748
APPROPRIATIONS
Available for the Year
Ending June 30
2008 2009
Alternative
Care Transfer. Any money allocated to the alternative care program that is not spent
for the purposes indicated does not cancel but is transferred to the medical
assistance account.
Base
Adjustment. The general fund base is increased by $547,000 in fiscal year 2010
and $784,000 in fiscal year 2011 for alternative care grants.
(c) Medical Assistance Grants - Long-Term Care Facilities
General 499,278,000 513,016,000
New Nursing
Facility Reimbursement System Delay. Notwithstanding Minnesota Statutes, section 256B.441,
subdivision 1, paragraph (c), the commissioner shall begin to phase in the new
reimbursement system for nursing facilities on or after October 1, 2009.
Long-Term
Care Consultation Funding Increase. For the rate year beginning October 1, 2008, the
county long-term care consultation allocations in Minnesota Statutes, section
256B.0911, subdivision 6, must be increased based on the number of transitional
long-term care consultation visits projected by the commissioner in each
county. For the rate year beginning October 1, 2009, final allocations must be
determined based on the average between the actual number of transitional
long-term care visits that were conducted in the prior 12-month period and the
projected number of consultations that will be provided in the rate year
beginning October 1, 2009. Notwithstanding section 7, this rider expires June
30, 2010.
Life Safety
Code Compliance. Of the general fund appropriation, $1,000,000 in fiscal year 2008
is for payments to nursing facilities for life safety code compliance under
Minnesota Statutes, section 256B.434, subdivision 4, paragraph (e). This is a
onetime appropriation and available until spent.
(d) Medical Assistance Grants - Long-Term Care Waivers and Home Care
Grants
General 966,623,000 1,099,540,000
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Day - Friday, April 13, 2007 - Top of Page 3749
APPROPRIATIONS
Available for the Year
Ending June 30
2008 2009
(e) Mental Health Grants
Appropriations by Fund
General 57,522,000 60,678,000
Health Care Access 750,000 750,000
Lottery Prize 1,733,000 1,633,000
Dual Diagnosis;
Demonstration Project. Of the general fund appropriation, $800,000 in fiscal year 2008 and
$1,600,000 in fiscal year 2009 are to the commissioner of human services to fund
the dual diagnosis demonstration project.
Mobile Mental Health Crisis
Services.
Of the general fund appropriation, $2,500,000 in fiscal year 2008 and
$3,625,000 in fiscal year 2009 are to the commissioner of human services for
statewide funding of adult mobile mental health crisis services. Providers must
utilize all available funding streams.
National Council on Problem
Gambling.
(1) $225,000 in fiscal year 2008 and $225,000 in fiscal year 2009 are
appropriated from the lottery prize fund to the commissioner of human services
for a grant to the state affiliate recognized by the National Council on
Problem Gambling. The affiliate must provide services to increase public
awareness of problem gambling, education, and training for individuals and
organizations providing effective treatment services to problem gamblers and
their families, and research relating to problem gambling. These services must
be complementary to and not duplicative of the services provided through the
problem gambling program administered by the commissioner of human services.
This grant does not prevent the commissioner from regular monitoring and
oversight of the grant or the ability to reallocate the funds to other services
within the problem gambling program for nonperformance of duties by the
grantee.
(2) Of this appropriation, $100,000 in fiscal year
2008 and $100,000 in fiscal year 2009 are contingent on the contribution of
nonstate matching funds. Matching funds may be either cash or qualifying in-kind
contributions. The commissioner of finance may disburse the state portion of
the matching funds in increments of $25,000 upon receipt of a commitment for an
equal amount of matching nonstate funds. The general fund base shall be
$100,000 in fiscal year 2010 and $100,000 in fiscal year 2011
Journal of the House - 47th
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APPROPRIATIONS
Available for the Year
Ending June 30
2008 2009
(3) $100,000 in fiscal year
2008 is appropriated from the lottery prize fund to the commissioner of human
services for a grant or grants to be awarded competitively to develop programs
and services for problem gambling treatment, prevention, and education in
immigrant communities. This appropriation is available until June 30, 2009, at
which time the project must be completed and final products delivered, unless
an earlier completion date is specified in the work program.
Compulsive
Gambling.
$300,000 in fiscal year 2008 and $100,000 in fiscal year 2009 are appropriated
from the lottery prize fund to the commissioner of human services for purposes
of compulsive gambling education, assessment, and treatment under Minnesota
Statutes, section 245.98.
Compulsive
Gambling Study. $100,000 in fiscal year 2008 is to continue the study currently
being done on compulsive gambling treatment effectiveness and long-term effects
of gambling.
Base
Adjustment. The general fund base is increased by $266,000 in fiscal year 2010.
(f) Deaf and Hard-of-Hearing Grants
General 1,932,000 2,380,000
Hearing
Loss Mentors. Of the general fund appropriation, $80,000 is to provide mentors
who have a hearing loss to parents of newly identified infants and children
with hearing loss.
Base
Adjustment. The general fund base is increased by $7,000 in fiscal year 2010
and $7,000 in fiscal year 2011 for deaf and hard-of-hearing grants.
(g) Chemical Dependency Entitlement Grants
General 78,749,000 89,946,000
(h) Chemical Dependency Nonentitlement Grants
General 1,055,000 1,055,000
Journal of the House - 47th
Day - Friday, April 13, 2007 - Top of Page 3751
APPROPRIATIONS
Available for the Year
Ending June 30
2008 2009
(i) Other Continuing Care Grants
Appropriations by Fund
General 23,668,000 20,169,000
Native American Juvenile
Treatment Center. Of the general fund appropriation, $50,000 is to conduct a
feasibility study of and to predesign a Native American juvenile treatment
center on or near the White Earth Reservation. The facility must house and
treat Native American juveniles and provide culturally specific programming to
juveniles placed in the treatment center. The commissioner of human services
may contract with parties who have experience in the design and construction of
juvenile treatment centers to assist in the feasibility study and predesign. On
or before January 15, 2008, the commissioner shall present the results of the
feasibility study and the predesign of the facility to the chairs of house of
representatives and senate committees having jurisdiction over human services
finance, public safety finance, and capital investment.
Leech Lake Youth Treatment
Center.
Of the general fund appropriation, $75,000 in fiscal year 2008 and $75,000
in fiscal year 2009 are for a grant to the Leech Lake Youth Treatment Center
project partners, in order to pay the salaries and other directly related costs
associated with the development of this project.
Assistive Technology. Of the general fund
appropriation, $300,000 in fiscal year 2008 is to the Minnesota State Council
on Disability for the purposes of providing $100,000 in financial support to
the Minnesota Regions Assistive Technology Collaborative and $200,000 in fiscal
year 2008 is for a local match required to access the federal
Technology-Related Assistance for Individuals with Disabilities Act, alternate
finance project.
