ARTICLE 1

CHILDREN AND FAMILY SERVICES

new text begin [256.987] ELECTRONIC BENEFIT TRANSFER CARD.
new text end

256D.47 PAYMENT METHODS.

new text begin [256N.10] ADULT ASSISTANCE GRANT PROGRAM.
new text end

new text begin [256N.20] DEFINITIONS.
new text end

new text begin [256N.22] RESIDENCY.
new text end

new text begin [256N.25] PROGRAM EVALUATION.
new text end

new text begin [256N.30] FUNDING.
new text end

new text begin [256N.35] APPLICANT REQUIREMENTS.
new text end

260D.01 CHILD IN VOLUNTARY FOSTER CARE FOR TREATMENT.

518A.51 FEES FOR IV-D SERVICES.

ARTICLE 2

DEPARTMENT OF HEALTH

62J.692 MEDICAL EDUCATION.

new text begin [62U.15] ALZHEIMER'S DISEASE; PREVALENCE AND SCREENING
MEASURES.
new text end

144A.102 WAIVER FROM FEDERAL RULES AND REGULATIONS;
PENALTIES.

144E.123 PREHOSPITAL CARE DATA.

new text begin [145.4221] HUMAN CLONING PROHIBITED.
new text end

new text begin [145.9271] WHITE EARTH BAND URBAN CLINIC.
new text end

new text begin [145.9272] COMMUNITY MENTAL HEALTH CENTER GRANTS.
new text end

new text begin [145.987] COMMUNITY HEALTH CENTERS DEVELOPMENT
GRANTS.
new text end

ARTICLE 3

MISCELLANEOUS

326B.175 ELEVATORS, ENTRANCES SEALED.

new text begin [326B.188] COMPLIANCE WITH ELEVATOR CODE CHANGES.
new text end

ARTICLE 4

HEALTH RELATED LICENSING

148.231 REGISTRATION; FAILURE TO REGISTER; REREGISTRATION;
VERIFICATION.

new text begin [148.242] FEES.
new text end

new text begin [148.243] FEE AMOUNTS.
new text end

new text begin [148.2855] NURSE LICENSURE COMPACT.
new text end

new text begin [148.2856] APPLICATION OF NURSE LICENSURE COMPACT TO
EXISTING LAWS.
new text end

new text begin [148.2857] WITHDRAWAL FROM COMPACT.
new text end

new text begin [148.2858] MISCELLANEOUS PROVISIONS.
new text end

new text begin [148.2859] NURSE LICENSURE COMPACT ADVISORY
COMMITTEE.
new text end

148B.17 FEES.

148B.52 DUTIES OF THE BOARD.

new text begin [151.065] FEE AMOUNTS.
new text end

151.07 MEETINGS; EXAMINATION FEE.

151.101 INTERNSHIP.

151.12 RECIPROCITY; LICENSURE.

151.19 REGISTRATION; FEES.

151.25 REGISTRATION OF MANUFACTURERS; FEE; PROHIBITIONS.

151.48 OUT-OF-STATE WHOLESALE DRUG DISTRIBUTOR LICENSING.

new text begin [214.107] HEALTH-RELATED LICENSING BOARDS
ADMINISTRATIVE SERVICES UNIT.
new text end

ARTICLE 5

HEALTH CARE

new text begin [1.06] FREEDOM OF CHOICE IN HEALTH CARE ACT.
new text end

new text begin [62E.121] HIGH-DEDUCTIBLE, BASIC PLAN.
new text end

new text begin [62J.824] BILLING FOR PROCEDURES TO CORRECT MEDICAL
ERRORS PROHIBITED.
new text end

62Q.32 LOCAL OMBUDSPERSON.

256B.0644 REIMBURSEMENT UNDER OTHER STATE HEALTH CARE
PROGRAMS.

new text begin [256B.771] COMPLEMENTARY AND ALTERNATIVE MEDICINE
DEMONSTRATION PROJECT.
new text end

new text begin [256B.841] MINNESOTA CHOICE WAIVER APPLICATION AND
PROCESS.
new text end

new text begin [256B.842] PRINCIPLES AND GOALS FOR MEDICAL ASSISTANCE
REFORM.
new text end

new text begin [256B.843] CHOICE WAIVER APPLICATION REQUIREMENTS.
new text end

new text begin [256L.031] HEALTHY MINNESOTA CONTRIBUTION PROGRAM.
new text end

ARTICLE 6

CONTINUING CARE

new text begin [15.996] PERFORMANCE-BASED ORGANIZATIONS.
new text end

new text begin [256B.0961] STATE QUALITY ASSURANCE, QUALITY
IMPROVEMENT, AND LICENSING SYSTEM.
new text end

ARTICLE 7

CHEMICAL AND MENTAL HEALTH

246B.10 LIABILITY OF COUNTY; REIMBURSEMENT.

253B.212 COMMITMENT; RED LAKE BAND OF CHIPPEWA INDIANSnew text begin ;
WHITE EARTH BAND OF OJIBWEnew text end .

ARTICLE 8

REDESIGNING SERVICE DELIVERY

402A.15 STEERING COMMITTEE ON PERFORMANCE AND OUTCOME
REFORMS.

402A.18 COMMISSIONER POWER TO REMEDY FAILURE TO MEET
PERFORMANCE OUTCOMES.

402A.20 COUNCIL.

new text begin [402A.35] DESIGNATION OF SERVICE DELIVERY AUTHORITY.
new text end

new text begin [402A.40] TRANSITION TO NEW BARGAINING UNIT STRUCTURE.
new text end

ARTICLE 9

HUMAN SERVICES FORECAST ADJUSTMENTS

ARTICLE 10

HEALTH AND HUMAN SERVICES APPROPRIATIONS

SF 760

ARTICLE 1

CHILDREN AND FAMILY SERVICES

new text begin [256.987] ELECTRONIC BENEFIT TRANSFER CARD. new text end

256D.47 PAYMENT METHODS.

new text begin [256.987] ELECTRONIC BENEFIT TRANSFER CARD.
new text end

new text begin [256N.10] ADULT ASSISTANCE GRANT PROGRAM.
new text end

new text begin [256N.20] DEFINITIONS.
new text end

new text begin [256N.22] RESIDENCY.
new text end

new text begin [256N.25] PROGRAM EVALUATION.
new text end

new text begin [256N.30] FUNDING.
new text end

new text begin [256N.35] APPLICANT REQUIREMENTS.
new text end

Section 1.

Subd. 13.

new text begin EFFECTIVE DATE. new text end

Sec. 2.

Subd. 4.

new text begin EFFECTIVE DATE. new text end

Sec. 3.

new text begin Subd. 9a. new text end

new text begin EFFECTIVE DATE. new text end

Sec. 4.

Subd. 10.

new text begin EFFECTIVE DATE. new text end

Sec. 5.

new text begin Subd. 13. new text end

new text begin EFFECTIVE DATE. new text end

Sec. 6.

new text begin Subd. 1b. new text end

Sec. 7.

Subdivision 1.

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Sec. 8.

Subd. 1a.

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Sec. 9.

Subd. 7.

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Sec. 10.

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new text begin Subd. 2. new text end

new text begin Subd. 3. new text end

new text begin EFFECTIVE DATE. new text end

Sec. 11.

Subd. 12a.

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Sec. 12.

Subdivision 1.

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Sec. 13.

Subd. 2.

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Sec. 14.

Subd. 5.

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Sec. 15.

Subdivision 1.

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Sec. 16.

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Sec. 17.

Subd. 5.

Sec. 18.

Subd. 6.

Sec. 19.

new text begin Subd. 8. new text end

Sec. 20.

Subdivision 1.

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Sec. 21.

Subd. 2b.

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Sec. 22.

Subd. 1a.

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Sec. 23.

Subd. 1a.

Sec. 24.

Subd. 2.

Sec. 25.

Subd. 3.

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Sec. 26.

new text begin Subd. 3c. new text end

new text begin EFFECTIVE DATE. new text end

Sec. 27.

Subd. 13.

Sec. 28.

Subd. 2.

Sec. 29.

new text begin EFFECTIVE DATE. new text end

Sec. 30.

new text begin Subdivision 1. new text end

new text begin Subd. 2. new text end

new text begin Subd. 3. new text end

new text begin Subd. 4. new text end

new text begin Subd. 5. new text end

new text begin Subd. 6. new text end

new text begin EFFECTIVE DATE. new text end

Sec. 31.

new text begin EFFECTIVE DATE. new text end

Sec. 32.

new text begin Subdivision 1. new text end

new text begin Subd. 2. new text end

new text begin EFFECTIVE DATE. new text end

Sec. 33.

new text begin Subdivision 1. new text end

new text begin Subd. 2. new text end

new text begin EFFECTIVE DATE. new text end

Sec. 34.

new text begin EFFECTIVE DATE. new text end

Sec. 35.

Subd. 3.

Sec. 36.

Sec. 37.

Subd. 10a.

Sec. 38.

Sec. 39. new text begin REQUIREMENT FOR LIQUOR STORES, TOBACCO STORES,
GAMBLING ESTABLISHMENTS, AND TATTOO PARLORS.
new text end

Sec. 40. new text begin MINNESOTA EBT BUSINESS TASK FORCE.
new text end

new text begin Subdivision 1. new text end

new text begin Subd. 2. new text end

new text begin Subd. 3. new text end

new text begin Subd. 4. new text end

Sec. 41. new text begin STREAMLINING CHILDREN AND COMMUNITY SERVICES ACT
REPORTING REQUIREMENTS.
new text end

Sec. 42. new text begin REVISOR'S INSTRUCTION.
new text end

Sec. 43. new text begin REPEALER.
new text end

Section 1.

Subd. 7.

Sec. 2.

Subd. 3.

new text begin EFFECTIVE DATE. new text end

Sec. 3.

Subd. 4a.

new text begin EFFECTIVE DATE. new text end

Sec. 4.

new text begin Subd. 7. new text end

Sec. 5.

Subdivision 1.

Subd. 3.

Subd. 4.

Subd. 5.

Subd. 6.

Subd. 7.

Subd. 7a.

Subd. 8.

Subd. 9.

new text begin Subd. 11. new text end

Sec. 6.

new text begin Subdivision 1. new text end

new text begin Subd. 2. new text end

new text begin Subd. 3. new text end

new text begin Subd. 4. new text end

Sec. 7.

Subdivision 1.

Sec. 8.

Subd. 5.

Sec. 9.

Subd. 6.

Sec. 10.

Subd. 2a.

Sec. 11.

Subd. 7.

Sec. 12.

new text begin Subd. 8. new text end

Sec. 13.

new text begin Subd. 9. new text end

Sec. 14.

Sec. 15.

new text begin Subd. 9. new text end

Sec. 16.

Subdivision 1.

Subd. 2.

Subd. 3.

