HF 1988

3rd Engrossment - 86th Legislature (2009 - 2010) Posted on 02/09/2010 01:57am

A bill for an act
relating to state government; making technical health and human services
changes; making health care program policy changes; changing health care
eligibility provisions; authorizing rulemaking; requiring reports; changing
appropriations; appropriating money; amending Minnesota Statutes 2008,
sections 62J.2930, subdivision 3; 62J.497, subdivision 5, as added; 144.0724,
subdivision 11, as added; 245.494, subdivision 3; 245A.11, subdivision 7a,
as added; 245C.03, by adding a subdivision; 245C.04, subdivision 1, as
amended, by adding a subdivision; 245C.05, subdivision 2b, as added; 245C.10,
subdivision 5, as added, by adding a subdivision; 245C.21, subdivision 1a, as
amended; 246.50, subdivision 3; 256.01, subdivision 18b, as added; 256.015,
subdivision 7; 256.969, subdivisions 2b, as amended, 3a, 29, as added, by adding
a subdivision; 256.975, subdivision 7, as amended; 256B.037, subdivision 5;
256B.056, subdivisions 1c, 3b, 3c, 6; 256B.057, subdivision 11, as added;
256B.06, subdivision 4, as amended; 256B.0625, subdivisions 3c, as amended,
13h, as amended, by adding subdivisions; 256B.0655, subdivision 4, as amended;
256B.0659, subdivisions 9, as added, 10, as added, 13, as added, 21, as added,
29, as added; 256B.0911, subdivision 1a, as amended; 256B.094, subdivision
3; 256B.195, subdivisions 1, 2, 3; 256B.441, subdivision 55, as amended;
256B.49, subdivision 11a, as added; 256B.69, subdivision 5a; 256B.756, as
added; 256B.76, subdivision 1, as amended; 256B.77, subdivision 13; 256D.03,
subdivisions 3, 4, as amended; 256J.575, subdivision 3, as amended; 256L.01,
by adding a subdivision; 256L.03, subdivisions 3b, as added, 5; 256L.04,
subdivision 1, as amended; 256L.05, subdivision 1c, as added; 256L.11,
subdivision 1, as amended; 256L.15, subdivision 2; 402A.30, subdivision 4, as
added; 626.556, subdivision 3c, as amended; Laws 2005, First Special Session
chapter 4, article 8, sections 54; 61; 63; 66; 74; Laws 2009, chapter 79, article
2, section 36; article 5, sections 25; 52; article 8, sections 8; 13; 73; article 10,
section 46; article 13, sections 3; 4; 5; 6; repealing Minnesota Statutes 2008,
sections 256B.031; 256L.01, subdivision 4; Laws 2005, First Special Session
chapter 4, article 8, sections 21; 22; 23; 24; Laws 2009, chapter 79, article 7,
section 12; article 13, sections 7; 8.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

ARTICLE 1

HEALTH AND HUMAN SERVICES TECHNICAL

Section 1.

Minnesota Statutes 2008, section 62J.497, subdivision 5, as added by Laws
2009, chapter 79, article 4, section 6, is amended to read:

Subd. 5.

Electronic drug prior authorization standardization and transmission.

(a) The commissioner of health, in consultation with the Minnesota e-Health Advisory
Committee and the Minnesota Administrative Uniformity Committee, shall, by February
15, 2010, identify an outline on how best to standardize drug prior authorization request
transactions between providers and group purchasers with the goal of maximizing
administrative simplification and efficiency in preparation for electronic transmissions.

(b) No later than January 1, 2011, drug prior authorization requests must be
accessible and submitted by health care providers, and accepted deleted text begin and processed deleted text end by group
purchasers, electronically through secure electronic transmissions. Facsimile shall not be
considered electronic transmission.

Sec. 2.

Minnesota Statutes 2008, section 144.0724, subdivision 11, as added by Laws
2009, chapter 79, article 8, section 4, is amended to read:

Subd. 11.

Nursing facility level of care.

(a) For purposes of medical assistance
payment of long-term care services, a recipient must be determined, using assessments
defined in subdivision 4, to meet one of the following nursing facility level of care criteria:

(1) the person needs the assistance of another person or constant supervision to begin
and complete at least four of the following activities of living: bathing, bed mobility,
dressing, eating, grooming, toileting, transferring, and walking;

(2) the person needs the assistance of another person or constant supervision to begin
and complete toileting, transferring, or positioning and the assistance cannot be scheduled;

(3) the person has significant difficulty with memory, using information, daily
decision making, or behavioral needs that require intervention;

(4) the person has had a qualifying nursing facility stay of at least 90 days; or

(5) the person is determined to be at risk for nursing facility admission or
readmission through a face-to-face long-term care consultation assessment as specified
in section 256B.0911, subdivision 3a, 3b, or 4d, by a county, tribe, or managed care
organization under contract with the Department of Human Services. The person is
considered at risk under this clause if the person currently lives alone or will live alone
upon discharge and also meets one of the following criteria:

(i) the person has experienced a fall resulting in a fracture;

(ii) the person has been determined to be at risk of maltreatment or neglect,
including self-neglect; or

(iii) the person has a sensory impairment that substantially impacts functional ability
and maintenance of a community residence.

(b) The assessment used to establish medical assistance payment for nursing facility
services must be the most recent assessment performed under subdivision 4, paragraph
(b), that occurred no more than 90 calendar days before the effective date of medical
assistance eligibility for payment of long-term care services. In no case shall medical
assistance payment for long-term care services occur prior to the date of the determination
of nursing facility level of care.

(c) The assessment used to establish medical assistance payment for long-term care
services provided under sections 256B.0915 and 256B.49 and alternative care payment
for services provided under section 256B.0913 must be the most recent face-to-face
assessment performed under section 256B.0911, subdivision 3a, new text begin 3b, or 4d, new text end that occurred
no more than 60 calendar days before the effective date of medical assistance eligibility
for payment of long-term care services.

Sec. 3.

Minnesota Statutes 2008, section 245A.11, subdivision 7a, as added by Laws
2009, chapter 79, article 1, section 4, is amended to read:

Subd. 7a.

Alternate overnight supervision technology; adult foster care license.

(a) The commissioner may grant an applicant or license holder an adult foster care license
for a residence that does not have a caregiver in the residence during normal sleeping
hours as required under Minnesota Rules, part 9555.5105, subpart 37, item B, but uses
monitoring technology to alert the license holder when an incident occurs that may
jeopardize the health, safety, or rights of a foster care recipient. The applicant or license
holder must comply with all other requirements under Minnesota Rules, parts 9555.5105
to 9555.6265, and the requirements under this subdivision. The license printed by the
commissioner must state in bold and large font:

(1) that the facility is under electronic monitoring; and

(2) the telephone number of the county's common entry point for making reports of
suspected maltreatment of vulnerable adults under section 626.557, subdivision 9.

(b) Applications for a license under this section must be submitted directly to
the Department of Human Services licensing division. The licensing division must
immediately notify the host county and lead county contract agency and the host county
licensing agency. The licensing division must collaborate with the county licensing
agency in the review of the application and the licensing of the program.

(c) Before a license is issued by the commissioner, and for the duration of the
license, the applicant or license holder must establish, maintain, and document the
implementation of written policies and procedures addressing the requirements in
paragraphs (d) through (f).

(d) The applicant or license holder must have policies and procedures that:

(1) establish characteristics of target populations that will be admitted into the home,
and characteristics of populations that will not be accepted into the home;

(2) explain the discharge process when a foster care recipient requires overnight
supervision or other services that cannot be provided by the license holder due to the
limited hours that the license holder is on-site;

(3) describe the types of events to which the program will respond with a physical
presence when those events occur in the home during time when staff are not on-site, and
how the license holder's response plan meets the requirements in paragraph (e), clause
(1) or (2);

(4) establish a process for documenting a review of the implementation and
effectiveness of the response protocol for the response required under paragraph (e),
clause (1) or (2). The documentation must include:

(i) a description of the triggering incident;

(ii) the date and time of the triggering incident;

(iii) the time of the response or responses under paragraph (e), clause (1) or (2);

(iv) whether the response met the resident's needs;

(v) whether the existing policies and response protocols were followed; and

(vi) whether the existing policies and protocols are adequate or need modification.

When no physical presence response is completed for a three-month period, the
license holder's written policies and procedures must require a physical presence response
drill be to conducted for which the effectiveness of the response protocol under paragraph
(e), clause (1) or (2), will be reviewed and documented as required under this clause; and

(5) establish that emergency and nonemergency phone numbers are posted in a
prominent location in a common area of the home where they can be easily observed by a
person responding to an incident who is not otherwise affiliated with the home.

(e) The license holder must document and include in the license application which
response alternative under clause (1) or (2) is in place for responding to situations that
present a serious risk to the health, safety, or rights of people receiving foster care services
in the home:

(1) response alternative (1) requires only the technology to provide an electronic
notification or alert to the license holder that an event is underway that requires a response.
Under this alternative, no more than ten minutes will pass before the license holder will be
physically present on-site to respond to the situation; or

(2) response alternative (2) requires the electronic notification and alert system
under alternative (1), but more than ten minutes may pass before the license holder is
present on-site to respond to the situation. Under alternative (2), all of the following
conditions are met:

(i) the license holder has a written description of the interactive technological
applications that will assist the deleted text begin licenser deleted text end new text begin license new text end holder in communicating with and assessing
the needs related to care, health, and safety of the foster care recipients. This interactive
technology must permit the license holder to remotely assess the well being of the foster
care recipient without requiring the initiation of the foster care recipient. Requiring the
foster care recipient to initiate a telephone call does not meet this requirement;

(ii) the license holder documents how the remote license holder is qualified and
capable of meeting the needs of the foster care recipients and assessing foster care
recipients' needs under item (i) during the absence of the license holder on-site;

(iii) the license holder maintains written procedures to dispatch emergency response
personnel to the site in the event of an identified emergency; and

(iv) each foster care recipient's individualized plan of care, individual service plan
under section 256B.092, subdivision 1b, if required, or individual resident placement
agreement under Minnesota Rules, part 9555.5105, subpart 19, if required, identifies the
maximum response time, which may be greater than ten minutes, for the license holder
to be on-site for that foster care recipient.

(f) All placement agreements, individual service agreements, and plans applicable
to the foster care recipient must clearly state that the adult foster care license category is
a program without the presence of a caregiver in the residence during normal sleeping
hours; the protocols in place for responding to situations that present a serious risk
to health, safety, or rights of foster care recipients under paragraph (e), clause (1) or
(2); and a signed informed consent from each foster care recipient or the person's
legal representative documenting the person's or legal representative's agreement with
placement in the program. If electronic monitoring technology is used in the home, the
informed consent form must also explain the following:

(1) how any electronic monitoring is incorporated into the alternative supervision
system;

(2) the backup system for any electronic monitoring in times of electrical outages or
other equipment malfunctions;

(3) how the license holder is trained on the use of the technology;

(4) the event types and license holder response times established under paragraph (e);

(5) how the license holder protects the foster care recipient's privacy related to
electronic monitoring and related to any electronically recorded data generated by the
monitoring system. A foster care recipient may not be removed from a program under
this subdivision for failure to consent to electronic monitoring. The consent form must
explain where and how the electronically recorded data is stored, with whom it will be
shared, and how long it is retained; and

(6) the risks and benefits of the alternative overnight supervision system.

The written explanations under clauses (1) to (6) may be accomplished through
cross-references to other policies and procedures as long as they are explained to the
person giving consent, and the person giving consent is offered a copy.

(g) Nothing in this section requires the applicant or license holder to develop or
maintain separate or duplicative polices, procedures, documentation, consent forms, or
individual plans that may be required for other licensing standards, if the requirements of
this section are incorporated into those documents.

(h) The commissioner may grant variances to the requirements of this section
according to section 245A.04, subdivision 9.

(i) For the purposes of paragraphs (d) through (h), license holder has the meaning
under section 245A.2, subdivision 9, and additionally includes all staff, volunteers, and
contractors affiliated with the license holder.

(j) For the purposes of paragraph (e), the terms "assess" and "assessing" mean to
remotely determine what action the license holder needs to take to protect the well-being
of the foster care recipient.

Sec. 4.

Minnesota Statutes 2008, section 245C.03, is amended by adding a subdivision
to read:

new text begin Subd. 6. new text end

new text begin Unlicensed home and community-based waiver providers of service to
seniors and individuals with disabilities. new text end

new text begin The commissioner shall conduct background
studies on any individual required under section 256B.4912 to have a background study
completed under this chapter.
new text end

Sec. 5.

Minnesota Statutes 2008, section 245C.04, subdivision 1, as amended by Laws
2009, chapter 79, article 1, section 8, 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.

(c) The commissioner is not required to conduct a study of an individual at the time
of reapplication for a license if the individual's background study was completed by the
commissioner of human services for an adult foster care license holder that is also:

(1) registered under chapter 144D; or

(2) licensed to provide home and community-based services to people with
disabilities at the foster care location and the license holder does not reside in the foster
care residence; and

(3) the following conditions are met:

(i) a study of the individual was conducted either at the time of initial licensure or
when the individual became affiliated with the license holder;

(ii) the individual has been continuously affiliated with the license holder since
the last study was conducted; and

(iii) the last study of the individual was conducted on or after October 1, 1995.

(d) From July 1, 2007, to June 30, 2009, the commissioner of human services shall
conduct a study of an individual required to be studied under section 245C.03, at the
time of reapplication for a child foster care license. The county or private agency shall
collect and forward to the commissioner the information required under section 245C.05,
subdivisions 1, paragraphs (a) and (b), and 5, paragraphs (a) and (b). The background
study conducted by the commissioner of human services under this paragraph must
include a review of the information required under section 245C.08, subdivisions 1,
paragraph (a), clauses (1) to (5), 3, and 4.

(e) The commissioner of human services shall conduct a background study of an
individual specified under section 245C.03, subdivision 1, paragraph (a), clauses (2)
to (6), who is newly affiliated with a child foster care license holder. The county or
private agency shall collect and forward to the commissioner the information required
under section 245C.05, subdivisions 1 and 5. The background study conducted by the
commissioner of human services under this paragraph must include a review of the
information required under section 245C.08, subdivisions 1, 3, and 4.

(f) From January 1, 2010, to December 31, 2012, unless otherwise specified in
paragraph (c), the commissioner shall conduct a study of an individual required to be
studied under section 245C.03 at the time of reapplication for an adult foster care or family
adult day services license: (1) the county shall collect and forward to the commissioner
the information required under section 245C.05, subdivision 1, paragraphs (a) and (b),
and subdivision 5, paragraphs (a) and (b), for background studies conducted by the
commissioner for new text begin all family adult day services and for new text end adult foster care deleted text begin and family adult
day services deleted text end when the new text begin adult foster care new text end license holder resides in the adult foster care
or family adult day services residence; (2) the license holder 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), for background studies conducted by
the commissioner for adult foster care when the license holder does not reside in the adult
foster care residence; and (3) the background study conducted by the commissioner under
this paragraph must include a review of the information required under section 245C.08,
subdivision 1, paragraph (a), clauses (1) to (5), and subdivisions 3 and 4.

(g) The commissioner shall conduct a background study of an individual specified
under section 245C.03, subdivision 1, paragraph (a), clauses (2) to (6), who is newly
affiliated with an adult foster care or family adult day services license holder: (1) the
county shall collect and forward to the commissioner the information required under
section 245C.05, subdivision 1, paragraphs (a) and (b), and subdivision 5, paragraphs (a)
and (b), for background studies conducted by the commissioner for new text begin all family adult day
services and for new text end adult foster care deleted text begin and family adult day services deleted text end when the new text begin adult foster care
new text end license holder resides in the adult foster care deleted text begin or family adult day services deleted text end residence; (2)
the license holder 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), for background studies conducted by the commissioner for adult foster care
when the license holder does not reside in the adult foster care residence; and (3) the
background study conducted by the commissioner under this paragraph must include a
review of the information required under section 245C.08, subdivision 1, paragraph (a),
and subdivisions 3 and 4.

(h) Applicants for licensure, license holders, and other entities as provided in this
chapter must submit completed background study forms to the commissioner before
individuals specified in section 245C.03, subdivision 1, begin positions allowing direct
contact in any licensed program.

(i) For purposes of this section, a physician licensed under chapter 147 is considered
to be continuously affiliated upon the license holder's receipt from the commissioner of
health or human services of the physician's background study results.

Sec. 6.

Minnesota Statutes 2008, section 245C.04, is amended by adding a subdivision
to read:

new text begin Subd. 6. new text end

new text begin Unlicensed home and community-based waiver providers of service to
seniors and individuals with disabilities. new text end

new text begin (a) Providers required to initiate background
studies under section 256B.4912 must initiate a study before the individual begins in a
position allowing direct contact with persons served by the provider.
new text end

new text begin (b) The commissioner shall conduct a background study annually of an individual
required to be studied under section 245C.03, subdivision 6.
new text end

Sec. 7.

Minnesota Statutes 2008, section 245C.05, subdivision 2b, as added by Laws
2009, chapter 79, article 1, section 9, is amended to read:

Subd. 2b.

County agency to collect and forward information to the
commissioner.

For background studies related to new text begin all family adult day services and to new text end adult
foster care deleted text begin and family adult day services deleted text end when the new text begin adult foster care new text end license holder resides
in the adult foster care deleted text begin or family adult day services deleted text end residence, the county agency must
collect the information required under subdivision 1 and forward it to the commissioner.

Sec. 8.

Minnesota Statutes 2008, section 245C.10, subdivision 5, as added by Laws
2009, chapter 79, article 1, section 12, is amended to read:

Subd. 5.

Adult foster care new text begin and family adult day new text end services.

The commissioner shall
recover the cost of background studies required under section 245C.03, subdivision 1,
for the purposes of adult foster care and family adult day services licensing, through
a fee of no more than $20 per study charged to the license holder. The fees collected
under this subdivision are appropriated to the commissioner for the purpose of conducting
background studies.

Sec. 9.

Minnesota Statutes 2008, section 245C.10, is amended by adding a subdivision
to read:

new text begin Subd. 6. new text end

new text begin Unlicensed home and community-based waiver providers of service to
seniors and individuals with disabilities. new text end

new text begin The commissioner shall recover the cost of
background studies initiated by unlicensed home and community-based waiver providers
of service to seniors and individuals with disabilities under section 256B.4912 through a
fee of no more than $20 per study.
new text end

Sec. 10.

Minnesota Statutes 2008, section 245C.21, subdivision 1a, as amended by
Laws 2009, chapter 79, article 1, section 16, is amended to read:

Subd. 1a.

Submission of reconsideration request.

(a) For disqualifications related
to studies conducted by county agencies for family child care, and for disqualifications
related to studies conducted by the commissioner for child foster care, adult foster care,
and family adult day services, the individual shall submit the request for reconsideration
to the county agency that initiated the background study.

(b) For disqualifications related to studies conducted by the commissioner for child
foster care new text begin providers monitored by private licensing agencies under section 245A.16 new text end , the
individual shall submit the request for reconsideration to the private agency that initiated
the background study.

(c) A reconsideration request shall be submitted within 30 days of the individual's
receipt of the disqualification notice or the time frames specified in subdivision 2,
whichever time frame is shorter.

(d) The county or private agency shall forward the individual's request for
reconsideration and provide the commissioner with a recommendation whether to set aside
the individual's disqualification.

Sec. 11.

Minnesota Statutes 2008, section 246.50, subdivision 3, is amended to read:

Subd. 3.

State facility.

"State facility" means any state facility owned or operated
by the state of Minnesota and under the programmatic direction or fiscal control of the
commissioner new text begin , except the Minnesota sex offender program under chapter 246B new text end . State
facility includes regional treatment centers; the state nursing homes; state-operated,
community-based programs; and other facilities owned or operated by the state and under
the commissioner's control.

Sec. 12.

Minnesota Statutes 2008, section 256.01, subdivision 18b, as added by Laws
2009, chapter 79, article 5, section 7, is amended to read:

Subd. 18b.

Protections for American Indians.

Effective deleted text begin February 18 deleted text end new text begin July 1 new text end ,
2009, the commissioner shall comply with the federal requirements in the American
Recovery and Reinvestment Act of 2009, Public Law 111-5, section 5006, regarding
American Indians.

Sec. 13.

Minnesota Statutes 2008, section 256.969, subdivision 2b, as amended by
Laws 2009, chapter 79, article 5, section 11, is amended to read:

Subd. 2b.

Operating payment rates.

In determining operating payment rates for
admissions occurring on or after the rate year beginning January 1, 1991, and every two
years after, or more frequently as determined by the commissioner, the commissioner
shall obtain operating data from an updated base year and establish operating payment
rates per admission for each hospital based on the cost-finding methods and allowable
costs of the Medicare program in effect during the base year. Rates under the general
assistance medical care, medical assistance, and MinnesotaCare programs shall not be
rebased to more current data on January 1, 1997, January 1, 2005, for the first 24 months
of the rebased period beginning January 1, 2009 deleted text begin , and deleted text end new text begin . new text end For the first three months of the
rebased period beginning January 1, 2011 new text begin , rates shall be rebased at 74.25 percent of the
full value of the rebasing percentage change new text end . From April 1, 2011, to March 31, 2012,
rates shall be rebased at 39.2 percent of the full value of the rebasing percentage change.
Effective April 1, 2012, rates shall be rebased at full value. The base year operating
payment rate per admission is standardized by the case mix index and adjusted by the
hospital cost index, relative values, and disproportionate population adjustment. The
cost and charge data used to establish operating rates shall only reflect inpatient services
covered by medical assistance and shall not include property cost information and costs
recognized in outlier payments.

Sec. 14.

Minnesota Statutes 2008, section 256.969, is amended by adding a subdivision
to read:

new text begin Subd. 28. new text end

new text begin Payment rates for births. new text end

new text begin (a) For admissions occurring on or after
October 1, 2009, the total operating and property payment rate, excluding disproportionate
population adjustment, for the following diagnosis-related groups, as they fall within
the diagnostic categories: (1) 371 cesarean section without complicating diagnosis; (2)
372 vaginal delivery with complicating diagnosis; and (3) 373 vaginal delivery without
complicating diagnosis, shall be no greater than $3,528.
new text end

new text begin (b) The rates described in this subdivision do not include newborn care.
new text end

new text begin (c) Payments to managed care and county-based purchasing plans under section
256B.69, 256B.692, or 256L.12 shall be reduced for services provided on or after October
1, 2009, to reflect the adjustments in paragraph (a).
new text end

new text begin (d) Prior authorization shall not be required before reimbursement is paid for a
cesarean section delivery.
new text end

Sec. 15.

Minnesota Statutes 2008, section 256.969, subdivision 29, as added by Laws
2009, chapter 79, article 5, section 15, is amended to read:

Subd. 29.

Reimbursement for the fee increase for the early hearing detection
and intervention program.

For deleted text begin services provided deleted text end new text begin admissions occurring new text end on or after
July 1, 2010, deleted text begin in addition to any other payment under this section, the commissioner
shall reimburse hospitals for the increase in the fee for the early hearing detection and
intervention program described in section 144.125, subdivision 1, paid by the hospital
for public program recipients deleted text end new text begin payment rates shall be adjusted to include the increase to
the fee that is effective on July 1, 2010, for the early hearing detection and intervention
program recipients under section 144.125, subdivision 1, that is paid by the hospital for
public program recipients. This payment increase shall be in effect until the increase
is fully recognized in the base year cost under subdivision 2b. This payment shall be
included in payments to contracted managed care organizations new text end .

Sec. 16.

Minnesota Statutes 2008, section 256.975, subdivision 7, as amended by Laws
2009, chapter 79, article 8, section 16, is amended to read:

Subd. 7.

Consumer information and assistance and long-term care options
counseling; Senior LinkAge Line.