Repayment. For the fiscal year
ending June 30, 2008, $5,287,000 is appropriated to the commissioner of human
services to repay the amount of overspending in the waiver program for persons
with developmental disabilities incurred by affected counties in calendar years
2004 and 2005.
Base Adjustment. The general fund base is
$20,276,000 in fiscal year 2010 and $20,332,000 in fiscal year 2011 for other
continuing care grants.
Journal of the House - 47th
Day - Friday, April 13, 2007 - Top of Page 3752
APPROPRIATIONS
Available for the Year
Ending June 30
2008 2009
Subd. 9. Continuing
Care Management 20,248,000 19,400,000
Appropriations by Fund
General 19,384,000 19,123,000
State Government
Special Revenue 121,000 123,000
Health Care Access 292,000 -0-
Lottery Prize 451,000 154,000
Community Trainee and
Consultation. Of the general fund appropriation, $125,000 in fiscal year 2008 is
to the commissioner of human services to contract for training and consultation
for clinical supervisors and staff of community mental health centers who
provide services to children and adults. The purpose of the training and
consultation is to improve clinical supervision of staff, strengthen compliance
with federal and state rules and regulations, and to recommend strategies for
standardization and simplification of administrative functions among community
mental health centers.
Mental Health Tracking
System.
Of the general fund appropriation, $448,000 in fiscal year 2008 and $324,000
in fiscal year 2009 are to the commissioner of human services to fund
implementation of the mental health services outcomes and tracking system.
Quality Management;
Assurance; and Improvement System for Minnesotans Receiving Disability
Services.
Of the general fund appropriation, up to $300,000 for the biennium beginning
July 1, 2007, may be used for the purposes of the quality management, assurance,
and improvement system for Minnesotans receiving disability services. Federal
Medicaid matching funds obtained for this purpose shall be dedicated to the
commissioner for this purpose.
Base Adjustment. The health care access
fund base is $0 in each of the fiscal years 2010 and 2011 for continuing care
management.
Disability Linkage Line. Of the general fund
appropriation, $650,000 in fiscal year 2008 and $626,000 in fiscal year 2009
are to establish and maintain the disability linkage line.
Journal of the House - 47th
Day - Friday, April 13, 2007 - Top of Page 3753
APPROPRIATIONS
Available for the Year
Ending June 30
2008 2009
Subd. 10. State-Operated
Services 266,645,000 267,718,000
General 266,645,000 267,718,000
Remembering
With Dignity Project. (1) $200,000 is appropriated from the general fund to the
commissioner of human services to be available until September 30, 2008, to
make a grant to Advocating Change Together for the purposes of the Remembering
With Dignity project in paragraph (2).
(2) As part of the
Remembering With Dignity project, the grant recipient shall:
(i) conduct necessary
research on persons buried in state cemeteries who were residents of state hospitals
or regional treatment centers and buried in numbered or unmarked graves;
(ii) purchase and install
headstones that are properly inscribed with their names on the graves of those
persons; and
(iii) collaborate with
community groups and state and local government agencies to build community
involvement and public awareness, ensure public access to the graves, and
ensure appropriate perpetual maintenance of state cemeteries.
(3) This rider is effective
the day following final enactment.
Transfer Authority
Related to State-Operated Services. Money appropriated to finance state-operated
services programs and administrative services may be transferred between fiscal
years of the biennium with the approval of the commissioner of finance.
The amounts that may be
spent from the appropriation for each purpose are as follows:
(a) Mental Health Services
General 116,270,000 120,095,000
Appropriation
Limitation. No part of the appropriation in this article to the commissioner
for mental health treatment services at the regional treatment centers shall be
used for the Minnesota sex offender program.
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Day - Friday, April 13, 2007 - Top of Page 3754
APPROPRIATIONS
Available for the Year
Ending June 30
2008 2009
(b) Minnesota Sex Offender Services
General 67,719,000 62,787,000
(c) Minnesota Security Hospital and METO Services
General 82,656,000 84,836,000
Minnesota
Security Hospital. For the purposes of enhancing the safety of the public, improving
supervision, and enhancing community-based mental health treatment,
state-operated services may establish additional community capacity for
providing treatment and supervision of clients who have been ordered into a
less restrictive alternative care from the state-operated services transitional
services program consistent with Minnesota Statutes, section 246.014.
Sec. 4. COMMISSIONER OF HEALTH
Subdivision 1. Total
Appropriation $54,357,000 $45,785,000
Appropriations by Fund
2008 2009
General 18,185,000 16,213,000
State Government
Special Revenue 13,309,000 13,309,000
Health Care Access 22,863,000 16,263,000
Subd. 2. Community
and Family Health Promotion
Appropriations by Fund
General 46,707,000 46,443,000
State Government
Special Revenue 468,000 471,000
Health Care Access 3,539,000 3,562,000
Federal TANF 8,667,000 9,002,000
Journal of the House - 47th
Day - Friday, April 13, 2007 - Top of Page 3755
APPROPRIATIONS
Available for the Year
Ending June 30
2008 2009
TANF Appropriations. (a) $3,579,000 of the
TANF funds is appropriated in each year of the biennium to the commissioner for
home visiting and nutritional services listed under Minnesota Statutes, section
145.882, subdivision 7, clauses (6) and (7). Funding shall be distributed to
community health boards based on Minnesota Statutes, section 145A.131,
subdivision 1.
(b) $5,088,000 in the first
year and $5,423,000 in the second year are appropriated to the commissioner of
health for the family home visiting grant program. The commissioner shall
distribute funds to community health boards using a formula developed in
conjunction with the state Community Health Services Advisory Committee. The
commissioner may use five percent of the funds appropriated in each fiscal year
to conduct the ongoing evaluations required under Minnesota Statutes, section
145A.17, subdivision 7, and may use ten percent of the funds appropriated each
fiscal year to provide training and technical assistance as required under
Minnesota Statutes, section 145A.17, subdivisions 4 and 5.
TANF
Carryforward. Any unexpended balance of the TANF appropriation in the first year
of the biennium does not cancel but is available for the second year.
Loan
Forgiveness. $605,000 the first year and $775,000 the second year and thereafter
are for the loan forgiveness program under Minnesota Statutes, section
144.1501. This funding is in addition to the loan forgiveness program base.
MN ENABL. Base level funding for the
MN ENABL program, under Minnesota Statutes, section 145.9255, is reduced by
$220,000 each year of the biennium beginning July 1, 2007.
Fetal
Alcohol Spectrum Disorder. (a) $900,000 each year is added to the base for
fetal alcohol spectrum disorder. On July 1 each fiscal year, the portion of the
general fund appropriation to the commissioner of health for fetal alcohol
spectrum disorder administration and grants shall be transferred to a statewide
organization that focuses solely on prevention of and intervention with fetal
alcohol spectrum disorder as follows:
(1) on July 1, 2007,
$2,090,000; and
(2) on July 2, 2008, and
annually thereafter, $2,090,000.