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new text begin Subd. 5. new text end

new text begin EFFECTIVE DATE. new text end

Sec. 17.

new text begin Subdivision 1. new text end

new text begin Subd. 2. new text end

new text begin Subd. 3. new text end

new text begin Subd. 4. new text end

new text begin Subd. 5. new text end

new text begin EFFECTIVE DATE. new text end

Sec. 18.

Subdivision 1.

Sec. 19.

Subd. 2.

Sec. 20.

new text begin Subdivision 1. new text end

new text begin Subd. 2. new text end

Sec. 21.

new text begin Subdivision 1. new text end

new text begin Subd. 2. new text end

new text begin EFFECTIVE DATE. new text end

Sec. 22.

Subd. 7.

Sec. 23.

Subd. 8.

Sec. 24.

new text begin EFFECTIVE DATE. new text end

Sec. 25.

Subd. 3.

Sec. 26.

new text begin Subd. 7a. new text end

new text begin EFFECTIVE DATE. new text end

Sec. 27.

new text begin Subd. 5. new text end

Sec. 28.

Subdivision 1.

Sec. 29. new text begin EVALUATION OF HEALTH AND HUMAN SERVICES REGULATORY
RESPONSIBILITIES.
new text end

Sec. 30. new text begin STUDY OF FOR-PROFIT HEALTH MAINTENANCE
ORGANIZATIONS.
new text end

Sec. 31. new text begin MINNESOTA TASK FORCE ON PREMATURITY.
new text end

new text begin Subdivision 1. new text end

new text begin Subd. 2. new text end

new text begin Subd. 3. new text end

new text begin Subd. 4. new text end

Sec. 32. new text begin NURSING HOME REGULATORY EFFICIENCY.
new text end

Sec. 33. new text begin REPEALER.
new text end

Section 1.

Subd. 4.

Sec. 2.

new text begin Subd. 7. new text end

Sec. 3.

new text begin Subd. 8. new text end

Sec. 4.

Subd. 14a.

Sec. 5.

Subd. 17.

Sec. 6.

new text begin Subd. 5a. new text end

Sec. 7.

new text begin Subd. 3a. new text end

new text begin EFFECTIVE DATE. new text end

Sec. 8.

Sec. 9.

Sec. 10. new text begin NONEMERGENCY MEDICAL TRANSPORTATION SINGLE
ADMINISTRATIVE STRUCTURE PROPOSAL.
new text end

Section 1.

Subdivision 1.

Sec. 2.

new text begin Subd. 4. new text end

Sec. 3.

Subd. 2.

Sec. 4.

Subdivision 1.

Sec. 5.

Subdivision 1.

Subd. 4.

Subd. 5.

Subd. 6.

Sec. 6.

Sec. 7.

new text begin Subdivision 1. new text end

new text begin Subd. 2. new text end

new text begin Subd. 3. new text end

new text begin Subd. 4. new text end

new text begin Subd. 5. new text end

new text begin Subd. 6. new text end

new text begin Subd. 7. new text end

new text begin Subd. 8. new text end

new text begin Subd. 9. new text end

new text begin Subd. 10. new text end

new text begin Subd. 11. new text end

new text begin Subd. 12. new text end

new text begin Subd. 13. new text end

new text begin Subd. 14. new text end

new text begin Subd. 15. new text end

new text begin Subd. 16. new text end

new text begin Subd. 17. new text end

Sec. 8.

Sec. 9.

Sec. 10.

Sec. 11.

Sec. 12.

new text begin Subdivision 1. new text end

new text begin Subd. 2. new text end

new text begin Subd. 3. new text end

Sec. 13.

new text begin Subdivision. 1. new text end

new text begin Subd. 2. new text end

new text begin Subd. 3. new text end

Sec. 14.

Subd. 2.

Sec. 15.

Sec. 16.

Subd. 2.

Sec. 17.

Subd. 3.

Sec. 18.

Subd. 4.

Sec. 19.

Subd. 5.

Sec. 20.

Subd. 8.

Sec. 21.

new text begin Subd. 16. new text end

Sec. 22.

new text begin Subdivision 1. new text end

new text begin Subd. 2. new text end

new text begin Subd. 3. new text end

new text begin Subd. 4. new text end

new text begin Subd. 5. new text end

new text begin Subd. 6. new text end

Sec. 23.

Sec. 24.

Sec. 25.

new text begin Subd. 3. new text end

Sec. 26.

Sec. 27.

Subdivision 1.

Sec. 28.

Subdivision 1.

Subd. 2.

Subd. 3.

Sec. 29.

Sec. 30.

Subdivision 1.

Sec. 31.

Sec. 32.

Subd. 3.

Sec. 33.

new text begin Subdivision 1. new text end

new text begin Subd. 2. new text end

new text begin Subd. 3. new text end

Sec. 34. new text begin EFFECTIVE DATE.
new text end

Section 1.

new text begin Subdivision 1. new text end

new text begin Subd. 2. new text end

new text begin Subd. 3. new text end

new text begin Subd. 4. new text end

Sec. 2.

Subdivision 1.

Sec. 3.

Subd. 3a.

Sec. 4.

Subdivision 1.

Sec. 5.

new text begin Subdivision 1. new text end

new text begin Subd. 2. new text end

new text begin Subd. 3. new text end

new text begin Subd. 4. new text end

new text begin Subd. 5. new text end

new text begin Subd. 6. new text end

new text begin Subd. 7. new text end

new text begin Subd. 8. new text end

new text begin Subd. 9. new text end

new text begin Subd. 10. new text end

new text begin Subd. 11. new text end

new text begin Subd. 12. new text end

new text begin Subd. 13. new text end

new text begin Subd. 14. new text end

new text begin Subd. 15. new text end

new text begin Subd. 16. new text end

Sec. 6.

new text begin Subd. 4f. new text end

Sec. 7.

Subd. 9.

Sec. 8.

Subd. 7.

Sec. 9.

Subd. 9.

Sec. 10.

Sec. 11.

Sec. 12.

Subd. 3.

Sec. 13.

Subd. 9.

Sec. 14.

Subd. 2.

Sec. 15.

Subd. 2b.

Sec. 16.

new text begin Subd. 33. new text end

Sec. 17.

Subd. 2b.

Sec. 18.

Subd. 18.

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Sec. 19.

Subd. 3.

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Sec. 20.

Subd. 4.

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Sec. 21.

Subd. 4.

Sec. 22.

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Sec. 23.

Subd. 8.

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Sec. 24.

Subd. 8a.

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Sec. 25.

Subd. 8b.

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Sec. 26.

Subd. 8c.

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Sec. 27.

Subd. 8e.

Sec. 28.

new text begin Subd. 8f. new text end

Sec. 29.

Subd. 13e.

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Sec. 30.

Subd. 13h.

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Sec. 31.

Subd. 17.

Sec. 32.

Subd. 17a.

Sec. 33.

Subd. 18.

Sec. 34.

new text begin Subd. 25b. new text end

Sec. 35.

Subd. 31a.

Sec. 36.

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Sec. 37.

new text begin Subd. 56. new text end

Sec. 38.

new text begin Subd. 57. new text end

new text begin EFFECTIVE DATE. new text end

Sec. 39.

new text begin Subd. 58. new text end

Sec. 40.

new text begin Subd. 59. new text end

Sec. 41.

Subdivision 1.

Sec. 42.

Subd. 2.

Sec. 43.

Subd. 3.

Sec. 44.

Sec. 45.

Subd. 4.

Sec. 46.

new text begin Subd. 8. new text end

Sec. 47.

Subd. 5a.

Sec. 48.

Subd. 5c.

Sec. 49.

Subd. 28.

Sec. 50.

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new text begin EFFECTIVE DATE. new text end

Sec. 51.

new text begin Subd. 32. new text end

Sec. 52.

Subd. 4.

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Sec. 53.

new text begin Subdivision 1. new text end

new text begin Subd. 2. new text end

new text begin Subd. 3. new text end

new text begin Subd. 4. new text end

new text begin Subd. 5. new text end

new text begin Subd. 6. new text end

Sec. 54.

new text begin Subdivision 1. new text end

new text begin Subd. 2. new text end

new text begin Subd. 3. new text end

new text begin Subd. 4. new text end

Sec. 55.

new text begin Subdivision 1. new text end

new text begin Subd. 2. new text end

new text begin Subd. 3. new text end

Sec. 56.

new text begin Subdivision 1. new text end

new text begin Subd. 2. new text end

Sec. 57.

Subd. 3.

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Sec. 58.

Subdivision 1.

Sec. 59.

Subd. 6.

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Sec. 60.

Subd. 7.

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Sec. 61.

Subd. 9.

Sec. 62.

Subd. 10.

Sec. 63.

Subd. 4a.

Sec. 64.

Subd. 3.

Sec. 65.

Subd. 5.

Sec. 66.

new text begin Subdivision 1. new text end

new text begin Subd. 2. new text end

new text begin Subd. 3. new text end

new text begin Subd. 4. new text end

new text begin Subd. 5. new text end

new text begin Subd. 6. new text end

new text begin Subd. 7. new text end

Sec. 67.

Subdivision 1.

Sec. 68.

Subd. 7.

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Sec. 69.

Subd. 10.

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Sec. 70.

Subd. 2.

Sec. 71.

Subd. 3a.

Sec. 72.

new text begin Subd. 6. new text end

Sec. 73.

Subdivision 1.

Sec. 74.

Subd. 7.

Sec. 75.

Subd. 9.

Sec. 76.

Subd. 1a.

Sec. 77. new text begin PLAN TO COORDINATE CARE FOR CHILDREN WITH HIGH-COST
MENTAL HEALTH CONDITIONS.
new text end

Sec. 78. new text begin REGULATORY SIMPLIFICATION AND REDUCTION OF
PROVIDER REPORTING AND DATA SUBMITTAL REQUIREMENTS.
new text end

new text begin Subdivision 1. new text end

new text begin Subd. 2. new text end

new text begin Subd. 3. new text end

Sec. 79. new text begin SPECIALIZED MAINTENANCE THERAPY.
new text end

Sec. 80. new text begin BENEFIT SET OPTIONS.
new text end

Sec. 81. new text begin REDUCING HOSPITALIZATION RATES.
new text end

Sec. 82. new text begin MEDICAID FRAUD PREVENTION AND DETECTION.
new text end

new text begin Subdivision 1. new text end

new text begin Subd. 2. new text end

new text begin Subd. 3. new text end

new text begin Subd. 4. new text end

new text begin Subd. 5. new text end

new text begin Subd. 6. new text end

Sec. 83. new text begin WOUND CARE TREATMENT.
new text end

Sec. 84. new text begin PROHIBITION OF STATE FUNDS TO IMPLEMENT CERTAIN
FEDERAL HEALTH CARE REFORMS.
new text end

new text begin EFFECTIVE DATE. new text end

Sec. 85. new text begin COMMISSIONER'S ACTIONS; REPEAL OF EARLY MEDICAL
ASSISTANCE EXPANSION.
new text end

Sec. 86. new text begin GENERAL ASSISTANCE MEDICAL CARE PROGRAM;
PROVISIONS REVIVED.
new text end

Sec. 87. new text begin REPEALER.
new text end

Sec. 88. new text begin REPEALER.
new text end

Section 1.

new text begin Subdivision 1. new text end

new text begin Subd. 2. new text end

new text begin Subd. 3. new text end

Sec. 2.