(a) The Minnesota Board on Aging shall operate a
statewide 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 provide long-term care options counseling by assisting older
adults, caregivers, and providers in accessing information and options counseling 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;

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

(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;

(10) provide long-term care options counseling. Long-term care options counselors
shall:

(i) for individuals not eligible for case management under a public program or public
funding source, provide interactive decision support under which consumers, family
members, or other helpers are supported in their deliberations to determine appropriate
long-term care choices in the context of the consumer's needs, preferences, values, and
individual circumstances, including implementing a community support plan;

(ii) provide Web-based educational information and collateral written materials to
familiarize consumers, family members, or other helpers with the long-term care basics,
issues to be considered, and the range of options available in the community;

(iii) provide long-term care futures planning, which means providing assistance to
individuals who anticipate having long-term care needs to develop a plan for the more
distant future; and

(iv) provide expertise in benefits and financing options for long-term care, including
Medicare, long-term care insurance, tax or employer-based incentives, reverse mortgages,
private pay options, and ways to access low or no-cost services or benefits through
volunteer-based or charitable programs; and

(11) using risk management and support planning protocols, provide long-term care
options counseling to current residents of nursing homes deemed appropriate for discharge
by the commissioner. In order to meet this requirement, the commissioner shall provide
designated Senior LinkAge Line contact centers with a list of nursing home residents
appropriate for discharge planning via a secure Web portal. Senior LinkAge Line shall
provide these residents, if they indicate a preference to receive long-term care options
counseling, with initial assessment, review of risk factors, independent living support
consultation, or referral to:

(i) new text begin long-term care consultation new text end services under section 256B.0911 deleted text begin , subdivision 3 deleted text end ;

(ii) designated care coordinators of contracted entities under section 256B.035 for
persons who are enrolled in a managed care plan; or

(iii) the long-term care consultation team for those who are appropriate for relocation
service coordination due to high-risk factors or psychological or physical disability.

Sec. 17.

Minnesota Statutes 2008, section 256B.056, subdivision 3b, is amended to
read:

Subd. 3b.

Treatment of trusts.

(a) A "medical assistance qualifying trust" is a
revocable or irrevocable trust, or similar legal device, established on or before August
10, 1993, by a person or the person's spouse under the terms of which the person
receives or could receive payments from the trust principal or income and the trustee
has discretion in making payments to the person from the trust principal or income.
Notwithstanding that definition, a medical assistance qualifying trust does not include:
(1) a trust set up by will; (2) a trust set up before April 7, 1986, solely to benefit a person
with a developmental disability living in an intermediate care facility for persons with
developmental disabilities; or (3) a trust set up by a person with payments made by the
Social Security Administration pursuant to the United States Supreme Court decision in
Sullivan v. Zebley, 110 S. Ct. 885 (1990). The maximum amount of payments that a
trustee of a medical assistance qualifying trust may make to a person under the terms of
the trust is considered to be available assets to the person, without regard to whether the
trustee actually makes the maximum payments to the person and without regard to the
purpose for which the medical assistance qualifying trust was established.

(b) new text begin Except as provided in paragraphs (c) and (d), new text end trusts established after August 10,
1993, are treated according to section 13611(b) of the Omnibus Budget Reconciliation
Act of 1993 (OBRA), Public Law 103-66.

new text begin (c) For purposes of paragraph (d), a pooled trust means a trust established under
United States Code, title 42, section 1396p(d)(4)(C).
new text end

new text begin (d) A beneficiary's interest in a pooled trust is considered an available asset unless
the trust provides that upon the death of the beneficiary or termination of the trust during
the beneficiary's lifetime, whichever is sooner, the department receives any amount, up
to the amount of medical assistance benefits paid on behalf of the beneficiary, remaining
in the beneficiary's trust account after a deduction for reasonable administrative fees
and expenses, and an additional remainder amount. The retained remainder amount
of the subaccount must not exceed ten percent of the account value at the time of the
beneficiary's death or termination of the trust, and must only be used for the benefit of
disabled individuals who have a beneficiary interest in the pooled trust.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for pooled trust accounts established
on or after January 1, 2011.
new text end

Sec. 18.

Minnesota Statutes 2008, section 256B.057, subdivision 11, as added by Laws
2009, chapter 79, article 5, section 19, is amended to read:

Subd. 11.

Treatment for colorectal cancer.

(a) Medical assistance shall be paid for
an individual who:

(1) has been screened for colorectal cancer by the colorectal cancer prevention
demonstration project;

(2) according to the individual's treating health professional, needs treatment for
colorectal cancer;

(3) meets income eligibility guidelines for the colorectal cancer prevention
demonstration project;

(4) is under the age of 65; and

(5) is not otherwise eligible for medical assistance or covered under creditable
coverage as defined under United States Code, title 42, section 300gg deleted text begin (a) deleted text end new text begin (c), but without
regard to paragraph (1)(F) of such section new text end .

(b) Medical assistance provided under this subdivision shall be limited to services
provided during the period that the individual receives treatment for colorectal cancer.

(c) An individual meeting the criteria in paragraph (a) is eligible for medical
assistance without meeting the eligibility criteria relating to income and assets in section
256B.056, subdivisions 1a to 5b.

(d) This subdivision expires December 31, 2010.

Sec. 19.

Minnesota Statutes 2008, section 256B.06, subdivision 4, as amended by
Laws 2009, chapter 79, article 5, section 23, is amended to read:

Subd. 4.

Citizenship requirements.

(a) Eligibility for medical assistance is limited
to citizens of the United States, qualified noncitizens as defined in this subdivision, and
other persons residing lawfully in the United States. Citizens or nationals of the United
States must cooperate in obtaining satisfactory documentary evidence of citizenship or
nationality according to the requirements of the federal Deficit Reduction Act of 2005,
Public Law 109-171.

(b) "Qualified noncitizen" means a person who meets one of the following
immigration criteria:

(1) admitted for lawful permanent residence according to United States Code, title 8;

(2) admitted to the United States as a refugee according to United States Code,
title 8, section 1157;

(3) granted asylum according to United States Code, title 8, section 1158;

(4) granted withholding of deportation according to United States Code, title 8,
section 1253(h);

(5) paroled for a period of at least one year according to United States Code, title 8,
section 1182(d)(5);

(6) granted conditional entrant status according to United States Code, title 8,
section 1153(a)(7);

(7) determined to be a battered noncitizen by the United States Attorney General
according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996,
title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;

(8) is a child of a noncitizen determined to be a battered noncitizen by the United
States Attorney General according to the Illegal Immigration Reform and Immigrant
Responsibility Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill,
Public Law 104-200; or

(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public
Law 96-422, the Refugee Education Assistance Act of 1980.

(c) All qualified noncitizens who were residing in the United States before August
22, 1996, who otherwise meet the eligibility requirements of this chapter, are eligible for
medical assistance with federal financial participation.

(d) All qualified noncitizens who entered the United States on or after August 22,
1996, and who otherwise meet the eligibility requirements of this chapter, are eligible for
medical assistance with federal financial participation through November 30, 1996.

Beginning December 1, 1996, qualified noncitizens who entered the United States
on or after August 22, 1996, and who otherwise meet the eligibility requirements of this
chapter are eligible for medical assistance with federal participation for five years if they
meet one of the following criteria:

(i) refugees admitted to the United States according to United States Code, title 8,
section 1157;

(ii) persons granted asylum according to United States Code, title 8, section 1158;

(iii) persons granted withholding of deportation according to United States Code,
title 8, section 1253(h);

(iv) veterans of the United States armed forces with an honorable discharge for
a reason other than noncitizen status, their spouses and unmarried minor dependent
children; or

(v) persons on active duty in the United States armed forces, other than for training,
their spouses and unmarried minor dependent children.

Beginning December 1, 1996, qualified noncitizens who do not meet one of the
criteria in items (i) to (v) are eligible for medical assistance without federal financial
participation as described in paragraph (j).

Notwithstanding paragraph (j), beginning July 1, 2010, children and pregnant
women who are deleted text begin qualified deleted text end noncitizens deleted text begin , as deleted text end described in paragraph (b) new text begin or (e) new text end , are eligible
for medical assistance with federal financial participation as provided by the federal
Children's Health Insurance Program Reauthorization Act of 2009, Public Law 111-3.

(e) Noncitizens who are not qualified noncitizens as defined in paragraph (b), who
are lawfully present in the United States, as defined in Code of Federal Regulations, title
8, section 103.12, and who otherwise meet the eligibility requirements of this chapter, are
eligible for medical assistance under clauses (1) to (3). These individuals must cooperate
with the United States Citizenship and Immigration Services to pursue any applicable
immigration status, including citizenship, that would qualify them for medical assistance
with federal financial participation.

(1) Persons who were medical assistance recipients on August 22, 1996, are eligible
for medical assistance with federal financial participation through December 31, 1996.

(2) Beginning January 1, 1997, persons described in clause (1) are eligible for
medical assistance without federal financial participation as described in paragraph (j).

(3) Beginning December 1, 1996, persons residing in the United States prior to
August 22, 1996, who were not receiving medical assistance and persons who arrived on
or after August 22, 1996, are eligible for medical assistance without federal financial
participation as described in paragraph (j).

(f) Nonimmigrants who otherwise meet the eligibility requirements of this chapter
are eligible for the benefits as provided in paragraphs (g) to (i). For purposes of this
subdivision, a "nonimmigrant" is a person in one of the classes listed in United States
Code, title 8, section 1101(a)(15).

(g) Payment shall also be made for care and services that are furnished to noncitizens,
regardless of immigration status, who otherwise meet the eligibility requirements of
this chapter, if such care and services are necessary for the treatment of an emergency
medical condition, except for organ transplants and related care and services and routine
prenatal care.

(h) For purposes of this subdivision, the term "emergency medical condition" means
a medical condition that meets the requirements of United States Code, title 42, section
1396b(v).

(i) Beginning July 1, 2009, pregnant noncitizens who are undocumented,
nonimmigrants, or lawfully present as designated in paragraph (e) and who are not
covered by a group health plan or health insurance coverage according to Code of
Federal Regulations, title 42, section 457.310, and who otherwise meet the eligibility
requirements of this chapter, are eligible for medical assistance through the period of
pregnancy, including labor and delivery, and 60 days postpartum, to the extent federal
funds are available under title XXI of the Social Security Act, and the state children's
health insurance program.

(j) Qualified noncitizens as described in paragraph (d), and all other noncitizens
lawfully residing in the United States as described in paragraph (e), who are ineligible
for medical assistance with federal financial participation and who otherwise meet the
eligibility requirements of chapter 256B and of this paragraph, are eligible for medical
assistance without federal financial participation. Qualified noncitizens as described
in paragraph (d) are only eligible for medical assistance without federal financial
participation for five years from their date of entry into the United States.

(k) Beginning October 1, 2003, persons who are receiving care and rehabilitation
services from a nonprofit center established to serve victims of torture and are otherwise
ineligible for medical assistance under this chapter are eligible for medical assistance
without federal financial participation. These individuals are eligible only for the period
during which they are receiving services from the center. Individuals eligible under this
paragraph shall not be required to participate in prepaid medical assistance.

Sec. 20.

Minnesota Statutes 2008, section 256B.0625, subdivision 3c, as amended by
Laws 2009, chapter 79, article 5, section 26, is amended to read:

Subd. 3c.

Health Services Policy Committee.

(a) The commissioner, after
receiving recommendations from professional physician associations, professional
associations representing licensed nonphysician health care professionals, and consumer
groups, shall establish a 13-member Health Services Policy Committee, which consists of
12 voting members and one nonvoting member. The Health Services Policy Committee
shall advise the commissioner regarding health services pertaining to the administration
of health care benefits covered under the medical assistance, general assistance medical
care, and MinnesotaCare programs. The Health Services Policy Committee shall meet at
least quarterly. The Health Services Policy Committee shall annually elect a physician
chair from among its members, who shall work directly with the commissioner's medical
director, to establish the agenda for each meeting. The Health Services Policy Committee
shall also recommend criteria for verifying centers of excellence for specific aspects of
medical care where a specific set of combined services, a volume of patients necessary to
maintain a high level of competency, or a specific level of technical capacity is associated
with improved health outcomes.

(b) The commissioner shall establish a dental subcommittee to operate under the
Health Services Policy Committee. The dental subcommittee consists of general dentists,
dental specialists, safety net providers, dental hygienists, health plan company and
county and public health representatives, health researchers, consumers, and a designee
of the commissioner of health. The dental subcommittee shall advise the commissioner
regarding:

(1) the critical access dental program under section 256B.76, subdivision 4, including
but not limited to criteria for designating and terminating critical access dental providers;

(2) any changes to the critical access dental provider program necessary to comply
with program expenditure limits;

(3) dental coverage policy based on evidence, quality, continuity of care, and best
practices;

(4) the development of dental delivery models; and

(5) dental services to be added or eliminated from subdivision 9, paragraph (b).

(c) The Health Services Policy Committee shall study approaches to making
provider reimbursement under the medical assistance, MinnesotaCare, and general
assistance medical care programs contingent on patient participation in a patient-centered
decision-making process, and shall evaluate the impact of these approaches on health
care quality, patient satisfaction, and health care costs. The committee shall present
findings and recommendations to the commissioner and the legislative committees with
jurisdiction over health care by January 15, 2010.

(d) The Health Services Policy Committee shall monitor and track the practice
patterns of physicians providing services to medical assistance, MinnesotaCare, and
general assistance medical care enrollees under fee-for-service, managed care, and
county-based purchasing. The committee shall focus on services or specialties for which
there is a high variation in utilization across physicians, or which are associated with
high medical costs. The commissioner, based upon the findings of the committee, shall
regularly notify physicians whose practice patterns indicate higher than average utilization
or costs. Managed care and county-based purchasing plans shall provide the deleted text begin committee deleted text end new text begin
commissioner new text end with utilization and cost data necessary to implement this paragraph new text begin , and
the commissioner shall make this data available to the committee new text end .

(e) The Health Services Policy Committee shall review caesarean section rates
for the fee-for-service medical assistance population. The committee may develop best
practices policies related to the minimization of caesarean sections, including but not
limited to standards and guidelines for health care providers and health care facilities.

Sec. 21.

Minnesota Statutes 2008, section 256B.0625, subdivision 13h, as amended by
Laws 2009, chapter 79, article 5, section 31, is amended to read:

Subd. 13h.

Medication therapy management services.

(a) Medical assistance
and general assistance medical care cover medication therapy management services for
a recipient taking four or more prescriptions to treat or prevent two or more chronic
medical conditions, or a recipient with a drug therapy problem that is identified or prior
authorized by the commissioner that has resulted or is likely to result in significant
nondrug program costs. The commissioner may cover medical therapy management
services under MinnesotaCare if the commissioner determines this is cost-effective. For
purposes of this subdivision, "medication therapy management" means the provision
of the following pharmaceutical care services by a licensed pharmacist to optimize the
therapeutic outcomes of the patient's medications:

(1) performing or obtaining necessary assessments of the patient's health status;

(2) formulating a medication treatment plan;

(3) monitoring and evaluating the patient's response to therapy, including safety
and effectiveness;

(4) performing a comprehensive medication review to identify, resolve, and prevent
medication-related problems, including adverse drug events;

(5) documenting the care delivered and communicating essential information to
the patient's other primary care providers;

(6) providing verbal education and training designed to enhance patient
understanding and appropriate use of the patient's medications;

(7) providing information, support services, and resources designed to enhance
patient adherence with the patient's therapeutic regimens; and

(8) coordinating and integrating medication therapy management services within the
broader health care management services being provided to the patient.

Nothing in this subdivision shall be construed to expand or modify the scope of practice of
the pharmacist as defined in section 151.01, subdivision 27.

(b) To be eligible for reimbursement for services under this subdivision, a pharmacist
must meet the following requirements:

(1) have a valid license issued under chapter 151;

(2) have graduated from an accredited college of pharmacy on or after May 1996, or
completed a structured and comprehensive education program approved by the Board of
Pharmacy and the American Council of Pharmaceutical Education for the provision and
documentation of pharmaceutical care management services that has both clinical and
didactic elements;

(3) be practicing in an ambulatory care setting as part of a multidisciplinary team or
have developed a structured patient care process that is offered in a private or semiprivate
patient care area that is separate from the commercial business that also occurs in the
setting, or in home settings, excluding long-term care and group homes, if the service is
ordered by the provider-directed care coordination team; and

(4) make use of an electronic patient record system that meets state standards.

(c) For purposes of reimbursement for medication therapy management services,
the commissioner may enroll individual pharmacists as medical assistance and general
assistance medical care providers. The commissioner may also establish contact
requirements between the pharmacist and recipient, including limiting the number of
reimbursable consultations per recipient.

(d) The commissioner shall establish a pilot project for an intensive medication
therapy management program for patients identified by the commissioner with multiple
chronic conditions and a high number of medications who are at high risk of preventable
hospitalizations, emergency room use, medication complications, and suboptimal
treatment outcomes due to medication-related problems. For purposes of the pilot
project, medication therapy management services may be provided in a patient's home
or community setting, in addition to other authorized settings. The commissioner may
waive existing payment policies and establish special payment rates for the pilot project.
The pilot project must be designed to produce a net savings to the state compared to the
estimated costs that would otherwise be incurred for similar patients without the program. new text begin
The pilot project must begin by January 1, 2010, and end June 30, 2012.
new text end

Sec. 22.

Minnesota Statutes 2008, section 256B.0655, subdivision 4, as amended by
Laws 2009, chapter 79, article 8, section 28, is amended to read:

Subd. 4.

Authorization; personal care assistance and qualified professional.

(a) All personal care assistance services, supervision by a qualified professional, and
additional services beyond the limits established in section 256B.0651, subdivision 11,
must be authorized by the commissioner or the commissioner's designee before services
begin except for the assessments established in sections 256B.0651, subdivision 11, and
256B.0911. The authorization for personal care assistance and qualified professional
services under section 256B.0659 must be completed within 30 days after receiving
a complete request.

(b) The amount of personal care assistance services authorized must be based
on the recipient's home care rating. The home care rating shall be determined by the
commissioner or the commissioner's designee based on information submitted to the
commissioner identifying the following:

(1) total number of dependencies of activities of daily living as defined in section
256B.0659;

(2) number of complex health-related deleted text begin functions deleted text end new text begin needs new text end as defined in section
256B.0659; and

(3) number of behavior descriptions as defined in section 256B.0659.

(c) The methodology to determine total time for personal care assistance services for
each home care rating is based on the median paid units per day for each home care rating
from fiscal year 2007 data for the personal care assistance program. Each home care rating
has a base level of hours assigned. Additional time is added through the assessment and
identification of the following:

(1) 30 additional minutes per day for a dependency in each critical activity of daily
living as defined in section 256B.0659;

(2) 30 additional minutes per day for each complex health-related function as
defined in section 256B.0659; and

(3) 30 additional minutes per day for each behavior issue as defined in section
256B.0659.

(d) A limit of 96 units of qualified professional supervision may be authorized for
each recipient receiving personal care assistance services. A request to the commissioner
to exceed this total in a calendar year must be requested by the personal care provider
agency on a form approved by the commissioner.

Sec. 23.

Minnesota Statutes 2008, section 256B.0659, subdivision 9, as added by Laws
2009, chapter 79, article 8, section 31, is amended to read:

Subd. 9.

Responsible party; generally.

(a) "Responsible party deleted text begin , deleted text end " deleted text begin effective January
1, 2010, deleted text end means an individual who is capable of providing the support necessary to assist
the recipient to live in the community.

(b) A responsible party must be 18 years of age, actively participate in planning and
directing of personal care assistance services, and attend all assessments for the recipient.

(c) A responsible party must not be the:

(1) personal care assistant;

(2) home care provider agency owner or staff; or

(3) county staff acting as part of employment.

(d) A licensed family foster parent who lives with the recipient may be the
responsible party as long as the family foster parent meets the other responsible party
requirements.

(e) A responsible party is required when:

(1) the person is a minor according to section 524.5-102, subdivision 10;

(2) the person is an incapacitated adult according to section 524.5-102, subdivision
6, resulting in a court-appointed guardian; or

(3) the assessment according to section 256B.0655, subdivision 1b, determines that
the recipient is in need of a responsible party to direct the recipient's care.

(f) There may be two persons designated as the responsible party for reasons such
as divided households and court-ordered custodies. Each person named as responsible
party must meet the program criteria and responsibilities.

(g) The recipient or the recipient's legal representative shall appoint a responsible
party if necessary to direct and supervise the care provided to the recipient. The
responsible party must be identified at the time of assessment and listed on the recipient's
service agreement and personal care assistance care plan.

Sec. 24.

Minnesota Statutes 2008, section 256B.0659, subdivision 10, as added by
Laws 2009, chapter 79, article 8, section 31, is amended to read:

Subd. 10.

Responsible party; duties; delegation.

(a) A responsible party shall
enter into a written agreement with a personal care assistance provider agency, on a form
determined by the commissioner, to perform the following duties:

(1) be available while care is provided in a method agreed upon by the individual
or the individual's legal representative and documented in the recipient's personal care
assistance care plan;

(2) monitor personal care assistance services to ensure the recipient's personal care
assistance care plan is being followed; and

(3) review and sign personal care assistance time sheets after services are provided
to provide verification of the personal care assistance services.

Failure to provide the support required by the recipient must result in a referral to the
county common entry point.

(b) Responsible parties who are parents of minors or guardians of minors or
incapacitated persons may delegate the responsibility to another adult who is not the
personal care assistant during a temporary absence of at least 24 hours but not more
than six months. The person delegated as a responsible party must be able to meet the
definition of the responsible party deleted text begin , except that the delegated responsible party is required
to reside with the recipient only while serving as the responsible party deleted text end . The responsible
party must ensure that the delegate performs the functions of the responsible party, is
identified at the time of the assessment, and is listed on the personal care assistance
care plan. The responsible party must communicate to the personal care assistance
provider agency about the need for a delegate responsible party, including the name of the
delegated responsible party, dates the delegated responsible party will be living with the
recipient, and contact numbers.

Sec. 25.

Minnesota Statutes 2008, section 256B.0659, subdivision 13, as added by
Laws 2009, chapter 79, article 8, section 31, is amended to read:

Subd. 13.

Qualified professional; qualifications.

(a) The qualified professional
must be employed by a personal care assistance provider agency and meet the definition
under section 256B.0625, subdivision 19c. Before a qualified professional provides
services, the personal care assistance provider agency must initiate a background study on
the qualified professional under chapter 245C, and the personal care assistance provider
agency must have received a notice from the commissioner that the qualified professional:

(1) is not disqualified under section 245C.14; or

(2) is disqualified, but the qualified professional has received a set aside of the
disqualification under section 245C.22.

(b) The qualified professional shall perform the duties of training, supervision, and
evaluation of the personal care assistance staff and evaluation of the effectiveness of
personal care assistance services. The qualified professional shall:

(1) develop and monitor with the recipient a personal care assistance care plan based
on the service plan and individualized needs of the recipient;

(2) develop and monitor with the recipient a monthly plan for the use of personal
care assistance services;

(3) review documentation of personal care assistance services provided;

(4) provide training and ensure competency for the personal care assistant in the
individual needs of the recipient; and

(5) document all training, communication, evaluations, and needed actions to
improve performance of the personal care assistants.

(c) new text begin Effective January 1, 2010, new text end the qualified professional shall complete the provider
training with basic information about the personal care assistance program approved
by the commissioner within six months of the date hired by a personal care assistance
provider agency. Qualified professionals who have completed the required trainings as
an employee with a personal care assistance provider agency do not need to repeat the
required trainings if they are hired by another agency, if they have completed the training
within the last three years.

Sec. 26.

Minnesota Statutes 2008, section 256B.0659, subdivision 21, as added by
Laws 2009, chapter 79, article 8, section 31, is amended to read:

Subd. 21.

Requirements for initial enrollment of personal care assistance
provider agencies.

(a) All personal care assistance provider agencies must provide, at the
time of enrollment as a personal care assistance provider agency in a format determined
by the commissioner, information and documentation that includes, but is not limited to,
the following:

(1) the personal care assistance provider agency's current contact information
including address, telephone number, and e-mail address;

(2) proof of surety bond coverage in the amount of $50,000 or ten percent of the
provider's payments from Medicaid in the previous year, whichever is less;

(3) proof of fidelity bond coverage in the amount of $20,000;

(4) proof of workers' compensation insurance coverage;

(5) a description of the personal care assistance provider agency's organization
identifying the names of all owners, managing employees, staff, board of directors, and
the affiliations of the directors, owners, or staff to other service providers;

(6) a copy of the personal care assistance provider agency's written policies and
procedures including: hiring of employees; training requirements; service delivery;
and employee and consumer safety including process for notification and resolution
of consumer grievances, identification and prevention of communicable diseases, and
employee misconduct;

(7) copies of all other forms the personal care assistance provider agency uses in
the course of daily business including, but not limited to:

(i) a copy of the personal care assistance provider agency's time sheet if the time
sheet varies from the standard time sheet for personal care assistance services approved
by the commissioner, and a letter requesting approval of the personal care assistance
provider agency's nonstandard time sheet;

(ii) the personal care assistance provider agency's template for the personal care
assistance care plan; and

(iii) the personal care assistance provider agency's template deleted text begin and deleted text end new text begin for new text end the written
agreement in subdivision 20 for recipients using the personal care assistance choice
option, if applicable;

(8) a list of all trainings and classes that the personal care assistance provider agency
requires of its staff providing personal care assistance services;

(9) documentation that the personal care assistance provider agency and staff have
successfully completed all the training required by this section;

(10) documentation of the agency's marketing practices;

(11) disclosure of ownership, leasing, or management of all residential properties
that is used or could be used for providing home care services; and

(12) documentation that the agency will use the following percentages of revenue
generated from the medical assistance rate paid for personal care assistance services
for employee personal care assistant wages and benefits: 72.5 percent of revenue in the
personal care assistance choice option and 72.5 percent of revenue from other personal
care assistance providers.