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APPROPRIATIONS
Available for the Year
Ending June 30
2008 2009
(b) The money shall be used for prevention and
intervention services and programs, including, but not limited to, community
grants, professional education, public awareness, and diagnosis. The organization
may retain $60,000 of the transferred money for administrative costs. The
organization shall report to the commissioner annually by January 15 on the
services and programs funded by the appropriation.
Deaf or Hearing Loss
Support.
$100,000 for the first year and $100,000 for the second year is for the
purpose of providing family support and assistance to families with children
who are deaf or have a hearing loss. The family support provided must include
direct parent-to-parent assistance and information on communication,
educational, and medical options. The commissioner may contract with a
nonprofit organization that has the ability to provide these services
throughout the state.
Heart Disease and Stroke
Prevention. $200,000 is appropriated in the first year for the heart disease
and stroke prevention unit of the Department of Health to fund data collection
and other activities to improve cardiovascular health and reduce the burden of
heart disease and stroke in Minnesota. This is a onetime appropriation.
Family Planning Grants. $1,000,000 each year is
for family planning grants under Minnesota Statutes, section 145.925.
Bright Smiles Pilot Project. (a) $384,000 in the
first year and $50,000 in the second year is to fund a grant for the Bright
Smiles pilot project.
(b) Of these amounts, $50,000 each year is to fund a
dental health coordinator position.
(c) The commissioner of health shall establish a
pilot project to fund a Bright Smiles program designed to increase access to
oral health care for low-income and immigrant children, ages birth to five
years, and their families and to build the knowledge and ability of parents to
care for the oral health of their children. Under this pilot project, a Bright
Smiles program shall serve the medically underserved areas in Minneapolis and
the Bemidji area, as determined by the commissioner of health.
(d) A grant shall be used to fund costs related to
improving oral health outreach, education, screening, and access to care for
families with children, ages birth to five years.
Journal of the House - 47th
Day - Friday, April 13, 2007 - Top of Page 3757
APPROPRIATIONS
Available for the Year
Ending June 30
2008 2009
(e) Grant applicants shall submit to the
commissioner a written plan that demonstrates the ability to provide the
following:
(1) new programs or continued expansion of current
access programs that have demonstrated success in providing dental services in
underserved areas of Minneapolis and the Bemidji area;
(2) programs for screening children entering the
Minneapolis and the Bemidji area public school systems and facilitating access
to care for their families;
(3) programs testing new models of care that are
sensitive to cultural needs of the recipients;
(4) programs creating new educational campaigns that
inform individuals of the importance of good oral health and the link between
dental diseases, overall health status, and success in school; and
(5) programs testing new delivery models by creating
partnerships between local early childhood and school-age education and
community clinic dental providers.
(f) Qualified applicants are partnerships among
early childhood experts, Minneapolis or Bemidji area public schools, and nonprofit
clinics that are established to provide health services to low-income patients,
provide preventive and dental care services, and utilize a sliding-scale fee or
other method of providing charity care that ensures that no person is denied
services because of inability to pay.
(g) Applicants shall submit to the commissioner an
application and supporting documentation, in the form and manner specified by
the commissioner. Applicants must be able to provide culturally appropriate
outreach, screenings, and access to dental care for children, ages birth to
five years, their parents, and pregnant women most at risk of poor oral health
due to lack of access to dental care. Applicants must also meet the following
criteria:
(1) have the potential to successfully increase
access to families with children, ages birth to five years;
(2) incorporate quality program evaluation;
(3) maximize use of grant funds; and
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APPROPRIATIONS
Available for the Year
Ending June 30
2008 2009
(4) have experience in providing services to the
target populations of this program.
(h) The commissioner shall evaluate the effectiveness
of this pilot program on the oral health of children and their families and
report to the house of representatives and senate committees with jurisdiction
over public health policy and finance by January 1, 2009, with recommendations
as to how to develop programs throughout Minnesota that provide education and
access to oral health care for low-income and immigrant children.
Suicide prevention programs. $600,000 each year is to
fund the suicide prevention program. The base for fiscal years 2010 and 2011 is
reduced by $300,000.
Subd. 3. Policy,
Quality, and Compliance 51,557,000 45,785,000
Appropriations by Fund
General 18,185,000 16,213,000
State Government
Special Revenue 13,309,000 13,309,000
Health Care Access 22,863,000 16,263,000
Health Care Access Survey. Of the health care
access fund appropriation, $600,000 in fiscal year 2008 is appropriated to the
commissioner to conduct a health insurance survey of Minnesota households, in
partnership with the State Health Access Data Assistance Center at the
University of Minnesota. The commissioner shall contract with the State Health
Access Data Assistance Center to conduct a survey that provides information on
the characteristics of the uninsured in Minnesota and the reasons for changing
patterns of insurance coverage and access to health care services. This
appropriation shall become part of the agency's base budget for even-numbered
fiscal years.
MERC. Of the general fund
appropriation, $8,000,000 each fiscal year is for distribution of MERC grants
as follows:
(1) $5,000,000 according to Minnesota Statutes,
section 62J.692, subdivision 4, paragraph (c);
(2) $900,000 according to Minnesota Statutes,
section 62J.692, subdivision 4, paragraph (d);
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Day - Friday, April 13, 2007 - Top of Page 3759
APPROPRIATIONS
Available for the Year
Ending June 30
2008 2009
(3) $100,000 according to
Minnesota Statutes, section 62J.692, subdivision 4, paragraph (e); and
(4) $2,000,000 according to Minnesota
Statutes, section 62J.692, subdivision 7a, paragraph (b).
Health
Information Technology. Of the health care access fund appropriation, $6,750,000 each
fiscal year is to implement Minnesota Statutes, section 144.3345. Up to
$350,000 each fiscal year is available for grant administration and health
information technology technical assistance and $6,400,000 each year is to be
transferred to the commissioner of finance to establish and implement a
revolving account under Minnesota Statutes, section 62J.496. This appropriation
shall not be included in the agency's base budget for the fiscal year beginning
July 1, 2009.
Health
Insurance Exchange. Of the health care access fund appropriation, $6,000,000 in fiscal
year 2008 is appropriated to the commissioner to establish the health insurance
exchange in Minnesota Statutes, section 62A.76. Up to $50,000 in fiscal year
2008 is available for administrative costs incurred by the Department of Health
in establishing and providing grant funding to the legal entity responsible for
implementing the health insurance exchange. This is a onetime appropriation.
Hearing Aid
Loan Bank.
Of the general fund appropriation, $70,000 in fiscal year 2008 and $70,000
in fiscal year 2009 are for the purpose of providing a statewide hearing aid
and instrument loan bank to families with children newly diagnosed with hearing
loss from birth to the age of ten. This appropriation shall cover the
administrative costs of the program.
Uncompensated
Care Fund.