Subd. 2a.

Sec. 3.

Subd. 24.

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Sec. 4.

Subd. 29.

new text begin EFFECTIVE DATE. new text end

Sec. 5.

new text begin Subd. 20. new text end

Sec. 6.

new text begin Subd. 5. new text end

Sec. 7.

Subd. 3.

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Sec. 8.

Subd. 9.

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Sec. 9.

Subd. 11.

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Sec. 10.

Subd. 28.

Sec. 11.

Subd. 1a.

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Sec. 12.

Subd. 3a.

new text begin EFFECTIVE DATE. new text end

Sec. 13.

Subd. 4.

Sec. 14.

Subd. 3a.

Sec. 15.

Subd. 3b.

Sec. 16.

Subd. 3e.

Sec. 17.

Subd. 3h.

Sec. 18.

Subd. 10.

Sec. 19.

Subd. 6a.

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Sec. 20.

Subd. 1b.

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Sec. 21.

Subd. 1e.

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Sec. 22.

Subd. 1g.

new text begin EFFECTIVE DATE. new text end

Sec. 23.

Subd. 3.

new text begin EFFECTIVE DATE. new text end

Sec. 24.

Subd. 8.

new text begin EFFECTIVE DATE. new text end

Sec. 25.

new text begin Subdivision 1. new text end

new text begin Subd. 2. new text end

new text begin Subd. 3. new text end

new text begin Subd. 4. new text end

new text begin Subd. 5. new text end

new text begin Subd. 6. new text end

new text begin EFFECTIVE DATE. new text end

Sec. 26.

Subd. 2r.

Sec. 27.

Subd. 32.

Sec. 28.

Subd. 4.

Sec. 29.

Subd. 6.

Sec. 30.

Subd. 50a.

Sec. 31.

new text begin Subd. 61. new text end

Sec. 32.

Subdivision 1.

Sec. 33.

Subd. 13.

new text begin EFFECTIVE DATE. new text end

Sec. 34.

Subd. 14.

new text begin EFFECTIVE DATE. new text end

Sec. 35.

Subd. 15.

new text begin EFFECTIVE DATE. new text end

Sec. 36.

new text begin Subd. 9. new text end

new text begin EFFECTIVE DATE. new text end

Sec. 37.

new text begin Subd. 10. new text end

Sec. 38.

Subd. 6.

new text begin EFFECTIVE DATE. new text end

Sec. 39.

Subd. 8.

Sec. 40. new text begin ESTABLISHMENT OF RATES FOR SHARED HOME AND
COMMUNITY-BASED WAIVER SERVICES.
new text end

Sec. 41. new text begin ESTABLISHMENT OF RATE FOR CASE MANAGEMENT
SERVICES.
new text end

Sec. 42. new text begin RECOMMENDATIONS FOR FURTHER CASE MANAGEMENT
REDESIGN.
new text end

Sec. 43. new text begin MY LIFE, MY CHOICES TASK FORCE.
new text end

new text begin Subdivision 1. new text end

new text begin Subd. 2. new text end

new text begin Subd. 3. new text end

new text begin Subd. 4. new text end

new text begin Subd. 5. new text end

new text begin EFFECTIVE DATE. new text end

Sec. 44. new text begin DIRECTION TO OMBUDSMAN FOR LONG-TERM CARE.
new text end

Sec. 45. new text begin DIRECTION TO COUNTIES.
new text end

Sec. 46. new text begin NURSING FACILITY PILOT PROJECT.
new text end

new text begin Subdivision 1. new text end

new text begin Subd. 2. new text end

Section 1.

new text begin EFFECTIVE DATE. new text end

Sec. 2.

Subd. 7.

Sec. 3.

Subdivision 1.

new text begin Subd. 1a. new text end

Subd. 2.

Sec. 4.

Subdivision 1.

Sec. 5.

Subd. 4.

new text begin EFFECTIVE DATE. new text end

Sec. 6.

Subdivision 1.

new text begin EFFECTIVE DATE. new text end

Sec. 7.

new text begin Subd. 2a. new text end

Sec. 8.

Subd. 2.

new text begin EFFECTIVE DATE. new text end

Sec. 9.

Subd. 41.

new text begin EFFECTIVE DATE. new text end

Sec. 10.

Subd. 4.

new text begin EFFECTIVE DATE. new text end

Sec. 11. new text begin COMMUNITY MENTAL HEALTH SERVICES; USE OF
BEHAVIORAL HEALTH HOSPITALS.
new text end

Sec. 12. new text begin INTEGRATED DUAL DIAGNOSIS TREATMENT.
new text end

Sec. 13. new text begin REGIONAL TREATMENT CENTERS; EMPLOYEES; REPORT.
new text end

Sec. 14. new text begin COMMISSIONER'S CRITERIA FOR RESIDENTIAL TREATMENT.
new text end

Sec. 15. new text begin REPEALER.
new text end

Section 1.

Subd. 14.

Sec. 2.

Subd. 14b.

Sec. 3.

new text begin Subd. 30. new text end

Sec. 4.

Subd. 6.

Sec. 5.

Subd. 3.

Sec. 6.

Subdivision 1.

Sec. 7.

Subd. 10.

Sec. 8.

Subd. 4.

Sec. 9.

Subd. 5.

Sec. 10.

Subdivision 1.

Subd. 2.

Sec. 11.

Subdivision 1.

Subd. 2.

new text begin Subd. 2a. new text end

Subd. 3.

Sec. 12.

Subdivision 1.

Subd. 2.

new text begin Subd. 3. new text end

Sec. 13.

new text begin Subdivision 1. new text end

new text begin Subd. 2. new text end

new text begin Subd. 3. new text end

new text begin Subd. 4. new text end

new text begin Subd. 5. new text end

Sec. 14.

new text begin Subdivision 1. new text end

new text begin Subd. 2. new text end

new text begin Subd. 3. new text end

new text begin Subd. 4. new text end

new text begin Subd. 5. new text end

new text begin Subd. 6. new text end

Sec. 15. new text begin COUNTY ELECTRONIC VERIFICATION PROCEDURES.
new text end

Sec. 16. new text begin ALIGNMENT OF PROGRAM POLICY AND PROCEDURES.
new text end

Sec. 17. new text begin ALTERNATIVE STRATEGIES FOR CERTAIN
REDETERMINATIONS.
new text end

Sec. 18. new text begin SIMPLIFICATION OF ELIGIBILITY AND ENROLLMENT
PROCESS.
new text end

new text begin EFFECTIVE DATE. new text end

Sec. 19. new text begin WHITE EARTH BAND OF OJIBWE HUMAN SERVICES PROJECT.
new text end

Sec. 20. new text begin REPEALER.
new text end

Section 1. new text begin DEPARTMENT OF HUMAN SERVICES FORECAST ADJUSTMENT
APPROPRIATIONS.new text end

Sec. 2. new text begin COMMISSIONER OF HUMAN
SERVICES
new text end

new text begin Subdivision 1. new text end

new text begin Subd. 2. new text end

new text begin Subd. 3. new text end

new text begin Subd. 4. new text end

new text begin Subd. 5. new text end

Sec. 3.

Subd. 6.

Sec. 4. new text begin EFFECTIVE DATE.
new text end

Section 1. new text begin SUMMARY OF APPROPRIATIONS.
new text end

Sec. 2. new text begin HUMAN SERVICES APPROPRIATIONS.new text end

Sec. 3. new text begin COMMISSIONER OF HUMAN
SERVICES
new text end

new text begin Subdivision 1. new text end

new text begin Subd. 2. new text end

new text begin Subd. 3. new text end

new text begin Subd. 4. new text end

new text begin Subd. 5. new text end

new text begin Subd. 6. new text end

new text begin Subd. 7. new text end

Sec. 4. new text begin COMMISSIONER OF HEALTH
new text end

new text begin Subdivision 1. new text end

new text begin Subd. 2. new text end

new text begin Subd. 3. new text end

new text begin Subd. 4. new text end

new text begin Subd. 5. new text end

Sec. 5. new text begin COUNCIL ON DISABILITY
new text end

Sec. 6. new text begin OMBUDSMAN FOR MENTAL
HEALTH AND DEVELOPMENTAL
DISABILITIES
new text end

Sec. 7. new text begin OMBUDSPERSON FOR FAMILIES
new text end

Sec. 8. new text begin HEALTH-RELATED BOARDS
new text end

new text begin Subdivision 1. new text end

new text begin Subd. 2. new text end

new text begin Subd. 3. new text end

new text begin Subd. 4. new text end

new text begin Subd. 5. new text end

new text begin Subd. 6. new text end

new text begin Subd. 7. new text end

new text begin Subd. 8. new text end

new text begin Subd. 9. new text end

new text begin Subd. 10. new text end

new text begin Subd. 11. new text end

new text begin Subd. 12. new text end

new text begin Subd. 13. new text end

new text begin Subd. 14. new text end

new text begin Subd. 15. new text end

new text begin Subd. 16. new text end

Sec. 9. new text begin EMERGENCY MEDICAL SERVICES
REGULATORY BOARD
new text end

Sec. 10.

new text begin Subd. 33. new text end

Sec. 11.

Subd. 6.

Sec. 12. new text begin TRANSFERS.
new text end

new text begin Subdivision 1. new text end

new text begin Subd. 2. new text end

Sec. 13. new text begin INDIRECT COSTS NOT TO FUND PROGRAMS.
new text end

Sec. 14. new text begin EXPIRATION OF UNCODIFIED LANGUAGE.
new text end

Sec. 15. new text begin EFFECTIVE DATE.
new text end

Bill Text Versions

Current Version - 4th Engrossment

Section 1.

Subd. 13.

new text begin EFFECTIVE DATE. new text end

Sec. 2.

Subd. 4.

new text begin EFFECTIVE DATE. new text end

Sec. 3.

new text begin Subd. 9a. new text end

new text begin EFFECTIVE DATE. new text end

Sec. 4.

Subd. 10.

new text begin EFFECTIVE DATE. new text end

Sec. 5.

new text begin Subd. 13. new text end

new text begin EFFECTIVE DATE. new text end

Sec. 6.

new text begin Subd. 1b. new text end

Sec. 7.

Subdivision 1.

new text begin EFFECTIVE DATE. new text end

Sec. 8.

Subd. 1a.

new text begin EFFECTIVE DATE. new text end

Sec. 9.

Subd. 7.

new text begin EFFECTIVE DATE. new text end

Sec. 10.

new text begin Subdivision 1. new text end

new text begin Subd. 2. new text end

new text begin Subd. 3. new text end

new text begin EFFECTIVE DATE. new text end

Sec. 11.