(b) Personal care assistance provider agencies shall provide the information specified
in paragraph (a) to the commissioner at the time the personal care assistance provider
agency enrolls as a vendor or upon request from the commissioner. The commissioner
shall collect the information specified in paragraph (a) from all personal care assistance
providers beginning upon enactment of this section.

(c) All personal care assistance provider agencies shall complete mandatory training
as determined by the commissioner before enrollment as a provider. Personal care
assistance provider agencies are required to send all owners, qualified professionals
employed by the agency, and all other managing employees to the initial and subsequent
trainings. Personal care assistance provider agency billing staff shall complete training
about personal care assistance program financial management. This training is effective
upon enactment of this section. Any personal care assistance provider agency enrolled
before that date shall, if it has not already, complete the provider training within 18 months
of the effective date of this section. Any new owners, new qualified professionals, and new
managing employees are required to complete mandatory training as a requisite of hiring.

Sec. 27.

Minnesota Statutes ..., section 256B.0659, subdivision 29, as added by Laws
2009, chapter 79, article 8, section 31, is amended to read:

Subd. 29.

Transitional assistance.

The commissioner, counties, health plans, tribes,
and personal care assistance providers shall work together to provide transitional assistance
for recipients and families to come into compliance with the new requirements of this
section new text begin that may require a change in living arrangement no later than August 10, 2010 new text end deleted text begin and
ensure the personal care assistance services are not provided by the housing provider deleted text end .

Sec. 28.

Minnesota Statutes 2008, section 256B.0911, subdivision 1a, as amended by
Laws 2009, chapter 79, article 8, section 33, is amended to read:

Subd. 1a.

Definitions.

For purposes of this section, the following definitions apply:

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

(1) assistance in identifying services needed to maintain an individual in the most
inclusive environment;

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

(3) development of an individual's person-centered community support plan;

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

(5) face-to-face long-term care consultation assessments, which may be completed
in a hospital, nursing facility, intermediate care facility for persons with developmental
disabilities (ICF/DDs), regional treatment centers, or the person's current or planned
residence;

(6) federally mandated screening to determine the need for a institutional level of
care under section 256B.0911, subdivision 4, paragraph (a);

(7) determination of home and community-based waiver service eligibility including
level of care determination for individuals who need an institutional level of care as
defined under section 144.0724, subdivision 11, or 256B.092, service eligibility including
state plan home care services identified in section 256B.0625, subdivisions 6, 7, and
19, paragraphs (a) and (c), based on assessment and support plan development with
appropriate referrals;

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

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

(b) "Long-term new text begin care new text end options counseling" means the services provided by the linkage
lines as mandated by sections 256.01 and 256.975, subdivision 7, and also includes
telephone assistance and follow up once a long-term care consultation assessment has
been completed.

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

(d) "Lead agencies" means counties or a collaboration of counties, tribes, and health
plans administering long-term care consultation assessment and support planning services.

Sec. 29.

Minnesota Statutes 2008, section 256B.441, subdivision 55, as amended by
Laws 2009, chapter 79, article 8, section 61, is amended to read:

Subd. 55.

Phase-in of rebased operating payment rates.

(a) For the rate years
beginning October 1, 2008, to October 1, 2015, the operating payment rate calculated
under this section shall be phased in by blending the operating rate with the operating
payment rate determined under section 256B.434. For purposes of this subdivision, the
rate to be used that is determined under section 256B.434 shall not include the portion of
the operating payment rate related to performance-based incentive payments under section
256B.434, subdivision 4, paragraph (d). For the rate year beginning October 1, 2008, the
operating payment rate for each facility shall be 13 percent of the operating payment rate
from this section, and 87 percent of the operating payment rate from section 256B.434.
For the rate deleted text begin period deleted text end new text begin year new text end beginning October 1, 2009, deleted text begin through September 30, 2013, deleted text end the
operating payment rate for each facility shall be 14 percent of the operating payment rate
from this section, and 86 percent of the operating payment rate from section 256B.434.
new text begin For rate years beginning October 1, 2010; October 1, 2011; and October 1, 2012, no
rate adjustments shall be implemented under this section, but shall be determined under
section 256B.434. new text end For the rate year beginning October 1, 2013, the operating payment
rate for each facility shall be 65 percent of the operating payment rate from this section,
and 35 percent of the operating payment rate from section 256B.434. For the rate year
beginning October 1, 2014, the operating payment rate for each facility shall be 82 percent
of the operating payment rate from this section, and 18 percent of the operating payment
rate from section 256B.434. For the rate year beginning October 1, 2015, the operating
payment rate for each facility shall be the operating payment rate determined under this
section. The blending of operating payment rates under this section shall be performed
separately for each RUG's class.

(b) For the rate year beginning October 1, 2008, the commissioner shall apply limits
to the operating payment rate increases under paragraph (a) by creating a minimum
percentage increase and a maximum percentage increase.

(1) Each nursing facility that receives a blended October 1, 2008, operating payment
rate increase under paragraph (a) of less than one percent, when compared to its operating
payment rate on September 30, 2008, computed using rates with RUG's weight of 1.00,
shall receive a rate adjustment of one percent.

(2) The commissioner shall determine a maximum percentage increase that will
result in savings equal to the cost of allowing the minimum increase in clause (1). Nursing
facilities with a blended October 1, 2008, operating payment rate increase under paragraph
(a) greater than the maximum percentage increase determined by the commissioner, when
compared to its operating payment rate on September 30, 2008, computed using rates with
a RUG's weight of 1.00, shall receive the maximum percentage increase.

(3) Nursing facilities with a blended October 1, 2008, operating payment rate
increase under paragraph (a) greater than one percent and less than the maximum
percentage increase determined by the commissioner, when compared to its operating
payment rate on September 30, 2008, computed using rates with a RUG's weight of 1.00,
shall receive the blended October 1, 2008, operating payment rate increase determined
under paragraph (a).

(4) The October 1, 2009, through October 1, 2015, operating payment rate for
facilities receiving the maximum percentage increase determined in clause (2) shall be
the amount determined under paragraph (a) less the difference between the amount
determined under paragraph (a) for October 1, 2008, and the amount allowed under clause
(2). This rate restriction does not apply to rate increases provided in any other section.

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

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

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

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

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

Sec. 30.

Minnesota Statutes 2008, section 256B.49, subdivision 11a, as added by Laws
2009, chapter 79, article 8, section 64, is amended to read:

Subd. 11a.

Waivered services deleted text begin waiting list deleted text end new text begin statewide priorities new text end .

(a) The
commissioner shall establish statewide priorities for individuals on the waiting list for
CAC, CADI, and TBI waiver services, as of January 1, 2010. The statewide priorities
must include, but are not limited to, individuals who continue to have a need for waiver
services after they have maximized the use of state plan services and other funding
resources, including natural supports, prior to accessing waiver services, and who meet at
least one of the following criteria:

(1) have unstable living situations due to the age, incapacity, or sudden loss of
the primary caregivers;

(2) are moving from an institution due to bed closures;

(3) experience a sudden closure of their current living arrangement;

(4) require protection from confirmed abuse, neglect, or exploitation;

(5) experience a sudden change in need that can no longer be met through state plan
services or other funding resources alone; or

(6) meet other priorities established by the department.

(b) When allocating resources to lead agencies, the commissioner must take into
consideration the number of individuals waiting who meet statewide priorities and the
lead agencies' current use of waiver funds and existing service options.

(c) The commissioner shall evaluate the impact of the use of statewide priorities and
provide recommendations to the legislature on whether to continue the use of statewide
priorities in the November 1, 2011, annual report required by the commissioner in sections
256B.0916, subdivision 7, and 256B.49, subdivision 21.

Sec. 31.

Minnesota Statutes 2008, section 256B.756, as added by Laws 2009, chapter
79, article 5, section 50, is amended to read:

256B.756 REIMBURSEMENT RATES FOR BIRTHS.

Subdivision 1.

deleted text begin Facility deleted text end new text begin Provider new text end rate.

(a) Notwithstanding section deleted text begin 256.969 deleted text end new text begin
256B.76 new text end , effective for services provided on or after October 1, 2009, the deleted text begin facility deleted text end payment
rate for deleted text begin the following diagnosis-related groups, as they fall within the diagnostic
categories: (1) 371 cesarean section without complicating diagnosis; (2) 372 vaginal
delivery with complicating diagnosis; and (3) 373 vaginal delivery without complicating
diagnosis, shall be calculated as provided in deleted text end new text begin professional services related to labor,
delivery, and antepartum and postpartum care when provided for any of the diagnostic
categories identified in paragraph (b) shall be calculated using the methodology specified
in new text end paragraph (b).

(b) The commissioner shall calculate a single rate for deleted text begin all of the diagnostic related
groups specified in paragraph (a) deleted text end new text begin the following diagnosis-related groups, as they fall within
the diagnostic categories: (1) 371 cesarean sections without complicating diagnosis; (2)
372 vaginal delivery with complicating diagnosis; and (3) 373 vaginal delivery without
complicating diagnosis. The rate shall be new text end consistent with an increase in the proportion of
births by vaginal delivery and a reduction in the percentage of births by cesarean section.
The calculated single rate must deleted text begin be based on an expected increase in the number of vaginal
births and expected reduction in the number of cesarean section such that the reduction
in cesarean sections is less than or equal to one standard deviation below the average in
the frequency of cesarean births for Minnesota health care program clients at hospitals
performing greater than 50 deliveries per year. deleted text end new text begin not reflect a shift of greater than five
percent in the current proportion of all births delivered vaginally and by cesarean section.
new text end

(c) The rates described in this subdivision do not include newborn care.

deleted text begin Subd. 2. deleted text end

deleted text begin Provider rate. deleted text end

deleted text begin Notwithstanding section 256B.76, effective for services
provided on or after October 1, 2009, the payment rate for professional services related
to labor, delivery, and antepartum and postpartum care when provided for any of the
diagnostic categories identified in subdivision 1, paragraph (a), shall be calculated using
the methodology specified in subdivision 1, paragraph (b).
deleted text end

Subd. 3.

Health plans.

Payments to managed care and county-based purchasing
plans under sections 256B.69, 256B.692, or 256L.12 shall be reduced for services provided
on or after October 1, 2009, to reflect the adjustments in deleted text begin subdivisions deleted text end new text begin subdivision new text end 1 deleted text begin and 2 deleted text end .

Subd. 4.

Prior authorization.

Prior authorization shall not be required before
reimbursement is paid for a cesarean section delivery.

Sec. 32.

Minnesota Statutes 2008, section 256B.76, subdivision 1, as amended by
Laws 2009, chapter 79, article 5, section 51, is amended to read:

Subdivision 1.

Physician reimbursement.

(a) Effective for services rendered on
or after October 1, 1992, the commissioner shall make payments for physician services
as follows:

(1) payment for level one Centers for Medicare and Medicaid Services' common
procedural coding system codes titled "office and other outpatient services," "preventive
medicine new and established patient," "delivery, antepartum, and postpartum care,"
"critical care," cesarean delivery and pharmacologic management provided to psychiatric
patients, and level three codes for enhanced services for prenatal high risk, shall be paid
at the lower of (i) submitted charges, or (ii) 25 percent above the rate in effect on June
30, 1992. If the rate on any procedure code within these categories is different than the
rate that would have been paid under the methodology in section 256B.74, subdivision 2,
then the larger rate shall be paid;

(2) payments for all other services shall be paid at the lower of (i) submitted charges,
or (ii) 15.4 percent above the rate in effect on June 30, 1992; and

(3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th
percentile of 1989, less the percent in aggregate necessary to equal the above increases
except that payment rates for home health agency services shall be the rates in effect
on September 30, 1992.

(b) Effective for services rendered on or after January 1, 2000, payment rates for
physician and professional services shall be increased by three percent over the rates
in effect on December 31, 1999, except for home health agency and family planning
agency services. The increases in this paragraph shall be implemented January 1, 2000,
for managed care.

(c) Effective for services rendered on or after July 1, 2009, payment rates for
physician and professional services shall be reduced by five percent over the rates in effect
on June 30, 2009. This reduction does not apply to office or other outpatient deleted text begin services
(procedure codes 99201 to 99215) deleted text end new text begin visits new text end , preventive medicine deleted text begin services (procedure codes
99381 to 99412) deleted text end new text begin visits new text end and family planning deleted text begin services deleted text end new text begin visits new text end billed by new text begin physicians, advanced
practice nurses, or physician assistants in a family planning agency or in one of new text end the
following primary care deleted text begin specialties deleted text end new text begin practices new text end : general practice, new text begin general new text end internal medicine, new text begin
general new text end pediatrics, new text begin general new text end geriatrics, new text begin and new text end family deleted text begin practice, or by an advanced practice
registered nurse or physician assistant practicing in pediatrics, geriatrics, or family practice deleted text end new text begin
medicine new text end . This reduction does not apply to federally qualified health centers, rural health
centers, and Indian health services. Effective October 1, 2009, payments made to managed
care plans and county-based purchasing plans under sections 256B.69, 256B.692, and
256L.12 shall reflect the payment reduction described in this paragraph.

Sec. 33.

Minnesota Statutes 2008, section 256D.03, subdivision 4, as amended by
Laws 2009, chapter 79, article 5, section 53, is amended to read:

Subd. 4.

General assistance medical care; services.

(a)(i) For a person who is
eligible under subdivision 3, paragraph (a), clause (2), item (i), general assistance medical
care covers, except as provided in paragraph (c):

(1) inpatient hospital services;

(2) outpatient hospital services;

(3) services provided by Medicare certified rehabilitation agencies;

(4) prescription drugs and other products recommended through the process
established in section 256B.0625, subdivision 13;

(5) equipment necessary to administer insulin and diagnostic supplies and equipment
for diabetics to monitor blood sugar level;

(6) eyeglasses and eye examinations provided by a physician or optometrist;

(7) hearing aids;

(8) prosthetic devices;

(9) laboratory and X-ray services;

(10) physician's services;

(11) medical transportation except special transportation;

(12) chiropractic services as covered under the medical assistance program;

(13) podiatric services;

(14) dental services as covered under the medical assistance program;

(15) mental health services covered under chapter 256B;

(16) prescribed medications for persons who have been diagnosed as mentally ill as
necessary to prevent more restrictive institutionalization;

(17) medical supplies and equipment, and Medicare premiums, coinsurance and
deductible payments;

(18) medical equipment not specifically listed in this paragraph when the use of
the equipment will prevent the need for costlier services that are reimbursable under
this subdivision;

(19) services performed by a certified pediatric nurse practitioner, a certified family
nurse practitioner, a certified adult nurse practitioner, a certified obstetric/gynecological
nurse practitioner, a certified neonatal nurse practitioner, or a certified geriatric nurse
practitioner in independent practice, if (1) the service is otherwise covered under this
chapter as a physician service, (2) the service provided on an inpatient basis is not included
as part of the cost for inpatient services included in the operating payment rate, and (3) the
service is within the scope of practice of the nurse practitioner's license as a registered
nurse, as defined in section 148.171;

(20) services of a certified public health nurse or a registered nurse practicing in
a public health nursing clinic that is a department of, or that operates under the direct
authority of, a unit of government, if the service is within the scope of practice of the
public health nurse's license as a registered nurse, as defined in section 148.171;

(21) telemedicine consultations, to the extent they are covered under section
256B.0625, subdivision 3b;

(22) care coordination and patient education services provided by a community
health worker according to section 256B.0625, subdivision 49; and

(23) regardless of the number of employees that an enrolled health care provider
may have, sign language interpreter services when provided by an enrolled health care
provider during the course of providing a direct, person-to-person covered health care
service to an enrolled recipient who has a hearing loss and uses interpreting services.

(ii) Effective October 1, 2003, for a person who is eligible under subdivision 3,
paragraph (a), clause (2), item (ii), general assistance medical care coverage is limited
to inpatient hospital services, including physician services provided during the inpatient
hospital stay. A $1,000 deductible is required for each inpatient hospitalization.

(b) Effective August 1, 2005, sex reassignment surgery is not covered under this
subdivision.

(c) In order to contain costs, the commissioner of human services shall select
vendors of medical care who can provide the most economical care consistent with high
medical standards and shall where possible contract with organizations on a prepaid
capitation basis to provide these services. The commissioner shall consider proposals by
counties and vendors for prepaid health plans, competitive bidding programs, block grants,
or other vendor payment mechanisms designed to provide services in an economical
manner or to control utilization, with safeguards to ensure that necessary services are
provided. Before implementing prepaid programs in counties with a county operated or
affiliated public teaching hospital or a hospital or clinic operated by the University of
Minnesota, the commissioner shall consider the risks the prepaid program creates for the
hospital and allow the county or hospital the opportunity to participate in the program in a
manner that reflects the risk of adverse selection and the nature of the patients served by
the hospital, provided the terms of participation in the program are competitive with the
terms of other participants considering the nature of the population served. Payment for
services provided pursuant to this subdivision shall be as provided to medical assistance
vendors of these services under sections 256B.02, subdivision 8, and 256B.0625. For
payments made during fiscal year 1990 and later years, the commissioner shall consult
with an independent actuary in establishing prepayment rates, but shall retain final control
over the rate methodology.

(d) Effective January 1, 2008, drug coverage under general assistance medical
care is limited to prescription drugs that:

(i) are covered under the medical assistance program as described in section
256B.0625, subdivisions 13 and 13d; and

(ii) are provided by manufacturers that have fully executed general assistance
medical care rebate agreements with the commissioner and comply with the agreements.
Prescription drug coverage under general assistance medical care must conform to
coverage under the medical assistance program according to section 256B.0625,
subdivisions 13 to 13g.

(e) Recipients eligible under subdivision 3, paragraph (a), shall pay the following
co-payments for services provided on or after October 1, 2003, and before January 1, 2009:

(1) $25 for eyeglasses;

(2) $25 for nonemergency visits to a hospital-based emergency room;

(3) $3 per brand-name drug prescription and $1 per generic drug prescription,
subject to a $12 per month maximum for prescription drug co-payments. No co-payments
shall apply to antipsychotic drugs when used for the treatment of mental illness; and

(4) 50 percent coinsurance on restorative dental services.

(f) Recipients eligible under subdivision 3, paragraph (a), shall include the following
co-payments for services provided on or after January 1, 2009:

(1) $25 for nonemergency visits to a hospital-based emergency room; and

(2) $3 per brand-name drug prescription and $1 per generic drug prescription,
subject to a $7 per month maximum for prescription drug co-payments. No co-payments
shall apply to antipsychotic drugs when used for the treatment of mental illness.

(g) MS 2007 Supp [Expired]

(h) Effective January 1, 2009, co-payments shall be limited to one per day per
provider for nonemergency visits to a hospital-based emergency room. Recipients of
general assistance medical care are responsible for all co-payments in this subdivision.
The general assistance medical care reimbursement to the provider shall be reduced by the
amount of the co-payment, except that reimbursement for prescription drugs shall not be
reduced once a recipient has reached the $7 per month maximum for prescription drug
co-payments. The provider collects the co-payment from the recipient. Providers may not
deny services to recipients who are unable to pay the co-payment.

(i) General assistance medical care reimbursement to fee-for-service providers
and payments to managed care plans shall not be increased as a result of the removal of
the co-payments effective January 1, 2009.

(j) Any county may, from its own resources, provide medical payments for which
state payments are not made.

(k) Chemical dependency services that are reimbursed under chapter 254B must not
be reimbursed under general assistance medical care.

(l) The maximum payment for new vendors enrolled in the general assistance
medical care program after the base year shall be determined from the average usual and
customary charge of the same vendor type enrolled in the base year.

(m) The conditions of payment for services under this subdivision are the same
as the conditions specified in rules adopted under chapter 256B governing the medical
assistance program, unless otherwise provided by statute or rule.

(n) Inpatient and outpatient payments shall be reduced by five percent, effective July
1, 2003. This reduction is in addition to the five percent reduction effective July 1, 2003,
and incorporated by reference in paragraph (l).

(o) Payments for all other health services except inpatient, outpatient, and pharmacy
services shall be reduced by five percent, effective July 1, 2003.

(p) Payments to managed care plans shall be reduced by five percent for services
provided on or after October 1, 2003.

(q) A hospital receiving a reduced payment as a result of this section may apply the
unpaid balance toward satisfaction of the hospital's bad debts.

(r) Fee-for-service payments for nonpreventive visits shall be reduced by $3 for
services provided on or after January 1, 2006. For purposes of this subdivision, a visit
means an episode of service which is required because of a recipient's symptoms,
diagnosis, or established illness, and which is delivered in an ambulatory setting by
a physician or physician ancillary, chiropractor, podiatrist, advance practice nurse,
audiologist, optician, or optometrist.

(s) Payments to managed care plans shall not be increased as a result of the removal
of the $3 nonpreventive visit co-payment effective January 1, 2006.

(t) Payments for mental health services added as covered benefits after December
31, 2007, are not subject to the reductions in paragraphs (l), (n), (o), and (p).

(u) Effective for services provided on or after July 1, 2009, total payment rates for
basic care services shall be reduced by three percent, in accordance with section 256B.766.
Payments made to managed care plans shall be reduced for services provided on or after
October 1, 2009, to reflect this reduction.

(v) Effective for services provided on or after July 1, 2009, payment rates for
physician and professional services shall be reduced as described under section 256B.76,
subdivision 1, paragraph (c). Payments made to managed care new text begin and county-based
purchasing new text end plans shall be reduced for services provided on or after October 1, 2009,
to reflect this reduction.

Sec. 34.

Minnesota Statutes 2008, section 256J.575, subdivision 3, as amended by
Laws 2009, chapter 79, article 2, section 23, is amended to read:

Subd. 3.

Eligibility.

(a) The following MFIP participants are eligible for the
services under this section:

(1) a participant who meets the requirements for or has been granted a hardship
extension under section 256J.425, subdivision 2 or 3, except that it is not necessary for
the participant to have reached or be approaching 60 months of eligibility for this section
to apply;

(2) a participant who is applying for Supplemental Security Income or Social
Security disability insurance;

(3) a participant who is a noncitizen who has been in the United States for 12 or
fewer months; and

(4) a participant who is age 60 or older.

(b) Families must meet all other eligibility requirements for MFIP established in
this chapter. Families are eligible for financial assistance to the same extent as if they
were participating in MFIP.

(c) A participant under paragraph (a), clause (3), must be provided with English as a
second language opportunities and skills training for up to 12 months. After 12 months,
the case manager and participant must determine whether the participant should continue
with English as a second language classes or skills training, or both, and continue to
receive family stabilization services.

(d) If a county agency or employment services provider has information that
an MFIP participant may meet the eligibility criteria set forth in this subdivision, the
county agency or employment services provider must assist the participant in obtaining
the documentation necessary to determine eligibility. deleted text begin Until necessary documentation is
obtained, the participant must be treated as an eligible participant under subdivisions 5 to 7.
deleted text end

Sec. 35.

Minnesota Statutes 2008, section 256L.03, subdivision 3b, as added by Laws
2009, chapter 79, article 5, section 54, is amended to read:

Subd. 3b.

Chiropractic services.

MinnesotaCare covers the following chiropractic
services: medically necessary exams, manual manipulation of the spine, and x-rays.

EFFECTIVE DATE.

This section is effective January 1, 2010 new text begin , or upon federal
approval, whichever is later new text end .

Sec. 36.

Minnesota Statutes 2008, section 256L.04, subdivision 1, as amended by Laws
2009, chapter 79, article 5, section 55, 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 $57,500.

(e) Children formerly enrolled in medical assistance and automatically deemed
eligible for MinnesotaCare according to section 256B.057, subdivision 2c, are exempt
from the requirements of this section until renewal.

(f) Children deemed eligible for MinnesotaCare under section 256L.07, subdivision
8, are exempt from the eligibility requirements of this subdivision.

new text begin EFFECTIVE DATE. new text end

new text begin Paragraph (f) is effective July 1, 2009, or upon federal
approval, whichever is later.
new text end

Sec. 37.

Minnesota Statutes 2008, section 256L.05, subdivision 1c, as added by Laws
2009, chapter 79, article 5, section 60, is amended to read:

Subd. 1c.