Of the general fund appropriation, $65,000 in fiscal year 2008 is for the
commissioner of health to study and present recommendations to the governor and
the legislature by January 15, 2008, on the design, operation, and funding of
an uncompensated care fund to be used to provide subsidies to hospitals,
community clinics, federally qualified health centers, community mental health
centers, and other health care providers that serve a disproportionately large
percentage of uninsured patients. An organization must not provide or perform
abortion services under this program.
Journal of the House - 47th
Day - Friday, April 13, 2007 - Top of Page 3760
APPROPRIATIONS
Available for the Year
Ending June 30
2008 2009
Community
Collaboratives. Of the general fund appropriation, $300,000 for the biennium
beginning July 1, 2007, is to the commissioner of health to provide grants to
community collaboratives to cover the uninsured. This is a onetime
appropriation.
Uniform
Electronic Transactions. Of the general fund appropriation, $146,000 in
fiscal year 2008 is for development of uniform electronic transactions and
implementation guide standards under Minnesota Statutes, section 62J.536.
Medical
Home Learning Collaborative. Of the general fund appropriation, $500,000 in
fiscal year 2008 and $500,000 in fiscal year 2009 are to expand the medical
home learning collaborative initiative in collaboration with the commissioner
of human services. Services provided under this funding must support a medical
home model for children with special health care needs. The collaborative shall
report back to the legislature on use of the funds by January 15, 2010.
Federally
Qualified Health Centers. Of the general fund appropriation, $3,000,000 in
fiscal year 2008 and $3,900,000 in fiscal year 2009 are for subsidies to
federally qualified health centers under Minnesota Statutes, section 145.9269.
Pandemic
Influenza Preparedness. Of the general fund appropriation to the commissioner, $2,800,000
in fiscal year 2008 is for preparation, planning, and response to a pandemic
influenza outbreak. This appropriation is available until June 30, 2009. Base
funding for the 2010-2011 biennium is $0 each fiscal year.
Subd. 4. Health
Protection
Appropriations by Fund
General 17,744,000 13,900,000
State Government
Special Revenue 25,980,000 26,674,000
Environmental 300,000 300,000
Pandemic
Influenza Preparedness. Of the general fund appropriation to the commissioner, $3,235,000 in
fiscal year 2008 is for preparation, planning, and response to a pandemic
influenza outbreak. This appropriation is available until June 30, 2009.
Base funding for the
2010-2011 biennium is $0 each fiscal year.
Journal of the House - 47th
Day - Friday, April 13, 2007 - Top of Page 3761
APPROPRIATIONS
Available for the Year
Ending June 30
2008 2009
Environmental
Health Tracking and Biomonitoring. (a) $500,000 in the first year and $900,000 in
the second year are for the environmental health tracking and biomonitoring
program. The base for fiscal year 2010 and fiscal year 2011 is increased by
$300,000 each year.
(b) $300,000 each year is
from the environmental fund to the Pollution Control Agency for transfer to the
Department of Health for the health tracking and biomonitoring program. The
base for the environmental fund is $0 in fiscal year 2010 and after.
AIDS
Prevention Initiative Focusing on African-born Residents. $300,000 in 2008 is for
an AIDS prevention initiative focusing on African-born residents. This
appropriation is a onetime appropriation and shall not become part of the
base-level funding for the 2010-2011 biennium.
The commissioner of health
shall award grants in accordance with Minnesota Statutes, section 145.924, paragraph
(b), for a public education and awareness campaign targeting communities of
African-born Minnesota residents. The grants shall be designed to promote
knowledge and understanding about HIV and to increase knowledge in order to
eliminate and reduce the risk for HIV infection; to encourage screening and
testing for HIV; and to link individuals to public health and health care
resources. The grants must be awarded to collaborative efforts that bring
together nonprofit community-based groups with demonstrated experience in
addressing the public health, health care, and social service needs of
African-born communities.
Arsenic
Health Risk Standard. $920,000 in the first year and $461,000 in the second year is to fund
the study relating to arsenic health risk standards, under Minnesota Statutes,
section 144.967.
Lindane and
Bisphenol-A Studies. $114,000 in the first year is for the Lindane committee and the
study of bisphenol-A, under Minnesota Statutes, section 145.958. This is a
onetime appropriation.
Decabromodiphenyl
Ether Study. $118,000 in the first year is for transfer to the commissioner of
the pollution control agency for the study of decabromodiphenyl ether under
Minnesota Statutes, section 325E.387. This is a onetime appropriation.
Radiation
Study. $45,000
in the first year from the general fund and $15,000 in the first year from the
state government special revenue fund are for the radiation study in section
62. This is a onetime appropriation.
Journal of the House - 47th
Day - Friday, April 13, 2007 - Top of Page 3762
APPROPRIATIONS
Available for the Year
Ending June 30
2008 2009
Lead
Abatement.
$925,000 in the first year and $950,000 in the second year are for changes
in lead abatement requirements. Of this amount, $6,000 in the first year and
$11,000 in the second year are for transfer to the commissioner of human
services for increased medical assistance costs. A portion of this amount may
be used to reimburse local governments for costs of implementing the new
requirements.
Water
Treatment.
$40,000 in fiscal year 2008 is to augment any appropriation from the
remediation fund to conduct an evaluation of point of use water treatment units
at removing perfluorooctanoic acid, perfluorooctane sulfonate, and
perfluorobutanoic acid from known concentrations of these compounds in drinking
water. The evaluation shall be completed by December 31, 2007, and the
commissioner may contract for services to complete the evaluation. This is a
onetime appropriation.
Environmental
Justice Mapping. $137,000 in the first year and $53,000 in the second year is for
environmental justice mapping.
HIV
Information. $80,000 each year is to fund a community-based nonprofit organization
with demonstrated capacity to operate a statewide HIV information and referral
service using telephone, Internet, and other appropriate technologies.
Lead Hazard
Reduction.
$250,000 is appropriated each year of the biennium for a grant to a nonprofit
organization operating the CLEARCorps to conduct a pilot project to determine
the incidence of lead hazards in pre-1978 rental property. Any balance in the
first year does not cancel but is available in the second year.
Minnesota
Birth Defects Information System. $750,000 each year is to maintain the birth
defects information system that was established by Minnesota Statutes, section
144.2215.
Subd. 5. Minority
and Multicultural Health
Appropriations by Fund
General 5,042,000 5,052,000
Federal TANF 2,683,000 2,998,000
Journal of the House - 47th
Day - Friday, April 13, 2007 - Top of Page 3763
APPROPRIATIONS
Available for the Year
Ending June 30
2008 2009
TANF
Appropriations. (a) $2,421,000 of the TANF funds
is appropriated in each year of the biennium to the commissioner for home
visiting and nutritional services listed under Minnesota Statutes, section
145.882, subdivision 7, clauses (6) and (7). Funding shall be distributed to
tribal governments based on Minnesota Statutes, section 145A.14, subdivision
2a, paragraph (b).