Subd. 12a.

new text begin EFFECTIVE DATE. new text end

Sec. 12.

Subdivision 1.

new text begin EFFECTIVE DATE. new text end

Sec. 13.

Subd. 2.

new text begin EFFECTIVE DATE. new text end

Sec. 14.

Subd. 5.

new text begin EFFECTIVE DATE. new text end

Sec. 15.

Subdivision 1.

new text begin EFFECTIVE DATE. new text end

Sec. 16.

new text begin EFFECTIVE DATE. new text end

Sec. 17.

Subd. 5.

Sec. 18.

Subd. 6.

Sec. 19.

new text begin Subd. 8. new text end

Family.

Assistance.

new text begin Child care centers; assistance. new text end

Payment of funds.

new text begin Child care in the child's home. new text end

new text begin Training required. new text end

Subsidy restrictions.

Legal nonlicensed family child care provider rates.

Absent days.

new text begin Electronic benefit transfer (EBT) card. new text end

new text begin EBT card use restricted to Minnesota vendors. new text end

new text begin Prohibited purchases. new text end

Residentnew text begin ; general assistance medical carenew text end .

Eligibility.

Emergency need.

Special needs.

Eligibility.

Household eligibility; participation.

Withdrawal; matching; permissible uses.

new text begin Supplementary services. new text end

Individual eligibility requirements.

Group residential housing agreements.

Supplementary service rates.

deleted text begin 30-daydeleted text end new text begin 60-daynew text end residency requirement.

Exceptions.

Other property limitations.

new text begin Treatment of Supplemental Security Income. new text end

Work activity.

Approval of postsecondary education or training.

new text begin Scope. new text end

new text begin Adult assistance. new text end

new text begin Commissioner. new text end

new text begin County board. new text end

new text begin Eligible participant. new text end

new text begin Former programs. new text end

new text begin County evaluation. new text end

new text begin Statewide evaluation. new text end

new text begin Assistance. new text end

new text begin Allocation. new text end

Juvenile treatment screening team.

Expedited issuance of food stamps.

new text begin Members. new text end

new text begin Duties. new text end

new text begin Report. new text end

new text begin Expiration. new text end

Consistent administrative expenses and investment income reporting.

Cost containment duties.

Expenditure reporting.

new text begin Exemption. new text end

Definitions.

Application process.

Distribution of funds.

Report.

Other available funds.

Transfers from the commissioner of human services.

Clinical medical education innovations grants.

Federal financial participation.

Review of eligible providers.

new text begin Distribution of funds. new text end

new text begin Data from providers. new text end

new text begin Learning collaborative. new text end

new text begin Comparison data. new text end

new text begin Reporting. new text end

Definitions.

Statewide tobacco prevention grants.

Local tobacco prevention grants.

Standards.

Initial accreditation and annual accreditation renewal.

new text begin Exemption from national standards for quality control and personnel
requirements. new text end

new text begin Exemption from national standards for proficiency testing frequency.
new text end

new text begin Electronic transmission. new text end

Collection and maintenance.

Copy to receiving hospital.

Review.

deleted text begin Penalty. deleted text end

new text begin Working group. new text end

new text begin Definitions. new text end

new text begin Prohibition on cloning. new text end

new text begin Scientific research. new text end

new text begin Penalties. new text end

new text begin Severability. new text end

Eligible organizations; purpose.

Prohibition.

new text begin Establish urban clinic. new text end

new text begin Grant agreements. new text end

new text begin Definitions. new text end

new text begin Allocation of subsidies. new text end

Community grant program; immunization rates and infant mortality
rates.

Community grant program; other health disparities.

Requirements for programs; process.

new text begin Limited food establishment. new text end

new text begin Variance requests. new text end

Tax and use tax on cigarettes.

new text begin Establishment. new text end

new text begin Membership; meetings; staff. new text end

new text begin Duties. new text end

new text begin Report; expiration. new text end

Special family day care homes.

new text begin Children's therapeutic services and supports providers. new text end

new text begin Children's therapeutic services and supports providers. new text end

Level of need determination.

Transportation costs.

new text begin Background studies. new text end

new text begin Spousal contribution. new text end

Renewal fees.

new text begin Animal chiropractic. new text end

Powers.

Issuance.

Registration.

Failure to register.

Reregistration.

Verification.

new text begin Licensure by examination. new text end

new text begin Reexamination fee. new text end

new text begin Licensure by endorsement. new text end

new text begin Registration renewal. new text end

new text begin Reregistration. new text end

new text begin Replacement license. new text end

new text begin Public health nurse certification. new text end

new text begin Drug Enforcement Administration verification for Advanced Practice
Registered Nurse (APRN). new text end

new text begin Licensure verification other than through Nursys. new text end

new text begin Verification of examination scores. new text end

new text begin Microfilmed licensure application materials. new text end

new text begin Nursing business registration; initial application. new text end

new text begin Nursing business registration; annual application. new text end

new text begin Practicing without current registration. new text end

new text begin Practicing without current APRN certification. new text end

new text begin Dishonored check fee. new text end

new text begin Border state registry fee. new text end

new text begin Establishment; membership. new text end

new text begin Duties. new text end

new text begin Organization. new text end

new text begin Fees; Board of Marriage and Family Therapy. new text end

new text begin Licensure and application fees. new text end

new text begin Other fees. new text end

Fee.

Application fees.

Initial license or permit fees.

Annual license fees.

Biennial license or permit fees.

Duplicate license or certificate fee.

new text begin Failure of professional development portfolio audit. new text end

new text begin Application fees. new text end

new text begin Original license fee. new text end

new text begin Annual renewal fees. new text end

new text begin Miscellaneous fees. new text end

new text begin Late fees. new text end

new text begin Reinstatement fees. new text end

new text begin Registration fee. new text end

Renewal fee.

Pharmacy registration.

Nonresident pharmacies.

Sale of federally restricted medical gases.

Requirements.

Research project use of controlled substances.

new text begin Establishment. new text end

new text begin Authority. new text end

new text begin Funding. new text end

new text begin Citation. new text end

new text begin Definitions. new text end

new text begin Statement of public policy. new text end

new text begin Enforcement. new text end

Investigate offenses against provisions of certain designated
sections; assist in enforcement.

Private remedies.

Establishment.

new text begin Required offering. new text end

new text begin Annual deductible; out-of-pocket maximum. new text end

new text begin Office visits for nonpreventive care. new text end

new text begin Preventive care. new text end

new text begin Prescription drugs. new text end

new text begin Convenience care center visits. new text end

new text begin Urgent care center visits. new text end

new text begin Emergency room visits. new text end

new text begin Lab and x-ray; hospital services; ambulance; surgery. new text end

new text begin Eyewear. new text end

new text begin Maternity. new text end

new text begin Other eligible health care services. new text end

new text begin Option to remove mental health and substance abuse coverage.
new text end

new text begin Option to upgrade prescription drug coverage. new text end

new text begin Out-of-network services. new text end

new text begin Services not covered. new text end

new text begin Waiver of preexisting conditions for persons covered by healthy
Minnesota contribution program. new text end

Growth limits; federal programs.

Transfers from the commissioner of human services.

Review of eligible providers.

Provider peer grouping.

Uses of information.

Legislative oversight.

Performance payments.

new text begin Contingency contract fees. new text end

Operating payment rates.

Applications for medical assistance.

Asset limitations for individuals and families.

Income.

Citizenship requirements.

new text begin Evidence-based childbirth program. new text end

Physical therapy.

Occupational therapy.

Speech-language pathology and audiology services.

Care management; rehabilitation services.

Chiropractic services.

new text begin Acupuncture services. new text end

Payment rates.

Medication therapy management services.

Transportation costs.

Payment for ambulance services.

Bus or taxicab transportation.

new text begin Authorization with third-party liability. new text end

Augmentative and alternative communication systems.

new text begin Payment for noncovered services. new text end

new text begin Medical service coordination. new text end

new text begin Payment for Part B Medicare crossover claims. new text end

new text begin Early and periodic screening, diagnosis, and treatment services.
new text end

new text begin Services provided by advanced dental therapists and dental
therapists. new text end

deleted text begin Co-paymentsdeleted text end new text begin Cost-sharingnew text end .

Exceptions.

Collection.

Alternative modelsnew text begin and waivers of requirementsnew text end .

new text begin Coordination with local services. new text end

Managed care contracts.

Medical education and research fund.

Medicare special needs plans; medical assistance basic health care.

new text begin Provider payment rates. new text end

new text begin Health education. new text end

Critical access dental providers.

new text begin Establishment and implementation. new text end

new text begin RFP and project criteria. new text end

new text begin Enrollment. new text end

new text begin Federal approval. new text end

new text begin Project costs. new text end

new text begin Annual reports. new text end

new text begin Intent. new text end

new text begin Waiver application. new text end

new text begin Rulemaking; legislative proposals. new text end

new text begin Joint commission on waiver implementation. new text end

new text begin Goals for reform. new text end

new text begin Reformed medical assistance criteria. new text end

new text begin Annual report. new text end

new text begin Requirements for CHOICE waiver request. new text end

new text begin Agency coordination. new text end

General assistance medical care; eligibility.

Eligibility.

Coordinated care delivery systems.

Payments; rate setting for the deleted text begin hospitaldeleted text end coordinated care delivery
system.

Prescription drug pool.

Assistance for veterans.

Gross individual or gross family income.

Financial management.

deleted text begin Co-payments and coinsurancedeleted text end new text begin Cost-sharingnew text end .

new text begin Defined contributions to enrollees. new text end

new text begin Use of defined contribution; health plan requirements. new text end

new text begin Determination of defined contribution amount. new text end

new text begin Administration by commissioner. new text end

new text begin Assistance to enrollees. new text end

new text begin Minnesota Comprehensive Health Association (MCHA). new text end

new text begin Federal approval. new text end

Families with children.

Single adults and households with no children.

Citizenship requirements.

Commissioner's duties.

Renewal of eligibility.

new text begin Referral of veterans. new text end

General requirements.

Critical access dental providers.

Rate setting; performance withholds.

Payment options.

new text begin Regulatory simplification and report reduction work group. new text end

new text begin Plan development and other duties. new text end

new text begin New reporting and other duties. new text end

new text begin Request for proposals. new text end

new text begin Proof of concept phase. new text end

new text begin Data confidentiality. new text end

new text begin Full implementation phase. new text end

new text begin Selection of vendor. new text end

new text begin Progress report. new text end

new text begin Designation. new text end

new text begin Performance-based organization agreement. new text end

new text begin Duration; legislative approval; reporting. new text end

Contribution amount.

Disability Linkage Line.

State medical review team.

new text begin Money Follows the Person Rebalancing demonstration project. new text end

new text begin Obligation of local agency to process medical assistance applications
within established timelines. new text end

Asset limitations for individuals and families.

Employed persons with disabilities.

Personal care assistant; requirements.

Personal care assistance provider agency; required documentation.