Open enrollment and streamlined application and enrollment
process.

(a) The commissioner and local agencies working in partnership must develop a
streamlined and efficient application and enrollment process for medical assistance and
MinnesotaCare enrollees that meets the criteria specified in this subdivision.

(b) The commissioners of human services and education shall provide
recommendations to the legislature by January 15, 2010, on the creation of an open
enrollment process for medical assistance and MinnesotaCare that is coordinated with
the public education system. The recommendations must:

(1) be developed in consultation with medical assistance and MinnesotaCare
enrollees and representatives from organizations that advocate on behalf of children and
families, low-income persons and minority populations, counties, school administrators
and nurses, health plans, and health care providers;

(2) be based on enrollment and renewal procedures best practices deleted text begin , including express
lane eligibility as required under subdivision 1d deleted text end ;

(3) simplify the enrollment and renewal processes wherever possible; and

(4) establish a process:

(i) to disseminate information on medical assistance and MinnesotaCare to all
children in the public education system, including prekindergarten programs; and

(ii) for the commissioner of human services to enroll children and other household
members who are eligible.

The commissioner of human services in coordination with the commissioner of
education shall implement an open enrollment process by August 1, 2010, to be effective
beginning with the 2010-2011 school year.

(c) The commissioner and local agencies shall develop an online application process
for medical assistance and MinnesotaCare.

(d) The commissioner shall develop an application new text begin for children new text end that is easily
understandable and does not exceed four pages in length.

(e) The commissioner of human services shall present to the legislature, by January
15, 2010, an implementation plan for the open enrollment period and online application
process.

EFFECTIVE DATE.

This section is effective July 1, deleted text begin 2010 deleted text end new text begin 2009 new text end , or upon federal
approval, which must be requested by the commissioner, whichever is later.

Sec. 38.

Minnesota Statutes 2008, section 256L.11, subdivision 1, as amended by Laws
2009, chapter 79, article 5, section 67, is amended to read:

Subdivision 1.

Medical assistance rate to be used.

(a) Payment to providers under
sections 256L.01 to 256L.11 shall be at the same rates and conditions established for
medical assistance, except as provided in subdivisions 2 to 6.

(b) Effective for services provided on or after July 1, 2009, total payments for basic
care services shall be reduced by three percent, in accordance with section 256B.766.
Payments made to managed care new text begin and county-based purchasing new text end plans shall be reduced for
services provided on or after October 1, 2009, to reflect this reduction.

new text begin (c) Effective for services provided on or after July 1, 2009, payment rates for
physician and professional services shall be reduced as described under section 256B.76,
subdivision 1, paragraph (c). Payments made to managed care and county-based
purchasing plans shall be reduced for services provided on or after October 1, 2009,
to reflect this reduction.
new text end

Sec. 39.

Minnesota Statutes 2008, section 626.556, subdivision 3c, as amended by
Laws 2009, chapter 79, article 8, section 74, is amended to read:

Subd. 3c.

Local welfare agency, Department of Human Services or Department
of Health responsible for assessing or investigating reports of maltreatment.

(a)
The county local welfare agency is the agency responsible for assessing or investigating
allegations of maltreatment in child foster care, family child care, legally unlicensed child
care, juvenile correctional facilities licensed under section 241.021 located in the local
welfare agency's county, deleted text begin and unlicensed personal care assistance provider organizations
providing services and receiving reimbursements under chapter 256B deleted text end new text begin and reports involving
children served by an unlicensed personal care provider organization under section
256B.0659. Copies of findings related to personal care provider organizations under
section 256B.0659 must be forwarded to the Department of Human Services provider
enrollment new text end .

(b) The Department of Human Services is the agency responsible for assessing or
investigating allegations of maltreatment in facilities licensed under chapters 245A and
245B, except for child foster care and family child care.

(c) The Department of Health is the agency responsible for assessing or investigating
allegations of child maltreatment in facilities licensed under sections 144.50 to 144.58
and 144A.46.

(d) The commissioners of human services, public safety, and education must
jointly submit a written report by January 15, 2007, to the education policy and finance
committees of the legislature recommending the most efficient and effective allocation
of agency responsibility for assessing or investigating reports of maltreatment and must
specifically address allegations of maltreatment that currently are not the responsibility
of a designated agency.

Sec. 40.

Laws 2009, chapter 79, article 2, section 36, is amended to read:

Sec. 36. REPEALER.

Minnesota Statutes 2008, section 256I.06, subdivision 9, is repealed.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective April 1, 2010.
new text end

Sec. 41.

Laws 2009, chapter 79, article 5, section 25, is amended to read:

Sec. 25.

Minnesota Statutes 2008, section 256B.0625, subdivision 3, is amended to
read:

Subd. 3.

Physicians' services.

(a) Medical assistance covers physicians' services.

(b) Rates paid for anesthesiology services provided by physicians shall be according
to the formula utilized in the Medicare program and shall use a conversion factor "at
percentile of calendar year set by legislature, " except that rates paid to physicians for the
medical direction of a certified registered nurse anesthetist shall be the same as the rate
paid to the certified registered nurse anesthetist under medical direction.

new text begin (c) Medical assistance does not cover physicians' services related to the provision of
care related to a treatment reportable under section 144.7065, subdivision 2, clauses (1),
(2), (3), and (5), and subdivision 7, clause (1).
new text end

new text begin (d) Medical assistance does not cover physicians' services related to the provision of
care (1) for which hospital reimbursement is prohibited under section 256.969, subdivision
3b, paragraph (c), or (2) reportable under section 144.7065, subdivisions 2 to 7, if the
physicians' services are billed by a physician who delivered care that contributed to or
caused the adverse health care event or hospital-acquired condition.
new text end

new text begin (e) The payment limitations in this subdivision shall also apply to MinnesotaCare
and general assistance medical care.
new text end

new text begin (f) A physician shall not bill a recipient of services for any payment disallowed
under this subdivision.
new text end

Sec. 42.

Laws 2009, chapter 79, article 5, section 52, is amended to read:

Sec. 52.

256B.766 REIMBURSEMENT FOR BASIC CARE SERVICES.

(a) Effective for services provided on or after July 1, 2009, total payments for basic
care services, shall be reduced by three percent, prior to third-party liability and spenddown
calculation. Payments made to managed care plans and county-based purchasing plans
shall be reduced for services provided on or after October 1, 2009, to reflect this reduction.

(b) This section does not apply to physician and professional services, inpatient
hospital services, family planning services, mental health services, dental services,
prescription drugs, deleted text begin and deleted text end medical transportation new text begin , federally qualified health centers, rural
health centers, Indian health services, and Medicare cost-sharing new text end .

Sec. 43.

Laws 2009, chapter 79, article 8, section 8, the effective date, is amended to
read:

EFFECTIVE DATE.

This section is effective deleted text begin the day following final enactment deleted text end new text begin
July 1, 2009 new text end .

Sec. 44.

Laws 2009, chapter 79, article 8, section 13, is amended to read:

Sec. 13.

256.0281 INTERAGENCY DATA EXCHANGE.

The Department of Human Services, the Department of Health, and the Office of the
Ombudsman for Mental Health and Developmental Disabilities may establish interagency
agreements governing the electronic exchange of data on providers and individuals
collected, maintained, or used by each agency when such exchange is outlined by each
agency in an interagency agreement to accomplish the purposes in clauses (1) to (4):

(1) to improve provider enrollment processes for home and community-based
services and state plan home care services;

(2) to improve quality management of providers between state agencies;

(3) to establish and maintain provider eligibility to participate as providers under
Minnesota health care programs; or

(4) to meet the quality assurance reporting requirements under federal law under
section 1915(c) of the Social Security Act related to home and community-based waiver
programs.

Each interagency agreement must include provisions to ensure anonymity of individuals,
including mandated reporters, and must outline the specific uses of and access to shared
data within each agency. Electronic interfaces between source data systems developed
under these interagency agreements must incorporate these provisions as well as other
deleted text begin HIPPA deleted text end new text begin HIPAA new text end provisions related to individual data.

Sec. 45.

Laws 2009, chapter 79, article 8, section 73, is amended to read:

Sec. 73.

Minnesota Statutes 2008, 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.

(f)(1) 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 July of each year will be added to the standards of
assistance established in subdivisions 1 to 4 for adults under the age of 65 who qualify
as shelter needy and are: (i) relocating from an institution, or an adult mental health
residential treatment program under section 256B.0622; (ii) eligible for the self-directed
supports option as defined under section 256B.0657, subdivision 2; or (iii) home and
community-based waiver recipients living in their own home or rented or leased apartment
which is not owned, operated, or controlled by a provider of service not related by blood
or marriage.

(2) Notwithstanding subdivision 3, paragraph (c), an individual eligible for the
shelter needy benefit under this paragraph 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.

(3) "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.

deleted text begin (g) Notwithstanding this subdivision, recipients of home and community-based
services may relocate to services without 24-hour supervision and receive the equivalent
of the recipient's group residential housing allocation in Minnesota supplemental
assistance shelter needy funding if the cost of the services and housing is equal to or less
than provided to the recipient in home and community-based services and the relocation is
the recipient's choice and is approved by the recipient or guardian.
deleted text end

deleted text begin (h) To access housing and services as provided in paragraph (g), the recipient may
choose housing that may or may not be owned, operated, or controlled by the recipient's
service provider.
deleted text end

deleted text begin (i) The provisions in paragraphs (g) and (h) are effective to June 30, 2011. The
commissioner shall assess the development of publicly owned housing, other housing
alternatives, and whether a public equity housing fund may be established that would
maintain the state's interest, to the extent paid from group residential housing and
Minnesota supplemental aid shelter needy funds in provider-owned housing so that when
sold, the state would recover its share for a public equity fund to be used for future public
needs under this chapter. The commissioner shall report findings and recommendations to
the legislative committees and budget divisions with jurisdiction over health and human
services policy and financing by January 15, 2012.
deleted text end

deleted text begin (j) In selecting prospective services needed by recipients for whom home and
community-based services have been authorized, the recipient and the recipient's guardian
shall first consider alternatives to home and community-based services. Minnesota
supplemental aid shelter needy funding for recipients who utilize Minnesota supplemental
aid shelter needy funding as provided in this section shall remain permanent unless the
recipient with the recipient's guardian later chooses to access home and community-based
services.
deleted text end

new text begin (g) Notwithstanding this subdivision, to access housing and services as provided in
paragraph (f), the recipient may choose housing that may or may not be owned, operated,
or controlled by the recipient's service provider if the housing is located in a multifamily
building of six or more units. The maximum number of units that may be used by
recipients of this program shall be 50 percent of the units in a building. The department
shall develop an exception process to the 50 percent maximum. This paragraph expires
on June 30, 2011.
new text end

Sec. 46.

Minnesota Statutes 2008, section 402A.30, subdivision 4, as added by Laws
2009, chapter 79, article 9, section 6, is amended to read:

Subd. 4.

Process for establishing a service delivery authority.

(a) The county or
consortium of counties proposing to form a service delivery authority shall, in conjunction
with the commissioner, deleted text begin prevent deleted text end new text begin present new text end a proposed memorandum of understanding to
the council accompanied by a resolution from the board of commissioners of each
participating county stating the county's intent to participate in a service delivery authority.

(b) The council shall certify a county or consortium of counties as a service delivery
authority if:

(1) the conditions in subdivision 2, paragraphs (a) and (b), are met; and

(2) the county or consortium of counties are:

(i) a single county with a population of 55,000 or more;

(ii) a consortium of counties with a total combined population of 55,000 or more and
the counties comprising the consortium are in reasonable geographic proximity; or

(iii) four or more counties in reasonable geographic proximity without regard
to population.

The council may recommend that the commissioner of human services exempt a
single county or multicounty service delivery authority from the minimum population
standard if that service delivery authority can demonstrate that it can otherwise meet
the requirements of this chapter.

(c) After the council has certified a county or consortium of counties as a service
delivery authority, the commissioner may enter into the memoranda of understanding with
the participating counties to form the service delivery authority.

Sec. 47.

Laws 2009, chapter 79, article 10, section 46, is amended to read:

Sec. 46. FEASIBILITY PILOT PROJECT FOR CANCER SURVEILLANCE.

The commissioner of health must provide a grant to the Hennepin County Medical
Center for a one-year feasibility pilot project to collect occupational, residential, and
military service history data from newly diagnosed cancer patients at the Hennepin
County Medical Center's Cancer Center. deleted text begin Funding for this grant shall come from the
Department of Health's current resources for the Chronic Disease and Environmental
Epidemiology Section.
deleted text end

Under this pilot project, Hennepin County Medical Center will design an expansion
of its existing cancer registry to include the collection of additional data, including the
cancer patient's occupational, residential, and military service history. Patient consent is
required for collection of these additional data. The consent must be in writing and must
contain notice informing the patient about private and confidential data concerning the
patient pursuant to Minnesota Statutes, section 13.04, subdivision 2. The patient is entitled
to opt out of the project at any time. The data collection expansion may also include the
cancer patient's possible toxic environmental exposure history, if known. The purpose of
this pilot project is to determine the following:

(1) the feasibility of collecting these data on a statewide scale;

(2) the potential design of a self-administered patient questionnaire template; and

(3) necessary qualifications for staff who will collect these data.

Hennepin County Medical Center must report the results of this pilot project to the
legislature by October 1, 2010.

Sec. 48. new text begin EXPOSURE LEVELS STUDY.
new text end

new text begin The commissioner of health shall work with appropriate local, state, and federal
agencies to determine whether the levels of exposure to pentachlorophenol (PCP)
in Minneapolis neighborhoods where utility poles treated with PCP, creosote, or
probable human carcinogens are installed, exceed human health risk limits or maximum
contaminant levels for residents, utility workers, and others who handle the treated poles.
new text end

Sec. 49. new text begin REPEALER.
new text end

new text begin Laws 2009, chapter 79, article 7, section 12, new text end new text begin is repealed.
new text end

ARTICLE 2

TECHNICAL APPROPRIATION CHANGES

Section 1.

Laws 2009, chapter 79, article 13, section 3, is amended to read:

Sec. 3. HUMAN SERVICES

Subdivision 1. Total Appropriation

$

deleted text begin 5,230,100,000 deleted text end new text begin 5,225,451,000 new text end

$

deleted text begin 5,997,715,000 deleted text end new text begin 6,002,864,000 new text end

Appropriations by Fund
	2010	2011
General	deleted text begin 4,376,839,000 deleted text end new text begin 4,375,689,000 new text end	deleted text begin 5,211,018,000 deleted text end new text begin 5,209,765,000 new text end
State Government Special Revenue	deleted text begin 1,315,000 deleted text end new text begin 565,000 new text end	565,000
Health Care Access	deleted text begin 450,792,000 deleted text end new text begin 450,662,000 new text end	deleted text begin 527,489,000 deleted text end new text begin 527,411,000 new text end
Federal TANF	deleted text begin 289,487,000 deleted text end new text begin 286,770,000 new text end	deleted text begin 256,978,000 deleted text end new text begin 263,458,000 new text end
Lottery Prize	1,665,000	1,665,000
Federal Fund	110,000,000	0

Receipts for Systems Projects.
Appropriations and federal receipts for
information systems 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, except that any transfers
to one project that exceed $1,000,000 or
multiple transfers to one project that exceed
$1,000,000 in total require the express
approval of the legislature. The preceding
requirement for legislative approval does not
apply to transfers made to establish a project's
initial operating budget each year; instead,
the requirements of section 11, subdivision
2, of this article apply to those transfers. Any
unexpended balance in the appropriation
for these projects does not cancel but is
available for ongoing development and
operations. Any computer project with a
total cost exceeding $1,000,000, including,
but not limited to, a replacement for the
proposed HealthMatch system, shall not be
commenced without the express approval of
the legislature.

HealthMatch Systems Project. In fiscal
year 2010, $3,054,000 shall be transferred
from the HealthMatch account in the state
systems account in the special revenue fund
to the general fund.

Nonfederal Share Transfers. The
nonfederal share of activities for which
federal administrative reimbursement is
appropriated to the commissioner may be
transferred to the special revenue fund.

TANF Maintenance of Effort.

(a) In order to meet the basic 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) For fiscal years beginning with state
fiscal year 2003, 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 16 percent of
the total required under Code of Federal
Regulations, title 45, section 263.1.

(d) For the federal fiscal years beginning on
or after October 1, 2007, the commissioner
may not claim an amount of TANF/MOE in
excess of the 75 percent standard in Code
of Federal Regulations, title 45, section
263.1(a)(2), except:

(1) to the extent necessary to meet the 80
percent standard under Code of Federal
Regulations, title 45, section 263.1(a)(1),
if it is determined by the commissioner
that the state will not meet the TANF work
participation target rate for the current year;

(2) to provide any additional amounts
under Code of Federal Regulations, title 45,
section 264.5, that relate to replacement of
TANF funds due to the operation of TANF
penalties; and

(3) to provide any additional amounts that
may contribute to avoiding or reducing
TANF work participation penalties through
the operation of the excess MOE provisions
of Code of Federal Regulations, title 45,
section 261.43 (a)(2).

For the purposes of clauses (1) to (3),
the commissioner may supplement the
MOE claim with working family credit
expenditures to the extent such expenditures
or other qualified expenditures are otherwise
available after considering the expenditures
allowed in this section.

(e) 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, do not apply
if the grants or aids are federal TANF funds.

(f) Notwithstanding any contrary provision
in this article, this provision expires June 30,
2013.

Working Family Credit Expenditures as
TANF/MOE. The commissioner may claim
as TANF/MOE up to $6,707,000 per year of
working family credit expenditures for fiscal
year 2010 through fiscal year 2011.

Working Family Credit Expenditures
to be Claimed for TANF/MOE. The
commissioner may count the following
amounts of working family credit expenditure
as TANF/MOE:

(1) fiscal year 2010, deleted text begin $30,217,000 deleted text end new text begin
$50,973,000 new text end ;

(2) fiscal year 2011, deleted text begin $55,596,000 deleted text end new text begin
$53,793,000 new text end ;

(3) fiscal year 2012, deleted text begin $28,519,000 deleted text end new text begin
$23,516,000 new text end ; and

(4) fiscal year 2013, deleted text begin $22,138,000 deleted text end new text begin
$16,808,000 new text end .

Notwithstanding any contrary provision in
this article, this rider expires June 30, 2013.

deleted text begin TANF Transfer to Federal Child Care
and Development Fund. The following
TANF fund amounts are appropriated to the
commissioner for the purposes of MFIP and
transition year child care under Minnesota
Statutes, section 119B.05:
deleted text end

deleted text begin (1) fiscal year 2010, $5,909,000;
deleted text end

deleted text begin (2) fiscal year 2011, $9,808,000;
deleted text end

deleted text begin (3) fiscal year 2012, $10,826,000; and
deleted text end

deleted text begin (4) fiscal year 2013, $4,026,000.
deleted text end

deleted text begin The commissioner shall authorize the
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
to federal child care and development fund
regulations.
deleted text end

Food Stamps Employment and Training.
(a) The commissioner shall apply for and
claim the maximum allowable federal
matching funds under United States Code,
title 7, section 2025, paragraph (h), for
state expenditures made on behalf of family
stabilization services participants voluntarily
engaged in food stamp employment and
training activities, where appropriate.

(b) Notwithstanding Minnesota Statutes,
sections 256D.051, subdivisions 1a, 6b,
and 6c, and 256J.626, federal food stamps
employment and training funds received
as reimbursement of MFIP consolidated
fund grant expenditures for diversionary
work program participants and child
care assistance program expenditures for
two-parent families must be deposited in the
general fund. The amount of funds must be
limited to $3,350,000 in fiscal year 2010
and $4,440,000 in fiscal years 2011 through
2013, contingent on approval by the federal
Food and Nutrition Service.

(c) Consistent with the receipt of these federal
funds, the commissioner may adjust the
level of working family credit expenditures
claimed as TANF maintenance of effort.
Notwithstanding any contrary provision in
this article, this rider expires June 30, 2013.

ARRA Food Support Administration.
The funds available for food support
administration under the American Recovery
and Reinvestment Act (ARRA) of 2009
are appropriated to the commissioner
to pay actual costs of implementing the
food support benefit increases, increased
eligibility determinations, and outreach. Of
these funds, 20 percent shall be allocated
to the commissioner and 80 percent shall
be allocated to counties. The commissioner
shall allocate the county portion based on
caseload. Reimbursement shall be based on
actual costs reported by counties through
existing processes. Tribal reimbursement
must be made from the state portion based
on a caseload factor equivalent to that of a
county.

ARRA Food Support Benefit Increases.
The funds provided for food support benefit
increases under the Supplemental Nutrition
Assistance Program provisions of the
American Recovery and Reinvestment Act
(ARRA) of 2009 must be used for benefit
increases beginning July 1, 2009.

Emergency Fund for the TANF Program.
TANF Emergency Contingency funds
available under the American Recovery
and Reinvestment Act of 2009 (Public Law
111-5) are appropriated to the commissioner.
The commissioner must request TANF
Emergency Contingency funds from the
Secretary of the Department of Health
and Human Services to the extent the
commissioner meets or expects to meet the
requirements of section 403(c) of the Social
Security Act. The commissioner must seek
to maximize such grants. The funds received
must be used as appropriated. Each county
must maintain the county's current level of
emergency assistance funding under the
MFIP consolidated fund and use the funds
under this paragraph to supplement existing
emergency assistance funding levels.

Subd. 2. Agency Management

The amounts that may be spent from the
appropriation for each purpose are as follows:

(a) Financial Operations

Appropriations by Fund
General	3,380,000	3,908,000
Health Care Access	1,281,000	1,016,000
Federal TANF	122,000	122,000

(b) Legal and Regulatory Operations

Appropriations by Fund
General	13,749,000	13,534,000
State Government Special Revenue	440,000	440,000
Health Care Access	943,000	943,000
Federal TANF	100,000	100,000

new text begin Base Adjustment. The general fund base is
decreased by $180,000 in fiscal year 2012
and $180,000 in fiscal year 2013.
new text end

(c) Management Operations

Appropriations by Fund
General	4,334,000	4,562,000
Health Care Access	242,000	242,000

Lease Cost Reduction. Base level funding
to the commissioner shall be reduced by
$381,000 in fiscal year 2010, and $153,000
in fiscal year 2011, to reflect a reduction in
lease costs related to the Minnehaha Avenue
building.

Base Adjustment. The general fund base is
increased by $153,000 in each of fiscal years
2012 and 2013.

(d) Information Technology Operations

Appropriations by Fund
General	28,077,000	28,077,000
Health Care Access	4,856,000	4,868,000

Subd. 3. Revenue and Pass-Through Revenue Expenditures

deleted text begin 65,746,000 deleted text end new text begin 68,337,000 new text end

deleted text begin 67,068,000 deleted text end new text begin 70,505,000 new text end

This appropriation is from the federal TANF
fund.

new text begin TANF Transfer to Federal Child Care
and Development Fund. The following
TANF fund amounts are appropriated to the
commissioner for the purposes of MFIP and
transition year child care under Minnesota
Statutes, section 119B.05:
new text end

new text begin (1) fiscal year 2010, $6,531,000;
new text end

new text begin (2) fiscal year 2011, $10,241,000;
new text end

new text begin (3) fiscal year 2012, $10,826,000; and
new text end

new text begin (4) fiscal year 2013, $4,046,000.
new text end

new text begin The commissioner shall authorize the
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
to federal child care and development fund
regulations.
new text end

Subd. 4. Children and Economic Assistance Grants

The amounts that may be spent from this
appropriation for each purpose are as follows:

(a) MFIP/DWP Grants

Appropriations by Fund
General	63,205,000	89,033,000
Federal TANF	deleted text begin 100,404,000 deleted text end new text begin 100,818,000 new text end	deleted text begin 85,789,000 deleted text end new text begin 84,538,000 new text end

(b) Support Services Grants

Appropriations by Fund
General	8,715,000	12,498,000
Federal TANF	deleted text begin 121,257,000 deleted text end new text begin 116,557,000 new text end	deleted text begin 102,757,000 deleted text end new text begin 107,457,000 new text end

MFIP Consolidated Fund. The MFIP
consolidated fund TANF appropriation is
reduced by $1,854,000 in fiscal year deleted text begin 2011 deleted text end new text begin
2010 new text end and fiscal year deleted text begin 2012 deleted text end new text begin 2011 new text end .

Notwithstanding Minnesota Statutes, section
256J.626, subdivision 8, paragraph (b), the
commissioner shall reduce proportionately
the reimbursement to counties for
administrative expenses.