(b) $262,000 in the first
year and $577,000 in the second year are appropriated to the commissioner of
health for the family home visiting grant program. The commissioner shall distribute
funds to tribal governments using a formula developed in conjunction with
tribal governments. The commissioner may use five percent of the funds
appropriated in each fiscal year to conduct the ongoing evaluations required
under Minnesota Statutes, section 145A.17, subdivision 7, and may use ten
percent of the funds appropriated each fiscal year to provide training and
technical assistance as required under Minnesota Statutes, section 145A.17,
subdivisions 4 and 5.
TANF
Carryforward. Any unexpended balance of the TANF appropriation in the first year
of the biennium does not cancel but is available for the second year.
Subd. 6. Administrative
Support Services
Appropriations by Fund
General 11,047,000 11,197,000
Disease
Surveillance. $2,000,000 each fiscal year is for redesigning and implementing
coordinated and modern disease surveillance systems for the department,
ensuring that occupational and residential histories are included in the
database. Base level funding for the 2012-2013 biennium will be $600,000 each
fiscal year for maintaining and operating the systems.
Sec. 5. VETERANS
NURSING HOMES BOARD $44,124,000 $46,244,000
Veterans
Homes Special Revenue Account. The general fund appropriations made to the board
may be transferred to a veterans homes special revenue account in the special
revenue fund in the same manner as other receipts are deposited according to
Minnesota Statutes, section 198.34, and are appropriated to the board for the
operation of board facilities and programs.
Journal of the House - 47th
Day - Friday, April 13, 2007 - Top of Page 3764
APPROPRIATIONS
Available for the Year
Ending June 30
2008 2009
Repair and
Betterment. Of this appropriation, $4,000,000 in fiscal year 2008 and
$4,000,000 in fiscal year 2009 are to be used for repair, maintenance,
rehabilitation, and betterment activities at facilities statewide.
Base
Adjustment. The general fund base is decreased by $2,000,000 in fiscal year
2010 and $2,000,000 in fiscal year 2011.
Sec. 6. HEALTH-RELATED
BOARDS
Subdivision 1. Total
Appropriation; State Government
Special
Revenue Fund $14,654,000 $14,527,000
The commissioner of finance
shall not permit the allotment, encumbrance, or expenditure of money appropriated
in this section in excess of the anticipated biennial revenues or accumulated
surplus revenues from fees collected by the boards.
Subd. 2. Board
of Chiropractic Examiners 450,000 447,000
Subd. 3. Board
of Dentistry 987,000 1,009,000
Subd. 4. Board
of Dietetic and Nutrition Practice 103,000 119,000
Base
Adjustment. Of this appropriation in fiscal year 2009, $14,000 is onetime.
Subd. 5. Board
of Marriage and Family Therapy 134,000 154,000
Base
Adjustment. Of this appropriation in fiscal year 2009, $17,000 is onetime.
Subd. 6. Board
of Medical Practice 4,120,000 3,674,000
Subd. 7. Board
of Nursing 3,985,000 4,146,000
Subd. 8. Board
of Nursing Home Administrators 633,000 647,000
Administrative
Services Unit. Of this appropriation, $430,000 in fiscal year 2008 and $439,000 in
fiscal year 2009 are for the administrative services unit. The administrative
services unit may receive and expend reimbursements for services performed by
other agencies.
Journal of the House - 47th
Day - Friday, April 13, 2007 - Top of Page 3765
APPROPRIATIONS
Available for the Year
Ending June 30
2008 2009
Subd. 9. Board
of Optometry 98,000 114,000
Base
Adjustment. Of this appropriation in fiscal year 2009, $13,000 is onetime.
Subd. 10. Board
of Pharmacy 1,375,000 1,442,000
Base
Adjustment. Of this appropriation in fiscal year 2009, $29,000 is onetime.
Subd. 11. Board
of Physical Therapy 306,000 295,000
Subd. 12. Board
of Podiatry 54,000 63,000
Base
Adjustment. Of this appropriation in fiscal year 2009, $7,000 is onetime.
Subd. 13. Board
of Psychology 788,000 806,000
Subd. 14. Board
of Social Work 997,000 1,022,000
Subd. 15. Board
of Veterinary Medicine 230,000 195,000
Subd. 16. Board
of Behavioral Health and Therapy 394,000 394,000
Sec. 7. EMERGENCY
MEDICAL SERVICES BOARD $3,710,000 $3,745,000
Appropriations by Fund
2008 2009
General 3,023,000 3,041,000
State Government
Special Revenue 687,000 704,000
Regional
Emergency Medical Services Programs. $400,000 each year is for
regional emergency medical services programs, to be distributed equally to the
eight emergency medical service regions. This amount shall be added to the base
funding. Notwithstanding Minnesota Statutes, section 144E.50, 100 percent of
the appropriation shall be passed on to the emergency medical service regions.
Journal of the House - 47th
Day - Friday, April 13, 2007 - Top of Page 3766
APPROPRIATIONS
Available for the Year
Ending June 30
2008 2009
Health
Professional Services Program. $687,000 in fiscal year 2008 and $704,000 in
fiscal year 2009 from the state government special revenue fund are for the
health professional services program.
Sec. 8. COUNCIL ON
DISABILITY $582,000 $590,000
Options
Too. (a)
$75,000 for the first year and $75,000 for the second year are to continue the
work of the Options Too disability services interagency work group established
under Laws 2005, First Special Session chapter 4, article 7, section 57. Funds
shall be used to monitor and assist the work group and the Options Too Steering
Committee in the implementation of the recommendations in the Options Too
report dated February 15, 2007.
(b) For purposes of this
section, the Options Too Steering Committee shall consist of the following
members:
(1) a representative from
the Minnesota Housing Finance Agency;
(2) a representative from
the Minnesota State Council on Disability;
(3) a representative from the
Department of Veterans Affairs;
(4) a representative from
the Department of Transportation;
(5) a representative from
the Department of Human Services; and
(6) representatives from
interested stakeholders including counties, local public housing authorities,
the Metropolitan Council, disability service providers, and disability advocacy
organizations who are appointed by the Minnesota State Council on Disability
for two-year terms.
(c) Notwithstanding Laws
2005, First Special Session chapter 4, article 7, section 57, the interagency
work group shall be administered by the Minnesota Housing Finance Agency, the
Minnesota State Council on Disability, Department of Human Services, and the
Department of Transportation.
(d) The Options Too Steering
Committee shall report to the chairs of the health and human services policy
and finance committees of the senate and house of representatives by October
15, 2007, and October 15, 2008, on the continued progress of the work group
towards implementing the recommendations in the Options Too report dated
February 15, 2007.
Journal of the House - 47th
Day - Friday, April 13, 2007 - Top of Page 3767
APPROPRIATIONS
Available for the Year
Ending June 30
2008 2009
Sec. 9. OMBUDSMAN FOR MENTAL HEALTH
AND DEVELOPMENTAL
DISABILITIES $1,567,000 $1,621,000
Sec. 10. OMBUDSMAN
FOR FAMILIES $251,000 $257,000
Sec. 11. TRANSFERS.