Definitions.

Assessment and support planning.

Eligibility for funding for services for nonmedical assistance recipients.

Elderly waiver cost limits.

Cost limits for elderly waiver applicants who reside in a nursing
facility.

Customized living service rate.

Service rate limits; 24-hour customized living services.

Waiver payment rates; managed care organizations.

Statewide availability of deleted text begin consumer-directed communitydeleted text end new text begin self-directed
new text end support services.

deleted text begin Individual servicedeleted text end new text begin Coordinated services and supportnew text end plan.

new text begin Case management service monitoring, new text end coordination, new text begin and new text end evaluationdeleted text begin ,
and monitoring of servicesdeleted text end new text begin dutiesnew text end .

Conditions not requiring development of deleted text begin individual servicedeleted text end new text begin a
coordinated services and supportnew text end plan.

Authorization and termination of services.

deleted text begin Screening teamdeleted text end new text begin Additional certified assessor new text end duties.

new text begin Scope. new text end

new text begin Duties of the commissioner of human services. new text end

new text begin State Quality Council. new text end

new text begin Regional quality councils. new text end

new text begin Annual survey of service recipients. new text end

new text begin Mandated reporters. new text end

Payment restrictions on leave days.

Payment during first deleted text begin 90deleted text end new text begin 30new text end days.

Alternate rates for nursing facilities.

Planned closure rate adjustment.

Determination of proximity adjustments.

new text begin Rate increase for low-rate facilities. new text end

Prohibited practices.

Case management.

Assessment and reassessment.

deleted text begin Individualized servicedeleted text end new text begin Coordinated services and supportnew text end plannew text begin ;
comprehensive transitional service plan; maintenance service plannew text end .

new text begin ICF/MR rate increase. new text end

new text begin ICF/MR rate adjustment. new text end

Excluded time.

Continuing Care Grants

new text begin Establishment. new text end

new text begin Membership. new text end

new text begin Duties. new text end

new text begin Expense reimbursement. new text end

new text begin Expiration. new text end

new text begin Report. new text end

new text begin Contents of report. new text end

Minnesota extended treatment options.

Cost of care; commitment by tribal court ordernew text begin ; Red Lake
Band of Chippewa Indiansnew text end .

new text begin Cost of care; commitment by tribal court order; White Earth Band of
Ojibwe Indians. new text end

Effect given to tribal commitment order.

Local agency duties.

Division of costs.

Eligibility.

new text begin Eligibility for treatment in residential settings. new text end

Allocation of collections.

Residential services for children with severe emotional disturbance.

Payment rates.

Child welfare reform pilots.

American Indian child welfare projects.

new text begin Provision of required materials in alternative formats. new text end

Recovery of overpayments.

Overpayment of monthly grants and recovery of ATM errors.

Scope of overpayment.

Food stamp program; Maternal and Child Nutrition Act.

Essential human services or essential services.

Service delivery authority.

Duties.

Composition.

Underperforming county; specific service.

Underperforming county; more than one-half of deleted text begin servicedeleted text end new text begin servicesnew text end .

new text begin Financial responsibility of underperforming county. new text end

Conditions prior to imposing remedies.

Council.

Council duties.

new text begin Program evaluation. new text end

new text begin Requirements for establishing a service delivery authority.
new text end

new text begin Relief from statutory requirements. new text end

new text begin Duties. new text end

new text begin Process for establishing a service delivery authority. new text end

new text begin Commissioner authority to seek waivers. new text end

new text begin Application of section. new text end

new text begin Existing majority. new text end

new text begin No existing majority. new text end

new text begin Decertification. new text end

new text begin Continuing contract. new text end

new text begin Contract and representation responsibilities. new text end

new text begin Total Appropriation
new text end

new text begin Revenue and Pass-through
new text end

new text begin Children and Economic Assistance
Grants
new text end

new text begin Basic Health Care Grants
new text end

new text begin Continuing Care Grants
new text end

Health Care Grants

new text begin Total Appropriation
new text end

new text begin Central Office Operations
new text end

new text begin Forecasted Programs
new text end

new text begin Grant Programs
new text end

new text begin State-Operated Services
new text end

new text begin Sex Offender Program
new text end

new text begin Technical Activities
new text end

new text begin Total Appropriation
new text end

new text begin Community and Family Health
Promotion
new text end

new text begin Policy Quality and Compliance
new text end

new text begin Health Protection
new text end

new text begin Administrative Support Services
new text end

new text begin Total Appropriation
new text end

new text begin Board of Chiropractic Examiners
new text end

new text begin Board of Dentistry
new text end

new text begin Board of Dietetic and Nutrition
Practice
new text end

new text begin Board of Marriage and Family
Therapy
new text end

new text begin Board of Medical Practice
new text end

new text begin Board of Nursing
new text end

new text begin Board of Nursing Home
Administrators
new text end

new text begin Board of Optometry
new text end

new text begin Board of Pharmacy
new text end

new text begin Board of Physical Therapy
new text end

new text begin Board of Podiatry
new text end

new text begin Board of Psychology
new text end

new text begin Board of Social Work
new text end

new text begin Board of Veterinary Medicine
new text end

new text begin Board of Behavioral Health and
Therapy
new text end

new text begin Federal administrative reimbursement dedicated. new text end

Continuing Care Grants

new text begin Grants. new text end

new text begin Administration. new text end

Family.

Assistance.

new text begin Child care centers; assistance. new text end

Payment of funds.

new text begin Child care in the child's home. new text end

new text begin Training required. new text end

Subsidy restrictions.

Legal nonlicensed family child care provider rates.

Absent days.

new text begin Electronic benefit transfer (EBT) card. new text end

new text begin EBT card use restricted to Minnesota vendors. new text end

new text begin Prohibited purchases. new text end

Residentnew text begin ; general assistance medical carenew text end .

Eligibility.

Emergency need.

Special needs.

Eligibility.

Household eligibility; participation.

Withdrawal; matching; permissible uses.

Engrossments
Introduction		Posted on 03/10/2011
1st Engrossment		Posted on 03/28/2011
2nd Engrossment		Posted on 03/29/2011
3rd Engrossment		Posted on 03/31/2011
4th Engrossment		Posted on 05/19/2011

Unofficial Engrossments
1st Unofficial Engrossment		Posted on 04/05/2011
2nd Unofficial Engrossment		Posted on 04/07/2011

Conference Committee Reports
CCR-SF0760A		Posted on 05/17/2011

A bill for an act
relating to state government; establishing the health and human services
budget; making changes to children and family services, Department of Health,
miscellaneous provisions, health licensing fees, health care, and continuing
care; redesigning service delivery; making changes to chemical and mental
health; modifying fee schedules; modifying program eligibility requirements;
authorizing rulemaking; imposing criminal penalties; requiring reports;
appropriating money for the Departments of Health and Human Services and
other health-related boards and councils; making forecast adjustments; amending
Minnesota Statutes 2010, sections 8.31, subdivisions 1, 3a; 62D.08, subdivision
7; 62E.08, subdivision 1; 62E.14, by adding a subdivision; 62J.04, subdivisions
3, 9; 62J.17, subdivision 4a; 62J.495, by adding a subdivision; 62J.692; 62Q.32;
62U.04, subdivisions 3, 9; 62U.06, subdivision 2; 119B.011, subdivision 13;
119B.035, subdivision 4; 119B.09, subdivision 10, by adding subdivisions;
119B.125, by adding a subdivision; 119B.13, subdivisions 1, 1a, 7; 144.1501,
subdivision 1; 144.396, subdivisions 5, 6; 144.98, subdivisions 2a, 7, by adding
subdivisions; 144A.102; 144A.61, by adding a subdivision; 144E.123; 145.925,
subdivisions 1, 2; 145.928, subdivisions 7, 8; 145A.17, subdivision 3; 148.07,
subdivision 1; 148.108, by adding a subdivision; 148.191, subdivision 2;
148.212, subdivision 1; 148.231; 148B.17; 148B.33, subdivision 2; 148B.52;
150A.091, subdivisions 2, 3, 4, 5, 8, by adding a subdivision; 151.07; 151.101;
151.102, by adding a subdivision; 151.12; 151.13, subdivision 1; 151.19; 151.25;
151.47, subdivision 1; 151.48; 152.12, subdivision 3; 157.15, by adding a
subdivision; 157.20, by adding a subdivision; 245A.14, subdivision 4; 245C.03,
by adding a subdivision; 245C.10, by adding a subdivision; 246B.10; 252.025,
subdivision 7; 252.27, subdivision 2a; 253B.212; 254B.03, subdivisions 1, 4;
254B.04, subdivision 1, by adding a subdivision; 254B.06, subdivision 2; 256.01,
subdivisions 2b, 14, 14b, 24, 29, by adding a subdivision; 256.969, subdivision
2b; 256B.04, subdivisions 14a, 18, by adding a subdivision; 256B.05, by
adding a subdivision; 256B.056, subdivisions 3, 4; 256B.057, subdivision 9;
256B.06, subdivision 4; 256B.0625, subdivisions 8, 8a, 8b, 8c, 8e, 13e, 13h,
17, 17a, 18, 31a, 41, by adding subdivisions; 256B.0631, subdivisions 1, 2,
3; 256B.0644; 256B.0659, subdivisions 11, 28; 256B.0751, subdivision 4, by
adding a subdivision; 256B.0911, subdivisions 1a, 3a; 256B.0913, subdivision
4; 256B.0915, subdivisions 3a, 3b, 3e, 3h, 10; 256B.0916, subdivision 6a;
256B.092, subdivisions 1b, 1e, 1g, 3, 8; 256B.0943, by adding a subdivision;
256B.0945, subdivision 4; 256B.14, by adding a subdivision; 256B.431,
subdivisions 2r, 32; 256B.434, subdivision 4; 256B.437, subdivision 6;
256B.441, subdivision 50a, by adding a subdivision; 256B.48, subdivision
1; 256B.49, subdivisions 13, 14, 15; 256B.5012, by adding subdivisions;
256B.69, subdivisions 5a, 5c, 28, by adding subdivisions; 256B.76, subdivision
4; 256D.02, subdivision 12a; 256D.03, subdivision 3; 256D.031, subdivisions
1, 6, 7, 9, 10; 256D.05, subdivision 1; 256D.06, subdivision 2; 256D.09,
subdivision 6; 256D.44, subdivision 5; 256D.46, subdivision 1; 256D.47;
256D.49, subdivision 3; 256E.35, subdivisions 5, 6; 256G.02, subdivision
6; 256I.03, by adding a subdivision; 256I.04, subdivisions 1, 2b; 256I.05,
subdivision 1a; 256J.12, subdivisions 1a, 2; 256J.20, subdivision 3; 256J.37, by
adding a subdivision; 256J.38, subdivision 1; 256J.49, subdivision 13; 256J.53,
subdivision 2; 256L.01, subdivision 4a; 256L.02, subdivision 3; 256L.03,
subdivision 5; 256L.04, subdivisions 1, 7, 10; 256L.05, subdivisions 2, 3a, by
adding a subdivision; 256L.07, subdivision 1; 256L.11, subdivision 7; 256L.12,
subdivision 9; 256L.15, subdivision 1a; 260C.157, subdivision 3; 260D.01;
297F.10, subdivision 1; 326B.175; 393.07, subdivisions 10, 10a; 402A.10,
subdivisions 4, 5; 402A.15; 402A.18; 402A.20; 518A.51; Laws 2009, chapter
79, article 13, section 3, subdivision 8, as amended; Laws 2010, First Special
Session chapter 1, article 15, section 3, subdivision 6; article 25, section 3,
subdivision 6; proposing coding for new law in Minnesota Statutes, chapters 1;
15; 62E; 62J; 62U; 145; 148; 151; 214; 256; 256B; 256L; 326B; 402A; proposing
coding for new law as Minnesota Statutes, chapter 256N; repealing Minnesota
Statutes 2010, sections 62J.07, subdivisions 1, 2, 3; 62J.17, subdivisions 1, 3,
5a, 6a, 8; 62J.321, subdivision 5a; 62J.381; 62J.41, subdivisions 1, 2; 144.1464;
144.147; 144.1499; 256.979, subdivisions 5, 6, 7, 10; 256.9791; 256.9862,
subdivision 2; 256B.055, subdivision 15; 256B.057, subdivision 2c; 256B.0756;
256D.01, subdivisions 1, 1a, 1b, 1e, 2; 256D.03, subdivisions 1, 2, 2a; 256D.05,
subdivisions 1, 2, 4, 5, 6, 7, 8; 256D.0513; 256D.06, subdivisions 1, 1b, 2, 5, 7, 8;
256D.09, subdivisions 1, 2, 2a, 2b, 5, 6; 256D.10; 256D.13; 256D.15; 256D.16;
256D.35, subdivision 8b; 256D.46; 256L.07, subdivision 7; 402A.30; 402A.45;
Laws 2008, chapter 358, article 3, sections 8; 9; Laws 2009, chapter 79, article 3,
section 18, as amended; article 5, sections 55, as amended; 56; 57; 60; 61; 62; 63;
64; 65; 66; 68; 69; 79; Minnesota Rules, parts 3400.0130, subpart 8; 4651.0100,
subparts 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 14, 15, 16, 16a, 18, 19, 20, 20a, 21,
22, 23; 4651.0110, subparts 2, 2a, 3, 4, 5; 4651.0120; 4651.0130; 4651.0140;
4651.0150; 9500.1243, subpart 3; 9500.1261, subparts 3, items D, E, 4, 5.