Subsidized Employment Funding Through
ARRA. The commissioner is authorized to
apply for TANF emergency fund grants for
subsidized employment activities. Growth
in expenditures for subsidized employment
within the supported work program and the
MFIP consolidated fund over the amount
expended in the calendar quarters in the
TANF emergency fund base year shall be
used to leverage the TANF emergency fund
grants for subsidized employment and to
fund supported work. The commissioner
shall develop procedures to maximize
reimbursement of these expenditures over the
TANF emergency fund base year quarters,
and may contract directly with employers
and providers to maximize these TANF
emergency fund grants.

Supported Work. Of the TANF
appropriation, deleted text begin $6,400,000 deleted text end new text begin $4,700,000 new text end in
fiscal year deleted text begin 2011 is deleted text end new text begin 2010 and $4,700,000 in
fiscal year 2011 are new text end to the commissioner for
supported work for MFIP recipients and is
available until expended. Supported work
includes paid transitional work experience
and a continuum of employment assistance,
including outreach and recruitment,
program orientation and intake, testing and
assessment, job development and marketing,
preworksite training, supported worksite
experience, job coaching, and postplacement
follow-up, in addition to extensive case
management and referral services. new text begin This is a
onetime appropriation.
new text end

Base Adjustment. The general fund base
is reduced by $3,783,000 in each of fiscal
years 2012 and 2013. The TANF fund base is
increased by deleted text begin $9,704,000 deleted text end new text begin $5,004,000 new text end in each
of fiscal years 2012 and 2013.

Integrated Services Program Funding.
The TANF appropriation for integrated
services program funding is $1,250,000 in
fiscal year 2010 and deleted text begin $2,500,000 deleted text end new text begin $0 new text end in fiscal
year 2011 new text begin and the base for fiscal years 2012
and 2013 is $0 new text end .

TANF Emergency Fund; Nonrecurrent
Short-Term Benefits. TANF emergency
contingency fund grants received due to
increases in expenditures for nonrecurrent
short-term benefits must be used to offset the
increase in these expenditures for counties
under the MFIP consolidated fund, under
Minnesota Statutes, section 256J.626,
and the diversionary work program. The
commissioner shall develop procedures
to maximize reimbursement of these
expenditures over the TANF emergency fund
base year quarters. Growth in expenditures
for the diversionary work program over the
amount expended in the calendar quarters in
the TANF emergency fund base year shall be
used to leverage these funds.

(c) MFIP Child Care Assistance Grants

new text begin 61,171,000 new text end

new text begin 65,214,000 new text end

deleted text begin Appropriations by Fund deleted text end
deleted text begin General deleted text end	deleted text begin 61,171,000 deleted text end	deleted text begin 65,214,000 deleted text end
deleted text begin Federal TANF deleted text end	deleted text begin 1,022,000 deleted text end	deleted text begin 406,000 deleted text end

deleted text begin ARRA Child Care Development Block
Grant Funds. The funds available from the
child care development block grant under
ARRA must be used for MFIP child care to
the extent that those funds are not earmarked
for quality expansion or to improve the
quality of infant and toddler care.
deleted text end

Acceleration of ARRA Child Care and
Development Fund Expenditure. The
commissioner must liquidate all child care
and development money available under
the American Recovery and Reinvestment
Act (ARRA) of 2009, Public Law 111-5,
by September 30, 2010. In order to expend
those funds by September 30, 2010, the
commissioner may redesignate and expend
the ARRA child care and development funds
appropriated in fiscal year 2011 for purposes
under this section for related purposes that
will allow liquidation by September 30,
2010. Child care and development funds
otherwise available to the commissioner
for those related purposes shall be used to
fund the purposes from which the ARRA
child care and development funds had been
redesignated.

new text begin new text begin School Readiness Service Agreements. new text end
$400,000 in fiscal year 2010 and $400,000
in fiscal year 2011 are from the federal
TANF fund to the commissioner of human
services consistent with federal regulations
for the purpose of school readiness service
agreements under Minnesota Statutes, section
119B.231. This is a onetime appropriation.
Any unexpended balance the first year is
available in the second year.
new text end

(d) Basic Sliding Fee Child Care Assistance Grants

deleted text begin 40,104,000 deleted text end new text begin 40,100,000 new text end

deleted text begin 45,096,000 deleted text end new text begin 45,092,000 new text end

deleted text begin Base Adjustment. The general fund base is
decreased by $260,000 in each of fiscal years
2012 and 2013.
deleted text end

School Readiness Service Agreements.
deleted text begin $261,000 deleted text end new text begin $257,000 new text end in fiscal year 2010 and
deleted text begin $261,000 deleted text end new text begin $257,000 new text end in fiscal year 2011 are
from the deleted text begin federal child care development
funds received from the American Recovery
and Reinvestment Act of 2009, Public Law
111-5, to the commissioner of human services
consistent with federal regulations deleted text end new text begin general
fund new text end for the purpose of school readiness
service agreements under Minnesota
Statutes, section 119B.231. This is a onetime
appropriation. Any unexpended balance the
first year is available in the second year.

Child Care Development Fund
Unexpended Balance. In addition to
the amount provided in this section, the
commissioner shall expend $5,244,000 in
fiscal year 2010 from the federal child care
development fund unexpended balance
for basic sliding fee child care under
Minnesota Statutes, section 119B.03. The
commissioner shall ensure that all child
care and development funds are expended
according to the federal child care and
development fund regulations.

Basic Sliding Fee. deleted text begin $7,045,000 deleted text end new text begin $4,000,000 new text end in
fiscal year 2010 and deleted text begin $6,974,000 deleted text end new text begin $4,000,000 new text end
in fiscal year 2011 are from the federal child
care development funds received from the
American Recovery and Reinvestment Act of
2009, Public Law 111-5, to the commissioner
of human services consistent with federal
regulations for the purpose of basic sliding
fee child care assistance under Minnesota
Statutes, section 119B.03. This is a onetime
appropriation. Any unexpended balance the
first year is available in the second year.

Basic Sliding Fee Allocation for Calendar
Year 2010. Notwithstanding Minnesota
Statutes, section 119B.03, subdivision 6,
in calendar year 2010, basic sliding fee
funds shall be distributed according to
this provision. Funds shall be allocated
first in amounts equal to each county's
guaranteed floor, according to Minnesota
Statutes, section 119B.03, subdivision 8,
with any remaining available funds allocated
according to the following formula:

(a) Up to one-fourth of the funds shall be
allocated in proportion to the number of
families participating in the transition year
child care program as reported during and
averaged over the most recent six months
completed at the time of the notice of
allocation. Funds in excess of the amount
necessary to serve all families in this category
shall be allocated according to paragraph (d).

(b) Up to three-fourths of the funds shall
be allocated in proportion to the average
of each county's most recent six months of
reported waiting list as defined in Minnesota
Statutes, section 119B.03, subdivision 2, and
the reinstatement list of those families whose
assistance was terminated with the approval
of the commissioner under Minnesota Rules,
part 3400.0183, subpart 1. Funds in excess
of the amount necessary to serve all families
in this category shall be allocated according
to paragraph (d).

(c) The amount necessary to serve all families
in paragraphs (a) and (b) shall be calculated
based on the basic sliding fee average cost of
care per family in the county with the highest
cost in the most recently completed calendar
year.

(d) Funds in excess of the amount necessary
to serve all families in paragraphs (a) and
(b) shall be allocated in proportion to each
county's total expenditures for the basic
sliding fee child care program reported
during the most recent fiscal year completed
at the time of the notice of allocation. To
the extent that funds are available, and
notwithstanding Minnesota Statutes, section
119B.03, subdivision 8, for the period
January 1, 2011, to December 31, 2011, each
county's guaranteed floor must be equal to its
original calendar year 2010 allocation.

new text begin new text begin Base Adjustment. new text end The general fund base is
decreased by $257,000 in each of fiscal years
2012 and 2013.
new text end

(e) Child Care Development Grants

1,487,000

1,487,000

Family, friends, and neighbor grants.
$375,000 in fiscal year 2010 and $375,000
in fiscal year 2011 are from the child
care development fund required targeted
quality funds for quality expansion and
infant/toddler from the American Recovery
and Reinvestment Act of 2009, Public
Law 111-5, to the commissioner of human
services for family, friends, and neighbor
grants under Minnesota Statutes, section
119B.232. This appropriation may be used
on programs receiving family, friends, and
neighbor grant funds as of June 30, 2009,
or on new programs or projects. This is a
onetime appropriation. Any unexpended
balance the first year is available in the
second year.

Voluntary quality rating system training,
coaching, consultation, and supports.
$633,000 in fiscal year 2010 and $633,000
in fiscal year 2011 are from the federal child
care development fund required targeted
quality funds for quality expansion and
infant/toddler from the American Recovery
and Reinvestment Act of 2009, Public
Law 111-5, to the commissioner of human
services consistent with federal regulations
for the purpose of providing grants to provide
statewide child-care provider training,
coaching, consultation, and supports to
prepare for the voluntary Minnesota quality
rating system rating tool. This is a onetime
appropriation. Any unexpended balance the
first year is available in the second year.

Voluntary quality rating system. $184,000
in fiscal year 2010 and $1,200,000 in fiscal
year 2011 are from the federal child care
development fund required targeted funds for
quality expansion and infant/toddler from the
American Recovery and Reinvestment Act of
2009, Public Law 111-5, to the commissioner
of human services consistent with federal
regulations for the purpose of implementing
the voluntary Parent Aware quality star
rating system pilot in coordination with the
Minnesota Early Learning Foundation. The
appropriation for the first year is to complete
and promote the voluntary Parent Aware
quality rating system pilot program through
June 30, 2010, and the appropriation for
the second year is to continue the voluntary
Minnesota quality rating system pilot
through June 30, 2011. This is a onetime
appropriation. Any unexpended balance the
first year is available in the second year.

(f) Child Support Enforcement Grants

3,705,000

3,705,000

(g) Children's Services Grants

Appropriations by Fund
General	48,333,000	50,498,000
Federal TANF	340,000	240,000

Base Adjustment. The general fund base
is decreased by $5,371,000 in fiscal year
2012 and deleted text begin increased $8,737,000 deleted text end new text begin decreased
$5,371,000 new text end in fiscal year 2013.

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 2010 and fiscal year 2011 for the
adoption incentive grants are appropriated
to the commissioner for deleted text begin these purposes deleted text end new text begin
postadoption services including parent
support groups new text end .

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.

(h) Children and Community Services Grants

67,663,000

67,542,000

Targeted Case Management Temporary
Funding Adjustment. The commissioner
shall recover from each county and tribe
receiving a targeted case management
temporary funding payment in fiscal year
2008 an amount equal to that payment. The
commissioner shall recover one-half of the
funds by February 1, 2010, and the remainder
by February 1, 2011. At the commissioner's
discretion and at the request of a county
or tribe, the commissioner may revise
the payment schedule, but full payment
must not be delayed beyond May 1, 2011.
The commissioner may use the recovery
procedure under Minnesota Statutes, section
256.017, to recover the funds. Recovered
funds must be deposited into the general
fund.

(i) General Assistance Grants

48,215,000

48,608,000

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 2010 and
$7,889,812 in fiscal year 2011. Funds
to counties must be allocated by the
commissioner using the allocation method
specified in Minnesota Statutes, section
256D.06.

(j) Minnesota Supplemental Aid Grants

33,930,000

35,191,000

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 2010 and $1,100,000 in fiscal
year 2011. Funds to counties must be
allocated by the commissioner using the
allocation method specified in Minnesota
Statutes, section 256D.46.

(k) Group Residential Housing Grants

111,778,000

114,034,000

Group Residential Housing Costs
Refinanced. (a) Effective July 1, 2011, the
commissioner shall increase the home and
community-based service rates and county
allocations provided to programs for persons
with disabilities established under section
1915(c) of the Social Security Act to the
extent that these programs will be paying
for the costs above the rate established
in Minnesota Statutes, section 256I.05,
subdivision 1.

(b) For persons receiving services under
Minnesota Statutes, section 245A.02, who
reside in licensed adult foster care beds
for which a difficulty of care payment
was being made under Minnesota Statutes,
section 256I.05, subdivision 1c, paragraph
(b), counties may request an exception to
the individual's service authorization not to
exceed the difference between the client's
monthly service expenditures plus the
amount of the difficulty of care payment.

(l) Children's Mental Health Grants

16,885,000

16,882,000

Funding Usage. Up to 75 percent of a fiscal
year's appropriation for children's mental
health grants may be used to fund allocations
in that portion of the fiscal year ending
December 31.

(m) Other Children and Economic Assistance Grants

16,047,000

15,339,000

Fraud Prevention Grants. Of this
appropriation, deleted text begin $379,000 deleted text end new text begin $228,000 new text end in fiscal
year 2010 and deleted text begin $379,000 deleted text end new text begin $228,000 new text end in fiscal
year 2011 is to the commissioner for fraud
prevention grants to counties.

Homeless and Runaway Youth. $218,000
in fiscal year 2010 is 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. Any unexpended balance in
the first year is available in the second year.
Beginning July 1, 2011, the base is increased
by $119,000 each year.

ARRA Homeless Youth Funds. To the
extent permitted under federal law, the
commissioner shall designate $2,500,000
of the Homeless Prevention and Rapid
Re-Housing Program funds provided under
the American Recovery and Reinvestment
Act of 2009, Public Law 111-5, for agencies
providing homelessness prevention and rapid
rehousing services to youth.

Supportive Housing Services. $1,500,000
each year is for supportive services under
Minnesota Statutes, section 256K.26. This is
a onetime appropriation. deleted text begin Beginning in fiscal
year 2012, the base is increased by $68,000
per year.
deleted text end

Community Action Grants. Community
action grants are reduced one time by
deleted text begin $1,764,000 deleted text end new text begin $1,794,000 new text end each year. This
reduction is due to the availability of federal
funds under the American Recovery and
Reinvestment Act.

Base Adjustment. The general fund base
is increased by $773,000 in fiscal year 2012
and $773,000 in fiscal year 2013.

Federal ARRA Funds for Existing
Programs. (a) Federal funds received by the
commissioner for the emergency food and
shelter program from the American Recovery
and Reinvestment Act of 2009, Public
Law 111-5, but not previously approved
by the legislature are appropriated to the
commissioner for the purposes of the grant
program.

(b) Federal funds received by the
commissioner for the emergency shelter
grant program including the Homelessness
Prevention and Rapid Re-Housing
Program from the American Recovery and
Reinvestment Act of 2009, Public Law
111-5, are appropriated to the commissioner
for the purposes of the grant programs.

(c) Federal funds received by the
commissioner for the emergency food
assistance program from the American
Recovery and Reinvestment Act of 2009,
Public Law 111-5, are appropriated to the
commissioner for the purposes of the grant
program.

(d) Federal funds received by the
commissioner for senior congregate meals
and senior home-delivered meals from the
American Recovery and Reinvestment Act
of 2009, Public Law 111-5, are appropriated
to the commissioner for the Minnesota Board
on Aging, for purposes of the grant programs.

(e) Federal funds received by the
commissioner for the community services
block grant program from the American
Recovery and Reinvestment Act of 2009,
Public Law 111-5, are appropriated to the
commissioner for the purposes of the grant
program.

Long-Term Homeless Supportive
Service Fund Appropriation. To the
extent permitted under federal law, the
commissioner shall designate $3,000,000
of the Homelessness Prevention and Rapid
Re-Housing Program funds provided under
the American Recovery and Reinvestment
Act of 2009, Public Law, 111-5, to the
long-term homeless service fund under
Minnesota Statutes, section 256K.26. This
appropriation shall become available by July
1, 2009. This paragraph is effective the day
following final enactment.

Subd. 5. Children and Economic Assistance Management

The amounts that may be spent from the
appropriation for each purpose are as follows:

(a) Children and Economic Assistance Administration

Appropriations by Fund
General	10,318,000	10,308,000
Federal TANF	496,000	496,000

Base Adjustment. The federal TANF base
is increased by $700,000 in each of fiscal
years 2012 and 2013.

School Readiness Service Agreements.
deleted text begin $406,000 deleted text end new text begin $106,000 new text end in fiscal year 2010 and
deleted text begin $406,000 deleted text end new text begin $241,000 new text end in fiscal year 2011 are
from the federal child care development
funds received from the American Recovery
and Reinvestment Act of 2009, Public
Law 111-5, to the commissioner of human
services consistent with federal regulations
for the purpose of school readiness service
agreements under Minnesota Statutes,
section 119B.231 new text begin , and the voluntary quality
rating system in Minnesota Statutes, section
119B.231, subdivision 3e new text end . This is a onetime
appropriation. deleted text begin Any unexpended balance the
first year is available in the second year.
deleted text end

(b) Children and Economic Assistance Operations

Appropriations by Fund
General	33,590,000	33,423,000
Health Care Access	361,000	361,000

Financial Institution Data Match and
Payment of Fees. The commissioner is
authorized to allocate up to $310,000 each
year in fiscal years 2010 and 2011 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.

deleted text begin School Readiness Service Agreements.
$106,000 in fiscal year 2010 and $241,000
in fiscal year 2011 are from the federal
child care development funds received from
the American Recovery and Reinvestment
Act of 2009, Public Law 111-5, to the
commissioner of human services consistent
with federal regulations for the purpose of
school readiness service agreements under
Minnesota Statutes, section 119B.231. This
is a onetime appropriation.
deleted text end

deleted text begin Use of Federal Stabilization Funds.
$33,000,000 in fiscal year 2010 is
appropriated from the fiscal stabilization
account in the federal fund to the
commissioner. This appropriation must not
be used for any activity or service for which
federal reimbursement is claimed. This is a
onetime appropriation.
deleted text end

Subd. 6. Basic Health Care Grants

The amounts that may be spent from this
appropriation for each purpose are as follows:

(a) MinnesotaCare Grants

deleted text begin 391,915,000 deleted text end new text begin 391,785,000 new text end

deleted text begin 485,448,000 deleted text end new text begin 485,370,000 new text end

This appropriation is from the health care
access fund.

(b) MA Basic Health Care Grants - Families and Children

deleted text begin 751,988,000 deleted text end new text begin 751,166,000 new text end

deleted text begin 973,088,000 deleted text end new text begin 972,901,000 new text end

Medical Education Research Costs
(MERC). Of these funds, the commissioner
of human services shall transfer $38,000,000
in fiscal year 2010 to the medical education
research fund. These funds must restore the
fiscal year 2009 unallotment of the transfers
under Minnesota Statutes, section 256B.69,
subdivision 5c, paragraph (a), for the July 1,
2008, through June 30, 2009, period.

Newborn Screening Fee. Of the general
fund appropriation, $34,000 in fiscal year
2011 is to the commissioner for the hospital
reimbursement increase described under
Minnesota Statutes, section 256.969,
subdivision deleted text begin 28 deleted text end new text begin 29 new text end .

Local Share Payment Modification
Required for ARRA Compliance.
Effective new text begin retroactively new text end from deleted text begin July 1, 2009 deleted text end new text begin
October 1, 2008 new text end , to December 31, 2010,
Hennepin County's monthly contribution to
the nonfederal share of medical assistance
costs must be reduced to the percentage
required on September 1, 2008, to meet
federal requirements for enhanced federal
match under the American Reinvestment
and Recovery Act (ARRA) of 2009.
Notwithstanding the requirements of
Minnesota Statutes, section 256B.19,
subdivision 1c, paragraph (d), for the period
beginning deleted text begin July 1, 2009 deleted text end new text begin October 1, 2008 new text end ,
to December 31, 2010, Hennepin County's
monthly payment under that provision is
reduced to $434,688. new text begin This provision is
effective the day following final enactment.
new text end

Capitation Payments. Effective
new text begin retroactively new text end from deleted text begin July 1, 2009 deleted text end new text begin October 1,
2008 new text end , to December 31, 2010, notwithstanding
the provisions of Minnesota Statutes 2008,
section 256B.19, subdivision 1c, paragraph
(c), the commissioner shall increase
capitation payments made to the Metropolitan
Health Plan under Minnesota Statutes 2008,
section 256B.69, by $6,800,000 to recognize
higher than average medical education
costs. The increased amount includes federal
matching funds. new text begin This provision is effective
the day following final enactment.
new text end

Use of Savings. Any savings derived
from implementation of the prohibition in
Minnesota Statutes, section 256B.032, on the
enrollment of low-quality, high-cost health
care providers as vendors of state health care
program services shall be used to offset on a
pro rata basis the reimbursement reductions
for basic care services in Minnesota Statutes,
section 256B.766.

(c) MA Basic Health Care Grants - Elderly and Disabled

deleted text begin 970,183,000 deleted text end new text begin 969,992,000 new text end

deleted text begin 1,142,310,000 deleted text end new text begin 1,141,575,000 new text end

Minnesota Disability Health Options.
Notwithstanding Minnesota Statutes, section
256B.69, subdivision 5a, paragraph (b), for
the period beginning July 1, 2009, to June
30, 2011, the monthly enrollment of persons
receiving home and community-based
waivered services under Minnesota
Disability Health Options shall not exceed
1,000. If the budget neutrality provision
in Minnesota Statutes, section 256B.69,
subdivision 23, paragraph (f), is reached
prior to June 30, 2013, the commissioner may
waive this monthly enrollment requirement.

Hospital Fee-for-Service Payment Delay.
Payments from the Medicaid Management
Information System that would otherwise
have been made for inpatient hospital
services for Minnesota health care program
enrollees must be delayed as follows: for
fiscal year 2011, payments in the month of
June equal to $15,937,000 must be included
in the first payment of fiscal year 2012 and
for fiscal year 2013, payments in the month
of June equal to $6,666,000 must be included
in the first payment of fiscal year 2014. The
provisions of Minnesota Statutes, section
16A.124, do not apply to these delayed
payments. Notwithstanding any contrary
provision in this article, this paragraph
expires December 31, 2014.

Nonhospital Fee-for-Service Payment
Delay. Payments from the Medicaid
Management Information System that would
otherwise have been made for nonhospital
acute care services for Minnesota health
care program enrollees must be delayed as
follows: payments in the month of June equal
to $23,438,000 for fiscal year 2011 must be
included in the first payment for fiscal year
2012, and payments in the month of June
equal to $27,156,000 for fiscal year 2013
must be included in the first payment for
fiscal year 2014. This payment delay must
not include nursing facilities, intermediate
care facilities for persons with developmental
disabilities, home and community-based
services, prepaid health plans, personal care
provider organizations, and home health
agencies. The provisions of Minnesota
Statutes, section 16A.124, do not apply to
these delayed payments. Notwithstanding
any contrary provision in this article, this
paragraph expires December 31, 2014.

(d) General Assistance Medical Care Grants

deleted text begin 345,223,000 deleted text end new text begin 344,907,000 new text end

381,081,000

* (The preceding text "381,081,000" was indicated as vetoed by the Governor.)

(e) Other Health Care Grants

Appropriations by Fund
General	295,000	295,000
Health Care Access	23,533,000	7,080,000

Base Adjustment. The health care access
fund base is reduced deleted text begin to $190,000 in each of
fiscal years 2012 and 2013 deleted text end new text begin by $6,890,000
in fiscal year 2012 and $6,890,000 in fiscal
year 2013 new text end .

Subd. 7. Health Care Management

The amounts that may be spent from the
appropriation for each purpose are as follows:

(a) Health Care Administration

Appropriations by Fund
General	deleted text begin 7,831,000 deleted text end new text begin 7,880,000 new text end	deleted text begin 7,742,000 deleted text end new text begin 7,786,000 new text end
Health Care Access	1,812,000	906,000

new text begin Base Adjustment. The general fund base is
increased by $44,000 in fiscal year 2012 and
increased by $44,000 in fiscal year 2013.
new text end

(b) Health Care Operations

Appropriations by Fund
General	19,914,000	18,949,000
Health Care Access	25,099,000	25,875,000

Base Adjustment. The health care access
fund base is increased by $1,006,000 in
fiscal year 2012 and $1,781,000 in fiscal year
2013. The general fund base is decreased by
$237,000 in fiscal year 2012 and $237,000 in
fiscal year 2013.

Subd. 8. Continuing Care Grants

The amounts that may be spent from the
appropriation for each purpose are as follows:

deleted text begin (a) Aging and Adult Services Grants deleted text end

deleted text begin Appropriations by Fund deleted text end
deleted text begin General deleted text end	deleted text begin 13,488,000 deleted text end	deleted text begin 15,779,000 deleted text end
deleted text begin Federal deleted text end	deleted text begin 500,000 deleted text end	deleted text begin 0 deleted text end

new text begin (a) Aging and Adult Services Grants new text end

new text begin 13,499,000 new text end

new text begin 15,805,000 new text end

Base Adjustment. The general fund base is
increased by $5,751,000 in fiscal year 2012
and $6,705,000 in fiscal year 2013.