Subdivision 1. Grants. The commissioner of human services, with the
approval of the commissioner of finance and after notifying the chairs of the
senate and house committees with jurisdiction, may transfer unencumbered
appropriation balances for the biennium ending June 30, 2009, within fiscal
years among the MFIP; general assistance; general assistance medical care;
medical assistance; MFIP child care assistance under Minnesota Statutes,
section 119B.05; Minnesota supplemental aid and group residential housing
programs; and the entitlement portion of the chemical dependency consolidated
treatment fund and between fiscal years of the biennium.
Subd. 2. Administration. Positions, salary money, and nonsalary
administrative money may be transferred within the Departments of Human
Services and Health and within the programs operated by the Veterans Nursing
Homes Board as the commissioners and the board consider necessary, with the
advance approval of the commissioner of finance. The commissioner or the board
shall inform the chairs of the house and senate committees with jurisdiction
quarterly about transfers made under this provision.
Sec. 12. INDIRECT COSTS NOT TO FUND PROGRAMS.
The commissioners of health
and of human services shall not use indirect cost allocations to pay for the
operational costs of any program for which they are responsible.
Sec. 13. SUNSET OF UNCODIFIED LANGUAGE.
All uncodified language
contained in this article expires on June 30, 2009, unless a different
expiration date is explicit.
Sec. 14. EFFECTIVE DATE.
The provisions in this
article are effective July 1, 2007, unless a different effective date is specified."
Adjust the totals
accordingly
Delete the title and insert:
"A bill for an act
relating to state government; making changes to health and human services
programs; changing children and family provisions; modifying licensing
provisions; amending health care law; modifying continuing care provisions;
amending mental health provisions; changing Department of Health provisions;
establishing a children's health security program; changing public health
provisions; amending MinnesotaCare, medical assistance, and general assistance
medical care; instituting health care reform; establishing the Minnesota Health
Insurance Exchange; requiring Section 125 Plans; modifying health insurance
provisions; regulating anatomical gifts; establishing family supportive
services; providing rate increases for certain providers; changing health
records information provisions; making technical changes; providing civil and
criminal penalties; establishing task forces;
Journal of the House - 47th
Day - Friday, April 13, 2007 - Top of Page 3768
requiring reports; making
forecast adjustments; appropriating money for human services and health;
amending Minnesota Statutes 2006, sections 13.3806, by adding a subdivision;
13.46, subdivision 2; 16A.10, by adding a subdivision; 16A.724, subdivision 2;
16B.61, by adding a subdivision; 16D.13, subdivision 3; 43A.316; 62A.65,
subdivision 3; 62E.141; 62H.02; 62J.04, subdivision 3; 62J.17, subdivisions 2,
4a, 7; 62J.41, subdivision 1; 62J.495; 62J.52, subdivisions 1, 2; 62J.60, subdivisions
2, 3; 62J.692, subdivisions 1, 4, 7a, 8, 10; 62J.81, subdivision 1; 62J.82;
62L.12, subdivisions 2, 4; 62Q.165, subdivisions 1, 2; 62Q.80, subdivisions 3,
4, 13, 14, by adding a subdivision; 103I.101, subdivision 6; 103I.208,
subdivisions 1, 2; 103I.235, subdivision 1; 119B.05, subdivision 1; 119B.09,
subdivisions 1, 7, by adding subdivisions; 119B.12; 119B.125, subdivision 2;
119B.13, subdivisions 1, 3a, 6, 7; 119B.21, subdivision 5; 144.05, by adding a
subdivision; 144.123; 144.125; 144.2215, subdivision 1; 144.3345; 144.565;
144.651, subdivision 26; 144.672, subdivision 1; 144.698, subdivision 1;
144.699, by adding a subdivision; 144.9502, subdivision 3; 144.9504,
subdivision 2; 144.9507, by adding a subdivision; 144.9512; 144A.071,
subdivision 4c; 144E.101, subdivision 6; 144E.127; 144E.35, subdivision 1;
145A.17; 145C.05; 145C.07, by adding a subdivision; 148.235, by adding a
subdivision; 151.37, subdivision 2; 152.11, by adding a subdivision; 156.001,
by adding a subdivision; 156.02, subdivisions 1, 2; 156.04; 156.072,
subdivision 2; 156.073; 156.12, subdivisions 2, 4, 6; 156.15, subdivision 2;
156.16, subdivisions 3, 10; 156.18, subdivisions 1, 2; 156.19; 157.16,
subdivision 1; 179A.03, subdivision 7; 198.075; 245.462, subdivision 20;
245.465, by adding a subdivision; 245.4874; 245.50, subdivision 5; 245.98,
subdivisions 2, 5; 245A.035; 245A.10, subdivision 2; 245A.16, subdivisions 1,
3; 245C.02, by adding a subdivision; 245C.04, subdivision 1; 245C.05,
subdivisions 1, 4, 5, 7, by adding subdivisions; 245C.08, subdivisions 1, 2;
245C.10, by adding a subdivision; 245C.11, subdivisions 1, 2; 245C.12; 245C.16,
subdivision 1; 245C.17, by adding subdivisions; 245C.21, by adding a
subdivision; 245C.23, subdivision 2; 245C.24, subdivision 2; 246.54, subdivision
1; 252.27, subdivision 2a; 252.32, subdivision 3; 252.46, by adding a
subdivision; 253B.185, subdivision 2; 254A.03, subdivision 3; 254A.16,
subdivision 2; 254B.02, subdivisions 1, 5; 254B.03, subdivisions 1, 3; 254B.06,
subdivision 3; 256.01, subdivisions 2, 2b, 4, 18, by adding subdivisions;
256.015, subdivision 7; 256.017, subdivisions 1, 9; 256.0471, subdivision 1;
256.476, subdivisions 1, 2, 3, 4, 5, 10; 256.969, subdivisions 3a, 9, by adding
a subdivision; 256.974; 256.9741, subdivisions 1, 3; 256.9742, subdivisions 3,
4, 6; 256.9744, subdivision 1; 256.975, subdivision 7; 256.984, subdivision 1;
256B.04, subdivision 14, by adding a subdivision; 256B.056, subdivisions 1a, 3,
5c, by adding a subdivision; 256B.057, subdivision 8; 256B.0621, subdivision
11; 256B.0625, subdivisions 3f, 13c, 13d, 14, 17, 18a, 20, 23, 47, by adding
subdivisions; 256B.0644; 256B.0911, subdivisions 3a, 3b, 4b, 4c, 6, 7, by