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

Minnesota Statutes 2010, section 119B.011, subdivision 13, is amended to
read:

"Family" means parents, stepparents, guardians and their spouses,
or other eligible relative caregivers and their spouses, and their blood related dependent
children and adoptive siblings under the age of 18 years living in the same home including
children temporarily absent from the household in settings such as schools, foster care, and
residential treatment facilities or parents, stepparents, guardians and their spouses, or other
relative caregivers and their spouses temporarily absent from the household in settings
such as schools, military service, or rehabilitation programs.new text begin An adult family member who
is not in an authorized activity under this chapter may be temporarily absent for up to 60
days.new text end When a minor parent or parents and his, her, or their child or children are living with
other relatives, and the minor parent or parents apply for a child care subsidy, "family"
means only the minor parent or parents and their child or children. An adult age 18 or
older who meets this definition of family and is a full-time high school or postsecondary
student may be considered a dependent member of the family unit if 50 percent or more of
the adult's support is provided by the parents, stepparents, guardians, and their spouses or
eligible relative caregivers and their spouses residing in the same household.

new text begin This section is effective April 16, 2012.
new text end

Minnesota Statutes 2010, section 119B.035, subdivision 4, is amended to read:

(a) A family is limited to a lifetime total of 12 months of
assistance under subdivision 2. The maximum rate of assistance is equal to deleted text begin 90deleted text end new text begin 68new text end percent
of the rate established under section 119B.13 for care of infants in licensed family child
care in the applicant's county of residence.

(b) A participating family must report income and other family changes as specified
in the county's plan under section 119B.08, subdivision 3.

(c) Persons who are admitted to the at-home infant child care program retain their
position in any basic sliding fee program. Persons leaving the at-home infant child care
program reenter the basic sliding fee program at the position they would have occupied.

(d) Assistance under this section does not establish an employer-employee
relationship between any member of the assisted family and the county or state.

new text begin This section is effective October 31, 2011.
new text end

Minnesota Statutes 2010, section 119B.09, is amended by adding a subdivision
to read:

new text begin (a) For the purposes of this subdivision,
"qualifying child" means a child who satisfies both of the following:
new text end

new text begin (1) is not a child or dependent of an employee of the child care provider; and
new text end

new text begin (2) does not reside with an employee of the child care provider.
new text end

new text begin (b) Funds distributed under this chapter must not be paid for child care services
that are provided for a child by a child care provider who employs either the parent of
the child or a person who resides with the child, unless at all times at least 50 percent of
the children for whom the child care provider is providing care are qualifying children
under paragraph (a).
new text end

new text begin (c) If a child care provider satisfies the requirements for payment under paragraph
(b), but the percentage of qualifying children under paragraph (a) for whom the provider
is providing care falls below 50 percent, the provider shall have four weeks to raise the
percentage of qualifying children for whom the provider is providing care to at least 50
percent before payments to the provider are discontinued for child care services provided
for a child who is not a qualifying child.
new text end

new text begin This section is effective January 1, 2013.
new text end

Minnesota Statutes 2010, section 119B.09, subdivision 10, is amended to read:

All federal, state, and local child care funds must
be paid directly to the parent when a provider cares for children in the children's own
home. In all other cases, all federal, state, and local child care funds must be paid directly
to the child care provider, either licensed or legal nonlicensed, on behalf of the eligible
family.new text begin Funds distributed under this chapter must not be used for child care services that
are provided for a child by a child care provider who resides in the same household or
occupies the same residence as the child.
new text end

new text begin This section is effective March 5, 2012.
new text end

Minnesota Statutes 2010, section 119B.09, is amended by adding a subdivision
to read:

new text begin Child care assistance must only be
authorized in the child's home if the child's parents have authorized activities outside of
the home and if one or more of the following circumstances are met:
new text end

new text begin (1) the parents' qualifying activity occurs during times when out-of-home care is
not available. If child care is needed during any period when out-of-home care is not
available, in-home care can be approved for the entire time care is needed;
new text end

new text begin (2) the family lives in an area where out-of-home care is not available; or
new text end

new text begin (3) a child has a verified illness or disability that would place the child or other
children in an out-of-home facility at risk or creates a hardship for the child and the family
to take the child out of the home to a child care home or center.
new text end

new text begin This section is effective March 5, 2012.
new text end

Minnesota Statutes 2010, section 119B.125, is amended by adding a subdivision
to read:

new text begin (a) Effective November 1, 2011, prior to initial
authorization as required in subdivision 1, a legal nonlicensed family child care provider
must complete first aid and CPR training and provide the verification of first aid and CPR
training to the county. The training documentation must have valid effective dates as of
the date the registration request is submitted to the county and the training must have been
provided by an individual approved to provide first aid and CPR instruction.
new text end

new text begin (b) Legal nonlicensed family child care providers with an authorization effective
before November 1, 2011, must be notified of the requirements before October 1, 2011, or
at authorization, and must meet the requirements upon renewal of an authorization that
occurs on or after January 1, 2012.
new text end

new text begin (c) Upon each reauthorization after the authorization period when the initial first aid
and CPR training requirements are met, a legal nonlicensed family child care provider
must provide verification of at least eight hours of additional training listed in the
Minnesota Center for Professional Development Registry.
new text end

new text begin (d) This subdivision only applies to legal nonlicensed family child care providers.
new text end

Minnesota Statutes 2010, section 119B.13, subdivision 1, is amended to read:

(a) Beginning deleted text begin July 1, 2006deleted text end new text begin October 31, 2011new text end ,
the maximum rate paid for child care assistance in any county or multicounty region under
the child care fund shall be the rate for like-care arrangements in the county effective
deleted text begin Januarydeleted text end new text begin July new text end 1, 2006, deleted text begin increaseddeleted text end new text begin decreased new text end by deleted text begin sixdeleted text end new text begin five new text end percent.

deleted text begin (b) Rate changes shall be implemented for services provided in September 2006
unless a participant eligibility redetermination or a new provider agreement is completed
between July 1, 2006, and August 31, 2006.
deleted text end

deleted text begin As necessary, appropriate notice of adverse action must be made according to
Minnesota Rules, part 3400.0185, subparts 3 and 4.
deleted text end

deleted text begin New cases approved on or after July 1, 2006, shall have the maximum rates under
paragraph (a), implemented immediately.
deleted text end

deleted text begin (c)deleted text end new text begin (b) new text end Every year, the commissioner shall survey rates charged by child care
providers in Minnesota to determine the 75th percentile for like-care arrangements in
counties. When the commissioner determines that, using the commissioner's established
protocol, the number of providers responding to the survey is too small to determine
the 75th percentile rate for like-care arrangements in a county or multicounty region,
the commissioner may establish the 75th percentile maximum rate based on like-care
arrangements in a county, region, or category that the commissioner deems to be similar.

deleted text begin (d)deleted text end new text begin (c) new text end A rate which includes a special needs rate paid under subdivision 3 or under a
school readiness service agreement paid under section 119B.231, may be in excess of the
maximum rate allowed under this subdivision.

deleted text begin (e)deleted text end new text begin (d) new text end The department shall monitor the effect of this paragraph on provider rates.
The county shall pay the provider's full charges for every child in care up to the maximum
established. The commissioner shall determine the maximum rate for each type of care
on an hourly, full-day, and weekly basis, including special needs and disability care.new text begin The
maximum payment to a provider for one day of care must not exceed the daily rate. The
maximum payment to a provider for one week of care must not exceed the weekly rate.
new text end

new text begin (e) Child care providers receiving reimbursement under this chapter must not be
paid activity fees or an additional amount above the maximum rates for care provided
during nonstandard hours for families receiving assistance.
new text end

(f) When the provider charge is greater than the maximum provider rate allowed,
the parent is responsible for payment of the difference in the rates in addition to any
family co-payment fee.

(g) All maximum provider rates changes shall be implemented on the Monday
following the effective date of the maximum provider rate.

new text begin Paragraph (d) is effective April 16, 2012. Paragraph (e)
is effective September 3, 2012.
new text end

Minnesota Statutes 2010, section 119B.13, subdivision 1a, is amended to read:

(a) Legal
nonlicensed family child care providers receiving reimbursement under this chapter must
be paid on an hourly basis for care provided to families receiving assistance.