Information and Assistance
Reimbursement. Federal administrative
reimbursement obtained from information
and assistance services provided by the
Senior LinkAge or Disability Linkage lines
to people who are identified as eligible for
medical assistance shall be appropriated to
the commissioner for this activity.

Community Service Development Grant
Reduction. Funding for community service
development grants must be reduced by
deleted text begin $251,000 deleted text end new text begin $260,000 new text end for fiscal year 2010;
deleted text begin $266,000 deleted text end new text begin $284,000 new text end in fiscal year 2011;
deleted text begin $25,000 deleted text end new text begin $43,000 new text end in fiscal year 2012; and
deleted text begin $25,000 deleted text end new text begin $43,000 new text end in fiscal year 2013. Base
level funding shall be restored in fiscal year
2014.

new text begin Community Service Development Grant
Community Initiative. Funding for
community service development grants shall
be used to offset the cost of aging support
grants. Base level funding shall be restored
in fiscal year 2014.
new text end

Senior Nutrition Use of Federal Funds.
For fiscal year 2010, general fund grants
for home-delivered meals and congregate
dining shall be reduced by $500,000. The
commissioner must replace these general
fund reductions with equal amounts from
federal funding for senior nutrition from the
American Recovery and Reinvestment Act
of 2009.

(b) Alternative Care Grants

50,234,000

48,576,000

Base Adjustment. The general fund base is
decreased by $3,598,000 in fiscal year 2012
and $3,470,000 in fiscal year 2013.

Alternative Care Transfer. Any money
allocated to the alternative care program that
is not spent for the purposes indicated does
not cancel but must be transferred to the
medical assistance account.

(c) Medical Assistance Grants; Long-Term Care Facilities.

367,444,000

419,749,000

(d) Medical Assistance Long-Term Care Waivers and Home Care Grants

deleted text begin 854,373,000 deleted text end new text begin 853,567,000 new text end

deleted text begin 1,043,411,000 deleted text end new text begin 1,039,517,000 new text end

Manage Growth in TBI and CADI
Waivers. During the fiscal years beginning
on July 1, 2009, and July 1, 2010, the
commissioner shall allocate money for home
and community-based waiver programs
under Minnesota Statutes, section 256B.49,
to ensure a reduction in state spending that is
equivalent to limiting the caseload growth of
the TBI waiver to 12.5 allocations per month
each year of the biennium and the CADI
waiver to 95 allocations per month each year
of the biennium. Limits do not apply: (1)
when there is an approved plan for nursing
facility bed closures for individuals under
age 65 who require relocation due to the
bed closure; (2) to fiscal year 2009 waiver
allocations delayed due to unallotment; or (3)
to transfers authorized by the commissioner
from the personal care assistance program
of individuals having a home care rating
of "CS," "MT," or "HL." Priorities for the
allocation of funds must be for individuals
anticipated to be discharged from institutional
settings or who are at imminent risk of a
placement in an institutional setting.

Manage Growth in DD Waiver. The
commissioner shall manage the growth in
the DD waiver by limiting the allocations
included in the February 2009 forecast to 15
additional diversion allocations each month
for the calendar years that begin on January
1, 2010, and January 1, 2011. Additional
allocations must be made available for
transfers authorized by the commissioner
from the personal care program of individuals
having a home care rating of "CS," "MT,"
or "HL."

Adjustment to Lead Agency Waiver
Allocations. Prior to the availability of the
alternative license defined in Minnesota
Statutes, section 245A.11, subdivision 8,
the commissioner shall reduce lead agency
waiver allocations for the purposes of
implementing a moratorium on corporate
foster care.

Alternatives to Personal Care Assistance
Services. Base level funding of $3,237,000
in fiscal year 2012 and $4,856,000 in
fiscal year 2013 is to implement alternative
services to personal care assistance services
for persons with mental health and other
behavioral challenges who can benefit
from other services that more appropriately
meet their needs and assist them in living
independently in the community. These
services may include, but not be limited to, a
1915(i) state plan option.

(e) Mental Health Grants

Appropriations by Fund
General	77,739,000	77,739,000
Health Care Access	750,000	750,000
Lottery Prize	1,508,000	1,508,000

Funding Usage. Up to 75 percent of a fiscal
year's appropriation for adult mental health
grants may be used to fund allocations in that
portion of the fiscal year ending December
31.

(f) Deaf and Hard-of-Hearing Grants

1,930,000

1,917,000

(g) Chemical Dependency Entitlement Grants

111,303,000

122,822,000

Payments for Substance Abuse Treatment.
For services provided during fiscal years
2010 and 2011, county-negotiated rates and
provider claims to the consolidated chemical
dependency fund must not exceed rates
charged for these services on January 1,
2009. For services provided in fiscal years
2012 and 2013, statewide average rates under
the new rate methodology to be developed
under Minnesota Statutes, section 254B.12,
must not exceed the average rates charged
for these services on January 1, 2009, plus new text begin a
state share increase of new text end $3,787,000 for fiscal
year 2012 and $5,023,000 for fiscal year
2013. Notwithstanding any provision to the
contrary in this article, this provision expires
on June 30, 2013.

Chemical Dependency Special Revenue
Account. For fiscal year 2010, $750,000
must be transferred from the consolidated
chemical dependency treatment fund
administrative account and deposited into the
general fund.

County CD Share of MA Costs for
ARRA Compliance. Notwithstanding the
provisions of Minnesota Statutes, chapter
254B, for chemical dependency services
provided during the period deleted text begin July 1, 2009 deleted text end new text begin
October 1, 2008 new text end , to December 31, 2010,
and reimbursed by medical assistance
at the enhanced federal matching rate
provided under the American Recovery and
Reinvestment Act of 2009, the county share
is 30 percent of the nonfederal share. new text begin This
provision is effective the day following final
enactment.
new text end

(h) Chemical Dependency Nonentitlement Grants

1,729,000

1,729,000

deleted text begin Base Adjustment. The general fund base is
decreased by $3,000 in each of fiscal years
2012 and 2013.
deleted text end

(i) Other Continuing Care Grants

deleted text begin 18,272,000 deleted text end new text begin 19,201,000 new text end

deleted text begin 13,139,000 deleted text end new text begin 17,528,000 new text end

Base Adjustment. The general fund base
is increased by deleted text begin $7,028,000 deleted text end new text begin $2,639,000 new text end in
fiscal year 2012 and increased by deleted text begin $8,243,000 deleted text end new text begin
$3,854,000 new text end in fiscal year 2013.

Technology Grants. $650,000 in fiscal
year 2010 and $1,000,000 in fiscal year
2011 are for technology grants, case
consultation, evaluation, and consumer
information grants related to developing and
supporting alternatives to shift-staff foster
care residential service models.

Other Continuing Care Grants; HIV
Grants. Money appropriated for the HIV
drug and insurance grant program in fiscal
year 2010 may be used in either year of the
biennium.

new text begin Quality Assurance Commission. Effective
July 1, 2009, state funding for the quality
assurance commission under Minnesota
Statutes, section 256B.0951, is canceled.
new text end

Subd. 9. Continuing Care Management

Appropriations by Fund
General	24,927,000	25,314,000
State Government Special Revenue	deleted text begin 875,000 deleted text end new text begin 125,000 new text end	125,000
Lottery Prize	157,000	157,000

deleted text begin Quality Assurance Commission. Effective
July 1, 2009, state funding for the quality
assurance commission under Minnesota
Statutes, section 256B.0951, is canceled.
deleted text end

County Maintenance of Effort. $350,000 in
fiscal year 2010 is from the general fund for
the State-County Results Accountability and
Service Delivery Reform under Minnesota
Statutes, chapter 402A.

Base Adjustment. The general fund base is
decreased $2,697,000 in fiscal year 2012 and
$2,791,000 in fiscal year 2013.

Subd. 10. State-Operated Services

deleted text begin 258,794,000 deleted text end

deleted text begin 266,191,000 deleted text end

The amounts that may be spent from the
appropriation for each purpose are as follows:

Transfer Authority Related to
State-Operated Services. Money
appropriated to finance state-operated
services may be transferred between the
fiscal years of the biennium with the approval
of the commissioner of finance.

County Past Due Receivables. The
commissioner is authorized to withhold
county federal administrative reimbursement
when the county of financial responsibility
for cost-of-care payments due the state
under Minnesota Statutes, section 246.54
or 253B.045, is 90 days past due. The
commissioner shall deposit the withheld
federal administrative earnings for the county
into the general fund to settle the claims with
the county of financial responsibility. The
process for withholding funds is governed by
Minnesota Statutes, section 256.017.

Forecast and Census Data. The
commissioner shall include census data and
fiscal projections for state-operated services
and Minnesota sex offender services with the
November and February budget forecasts.
Notwithstanding any contrary provision in
this article, this paragraph shall not expire.

(a) Adult Mental Health Services

deleted text begin 107,702,000 deleted text end new text begin 106,702,000 new text end

107,201,000

Appropriation Limitation. No part of
the appropriation in this article to the
commissioner for mental health treatment
services provided by state-operated services
shall be used for the Minnesota sex offender
program.

Community Behavioral Health Hospitals.
Under Minnesota Statutes, section 246.51,
subdivision 1, a determination order for the
clients served in a community behavioral
health hospital operated by the commissioner
of human services is only required when
a client's third-party coverage has been
exhausted.

Base Adjustment. The general fund base is
decreased by $500,000 for fiscal year 2012
and by $500,000 for fiscal year 2013.

(b) Minnesota Sex Offender Services

Appropriations by Fund
General	38,348,000	67,503,000
Federal Fund	26,495,000	0

Use of Federal Stabilization Funds. Of
this appropriation, $26,495,000 in fiscal year
2010 is from the fiscal stabilization account
in the federal fund to the commissioner.
This appropriation must not be used for
any activity or service for which federal
reimbursement is claimed. This is a onetime
appropriation.

(c) Minnesota Security Hospital and METO Services

Appropriations by Fund
General	deleted text begin 230,000,000 deleted text end new text begin 230,000 new text end	83,735,000
Federal Fund	deleted text begin 83,504,000 deleted text end new text begin 83,505,000 new text end	0

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 of care from the
state-operated services transitional services
program consistent with Minnesota Statutes,
section 246.014.

Use of Federal Stabilization Funds.
$83,505,000 in fiscal year 2010 is
appropriated from the fiscal stabilization
account in the federal fund to the
commissioner. This appropriation must not
be used for any activity or service for which
federal reimbursement is claimed. This is a
onetime appropriation.

Sec. 2.

Laws 2009, chapter 79, article 13, section 4, is amended to read:

Sec. 4. COMMISSIONER OF HEALTH

Subdivision 1. Total Appropriation

$

165,717,000

$

161,841,000

Appropriations by Fund
	2010	2011
General	69,366,000	63,884,000
State Government Special Revenue	45,415,000	45,415,000
Health Care Access	39,203,000	40,809,000
Federal TANF	11,733,000	11,733,000

Subd. 2. Community and Family Health Promotion

Appropriations by Fund
General	44,814,000	39,671,000
State Government Special Revenue	1,033,000	deleted text begin 1,304,000 deleted text end new text begin 1,033,000 new text end
Federal TANF	11,733,000	11,733,000
Health Care Access	21,642,000	28,719,000

deleted text begin Newborn Screening Fee. Of the general
fund appropriation, $300,000 in fiscal year
2011 is to the commissioner for the purpose
of providing support services to families as
required under Minnesota Statutes, section
144.966, subdivision 3a. $74,000 of this
appropriation in fiscal year 2011 and $51,000
of this appropriation in subsequent fiscal
years may be used by the commissioner
for administrative costs associated with
increasing the fee, contract administration,
program oversight, and provide follow-up to
families who need assistance beyond those
available through the contractor.
deleted text end

Support Services for Families With
Children Who are Deaf or Have Hearing
Loss. Of the general fund amount, $16,000
in fiscal year 2010 and $284,000 in fiscal
year 2011 is for support services to families
with children who are deaf or have hearing
loss. Of this amount, in fiscal year 2011,
$223,000 is for grants and the balance is for
administrative costs. Base funding in fiscal
years 2012 and 2013 is $300,000 each year.
Of this amount, $241,000 each year is for
grants and the balance is for administrative
costs.

Funding Usage. Up to 75 percent of the
fiscal year 2012 appropriation for local public
health grants may be used to fund calendar
year 2011 allocations for this program. The
general fund reduction of $5,193,000 in
fiscal year 2011 for local public health grants
is onetime and the base funding for local
public health grants for fiscal year 2012 is
increased by $5,193,000.

Colorectal Screening. deleted text begin $88,000 deleted text end new text begin $188,000 new text end in
fiscal year 2010 and $62,000 in fiscal year
2011 are for grants to the Hennepin County
Medical Center and MeritCare Bemidji for
colorectal screening demonstration projects.

Feasibility Pilot Project for Cancer
Surveillance. Of the general fund
appropriation for fiscal year 2010, $100,000
is to the commissioner to provide grant
funding to cover the cost of one full-time
equivalent position at the Hennepin County
Medical Center to carry out the feasibility
pilot project.

American Recovery and Reinvestment
Act Funds. Federal funds received by the
commissioner for WIC program management
information systems from the American
Recovery and Reinvestment Act of 2009,
Public Law 111-5, are appropriated to the
commissioner for the purpose of the grant.

TANF Appropriations. (1) $1,156,000 of
the TANF funds are appropriated each year to
the commissioner for family planning grants
under Minnesota Statutes, section 145.925.

(2) $3,579,000 of the TANF funds are
appropriated each year to the commissioner
for home visiting and nutritional services
listed under Minnesota Statutes, section
145.882, subdivision 7, clauses (6) and (7).
Funds must be distributed to community
health boards according to Minnesota
Statutes, section 145A.131, subdivision 1.

(3) $2,000,000 of the TANF funds are
appropriated each year to the commissioner
for decreasing racial and ethnic disparities
in infant mortality rates under Minnesota
Statutes, section 145.928, subdivision 7.

(4) $4,998,000 of the TANF funds are
appropriated each year to the commissioner
for the family home visiting grant program
according to Minnesota Statutes, section
145A.17. $4,000,000 of the funding must
be distributed to community health boards
according to Minnesota Statutes, section
145A.131, subdivision 1. $998,000 of
the funding must be distributed to tribal
governments based on Minnesota Statutes,
section 145A.14, subdivision 2a. The
commissioner may use five percent of
the funds appropriated 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.

Base Adjustment. The general fund base
is increased by $10,302,000 for fiscal year
2012 and increased by $5,109,000 for fiscal
year 2013. The health care access fund base
is reduced to $1,719,000 for both fiscal years
2012 and 2013.

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. 3. Policy Quality and Compliance

Appropriations by Fund
General	7,491,000	deleted text begin 7,242,000 deleted text end new text begin 7,243,000 new text end
State Government Special Revenue	14,173,000	14,173,000
Health Care Access	17,561,000	12,090,000

Community-Based Health Care
Demonstration Project. Notwithstanding
the provisions of Laws 2007, chapter 147,
article 19, section 3, subdivision 6, paragraph
(e), base level funding to the commissioner
for the demonstration project grant described
in Minnesota Statutes, section 62Q.80,
subdivision 1a, shall be zero for fiscal years
2011 and 2012.

Medical Education and Research Cost
Federal Compliance. Notwithstanding
Laws 2008, chapter 363, article 18, section
4, subdivision 3, the base level funding
for the commissioner to distribute to the
Mayo Clinic for transitional funding while
federal compliance changes are made to the
medical education and research cost funding
distribution formula shall be $0 for fiscal
years 2010 and 2011.

Autism Clinical Research. The
commissioner, in partnership with a
Minnesota research institution, shall apply
for funds available for research grants under
the American Recovery and Reinvestment
Act (ARRA) of 2009 in order to expand
research and treatment of autism spectrum
disorders.

Health Information Technology. (a) Of
the health care access fund appropriation,
$4,000,000 is to fund the revolving loan
account under Minnesota Statutes, section
62J.496. This appropriation must not be
expended unless it is matched with federal
funding under the federal Health Information
Technology for Economic and Clinical
Health (HITECH) Act. This appropriation
must not be included in the agency's base
budget for the fiscal year beginning July 1,
2012.

(b) On or before June 30, 2013, $1,200,000
shall be transferred from the revolving loan
account under Minnesota Statutes, section
62J.496, to the health care access fund.
This is a onetime transfer and must not be
included in the agency's base budget for the
fiscal year beginning July 1, 2014.

Base Adjustment. The general fund
base is $8,243,000 in fiscal year 2012 and
$8,243,000 in fiscal year 2013. The health
care access fund base is $10,950,000 in fiscal
year 2012 and $6,816,000 in fiscal year 2013.

Subd. 4. Health Protection

Appropriations by Fund
General	9,871,000	9,780,000
State Government Special Revenue	30,209,000	30,209,000

Base Adjustment. The general fund base is
reduced by $50,000 in each of fiscal years
2012 and 2013.

Health Protection Appropriations. (a)
$163,000 each year is for the lead abatement
grant program.

(b) $100,000 each year is for emergency
preparedness and response activities.

(c) $50,000 each year is for tuberculosis
prevention and control. This is a onetime
appropriation.

new text begin (d) $55,000 in fiscal year 2010 is for
pentachlorophenol.
new text end

new text begin (e) $20,000 in fiscal year 2010 is for a PFC
Citizens Advisory Group.
new text end

American Recovery and Reinvestment
Act Funds. Federal funds received
by the commissioner for immunization
operations from the American Recovery
and Reinvestment Act of 2009, Public Law
111-5, are appropriated to the commissioner
for the purposes of the grant.

Subd. 5. Administrative Support Services

7,190,000

7,190,000

Sec. 3.

Laws 2009, chapter 79, article 13, section 5, is amended to read:

Sec. 5. HEALTH-RELATED BOARDS

Subdivision 1. Total Appropriation

$

deleted text begin 15,017,000 deleted text end new text begin 14,034,000 new text end

$

deleted text begin 14,831,000 deleted text end new text begin 13,848,000 new text end

This appropriation is from the state
government special revenue fund.

Transfer. In fiscal year deleted text begin 2010 deleted text end new text begin 2011 new text end ,
$6,000,000 shall be transferred from the
state government special revenue fund to
the general fund. new text begin The boards must allocate
this reduction to boards carrying a positive
balance as of July 1, 2009.
new text end

The amounts that may be spent for each
purpose are specified in the following
subdivisions.

Subd. 2. Board of Chiropractic Examiners

447,000

447,000

Subd. 3. Board of Dentistry

1,009,000

1,009,000

Subd. 4. Board of Dietetic and Nutrition Practice

105,000

105,000

Subd. 5. Board of Marriage and Family Therapy

137,000

137,000

Subd. 6. Board of Medical Practice

deleted text begin 3,674,000 deleted text end new text begin 3,682,000 new text end

deleted text begin 3,674,000 deleted text end new text begin 3,682,000 new text end

Subd. 7. Board of Nursing

deleted text begin 4,217,000 deleted text end new text begin 3,287,000 new text end

deleted text begin 4,219,000 deleted text end new text begin 3,289,000 new text end

Subd. 8. Board of Nursing Home Administrators

deleted text begin 1,146,000 deleted text end new text begin 1,211,000 new text end

deleted text begin 958,000 deleted text end new text begin 1,023,000 new text end

Administrative Services Unit - Operating
Costs. Of this appropriation, $524,000
in fiscal year 2010 and $526,000 in
fiscal year 2011 are for operating costs
of the administrative services unit. The
administrative services unit may receive
and expend reimbursements for services
performed by other agencies.

Administrative Services Unit - Retirement
Costs. Of this appropriation in fiscal year
2010, $201,000 is for onetime retirement
costs in the health-related boards. This
funding may be transferred to the health
boards incurring those costs for their
payment. These funds are available either
year of the biennium.

Administrative Services Unit - Volunteer
Health Care Provider Program. Of this
appropriation, $79,000 in fiscal year 2010
and $89,000 in fiscal year 2011 are to pay
for medical professional liability coverage
required under Minnesota Statutes, section
214.40.

Administrative Services Unit - Contested
Cases and Other Legal Proceedings. Of
this appropriation, $200,000 in fiscal year
2010 and $200,000 in fiscal year 2011
are for costs of contested case hearings
and other unanticipated costs of legal
proceedings involving health-related
boards funded under this section. Upon
certification of a health-related board to the
administrative services unit that the costs
will be incurred and that there is insufficient
money available to pay for the costs out of
money currently available to that board, the
administrative services unit is authorized
to transfer money from this appropriation
to the board for payment of those costs
with the approval of the commissioner of
finance. This appropriation does not cancel.
Any unencumbered and unspent balances
remain available for these expenditures in
subsequent fiscal years.

Subd. 9. Board of Optometry

101,000

101,000

Subd. 10. Board of Pharmacy

deleted text begin 1,413,000 deleted text end new text begin 1,388,000 new text end

deleted text begin 1,413,000 deleted text end new text begin 1,388,000 new text end

Subd. 11. Board of Physical Therapy

295,000

295,000

Subd. 12. Board of Podiatry

56,000

56,000

Subd. 13. Board of Psychology

806,000

806,000

Subd. 14. Board of Social Work

deleted text begin 1,022,000 deleted text end new text begin 921,000 new text end

deleted text begin 1,022,000 deleted text end new text begin 921,000 new text end

Subd. 15. Board of Veterinary Medicine

195,000

195,000

Subd. 16. Board of Behavioral Health and Therapy

394,000

394,000

Sec. 4.

Laws 2009, chapter 79, article 13, section 6, is amended to read:

Sec. 6. EMERGENCY MEDICAL SERVICES BOARD

$

deleted text begin 4,378,000 deleted text end new text begin 3,928,000 new text end

$

deleted text begin 3,828,000 deleted text end new text begin 3,828,000 new text end

Appropriations by Fund
	2010	2011
General	deleted text begin 3,674,000 deleted text end new text begin 3,224,000 new text end	3,124,000
State Government Special Revenue	704,000	704 ,000

Longevity Award and Incentive Program.
Of the general fund appropriation, $700,000
in fiscal year 2010 and $700,000 in fiscal year
2011 are to the board for the Cooper/Sams
volunteer ambulance program, under
Minnesota Statutes, section 144E.40.

Transfer. In fiscal year 2010, $6,182,000
is transferred from the Cooper/Sams
volunteer ambulance trust, established under
Minnesota Statutes, section 144E.42, to the
general fund.

Health Professional Services Program.
$704,000 in fiscal year 2010 and $704,000 in
fiscal year 2011 from the state government
special revenue fund are for the health
professional services program.

Comprehensive Advanced Life-Support
Educational (CALS) Program. $100,000
in the first year from the deleted text begin Cooper/Sams
volunteer ambulance trust deleted text end new text begin general fund new text end is
for the comprehensive advanced life-support
educational (CALS) program established
under Minnesota Statutes, section 144E.37.
This appropriation is to extend availability
and affordability of the CALS program
for rural emergency medical personnel
and to assist hospital staff in attaining
the credentialing levels necessary for
implementation of the statewide trauma
system.

new text begin new text begin Veterans Paramedic Apprenticeship
Program. new text end Of this appropriation, $200,000
in the first year is from the general fund for
transfer to the commissioner of veterans
affairs for a grant to the Minnesota
Ambulance Association to implement a
veterans paramedic apprenticeship program
to reintegrate returning military medics
into Minnesota's workforce in the field of
paramedic and emergency services, thereby
guaranteeing returning military medics
gainful employment with livable wages and
benefits. This appropriation is available until
expended.
new text end

new text begin new text begin Medical Response Unit Reimbursement
Pilot Program. new text end (a) $250,000 in the first
year is from the general fund for a transfer
to the Department of Public Safety for a
medical response unit reimbursement pilot
program. Of this appropriation, $75,000 is
for administrative costs to the Department of
Public Safety, including providing contract
staff support and technical assistance to the
pilot program partners if necessary.
new text end

new text begin (b) Of the amount in paragraph (a), $175,000
is to be used to provide a predetermined
reimbursement amount to the participating
medical response units. The Department
of Public Safety or its contract designee
will develop an agreement with the medical
response units outlining reimbursement and
program requirements to include HIPAA
compliance while participating in the pilot
program.
new text end

Sec. 5. new text begin REPEALER.
new text end

new text begin Laws 2009, chapter 79, article 13, sections 7; and 8, new text end new text begin are repealed.
new text end

ARTICLE 3

HEALTH CARE ELIGIBILITY

Section 1.