adding subdivisions; 256B.0913, subdivisions 4, 5, 5a, 8, 9, 10, 11, 12, 13,
14; 256B.0915; 256B.0917, subdivision 8; 256B.0919, subdivision 3; 256B.0943,
subdivisions 6, 9, 11, 12; 256B.0945, subdivision 4; 256B.095; 256B.0951,
subdivision 1; 256B.199; 256B.431, subdivisions 1, 2e, 3f, 17e; 256B.434,
subdivision 4, by adding subdivisions; 256B.437, by adding a subdivision;
256B.438, subdivision 3; 256B.439, subdivision 1; 256B.441, subdivisions 1, 2,
5, 6, 10, 11, 13, 14, 17, 20, 24, 30, 31, 34, 38, by adding subdivisions;
256B.49, subdivision 11, by adding a subdivision; 256B.5012, by adding a subdivision;
256B.69, subdivisions 5g, 5h, 23, 28; 256B.75; 256B.76; 256B.763; 256D.03,
subdivision 4; 256D.44, subdivisions 2, 5; 256E.35, subdivision 2; 256I.04,
subdivision 3; 256I.05, by adding subdivisions; 256J.01, by adding a
subdivision; 256J.02, subdivisions 1, 4; 256J.021; 256J.08, subdivision 65;
256J.21, subdivision 2; 256J.24, subdivision 10; 256J.42, subdivision 1;
256J.425, subdivisions 3, 4; 256J.46, by adding a subdivision; 256J.49,
subdivision 13; 256J.521, subdivisions 1, 2, by adding a subdivision; 256J.53,
subdivision 2; 256J.55, subdivision 1; 256J.626, subdivisions 1, 2, 3, 4, 5, 6;
256J.751, subdivisions 2, 5; 256J.95, subdivisions 3, 13; 256K.45, by adding a
subdivision; 256L.01, subdivision 4; 256L.03, subdivisions 1, 5; 256L.035;
256L.04, subdivisions 1, 12; 256L.11, subdivision 7; 256L.12, subdivision 9a;
259.20, subdivision 2; 259.24, subdivision 3; 259.29, subdivision 1; 259.41;
259.53, subdivisions 1, 2; 259.57, subdivisions 1, 2; 259.67, subdivisions 4,
7; 259.75, subdivision 8; 260.012; 260.755, subdivisions 12, 20; 260.761,
subdivision 7; 260.765, subdivision 5; 260.771, subdivisions 1, 2; 260B.157,
subdivision 1; 260C.152, subdivision 5; 260C.163, subdivision 1; 260C.201,
subdivision 11; 260C.209; 260C.212, subdivisions 1, 2, 4, 9; 260C.317,
subdivision 3; 260C.331, subdivision 1; 270B.14, subdivision 1; 609.115,
subdivision 9; 626.556, subdivisions 2, 3, 10, 10a, 10c, 10f, by adding
subdivisions; Laws 2000, chapter 340, section 19; Laws 2005, chapter 98,
article 3, section 25; Laws 2005, First Special Session chapter 4, article 9,
section 3, subdivision 2; Laws 2006, chapter 282, article 20, section 37;
proposing coding for new law in Minnesota Statutes, chapters 16A; 62A; 62J;
62Q; 144; 145; 152; 156; 245A; 245C; 254A; 256B; 256C; 256D; 256F; 256J; 260;
325E; proposing coding for new law as Minnesota Statutes, chapters 256N; 525A;
repealing Minnesota
Journal of the House - 47th
Day - Friday, April 13, 2007 - Top of Page 3769
Statutes 2006, sections
62J.052, subdivision 1; 62J.17, subdivisions 1, 5a, 6a, 8; 119B.08, subdivision
4; 144.335; 252.21; 252.22; 252.23; 252.24; 252.25; 252.261; 252.275,
subdivision 5; 254A.02, subdivisions 7, 9, 12, 14, 15, 16; 254A.085; 254A.086;
254A.12; 254A.14; 254A.15; 254A.16, subdivision 5; 254A.175; 254A.18; 256.969,
subdivision 27; 256.9743; 256B.0913, subdivisions 5b, 5c, 5d, 5e, 5f, 5g, 5h;
256B.441, subdivisions 12, 16, 21, 26, 28, 42, 45; 256J.29; 256J.37,
subdivisions 3a, 3b; 256J.561, subdivision 1; 256J.62, subdivision 9; 256J.626,
subdivisions 7, 9; 256J.65; 525.921; 525.9211; 525.9212; 525.9213; 525.9214;
525.9215; 525.9216; 525.9217; 525.9218; 525.9219; 525.9221; 525.9222; 525.9223;
525.9224; Laws 1997, chapter 8, section 1; Laws 2004, chapter 288, article 6,
section 27; Minnesota Rules, parts 9503.0035, subpart 2; 9560.0102, subpart 2,
item C; 9585.0030."
With the recommendation that
when so amended the bill pass and be re-referred to the Committee on Taxes.
The report was adopted.
SECOND READING OF HOUSE BILLS
H. F. Nos. 882, 1048 and 2227 were read for the second time.
SECOND READING OF SENATE BILLS
S. F. Nos. 493, 753, 837, 1048, 1236, 1335 and 1696 were read
for the second time.
INTRODUCTION AND FIRST READING OF HOUSE BILLS
The following House Files were introduced:
Clark introduced:
H. F. No. 2422, A bill for an act relating to taxation;
establishing alcohol health impact fund; imposing alcohol health impact fee;
amending Minnesota Statutes 2006, sections 295.75, subdivisions 2, 11; 297G.04,
subdivision 2; 297G.10; proposing coding for new law in Minnesota Statutes,
chapters 16A; 297G.
The bill was read for the first time and referred to the
Committee on Taxes.
Kelliher introduced:
H. F. No. 2423, A bill for an act relating to public health;
allowing municipalities to enact an ordinance authorizing dogs to accompany
persons patronizing outdoor areas of food and beverage service establishments;
proposing coding for new law in Minnesota Statutes, chapter 157.
The bill was read for the first time and referred to the
Committee on Health and Human Services.
Journal of the House - 47th
Day - Friday, April 13, 2007 - Top of Page 3770
Nelson; Smith, by request; Thissen and Lillie introduced:
H. F. No. 2424, A bill for an act relating to retirement;
adding certain positions to salary limit provisions; amending duties of certain
retirement associations' boards of trustees; amending Minnesota Statutes 2006,
sections 15A.0815, subdivisions 2, 3; 352.03, subdivision 4; 353.03,
subdivision 3a; 354.06, subdivision 2.
The bill was read for the first time and referred to the
Committee on Governmental Operations, Reform, Technology and Elections.
Hilstrom and Brod introduced:
H. F. No. 2425, A bill for an act relating to sales and use
tax; clarifying the treatment of kidney dialysis equipment; amending Minnesota
Statutes 2006, section 297A.67, subdivision 7.
The bill was read for the first time and referred to the
Committee on Taxes.
Norton, Liebling, Demmer and Welti introduced:
H. F. No. 2426, A bill for an act relating to human services;
requiring notice for a redetermination of eligibility for services to disabled
children; amending Minnesota Statutes 2006, section 252.27, by adding a
subdivision.