(b) The maximum rate paid to legal nonlicensed family child care providers must be
deleted text begin 80deleted text end new text begin 68new text end percent of the county maximum hourly rate for licensed family child care providers.
In counties where the maximum hourly rate for licensed family child care providers is
higher than the maximum weekly rate for those providers divided by 50, the maximum
hourly rate that may be paid to legal nonlicensed family child care providers is the rate
equal to the maximum weekly rate for licensed family child care providers divided by 50
and then multiplied by deleted text begin 0.80deleted text end new text begin 0.68. The maximum payment to a provider for one day of care
must not exceed the maximum hourly rate times ten. The maximum payment to a provider
for one week of care must not exceed the maximum hourly rate times 50new text end .

(c) A rate which includes a special needs rate paid under subdivision 3 may be in
excess of the maximum rate allowed under this subdivision.

(d) Legal nonlicensed family child care providers receiving reimbursement under
this chapter may not be paid registration fees for families receiving assistance.

new text begin This section is effective April 16, 2012, except the
amendment changing 80 to 68 and 0.80 to 0.68 is effective October 31, 2011.
new text end

Minnesota Statutes 2010, section 119B.13, subdivision 7, is amended to read:

(a) new text begin Licensed new text end child care providers deleted text begin maydeleted text end new text begin and license-exempt
centers mustnew text end not be reimbursed for more than deleted text begin 25deleted text end new text begin tennew text end full-day absent days per child,
excluding holidays, in a fiscal yeardeleted text begin , or for more than ten consecutive full-day absent days,
unless the child has a documented medical condition that causes more frequent absences.
Absences due to a documented medical condition of a parent or sibling who lives in the
same residence as the child receiving child care assistance do not count against the 25-day
absent day limit in a fiscal year. Documentation of medical conditions must be on the
forms and submitted according to the timelines established by the commissioner. A public
health nurse or school nurse may verify the illness in lieu of a medical practitioner. If a
provider sends a child home early due to a medical reason, including, but not limited to,
fever or contagious illness, the child care center director or lead teacher may verify the
illness in lieu of a medical practitionerdeleted text end .new text begin Legal nonlicensed family child care providers
must not be reimbursed for absent days.new text end If a child attends for part of the time authorized to
be in care in a day, but is absent for part of the time authorized to be in care in that same
day, the absent time deleted text begin willdeleted text end new text begin mustnew text end be reimbursed but the time deleted text begin willdeleted text end new text begin mustnew text end not count toward the
ten deleted text begin consecutive or 25 cumulativedeleted text end absent day deleted text begin limitsdeleted text end new text begin limitnew text end . deleted text begin Children in families where at
least one parent is under the age of 21, does not have a high school or general equivalency
diploma, and is a student in a school district or another similar program that provides or
arranges for child care, as well as parenting, social services, career and employment
supports, and academic support to achieve high school graduation, may be exempt from
the absent day limits upon request of the program and approval of the county. If a child
attends part of an authorized day, payment to the provider must be for the full amount
of care authorized for that day.deleted text end Child care providers deleted text begin maydeleted text end new text begin mustnew text end only be reimbursed for
absent days if the provider has a written policy for child absences and charges all other
families in care for similar absences.

(b) Child care providers must be reimbursed for up to ten federal or state holidays
or designated holidays per year when the provider charges all families for these days
and the holiday or designated holiday falls on a day when the child is authorized to be
in attendance. Parents may substitute other cultural or religious holidays for the ten
recognized state and federal holidays. Holidays do not count toward the ten deleted text begin consecutive
or 25 cumulativedeleted text end absent day deleted text begin limitsdeleted text end new text begin limitnew text end .

(c) A family or child care provider deleted text begin maydeleted text end new text begin mustnew text end not be assessed an overpayment for an
absent day payment unless (1) there was an error in the amount of care authorized for the
family, (2) all of the allowed full-day absent payments for the child have been paid, or (3)
the family or provider did not timely report a change as required under law.

(d) The deleted text begin provider and family must receive notification of the number of absent days
used upon initial provider authorization for a family and when the family has used 15
cumulative absent days. Upon statewide implementation of the Minnesota Electronic
Child Care System, thedeleted text end provider and family shall receive notification of the number of
absent days used upon initial provider authorization for a family and ongoing notification
of the number of absent days used as of the date of the notification.

deleted text begin (e) A county may pay for more absent days than the statewide absent day policy
established under this subdivision if current market practice in the county justifies payment
for those additional days. County policies for payment of absent days in excess of the
statewide absent day policy and justification for these county policies must be included in
the county's child care fund plan under section 119B.08, subdivision 3.
deleted text end

new text begin This section is effective January 1, 2013.
new text end

new text begin Cash benefits for the
general assistance and Minnesota supplemental aid programs under chapter 256D and
programs under chapter 256J must be issued on a separate EBT card with the name of the
head of household printed on the card. The card must include the following statement: "It
is unlawful to use this card to purchase tobacco products or alcoholic beverages." This
card must be issued within 30 calendar days of an eligibility determination. During the
initial 30 calendar days of eligibility, a recipient may have cash benefits issued on an EBT
card without a name printed on the card. This card may be the same card on which food
support benefits are issued and does not need to meet the requirements of this section.
new text end

new text begin EBT cardholders
receiving cash benefits under the general assistance and Minnesota supplemental aid
programs under chapter 256D or programs under chapter 256J are prohibited from using
their EBT cards at vendors located outside of Minnesota. This subdivision does not apply
to food support benefits.
new text end

new text begin EBT debit cardholders in programs listed under
subdivision 1 are prohibited from using the EBT debit card to purchase tobacco products
and alcoholic beverages, as defined in section 340A.101, subdivision 2. It is unlawful for
an EBT cardholder to purchase or attempt to purchase tobacco products or alcoholic
beverages with the cardholder's EBT card. Violation of this subdivision is a petty
misdemeanor. A retailer must not be held liable for the crime of another under section
609.05, for actions taken under this subdivision.
new text end

new text begin Subdivisions 1 and 2 of this section are effective June 1, 2012.
new text end

Minnesota Statutes 2010, section 256D.02, subdivision 12a, is amended to
read:

(a) For purposes of
eligibility for deleted text begin general assistance anddeleted text end general assistance medical care, a person must be a
resident of this state.

(b) A "resident" is a person living in the state for at least 30 days with the intention of
making the person's home here and not for any temporary purpose. Time spent in a shelter
for battered women shall count toward satisfying the 30-day residency requirement. All
applicants for these programs are required to demonstrate the requisite intent and can do
so in any of the following ways:

(1) by showing that the applicant maintains a residence at a verified address, other
than a place of public accommodation. An applicant may verify a residence address by
presenting a valid state driver's licensedeleted text begin ,deleted text end new text begin ;new text end a state identification carddeleted text begin ,deleted text end new text begin ;new text end a voter registration
carddeleted text begin ,deleted text end new text begin ;new text end a rent receiptdeleted text begin ,deleted text end new text begin ;new text end a statement by the landlord, apartment manager, or homeowner
verifying that the individual is residing at the addressdeleted text begin ,deleted text end new text begin ;new text end or other form of verification
approved by the commissioner; or

(2) by verifying residence according to Minnesota Rules, part 9500.1219, subpart
3, item C.

(c) For general assistance medical care, a county agency shall waive the 30-day
residency requirement in cases of medical emergencies. deleted text begin For general assistance, a county
shall waive the 30-day residency requirement where unusual hardship would result from
denial of general assistance. For purposes of this subdivision, "unusual hardship" means
the applicant is without shelter or is without available resources for food.
deleted text end

The county agency must report to the commissioner within 30 days on any waiver
granted under this section. The county shall not deny an application solely because the
applicant does not meet at least one of the criteria in this subdivision, but shall continue to
process the application and leave the application pending until the residency requirement
is met or until eligibility or ineligibility is established.

(d)deleted text begin For purposes of paragraph (c), the following definitions apply (1) "metropolitan
statistical area" is as defined by the United States Census Bureau; (2) "shelter" includes
any shelter that is located within the metropolitan statistical area containing the county
and for which the applicant is eligible, provided the applicant does not have to travel more
than 20 miles to reach the shelter and has access to transportation to the shelter. Clause (2)
does not apply to counties in the Minneapolis-St. Paul metropolitan statistical area.
deleted text end

deleted text begin (e)deleted text end Migrant workers as defined in section 256J.08 and, until March 31, 1998, their
immediate families are exempt from the residency requirements of this section, provided
the migrant worker provides verification that the migrant family worked in this state
within the last 12 months and earned at least $1,000 in gross wages during the time the
migrant worker worked in this state.

deleted text begin (f) For purposes of eligibility for emergency general assistance, the 30-day residency
requirement under this section shall not be waived.
deleted text end

deleted text begin (g)deleted text end new text begin (e)new text end If any provision of this subdivision is enjoined from implementation or found
unconstitutional by any court of competent jurisdiction, the remaining provisions shall
remain valid and shall be given full effect.

new text begin This section is effective October 1, 2012.
new text end

Minnesota Statutes 2010, section 256D.05, subdivision 1, is amended to read:

(a) Each assistance unit with income and resources
less than the standard of assistance established by the commissioner and with a member
who is a resident of the state shall be eligible for and entitled to general assistance if
the assistance unit is:

(1) a person who is suffering from a professionally certified permanent or temporary
illness, injury, or incapacity which is expected to continue for more than deleted text begin 30deleted text end new text begin 90new text end days and
which prevents the person from obtaining or retaining employment;

deleted text begin (2) a person whose presence in the home on a substantially continuous basis is
required because of the professionally certified illness, injury, incapacity, or the age of
another member of the household;
deleted text end

deleted text begin (3)deleted text end new text begin (2)new text end a person who has been placed in, and is residing in, a licensed or certified
facility for purposes of physical or mental health or rehabilitation, or in an approved
chemical dependency domiciliary facility, if the placement is based on illness or incapacity
and is according to a plan developed or approved by the county agency through its
director or designated representative;

deleted text begin (4)deleted text end new text begin (3)new text end a person who resides in a shelter facility described in subdivision 3;

deleted text begin (5)deleted text end new text begin (4)new text end a person not described in clause (1) or deleted text begin (3)deleted text end new text begin (2)new text end who is diagnosed by a licensed
physician, psychological practitioner, or other qualified professional, as developmentally
disabled or mentally ill, and that condition prevents the person from obtaining or retaining
employment;

deleted text begin (6) a person who has an application pending for, or is appealing termination of
benefits from, the Social Security disability program or the program of supplemental
security income for the aged, blind, and disabled, provided the person has a professionally
certified permanent or temporary illness, injury, or incapacity which is expected to
continue for more than 30 days and which prevents the person from obtaining or retaining
employment;
deleted text end

deleted text begin (7) a person who is unable to obtain or retain employment because advanced age
significantly affects the person's ability to seek or engage in substantial work;
deleted text end