Minnesota Statutes 2008, section 62J.2930, subdivision 3, is amended to
read:

Subd. 3.

Consumer information.

(a) The information clearinghouse or another
entity designated by the commissioner shall provide consumer information to health
plan company enrollees to:

(1) assist enrollees in understanding their rights;

(2) explain and assist in the use of all available complaint systems, including internal
complaint systems within health carriers, community integrated service networks, and
the Departments of Health and Commerce;

(3) provide information on coverage options in each region of the state;

(4) provide information on the availability of purchasing pools and enrollee
subsidies; and

(5) help consumers use the health care system to obtain coverage.

(b) The information clearinghouse or other entity designated by the commissioner
for the purposes of this subdivision shall not:

(1) provide legal services to consumers;

(2) represent a consumer or enrollee; or

(3) serve as an advocate for consumers in disputes with health plan companies.

(c) Nothing in this subdivision shall interfere with the ombudsman program
established under section deleted text begin 256B.031, subdivision 6 deleted text end new text begin 256B.69, subdivision 20 new text end , or other
existing ombudsman programs.

Sec. 2.

Minnesota Statutes 2008, section 245.494, subdivision 3, is amended to read:

Subd. 3.

Duties of the commissioner of human services.

The commissioner of
human services, in consultation with the Integrated Fund Task Force, shall:

(1) in the first quarter of 1994, in areas where a local children's mental health
collaborative has been established, based on an independent actuarial analysis, identify all
medical assistance and MinnesotaCare resources devoted to mental health services for
children in the target population including inpatient, outpatient, medication management,
services under the rehabilitation option, and related physician services in the total health
capitation of prepaid plans under contract with the commissioner to provide medical
assistance services under section 256B.69;

(2) assist each children's mental health collaborative to determine an actuarially
feasible operational target population;

(3) ensure that a prepaid health plan that contracts with the commissioner to provide
medical assistance or MinnesotaCare services shall pass through the identified resources
to a collaborative or collaboratives upon the collaboratives meeting the requirements
of section 245.4933 to serve the collaborative's operational target population. The
commissioner shall, through an independent actuarial analysis, specify differential rates
the prepaid health plan must pay the collaborative based upon severity, functioning, and
other risk factors, taking into consideration the fee-for-service experience of children
excluded from prepaid medical assistance participation;

(4) ensure that a children's mental health collaborative that enters into an agreement
with a prepaid health plan under contract with the commissioner shall accept medical
assistance recipients in the operational target population on a first-come, first-served basis
up to the collaborative's operating capacity or as determined in the agreement between
the collaborative and the commissioner;

(5) ensure that a children's mental health collaborative that receives resources passed
through a prepaid health plan under contract with the commissioner shall be subject to
the quality assurance standards, reporting of utilization information, standards set out in
sections 245.487 to 245.4889, and other requirements established in Minnesota Rules,
part 9500.1460;

(6) ensure that any prepaid health plan that contracts with the commissioner,
including a plan that contracts under section 256B.69, must enter into an agreement with
any collaborative operating in the same service delivery area that:

(i) meets the requirements of section 245.4933;

(ii) is willing to accept the rate determined by the commissioner to provide medical
assistance services; and

(iii) requests to contract with the prepaid health plan;

(7) ensure that no agreement between a health plan and a collaborative shall
terminate the legal responsibility of the health plan to assure that all activities under the
contract are carried out. The agreement may require the collaborative to indemnify the
health plan for activities that are not carried out;

(8) ensure that where a collaborative enters into an agreement with the commissioner
to provide medical assistance and MinnesotaCare services a separate capitation rate will
be determined through an independent actuarial analysis which is based upon the factors
set forth in clause (3) to be paid to a collaborative for children in the operational target
population who are eligible for medical assistance but not included in the prepaid health
plan contract with the commissioner;

(9) ensure that in counties where no prepaid health plan contract to provide medical
assistance or MinnesotaCare services exists, a children's mental health collaborative that
meets the requirements of section 245.4933 shall:

(i) be paid a capitated rate, actuarially determined, that is based upon the
collaborative's operational target population;

(ii) accept medical assistance or MinnesotaCare recipients in the operational target
population on a first-come, first-served basis up to the collaborative's operating capacity or
as determined in the contract between the collaborative and the commissioner; and

(iii) comply with quality assurance standards, reporting of utilization information,
standards set out in sections 245.487 to 245.4889, and other requirements established in
Minnesota Rules, part 9500.1460;

(10) subject to federal approval, in the development of rates for local children's
mental health collaboratives, the commissioner shall consider, and may adjust, trend and
utilization factors, to reflect changes in mental health service utilization and access;

(11) consider changes in mental health service utilization, access, and price, and
determine the actuarial value of the services in the maintenance of rates for local children's
mental health collaborative provided services, subject to federal approval;

(12) provide written notice to any prepaid health plan operating within the service
delivery area of a children's mental health collaborative of the collaborative's existence
within 30 days of the commissioner's receipt of notice of the collaborative's formation;

(13) ensure that in a geographic area where both a prepaid health plan including
those established under either section 256B.69 or 256L.12 and a local children's mental
health collaborative exist, medical assistance and MinnesotaCare recipients in the
operational target population who are enrolled in prepaid health plans will have the choice
to receive mental health services through either the prepaid health plan or the collaborative
that has a contract with the prepaid health plan, according to the terms of the contract;

(14) develop a mechanism for integrating medical assistance resources for mental
health service with MinnesotaCare and any other state and local resources available for
services for children in the operational target population, and develop a procedure for
making these resources available for use by a local children's mental health collaborative;

(15) gather data needed to manage mental health care including evaluation data and
data necessary to establish a separate capitation rate for children's mental health services
if that option is selected;

(16) by January 1, 1994, develop a model contract for providers of mental health
managed care that meets the requirements set out in sections 245.491 to 245.495 and
256B.69, and utilize this contract for all subsequent awards, and before January 1, 1995,
the commissioner of human services shall not enter into or extend any contract for any
prepaid plan that would impede the implementation of sections 245.491 to 245.495;

(17) develop revenue enhancement or rebate mechanisms and procedures to
certify expenditures made through local children's mental health collaboratives for
services including administration and outreach that may be eligible for federal financial
participation under medical assistance and other federal programs;

(18) ensure that new contracts and extensions or modifications to existing contracts
under section 256B.69 do not impede implementation of sections 245.491 to 245.495;

(19) provide technical assistance to help local children's mental health collaboratives
certify local expenditures for federal financial participation, using due diligence in order to
meet implementation timelines for sections 245.491 to 245.495 and recommend necessary
legislation to enhance federal revenue, provide clinical and management flexibility, and
otherwise meet the goals of local children's mental health collaboratives and request
necessary state plan amendments to maximize the availability of medical assistance for
activities undertaken by the local children's mental health collaborative;

(20) take all steps necessary to secure medical assistance reimbursement under the
rehabilitation option for family community support services and therapeutic support of
foster care and for individualized rehabilitation services;

(21) provide a mechanism to identify separately the reimbursement to a county
for child welfare targeted case management provided to children served by the local
collaborative for purposes of subsequent transfer by the county to the integrated fund;

(22) ensure that family members who are enrolled in a prepaid health plan and
whose children are receiving mental health services through a local children's mental
health collaborative file complaints about mental health services needed by the family
members, the commissioner shall comply with section deleted text begin 256B.031, subdivision 6 deleted text end new text begin 256B.69,
subdivision 20 new text end . A collaborative may assist a family to make a complaint; and

(23) facilitate a smooth transition for children receiving prepaid medical assistance
or MinnesotaCare services through a children's mental health collaborative who become
enrolled in a prepaid health plan.

Sec. 3.

Minnesota Statutes 2008, section 256.015, subdivision 7, is amended to read:

Subd. 7.

Cooperation new text begin with information requests new text end required.

new text begin (a) new text end Upon the request
of the deleted text begin Department deleted text end new text begin commissioner new text end of human services deleted text begin , deleted text end new text begin :
new text end

new text begin (1) new text end any state agency or third party payer shall cooperate deleted text begin with the department in deleted text end new text begin by new text end
furnishing information to help establish a third party liability deleted text begin . Upon the request of the
Department of Human Services or county child support or human service agencies deleted text end , new text begin as
required by the federal Deficit Reduction Act of 2005, Public Law 109-171;
new text end

new text begin (2) new text end any employer or third party payer shall cooperate deleted text begin in deleted text end new text begin by new text end furnishing new text begin a data file
containing new text end information about group health insurance deleted text begin plans deleted text end new text begin plan new text end or medical benefit deleted text begin plans
available to deleted text end new text begin plan coverage of new text end its employees new text begin or insureds within 60 days of the request new text end .

new text begin (b) new text end For purposes of section 176.191, subdivision 4, the deleted text begin Department deleted text end new text begin commissioner new text end
of labor and industry may allow the deleted text begin Department deleted text end new text begin commissioner new text end of human services and
county agencies direct access and data matching on information relating to workers'
compensation claims in order to determine whether the claimant has reported the fact of
a pending claim and the amount paid to or on behalf of the claimant to the deleted text begin Department deleted text end new text begin
commissioner new text end of human services.

new text begin (c) For the purpose of compliance with section 169.09, subdivision 13, and
federal requirements under Code of Federal Regulations, title 42, section 433.138(d)(4),
the commissioner of public safety shall provide accident data as requested by the
commissioner of human services. The disclosure shall not violate section 169.09,
subdivision 13, paragraph (d).
new text end

new text begin (d) new text end The deleted text begin Department deleted text end new text begin commissioner new text end of human services and county agencies shall
limit its use of information gained from agencies, third party payers, and employers to
purposes directly connected with the administration of its public assistance and child
support programs. The provision of information by agencies, third party payers, and
employers to the department under this subdivision is not a violation of any right of
confidentiality or data privacy.

Sec. 4.

Minnesota Statutes 2008, section 256.969, subdivision 3a, is amended to read:

Subd. 3a.

Payments.

(a) Acute care hospital billings under the medical
assistance program must not be submitted until the recipient is discharged. However,
the commissioner shall establish monthly interim payments for inpatient hospitals that
have individual patient lengths of stay over 30 days regardless of diagnostic category.
Except as provided in section 256.9693, medical assistance reimbursement for treatment
of mental illness shall be reimbursed based on diagnostic classifications. Individual
hospital payments established under this section and sections 256.9685, 256.9686, and
256.9695, in addition to third party and recipient liability, for discharges occurring during
the rate year shall not exceed, in aggregate, the charges for the medical assistance covered
inpatient services paid for the same period of time to the hospital. This payment limitation
shall be calculated separately for medical assistance and general assistance medical
care services. The limitation on general assistance medical care shall be effective for
admissions occurring on or after July 1, 1991. Services that have rates established under
subdivision 11 or 12, must be limited separately from other services. After consulting with
the affected hospitals, the commissioner may consider related hospitals one entity and
may merge the payment rates while maintaining separate provider numbers. The operating
and property base rates per admission or per day shall be derived from the best Medicare
and claims data available when rates are established. The commissioner shall determine
the best Medicare and claims data, taking into consideration variables of recency of the
data, audit disposition, settlement status, and the ability to set rates in a timely manner.
The commissioner shall notify hospitals of payment rates by December 1 of the year
preceding the rate year. The rate setting data must reflect the admissions data used to
establish relative values. Base year changes from 1981 to the base year established for the
rate year beginning January 1, 1991, and for subsequent rate years, shall not be limited
to the limits ending June 30, 1987, on the maximum rate of increase under subdivision
1. The commissioner may adjust base year cost, relative value, and case mix index data
to exclude the costs of services that have been discontinued by the October 1 of the year
preceding the rate year or that are paid separately from inpatient services. Inpatient stays
that encompass portions of two or more rate years shall have payments established based
on payment rates in effect at the time of admission unless the date of admission preceded
the rate year in effect by six months or more. In this case, operating payment rates for
services rendered during the rate year in effect and established based on the date of
admission shall be adjusted to the rate year in effect by the hospital cost index.

(b) For fee-for-service admissions occurring on or after July 1, 2002, the total
payment, before third-party liability and spenddown, made to hospitals for inpatient
services is reduced by .5 percent from the current statutory rates.

(c) In addition to the reduction in paragraph (b), the total payment for fee-for-service
admissions occurring on or after July 1, 2003, made to hospitals for inpatient services
before third-party liability and spenddown, is reduced five percent from the current
statutory rates. Mental health services within diagnosis related groups 424 to 432, and
facilities defined under subdivision 16 are excluded from this paragraph.

(d) In addition to the reduction in paragraphs (b) and (c), the total payment for
fee-for-service admissions occurring on or after deleted text begin July deleted text end new text begin August new text end 1, 2005, made to hospitals
for inpatient services before third-party liability and spenddown, is reduced 6.0 percent
from the current statutory rates. Mental health services within diagnosis related groups
424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph.
Notwithstanding section 256.9686, subdivision 7, for purposes of this paragraph, medical
assistance does not include general assistance medical care. Payments made to managed
care plans shall be reduced for services provided on or after January 1, 2006, to reflect
this reduction.

(e) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for
fee-for-service admissions occurring on or after July 1, 2008, through June 30, 2009, made
to hospitals for inpatient services before third-party liability and spenddown, is reduced
3.46 percent from the current statutory rates. Mental health services with diagnosis related
groups 424 to 432 and facilities defined under subdivision 16 are excluded from this
paragraph. Payments made to managed care plans shall be reduced for services provided
on or after January 1, 2009, through June 30, 2009, to reflect this reduction.

(f) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for
fee-for-service admissions occurring on or after July 1, 2009, through June 30, 2010, made
to hospitals for inpatient services before third-party liability and spenddown, is reduced
1.9 percent from the current statutory rates. Mental health services with diagnosis related
groups 424 to 432 and facilities defined under subdivision 16 are excluded from this
paragraph. Payments made to managed care plans shall be reduced for services provided
on or after July 1, 2009, through June 30, 2010, to reflect this reduction.

(g) In addition to the reductions in paragraphs (b), (c), and (d), the total payment
for fee-for-service admissions occurring on or after July 1, 2010, made to hospitals for
inpatient services before third-party liability and spenddown, is reduced 1.79 percent
from the current statutory rates. Mental health services with diagnosis related groups
424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph.
Payments made to managed care plans shall be reduced for services provided on or after
July 1, 2010, to reflect this reduction.

Sec. 5.

Minnesota Statutes 2008, section 256B.037, subdivision 5, is amended to read:

Subd. 5.

Other contracts permitted.

Nothing in this section prohibits the
commissioner from contracting with an organization for comprehensive health services,
including dental services, under deleted text begin section 256B.031, deleted text end new text begin sections new text end 256B.035, 256B.69, or
256D.03, subdivision 4, paragraph (c).

Sec. 6.

Minnesota Statutes 2008, section 256B.056, subdivision 1c, is amended to read:

Subd. 1c.

Families with children income methodology.

(a)(1) [Expired, 1Sp2003
c 14 art 12 s 17]

(2) For applications processed within one calendar month prior to July 1, 2003,
eligibility shall be determined by applying the income standards and methodologies in
effect prior to July 1, 2003, for any months in the six-month budget period before July
1, 2003, and the income standards and methodologies in effect on July 1, 2003, for any
months in the six-month budget period on or after that date. The income standards for
each month shall be added together and compared to the applicant's total countable income
for the six-month budget period to determine eligibility.

(3) For children ages one through 18 whose eligibility is determined under section
256B.057, subdivision 2, the following deductions shall be applied to income counted
toward the child's eligibility as allowed under the state's AFDC plan in effect as of July
16, 1996: $90 work expense, dependent care, and child support paid under court order.
This clause is effective October 1, 2003.

(b) For families with children whose eligibility is determined using the standard
specified in section 256B.056, subdivision 4, paragraph (c), 17 percent of countable
earned income shall be disregarded for up to four months and the following deductions
shall be applied to each individual's income counted toward eligibility as allowed under
the state's AFDC plan in effect as of July 16, 1996: dependent care and child support paid
under court order.

(c) If the four-month disregard in paragraph (b) has been applied to the wage
earner's income for four months, the disregard shall not be applied again until the wage
earner's income has not been considered in determining medical assistance eligibility for
12 consecutive months.

(d) The commissioner shall adjust the income standards under this section each July
1 by the annual update of the federal poverty guidelines following publication by the
United States Department of Health and Human Services.

new text begin (e) For children age 18 or under, annual gifts of $2,000 or less by a tax-exempt
organization to or for the benefit of the child with a life-threatening illness must be
disregarded from income.
new text end

Sec. 7.

Minnesota Statutes 2008, section 256B.056, subdivision 3c, is amended to read:

Subd. 3c.

Asset limitations for families and children.

A household of two or more
persons must not own more than $20,000 in total net assets, and a household of one
person must not own more than $10,000 in total net assets. In addition to these maximum
amounts, an eligible individual or family may accrue interest on these amounts, but they
must be reduced to the maximum at the time of an eligibility redetermination. The value of
assets that are not considered in determining eligibility for medical assistance for families
and children is the value of those assets excluded under the AFDC state plan as of July 16,
1996, as required by the Personal Responsibility and Work Opportunity Reconciliation
Act of 1996 (PRWORA), Public Law 104-193, with the following exceptions:

(1) household goods and personal effects are not considered;

(2) capital and operating assets of a trade or business up to $200,000 are not
considered;

(3) one motor vehicle is excluded for each person of legal driving age who is
employed or seeking employment;

(4) deleted text begin one burial plot and all other burial expenses equal to the supplemental security
income program asset limit are not considered for each individual deleted text end new text begin assets designated as
burial expenses are excluded to the same extent they are excluded by the Supplemental
Security Income program new text end ;

(5) court-ordered settlements up to $10,000 are not considered;

(6) individual retirement accounts and funds are not considered; and

(7) assets owned by children are not considered.

Sec. 8.

Minnesota Statutes 2008, section 256B.056, subdivision 6, is amended to read:

Subd. 6.

Assignment of benefits.

To be eligible for medical assistance a person
must have applied or must agree to apply all proceeds received or receivable by the person
or the person's legal representative from any third party liable for the costs of medical
care. By accepting or receiving assistance, the person is deemed to have assigned the
person's rights to medical support and third party payments as required by title 19 of
the Social Security Act. Persons must cooperate with the state in establishing paternity
and obtaining third party payments. By accepting medical assistance, a person assigns
to the Department of Human Services all rights the person may have to medical support
or payments for medical expenses from any other person or entity on their own or their
dependent's behalf and agrees to cooperate with the state in establishing paternity and
obtaining third party payments. Any rights or amounts so assigned shall be applied against
the cost of medical care paid for under this chapter. Any assignment takes effect upon
the determination that the applicant is eligible for medical assistance and up to three
months prior to the date of application if the applicant is determined eligible for and
receives medical assistance benefits. The application must contain a statement explaining
this assignment. For the purposes of this section, "the Department of Human Services or
the state" includes prepaid health plans under contract with the commissioner according
to sections deleted text begin 256B.031, deleted text end 256B.69, 256D.03, subdivision 4, paragraph (c), and 256L.12;
children's mental health collaboratives under section 245.493; demonstration projects for
persons with disabilities under section 256B.77; nursing facilities under the alternative
payment demonstration project under section 256B.434; and the county-based purchasing
entities under section 256B.692.

Sec. 9.

Minnesota Statutes 2008, section 256B.0625, is amended by adding a
subdivision to read:

new text begin Subd. 13i. new text end

new text begin Drug Utilization Review Board; report. new text end

new text begin (a) A nine-member Drug
Utilization Review Board is established. The board must be comprised of at least three
but no more than four licensed physicians actively engaged in the practice of medicine
in Minnesota; at least three licensed pharmacists actively engaged in the practice of
pharmacy in Minnesota; and one consumer representative. The remainder must 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 board must be appointed by the commissioner, shall
serve three-year terms, and may be reappointed by the commissioner. The board shall
annually elect a chair from among its members.
new text end

new text begin (b) The board must be staffed by an employee of the department who shall serve as
an ex officio nonvoting member of the board.
new text end

new text begin (c) The commissioner shall, with the advice of the board:
new text end

new text begin (1) implement a medical assistance retrospective and prospective drug utilization
review program as required by United States Code, title 42, section 1396r-8(g)(3);
new text end

new text begin (2) develop and implement the predetermined criteria and practice parameters for
appropriate prescribing to be used in retrospective and prospective drug utilization review;
new text end

new text begin (3) develop, select, implement, and assess interventions for physicians, pharmacists,
and patients that are educational and not punitive in nature;
new text end

new text begin (4) establish a grievance and appeals process for physicians and pharmacists under
this section;
new text end

new text begin (5) publish and disseminate educational information to physicians and pharmacists
regarding the board and the review program;
new text end

new text begin (6) adopt and implement procedures designed to ensure the confidentiality of any
information collected, stored, retrieved, assessed, or analyzed by the board, staff to
the board, or contractors to the review program that identifies individual physicians,
pharmacists, or recipients;
new text end

new text begin (7) establish and implement an ongoing process to:
new text end

new text begin (i) receive public comment regarding drug utilization review criteria and standards;
and
new text end

new text begin (ii) consider the comments along with other scientific and clinical information in
order to revise criteria and standards on a timely basis; and
new text end

new text begin (8) adopt any rules necessary to carry out this section.
new text end

new text begin (d) The board may establish advisory committees. The commissioner may contract
with appropriate organizations to assist the board in carrying out the board's duties.
The commissioner may enter into contracts for services to develop and implement a
retrospective and prospective review program.
new text end

new text begin (e) The board shall report to the commissioner annually on the date the drug
utilization review annual report is due to the Centers for Medicare and Medicaid Services.
This report must cover the preceding federal fiscal year. The commissioner shall make the
report available to the public upon request. The report must include information on the
activities of the board and the program; the effectiveness of implemented interventions;
administrative costs; and any fiscal impact resulting from the program. An honorarium
of $100 per meeting and reimbursement for mileage must be paid to each board member
in attendance.
new text end

new text begin (f) This subdivision is exempt from the provisions of section 15.059.
Notwithstanding section 15.059, subdivision 5, the board is permanent and does not expire.
new text end

Sec. 10.

Minnesota Statutes 2008, section 256B.0625, is amended by adding a
subdivision to read:

new text begin Subd. 53. new text end

new text begin Centers of excellence. new text end

new text begin For complex medical procedures with a high
degree of variation in outcomes, for which the Medicare program requires facilities
providing the services to meet certain criteria as a condition of coverage, the commissioner
may develop centers of excellence facility criteria in consultation with the Health Services
Policy Committee, section 256B.0625, subdivision 3c. The criteria must reflect facility
traits that have been linked to superior patient safety and outcomes for the procedures
in question, and must be based on the best available empirical evidence. For medical
assistance recipients enrolled on a fee-for-service basis, the commissioner may make
coverage for these procedures conditional upon the facility providing the services meeting
the specified criteria. Only facilities meeting the criteria may be reimbursed for the
procedures in question.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2009, or upon federal
approval, whichever is later.
new text end

Sec. 11.

Minnesota Statutes 2008, section 256B.094, subdivision 3, is amended to read:

Subd. 3.

Coordination and provision of services.

(a) In a county or reservation
where a prepaid medical assistance provider has contracted under section deleted text begin 256B.031 or deleted text end
256B.69 to provide mental health services, the case management provider shall coordinate
with the prepaid provider to ensure that all necessary mental health services required
under the contract are provided to recipients of case management services.

(b) When the case management provider determines that a prepaid provider is not
providing mental health services as required under the contract, the case management
provider shall assist the recipient to appeal the prepaid provider's denial pursuant to
section 256.045, and may make other arrangements for provision of the covered services.

(c) The case management provider may bill the provider of prepaid health care
services for any mental health services provided to a recipient of case management
services which the county or tribal social services arranges for or provides and which are
included in the prepaid provider's contract, and which were determined to be medically
necessary as a result of an appeal pursuant to section 256.045. The prepaid provider
must reimburse the mental health provider, at the prepaid provider's standard rate for that
service, for any services delivered under this subdivision.

(d) If the county or tribal social services has not obtained prior authorization for
this service, or an appeal results in a determination that the services were not medically
necessary, the county or tribal social services may not seek reimbursement from the
prepaid provider.

Sec. 12.

Minnesota Statutes 2008, section 256B.195, subdivision 1, is amended to read:

Subdivision 1.

Federal approval required.

deleted text begin Sections deleted text end new text begin Section new text end 145.9268 deleted text begin , 256.969,
subdivision 26, deleted text end and this section are contingent on federal approval of the intergovernmental
transfers and payments to safety net hospitals and community clinics authorized under
this section. These sections are also contingent on current payment, by the government
entities, of intergovernmental transfers under section 256B.19 and this section.