The bill was read for the first time and referred to the
Committee on Health and Human Services.
Paulsen and Huntley introduced:
H. F. No. 2427, A bill for an act relating to health
information technology; adding to the requirements of the Health Information
Technology and Infrastructure Advisory Committee; amending Minnesota Statutes
2006, section 62J.495, subdivision 1.
The bill was read for the first time and referred to the
Committee on Health and Human Services.
Rukavina introduced:
H. F. No. 2428, A bill for an act relating to capital
investment; authorizing spending to acquire and better public land and
buildings and other improvements of a capital nature; authorizing the issuance
of general obligation bonds; appropriating money for a grant to the city of
Eveleth for wastewater treatment plant renovation.
The bill was read for the first time and referred to the
Committee on Finance.
MESSAGES FROM THE SENATE
The following messages were received from the Senate:
Madam Speaker:
I hereby announce the passage by the Senate of the following
House File, herewith returned:
Journal of the House - 47th
Day - Friday, April 13, 2007 - Top of Page 3771
H. F. No. 1004, A bill for an act relating to mortgages;
prohibiting predatory lending practices; amending Minnesota Statutes 2006,
sections 58.02, by adding a subdivision; 58.13, subdivision 1; 58.137,
subdivision 1; 58.15; 58.16, subdivision 1; proposing coding for new law in
Minnesota Statutes, chapter 58.
Patrick
E. Flahaven,
Secretary of the Senate
Madam Speaker:
I hereby announce that the Senate accedes to the request of the
House for the appointment of a Conference Committee on the amendments adopted
by the Senate to the following House File:
H. F. No. 886, A bill for an
act relating to capital improvements; authorizing spending to acquire and
better public land and buildings and other improvements of a capital nature
with certain conditions; authorizing the sale of state bonds; appropriating
money; amending Minnesota Statutes 2006, sections 16A.695, subdivisions 2, 3,
by adding subdivisions; 16A.86, subdivision 3; 116R.01, subdivision 6; 116R.02,
subdivisions 1, 2, 4, 5; 116R.03; 116R.05, subdivision 2; 116R.11, subdivision
1; 116R.12, by adding a subdivision; 272.01, subdivision 2; 290.06, subdivision
24; 297A.71, subdivision 10; 360.013, subdivision 39; 360.032, subdivision 1;
360.038, subdivision 4; Laws 2005, chapter 20, article 1, sections 7,
subdivision 21; 20, subdivision 3; 23, subdivisions 8, 16; Laws 2006, chapter
258, sections 4, subdivision 4; 7, subdivision 11; 21, subdivisions 6, 15;
repealing Minnesota Statutes 2006, sections 116R.02, subdivisions 3, 6, 7, 9;
116R.16.
The Senate has appointed as
such committee:
Senators Langseth, Cohen,
Senjem, Metzen and Wergin.
Said House File is herewith
returned to the House.
Patrick
E. Flahaven,
Secretary of the Senate
Madam Speaker:
I hereby announce the passage by the Senate of the following
Senate Files, herewith transmitted:
S. F. Nos. 221, 1495, 380 and 248.
Patrick
E. Flahaven,
Secretary of the Senate
FIRST READING OF SENATE BILLS
S. F. No. 221, A bill for an
act relating to employment; requiring employers to provide written notice of
certain rights and remedies; proposing coding for new law in Minnesota
Statutes, chapter 181.
The bill was read for the
first time.
Holberg moved that S. F. No.
221 and H. F. No. 287, now on the General Register, be referred to the Chief
Clerk for comparison. The motion prevailed.
Journal of the House - 47th
Day - Friday, April 13, 2007 - Top of Page 3772
S. F.
No. 1495, A bill for an act relating to employment; extending laws governing payroll
card accounts; amending Laws 2005, chapter 158, section 4.
The
bill was read for the first time.
Atkins
moved that S. F. No. 1495 and H. F. No. 1554, now on the General Register, be
referred to the Chief Clerk for comparison. The motion prevailed.
S. F.
No. 380, A bill for an act relating to elections; changing certain school
district election provisions; eliminating an approval requirement for mail
elections; authorizing certain school board primary elections; amending
Minnesota Statutes 2006, sections 204B.46; 205A.03, subdivision 1; 205A.06,
subdivision 1a; 205A.12, by adding a subdivision.
The
bill was read for the first time.
Dittrich
moved that S. F. No. 380 and H. F. No. 646, now on the General Register, be
referred to the Chief Clerk for comparison. The motion prevailed.
S. F.
No. 248, A bill for an act relating to elections; changing a prohibition on
certain expenditures; amending Minnesota Statutes 2006, section 211B.12.
The
bill was read for the first time.
Pelowski
moved that S. F. No. 248 and H. F. No. 75, now on the General Register, be
referred to the Chief Clerk for comparison. The motion prevailed.
CALENDAR FOR THE DAY
Sertich moved that the Calendar for the Day be continued. The
motion prevailed.
MOTIONS AND RESOLUTIONS
Hansen moved that the name of Berns be added as an author on
H. F. No. 74. The motion prevailed.
Hansen moved that the name of Berns be added as an author on
H. F. No. 145. The motion prevailed.
Paulsen moved that the name of Berns be added as an author on
H. F. No. 376. The motion prevailed.
Rukavina moved that the names of Heidgerken and Poppe be added
as authors on H. F. No. 797. The motion prevailed.
Hortman moved that the name of Ruud be added as an author on
H. F. No. 863. The motion prevailed.
Journal of the House - 47th
Day - Friday, April 13, 2007 - Top of Page 3773
Heidgerken moved that the name of Urdahl be added as an author
on H. F. No. 1324. The motion prevailed.
Hortman moved that the name of Benson be added as an author on
H. F. No. 1602. The motion prevailed.
Bunn moved that the name of Hausman be added as an author on
H. F. No. 1621. The motion prevailed.
Severson moved that the name of Erickson be added as an author
on H. F. No. 1845. The motion prevailed.
Bunn moved that the name of Ruud be added as an author on
H. F. No. 1883. The motion prevailed.
Gottwalt moved that the name of Zellers be added as an author
on H. F. No. 2106. The motion prevailed.
Gottwalt moved that the name of Zellers be added as an author
on H. F. No. 2132. The motion prevailed.
Erickson moved that H. F. No. 2383 be returned
to its author. The motion prevailed.
ADJOURNMENT
Sertich moved that when the House adjourns today it adjourn
until 12:00 noon, Monday, April 16, 2007. The motion prevailed.
Sertich moved that the House adjourn. The motion prevailed, and
the Speaker declared the House stands adjourned until 12:00 noon, Monday, April
16, 2007.
Albin
A. Mathiowetz,
Chief Clerk, House of Representatives
Journal of the House - 47th
Day - Friday, April 13, 2007 - Top of Page 3774