Sec. 13.

Minnesota Statutes 2008, section 256B.195, subdivision 2, is amended to read:

Subd. 2.

Payments from governmental entities.

(a) In addition to any payment
required under section 256B.19, effective July 15, 2001, the following government entities
shall make the payments indicated deleted text begin before noon on the 15th of each month deleted text end new text begin annually new text end :

(1) Hennepin County, deleted text begin $2,000,000 deleted text end new text begin $24,000,000 new text end ; and

(2) Ramsey County, deleted text begin $1,000,000 deleted text end new text begin $12,000,000 new text end .

(b) These sums shall be part of the designated governmental unit's portion of the
nonfederal share of medical assistance costs. Of these payments, Hennepin County shall
pay 71 percent directly to Hennepin County Medical Center, and Ramsey County shall
pay 71 percent directly to Regions Hospital. The counties must provide certification to the
commissioner of payments to hospitals under this subdivision.

Sec. 14.

Minnesota Statutes 2008, section 256B.195, subdivision 3, is amended to read:

Subd. 3.

Payments to certain safety net providers.

(a) Effective July 15, 2001,
the commissioner shall make the following payments to the hospitals indicated deleted text begin after
noon on the 15th of each month deleted text end new text begin annually new text end :

(1) to Hennepin County Medical Center, any federal matching funds available to
match the payments received by the medical center under subdivision 2, to increase
payments for medical assistance admissions and to recognize higher medical assistance
costs in institutions that provide high levels of charity care; and

(2) to Regions Hospital, any federal matching funds available to match the payments
received by the hospital under subdivision 2, to increase payments for medical assistance
admissions and to recognize higher medical assistance costs in institutions that provide
high levels of charity care.

(b) Effective July 15, 2001, the following percentages of the transfers under
subdivision 2 shall be retained by the commissioner for deposit each month into the
general fund:

(1) 18 percent, plus any federal matching funds, shall be allocated for the following
purposes:

(i) during the fiscal year beginning July 1, 2001, of the amount available under
this clause, 39.7 percent shall be allocated to make increased hospital payments under
section 256.969, subdivision 26; 34.2 percent shall be allocated to fund the amounts
due from small rural hospitals, as defined in section 144.148, for overpayments under
section 256.969, subdivision 5a, resulting from a determination that medical assistance
and general assistance payments exceeded the charge limit during the period from 1994 to
1997; and 26.1 percent shall be allocated to the commissioner of health for rural hospital
capital improvement grants under section 144.148; and

(ii) during fiscal years beginning on or after July 1, 2002, of the amount available
under this clause, 55 percent shall be allocated to make increased hospital payments under
section 256.969, subdivision 26, and 45 percent shall be allocated to the commissioner of
health for rural hospital capital improvement grants under section 144.148; and

(2) 11 percent shall be allocated to the commissioner of health to fund community
clinic grants under section 145.9268.

(c) This subdivision shall apply to fee-for-service payments only and shall not
increase capitation payments or payments made based on average rates. The allocation in
paragraph (b), clause (1), item (ii), to increase hospital payments under section 256.969,
subdivision 26, shall not limit payments under that section.

(d) Medical assistance rate or payment changes, including those required to obtain
federal financial participation under section 62J.692, subdivision 8, shall precede the
determination of intergovernmental transfer amounts determined in this subdivision.
Participation in the intergovernmental transfer program shall not result in the offset of
any health care provider's receipt of medical assistance payment increases other than
limits resulting from hospital-specific charge limits and limits on disproportionate share
hospital payments.

(e) Effective July 1, 2003, if the amount available for allocation under paragraph
(b) is greater than the amounts available during March 2003, after any increase in
intergovernmental transfers and payments that result from section 256.969, subdivision
3a, paragraph (c), are paid to the general fund, any additional amounts available under this
subdivision after reimbursement of the transfers under subdivision 2 shall be allocated to
increase medical assistance payments, subject to hospital-specific charge limits and limits
on disproportionate share hospital payments, as follows:

(1) if the payments under subdivision 5 are approved, the amount shall be paid to
the largest ten percent of hospitals as measured by 2001 payments for medical assistance,
general assistance medical care, and MinnesotaCare in the nonstate government hospital
category. Payments shall be allocated according to each hospital's proportionate share
of the 2001 payments; or

(2) if the payments under subdivision 5 are not approved, the amount shall be paid to
the largest ten percent of hospitals as measured by 2001 payments for medical assistance,
general assistance medical care, and MinnesotaCare in the nonstate government category
and to the largest ten percent of hospitals as measured by payments for medical assistance,
general assistance medical care, and MinnesotaCare in the nongovernment hospital
category. Payments shall be allocated according to each hospital's proportionate
share of the 2001 payments in their respective category of nonstate government and
nongovernment. The commissioner shall determine which hospitals are in the nonstate
government and nongovernment hospital categories.

Sec. 15.

Minnesota Statutes 2008, section 256B.69, subdivision 5a, is amended to read:

Subd. 5a.

Managed care contracts.

(a) Managed care contracts under this section
and sections 256L.12 and 256D.03, shall be entered into or renewed on a calendar year
basis beginning January 1, 1996. Managed care contracts which were in effect on June
30, 1995, and set to renew on July 1, 1995, shall be renewed for the period July 1, 1995
through December 31, 1995 at the same terms that were in effect on June 30, 1995. The
commissioner may issue separate contracts with requirements specific to services to
medical assistance recipients age 65 and older.

(b) A prepaid health plan providing covered health services for eligible persons
pursuant to chapters 256B, 256D, and 256L, is responsible for complying with the terms
of its contract with the commissioner. Requirements applicable to managed care programs
under chapters 256B, 256D, and 256L, established after the effective date of a contract
with the commissioner take effect when the contract is next issued or renewed.

(c) Effective for services rendered on or after January 1, 2003, the commissioner
shall withhold five percent of managed care plan payments under this section for the
prepaid medical assistance and general assistance medical care programs pending
completion of performance targets. Each performance target must be quantifiable,
objective, measurable, and reasonably attainable, except in the case of a performance
target based on a federal or state law or rule. Criteria for assessment of each performance
target must be outlined in writing prior to the contract effective date. The managed
care plan must demonstrate, to the commissioner's satisfaction, that the data submitted
regarding attainment of the performance target is accurate. The commissioner shall
periodically change the administrative measures used as performance targets in order
to improve plan performance across a broader range of administrative services. The
performance targets must include measurement of plan efforts to contain spending
on health care services and administrative activities. The commissioner may adopt
plan-specific performance targets that take into account factors affecting only one plan,
including characteristics of the plan's enrollee population. The withheld funds must be
returned no sooner than July of the following year if performance targets in the contract
are achieved. The commissioner may exclude special demonstration projects under
subdivision 23. A managed care plan or a county-based purchasing plan under section
256B.692 may include as admitted assets under section 62D.044 any amount withheld
under this paragraph that is reasonably expected to be returned.

(d)(1) Effective for services rendered on or after January 1, 2009, the commissioner
shall withhold three percent of managed care plan payments under this section for the
prepaid medical assistance and general assistance medical care programs. The withheld
funds must be returned no sooner than July 1 and no later than July 31 of the following
year. The commissioner may exclude special demonstration projects under subdivision 23.

(2) A managed care plan or a county-based purchasing plan under section 256B.692
may include as admitted assets under section 62D.044 any amount withheld under
this paragraph. The return of the withhold under this paragraph is not subject to the
requirements of paragraph (c).

new text begin (e) Contracts between the commissioner and a prepaid health plan are exempt from
the set-aside and preference provisions of section 16C.16, subdivisions 6, paragraph
(a), and 7.
new text end

Sec. 16.

Minnesota Statutes 2008, section 256B.77, subdivision 13, is amended to read:

Subd. 13.

Ombudsman.

Enrollees shall have access to ombudsman services
established in section deleted text begin 256B.031, subdivision 6 deleted text end new text begin 256B.69, subdivision 20 new text end , and advocacy
services provided by the ombudsman for mental health and developmental disabilities
established in sections 245.91 to 245.97. The managed care ombudsman and the
ombudsman for mental health and developmental disabilities shall coordinate services
provided to avoid duplication of services. For purposes of the demonstration project,
the powers and responsibilities of the Office of Ombudsman for Mental Health and
Developmental Disabilities, as provided in sections 245.91 to 245.97 are expanded
to include all eligible individuals, health plan companies, agencies, and providers
participating in the demonstration project.

Sec. 17.

Minnesota Statutes 2008, section 256D.03, subdivision 3, is amended to read:

Subd. 3.

General assistance medical care; eligibility.

(a) General assistance
medical care may be paid for any person who is not eligible for medical assistance under
chapter 256B, including eligibility for medical assistance based on a spenddown of excess
income according to section 256B.056, subdivision 5, or MinnesotaCare deleted text begin as deleted text end new text begin for applicants
and recipients new text end defined in paragraph deleted text begin (b) deleted text end new text begin (c) new text end , except as provided in paragraph deleted text begin (c) deleted text end new text begin (d) new text end , and:

(1) who is receiving assistance under section 256D.05, except for families with
children who are eligible under Minnesota family investment program (MFIP), or who is
having a payment made on the person's behalf under sections 256I.01 to 256I.06; or

(2) who is a resident of Minnesota; and

(i) who has gross countable income not in excess of 75 percent of the federal poverty
guidelines for the family size, using a six-month budget period and whose equity in assets
is not in excess of $1,000 per assistance unit. General assistance medical care is not
available for applicants or enrollees who are otherwise eligible for medical assistance but
fail to verify their assets. Enrollees who become eligible for medical assistance shall be
terminated and transferred to medical assistance. Exempt assets, the reduction of excess
assets, and the waiver of excess assets must conform to the medical assistance program in
section 256B.056, subdivisions 3 and 3d, with the following exception: the maximum
amount of undistributed funds in a trust that could be distributed to or on behalf of the
beneficiary by the trustee, assuming the full exercise of the trustee's discretion under the
terms of the trust, must be applied toward the asset maximum; new text begin or new text end

(ii) who has gross countable income above 75 percent of the federal poverty
guidelines but not in excess of 175 percent of the federal poverty guidelines for the
family size, using a six-month budget period, whose equity in assets is not in excess
of the limits in section 256B.056, subdivision 3c, and who applies during an inpatient
hospitalization deleted text begin ; or deleted text end new text begin . new text end

deleted text begin (iii) deleted text end new text begin (b) new text end the commissioner shall adjust the income standards under this section each
July 1 by the annual update of the federal poverty guidelines following publication by the
United States Department of Health and Human Services.

deleted text begin (b) deleted text end new text begin (c) new text end Effective for applications and renewals processed on or after September 1,
2006, general assistance medical care may not be paid for applicants or recipients who are
adults with dependent children under 21 whose gross family income is equal to or less than
275 percent of the federal poverty guidelines who are not described in paragraph deleted text begin (e) deleted text end new text begin (f) new text end .

deleted text begin (c) deleted text end new text begin (d) new text end Effective for applications and renewals processed on or after September 1,
2006, general assistance medical care may be paid for applicants and recipients who meet
all eligibility requirements of paragraph (a), clause (2), item (i), for a temporary period
beginning the date of application. Immediately following approval of general assistance
medical care, enrollees shall be enrolled in MinnesotaCare under section 256L.04,
subdivision 7, with covered services as provided in section 256L.03 for the rest of the
six-month general assistance medical care eligibility period, until their six-month renewal.

deleted text begin (d) deleted text end new text begin (e) new text end To be eligible for general assistance medical care following enrollment in
MinnesotaCare as required by paragraph deleted text begin (c) deleted text end new text begin (d) new text end , an individual must complete a new
application.

deleted text begin (e) deleted text end new text begin (f) new text end Applicants and recipients eligible under paragraph (a), clause deleted text begin (1) deleted text end new text begin (2), item (i) new text end ,
are exempt from the MinnesotaCare enrollment requirements in this subdivision if they:

(1) have applied for and are awaiting a determination of blindness or disability by
the state medical review team or a determination of eligibility for Supplemental Security
Income or Social Security Disability Insurance by the Social Security Administration;

(2) fail to meet the requirements of section 256L.09, subdivision 2;

(3) are homeless as defined by United States Code, title 42, section 11301, et seq.;

(4) are classified as end-stage renal disease beneficiaries in the Medicare program;

(5) are enrolled in private health care coverage as defined in section 256B.02,
subdivision 9;

(6) are eligible under paragraph deleted text begin (j) deleted text end new text begin (k) new text end ;

(7) receive treatment funded pursuant to section 254B.02; or

(8) reside in the Minnesota sex offender program defined in chapter 246B.

deleted text begin (f) deleted text end new text begin (g) new text end For applications received on or after October 1, 2003, eligibility may begin no
earlier than the date of application. For individuals eligible under paragraph (a), clause
(2), item (i), a redetermination of eligibility must occur every 12 months. Individuals are
eligible under paragraph (a), clause (2), item (ii), only during inpatient hospitalization but
may reapply if there is a subsequent period of inpatient hospitalization.

deleted text begin (g) deleted text end new text begin (h) new text end Beginning September 1, 2006, Minnesota health care program applications
and renewals completed by recipients and applicants who are persons described
in paragraph deleted text begin (c) deleted text end new text begin (d) new text end and submitted to the county agency shall be determined for
MinnesotaCare eligibility by the county agency. If all other eligibility requirements of
this subdivision are met, eligibility for general assistance medical care shall be available
in any month during which MinnesotaCare enrollment is pending. Upon notification of
eligibility for MinnesotaCare, notice of termination for eligibility for general assistance
medical care shall be sent to an applicant or recipient. If all other eligibility requirements
of this subdivision are met, eligibility for general assistance medical care shall be available
until enrollment in MinnesotaCare subject to the provisions of paragraphs deleted text begin (c) deleted text end new text begin (d) new text end , deleted text begin (e) deleted text end new text begin (f) new text end ,
and deleted text begin (f) deleted text end new text begin (g) new text end .

deleted text begin (h) deleted text end new text begin (i) new text end The date of an initial Minnesota health care program application necessary
to begin a determination of eligibility shall be the date the applicant has provided a
name, address, and Social Security number, signed and dated, to the county agency
or the Department of Human Services. If the applicant is unable to provide a name,
address, Social Security number, and signature when health care is delivered due to a
medical condition or disability, a health care provider may act on an applicant's behalf to
establish the date of an initial Minnesota health care program application by providing
the county agency or Department of Human Services with provider identification and a
temporary unique identifier for the applicant. The applicant must complete the remainder
of the application and provide necessary verification before eligibility can be determined. new text begin
The applicant must complete the application within the time periods required under the
medical assistance program as specified in Minnesota Rules, parts 9505.0015, subpart
5, and 9505.0090, subpart 2. new text end The county agency must assist the applicant in obtaining
verification if necessary.

deleted text begin (i) deleted text end new text begin (j) new text end County agencies are authorized to use all automated databases containing
information regarding recipients' or applicants' income in order to determine eligibility for
general assistance medical care or MinnesotaCare. Such use shall be considered sufficient
in order to determine eligibility and premium payments by the county agency.

deleted text begin (j) deleted text end new text begin (k) new text end General assistance medical care is not available for a person in a correctional
facility unless the person is detained by law for less than one year in a county correctional
or detention facility as a person accused or convicted of a crime, or admitted as an
inpatient to a hospital on a criminal hold order, and the person is a recipient of general
assistance medical care at the time the person is detained by law or admitted on a criminal
hold order and as long as the person continues to meet other eligibility requirements
of this subdivision.

deleted text begin (k) deleted text end new text begin (l) new text end General assistance medical care is not available for applicants or recipients
who do not cooperate with the county agency to meet the requirements of medical
assistance.

deleted text begin (l) deleted text end new text begin (m) new text end In determining the amount of assets of an individual eligible under paragraph
(a), clause (2), item (i), there shall be included any asset or interest in an asset, including
an asset excluded under paragraph (a), that was given away, sold, or disposed of for
less than fair market value within the 60 months preceding application for general
assistance medical care or during the period of eligibility. Any transfer described in this
paragraph shall be presumed to have been for the purpose of establishing eligibility for
general assistance medical care, unless the individual furnishes convincing evidence to
establish that the transaction was exclusively for another purpose. For purposes of this
paragraph, the value of the asset or interest shall be the fair market value at the time it
was given away, sold, or disposed of, less the amount of compensation received. For any
uncompensated transfer, the number of months of ineligibility, including partial months,
shall be calculated by dividing the uncompensated transfer amount by the average monthly
per person payment made by the medical assistance program to skilled nursing facilities
for the previous calendar year. The individual shall remain ineligible until this fixed period
has expired. The period of ineligibility may exceed 30 months, and a reapplication for
benefits after 30 months from the date of the transfer shall not result in eligibility unless
and until the period of ineligibility has expired. The period of ineligibility begins in the
month the transfer was reported to the county agency, or if the transfer was not reported,
the month in which the county agency discovered the transfer, whichever comes first. For
applicants, the period of ineligibility begins on the date of the first approved application.

deleted text begin (m) deleted text end new text begin (n) new text end When determining eligibility for any state benefits under this subdivision,
the income and resources of all noncitizens shall be deemed to include their sponsor's
income and resources as defined in the Personal Responsibility and Work Opportunity
Reconciliation Act of 1996, title IV, Public Law 104-193, sections 421 and 422, and
subsequently set out in federal rules.

deleted text begin (n) deleted text end new text begin (o) new text end Undocumented noncitizens and nonimmigrants are ineligible for general
assistance medical care. For purposes of this subdivision, a nonimmigrant is an individual
in one or more of the classes listed in United States Code, title 8, section 1101(a)(15), and
an undocumented noncitizen is an individual who resides in the United States without the
approval or acquiescence of the United States Citizenship and Immigration Services.

deleted text begin (o) deleted text end new text begin (p) new text end Notwithstanding any other provision of law, a noncitizen who is ineligible for
medical assistance due to the deeming of a sponsor's income and resources, is ineligible
for general assistance medical care.

deleted text begin (p) deleted text end new text begin (q) new text end Effective July 1, 2003, general assistance medical care emergency services
end.

Sec. 18.

Minnesota Statutes 2008, section 256L.01, is amended by adding a subdivision
to read:

new text begin Subd. 4a. new text end

new text begin Gross individual or gross family income. new text end

new text begin (a) "Gross individual or gross
family income" for nonfarm self-employed means income calculated for the 12-month
period of eligibility using as a baseline the adjusted gross income reported on the
applicant's federal income tax form for the previous year and adding back in depreciation,
and carryover net operating loss amounts that apply to the business in which the family is
currently engaged.
new text end

new text begin (b) "Gross individual or gross family income" for farm self-employed means income
calculated for the 12-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.
new text end

new text begin (c) "Gross individual or gross family income" means the total income for all family
members, calculated for the 12-month period of eligibility.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2009, except that the
amendment made to the "gross individual or gross family income" for farm self-employed
is effective July 1, 2009, or upon federal approval, whichever is later.
new text end

Sec. 19.

Minnesota Statutes 2008, 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 deleted text begin and
$3,000 per family deleted text end ;

(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.

(c) Paragraph (a) does 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 200 percent of the federal
poverty guidelines or 215 percent of the federal poverty guidelines on or after July 1, 2009,
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.

(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. 20.

Minnesota Statutes 2008, section 256L.15, subdivision 2, is amended to read:

Subd. 2.

Sliding fee scale; monthly gross individual or family income.

(a) The
commissioner shall establish a sliding fee scale to determine the percentage of monthly
gross individual or family income that households at different income levels must pay to
obtain coverage through the MinnesotaCare program. The sliding fee scale must be based
on the enrollee's monthly gross individual or family income. The sliding fee scale must
contain separate tables based on enrollment of one, two, or three or more persons. Until
June 30, 2009, the sliding fee scale begins with a premium of 1.5 percent of monthly gross
individual or family income for individuals or families with incomes below the limits for
the medical assistance program for families and children in effect on January 1, 1999, and
proceeds through the following evenly spaced steps: 1.8, 2.3, 3.1, 3.8, 4.8, 5.9, 7.4, and
8.8 percent. These percentages are matched to evenly spaced income steps ranging from
the medical assistance income limit for families and children in effect on January 1, 1999,
to 275 percent of the federal poverty guidelines for the applicable family size, up to a
family size of five. The sliding fee scale for a family of five must be used for families of
more than five. The sliding fee scale and percentages are not subject to the provisions of
chapter 14. If a family or individual reports increased income after enrollment, premiums
shall be adjusted at the time the change in income is reported.

(b) Children in families whose gross income is above 275 percent of the federal
poverty guidelines shall pay the maximum premium. The maximum premium is defined
as a base charge for one, two, or three or more enrollees so that if all MinnesotaCare
cases paid the maximum premium, the total revenue would equal the total cost of
MinnesotaCare medical coverage and administration. In this calculation, administrative
costs shall be assumed to equal ten percent of the total. The costs of medical coverage
for pregnant women and children under age two and the enrollees in these groups shall
be excluded from the total. The maximum premium for two enrollees shall be twice the
maximum premium for one, and the maximum premium for three or more enrollees shall
be three times the maximum premium for one.

(c) Beginning July 1, 2009, MinnesotaCare enrollees shall pay premiums according
to the premium scale specified in paragraph (d) with the exception that children in families
with income at or below 150 percent of the federal poverty guidelines shall pay a monthly
premium of $4. For purposes of paragraph (d), "minimum" means a monthly premium
of $4.

(d) The following premium scale is established for individuals and families with
gross family incomes of deleted text begin 300 deleted text end new text begin 275 new text end percent of the federal poverty guidelines or less:

Federal Poverty Guideline Range	Percent of Average Gross Monthly Income
0-45%	minimum
46-54%	new text begin $4 or new text end 1.1% new text begin of family income, whichever is greater new text end
55-81%	1.6%
82-109%	2.2%
110-136%	2.9%
137-164%	3.6%
165-191%	4.6%
192-219%	5.6%
220-248%	6.5%
deleted text begin 249-274% deleted text end new text begin 249-275% new text end	7.2%
deleted text begin 275-300% deleted text end	deleted text begin 8.0% deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2009, or upon federal
approval, whichever is later. The commissioner of human services shall notify the revisor
of statutes when federal approval is obtained.
new text end

Sec. 21.

Laws 2005, First Special Session chapter 4, article 8, section 54, the effective
date, is amended to read:

EFFECTIVE DATE.

This section is effective August 1, deleted text begin 2007, or upon HealthMatch
implementation, whichever is later deleted text end new text begin 2009 new text end .

Sec. 22.

Laws 2005, First Special Session chapter 4, article 8, section 61, the effective
date, is amended to read:

EFFECTIVE DATE.

This section is effective August 1, deleted text begin 2007, or upon HealthMatch
implementation, whichever is later deleted text end new text begin 2009 new text end .

Sec. 23.

Laws 2005, First Special Session chapter 4, article 8, section 63, the effective
date, is amended to read:

EFFECTIVE DATE.

This section is effective August 1, deleted text begin 2007, or upon HealthMatch
implementation, whichever is later deleted text end new text begin 2009 new text end .

Sec. 24.

Laws 2005, First Special Session chapter 4, article 8, section 66, the effective
date, is amended to read:

EFFECTIVE DATE.

Paragraph (a) is effective August 1, deleted text begin 2007, or upon
HealthMatch implementation, whichever is later deleted text end new text begin 2009 new text end , and paragraph (e) is effective
September 1, 2006.

Sec. 25.

Laws 2005, First Special Session chapter 4, article 8, section 74, the effective
date, is amended to read:

EFFECTIVE DATE.

The amendment to paragraph (a) changing gross family or
individual income to monthly gross family or individual income is effective August 1,
deleted text begin 2007, or upon implementation of HealthMatch, whichever is later deleted text end new text begin 2009 new text end . The amendment
to paragraph (a) related to premium adjustments and changes of income and the
amendment to paragraph (c) are effective September 1, 2005, or upon federal approval,
whichever is later. deleted text begin Prior to the implementation of HealthMatch, deleted text end The commissioner
shall implement this section to the fullest extent possible, including the use of manual
processing. deleted text begin Upon implementation of HealthMatch, the commissioner shall implement this
section in a manner consistent with the procedures and requirements of HealthMatch.
deleted text end

Sec. 26. new text begin REPEALER.
new text end

new text begin (a) Minnesota Statutes 2008, sections 256B.031; and 256L.01, subdivision 4, new text end new text begin are
repealed.
new text end

new text begin (b) new text end new text begin Laws 2005, First Special Session chapter 4, article 8, sections 21; 22; 23; and
24, new text end new text begin are repealed.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2009.
new text end