deleted text begin (8)deleted text end new text begin (5)new text end a person who has been assessed by a vocational specialist and, in consultation
with the county agency, has been determined to be unemployable for purposes of this
clause; a person is considered employable if there exist positions of employment in the
local labor market, regardless of the current availability of openings for those positions,
that the person is capable of performing. The person's eligibility under this category must
be reassessed at least annually. The county agency must provide notice to the person not
later than 30 days before annual eligibility under this item ends, informing the person of the
date annual eligibility will end and the need for vocational assessment if the person wishes
to continue eligibility under this clause. For purposes of establishing eligibility under this
clause, it is the applicant's or recipient's duty to obtain any needed vocational assessment;

deleted text begin (9)deleted text end new text begin (6)new text end a person who is determined by the county agency, according to permanent
rules adopted by the commissioner, to deleted text begin be learning disableddeleted text end new text begin have a condition that qualifies
under Minnesota's special education rules as a specific learning disabilitynew text end , provided that deleted text begin ifdeleted text end
a rehabilitation plan for the person is developed or approved by the county agency, new text begin andnew text end
the person is following the plan;

deleted text begin (10)deleted text end new text begin (7)new text end a child under the age of 18 who is not living with a parent, stepparent, or
legal custodian, and only if: the child is legally emancipated or living with an adult with
the consent of an agency acting as a legal custodian; the child is at least 16 years of age
and the general assistance grant is approved by the director of the county agency or a
designated representative as a component of a social services case plan for the child; or the
child is living with an adult with the consent of the child's legal custodian and the county
agency. For purposes of this clause, "legally emancipated" means a person under the age
of 18 years who: (i) has been married; (ii) is on active duty in the uniformed services of
the United States; (iii) has been emancipated by a court of competent jurisdiction; or (iv)
is otherwise considered emancipated under Minnesota law, and for whom county social
services has not determined that a social services case plan is necessary, for reasons other
than the child has failed or refuses to cooperate with the county agency in developing
the plan;

deleted text begin (11)deleted text end new text begin (8)new text end a person who is eligible for displaced homemaker services, programs, or
assistance under section 116L.96, but only if that person is enrolled as a full-time student;

deleted text begin (12) a person who lives more than four hours round-trip traveling time from any
potential suitable employment;
deleted text end

deleted text begin (13)deleted text end new text begin (9)new text end a person who is involved with protective or court-ordered services that
prevent the applicant or recipient from working at least four hours per day;new text begin or
new text end

deleted text begin (14) a person over age 18 whose primary language is not English and who is
attending high school at least half time; or
deleted text end

deleted text begin (15)deleted text end new text begin (10)new text end a person whose alcohol and drug addiction is a material factor that
contributes to the person's disability; applicants who assert this clause as a basis for
eligibility must be assessed by the county agency to determine if they are amenable
to treatment; if the applicant is determined to be not amenable to treatment, but is
otherwise eligible for benefits, then general assistance must be paid in vendor form, for
the individual's shelter costs up to the limit of the grant amount, with the residual, if
any, paid according to section 256D.09, subdivision 2a; if the applicant is determined
to be amenable to treatment, then in order to receive benefits, the applicant must be in
a treatment program or on a waiting list and the benefits must be paid in vendor form,
for the individual's shelter costs, up to the limit of the grant amount, with the residual, if
any, paid according to section 256D.09, subdivision 2a.

(b) As a condition of eligibility under paragraph (a), clauses (1), deleted text begin (3)deleted text end new text begin (2)new text end , deleted text begin (5)deleted text end new text begin (4)new text end ,
deleted text begin (8)deleted text end new text begin (5)new text end , and deleted text begin (9)deleted text end new text begin (6)new text end , the recipient must complete an interim assistance agreement and
must apply for other maintenance benefits as specified in section 256D.06, subdivision
5, and must comply with efforts to determine the recipient's eligibility for those other
maintenance benefits.

(c) The burden of providing documentation for a county agency to use to verify
eligibility for general assistance or for exemption from the food stamp employment
and training program is upon the applicant or recipient. The county agency shall use
documents already in its possession to verify eligibility, and shall help the applicant or
recipient obtain other existing verification necessary to determine eligibility which the
applicant or recipient does not have and is unable to obtain.

new text begin This section is effective May 1, 2012.
new text end

Minnesota Statutes 2010, section 256D.06, subdivision 2, is amended to read:

new text begin (a) new text end Notwithstanding the provisions of subdivision 1, a
grant of emergency general assistance shall, to the extent funds are available, be made to
an eligible single adult, married couple, or family for an emergency needdeleted text begin , as defined in
rules promulgated by the commissioner,deleted text end where the recipient requests temporary assistance
not exceeding 30 days if an emergency situation appears to exist deleted text begin and the individual or
family is ineligible for MFIP or DWP or is not a participant of MFIP or DWPdeleted text end new text begin under
written criteria adopted by the county agencynew text end . If an applicant or recipient relates facts
to the county agency which may be sufficient to constitute an emergency situation, the
county agency shall, to the extent funds are available, advise the person of the procedure
for applying for assistance according to this subdivision.

new text begin (b) The applicant must be ineligible for assistance under chapter 256J, must have
annual net income no greater than 200 percent of the federal poverty guidelines for the
previous calendar year, and may receive new text end an emergency deleted text begin generaldeleted text end assistance grant deleted text begin is available
to a recipientdeleted text end not more than once in any 12-month period.

new text begin (c) new text end Funding for an emergency general assistance program is limited to the
appropriation. Each fiscal year, the commissioner shall allocate to counties the money
appropriated for emergency general assistance grants based on each county agency's
average share of state's emergency general expenditures for the immediate past three fiscal
years as determined by the commissioner, and may reallocate any unspent amounts to
other counties. new text begin No county shall be allocated less than $1,000 for a fiscal year.
new text end

new text begin (d) new text end Any emergency general assistance expenditures by a county above the amount of
the commissioner's allocation to the county must be made from county funds.

new text begin This section is effective November 1, 2011.
new text end

Minnesota Statutes 2010, section 256D.44, subdivision 5, is amended to read:

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.

deleted text begin (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:
deleted text end

deleted text begin (1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;
deleted text end

deleted text begin (2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent
of thrifty food plan;
deleted text end

deleted text begin (3) controlled protein diet, less than 40 grams and requires special products, 125
percent of thrifty food plan;
deleted text end

deleted text begin (4) low cholesterol diet, 25 percent of thrifty food plan;
deleted text end

deleted text begin (5) high residue diet, 20 percent of thrifty food plan;
deleted text end

deleted text begin (6) pregnancy and lactation diet, 35 percent of thrifty food plan;
deleted text end

deleted text begin (7) gluten-free diet, 25 percent of thrifty food plan;
deleted text end

deleted text begin (8) lactose-free diet, 25 percent of thrifty food plan;
deleted text end

deleted text begin (9) antidumping diet, 15 percent of thrifty food plan;
deleted text end

deleted text begin (10) hypoglycemic diet, 15 percent of thrifty food plan; or
deleted text end

deleted text begin (11) ketogenic diet, 25 percent of thrifty food plan.
deleted text end

deleted text begin (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.
deleted text end

deleted text begin (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.
deleted text end

deleted text begin (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,
deleted text end deleted text begin 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.
deleted text end

deleted text begin (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.
deleted text end

deleted text begin (f)deleted text end new text begin (a)new text end (1) deleted text begin Notwithstanding the language in this subdivision,deleted text end 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, unless allowed under paragraph deleted text begin (g)deleted text end new text begin (b)new text end .

(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,deleted text end new text begin (b) new text end To access housing and services as provided
in paragraph deleted text begin (f)deleted text end new text begin (a)new text end , the recipient may choose housing that may be owned, operated, or
controlled by the recipient's service provider. In a multifamily building of four or more
units, the maximum number of apartments that may be used by recipients of this program
shall be 50 percent of the units in a building. This paragraph expires on June 30, 2012.

new text begin This section is effective August 1, 2011.
new text end

Minnesota Statutes 2010, section 256D.46, subdivision 1, is amended to read:

deleted text begin A county agency must grant emergency Minnesota
supplemental aid, to the extent funds are available, if the recipient is without adequate
resources to resolve an emergency that, if unresolved, will threaten the health or safety of
the recipient. For the purposes of this section, the term "recipient" includes persons for
whom a group residential housing benefit is being paid under sections 256I.01 to 256I.06.deleted text end new text begin
Applicants for or recipients of SSI or Minnesota supplemental aid who have emergency
need may apply for emergency general assistance under section 256D.06, subdivision 2.new text end

new text begin This section is effective November 1, 2011.
new text end

Minnesota Statutes 2010, section 256D.47, is amended to read:

Minnesota supplemental aid payments must be issued to the recipient, a protective
payee, or a conservator or guardian of the recipient's estate in the form of county warrants
immediately redeemable in cash, electronic benefits transfer, or by direct deposit into the
recipient's account in a financial institution. Minnesota supplemental aid payments must
be issued regularly on the first day of the month. The supplemental aid warrants must be
mailed only to the address at which the recipient resides, unless another address has been
approved in advance by the county agency. Vendor payments must not be issued by the
county agency except for nonrecurring emergency need payments; at the request of the
recipient; fdeleted text begin or special needs, other than special diets;deleted text end or when the agency determines the
need for protective payments exist.

new text begin This section is effective August 1, 2011.
new text end

Minnesota Statutes 2010, section 256E.35, subdivision 5, is amended to read:

(a) To be eligible for deleted text begin state or TANFdeleted text end
matching funds in the family assets for independence initiative, a household must meet the
eligibility requirements of the federal Assets for Independence Act, Public Law 105-285,
in Title IV, section 408 of that act.

(b) Each participating household must sign a family asset agreement that includes
the amount of scheduled deposits into its savings account, the proposed use, and the
proposed savings goal. A participating household must agree to complete an economic
literacy training program.

Participating households may only deposit money that is derived from household
earned income or from state and federal income tax credits.

Minnesota Statutes 2010, section 256E.35, subdivision 6, is amended to read:

(a) To receive a match, a
participating household must transfer funds withdrawn from a family asset account to its
matching fund custodial account held by the fiscal agent, according to the family asset
agreement. The fiscal agent must determine if the match request is for a permissible use
consistent with the household's family asset agreement.

The fiscal agent must ensure the household's custodial account contains the
applicable matching funds to match the balance in the household's account, including
interest, on at least a quarterly basis and at the time of an approved withdrawal. deleted text begin Matches
must be provided as follows:
deleted text end

deleted text begin (1) from state grant and TANF funds a matching contribution of $1.50 for every $1
of funds withdrawn from the family asset account equal to the lesser of $720 per year or a
$3,000 lifetime limit; and
deleted text end

deleted text begin (2) from nonstate funds, a matching contribution of no less than $1.50 for every $1
of funds withdrawn from the family asset account equal to the lesser of $720 per year or
a $3,000 lifetime limit.
deleted text end

(b) Upon receipt of transferred custodial account funds, the fiscal agent must make a
direct payment to the vendor of the goods or services for the permissible use.

Minnesota Statutes 2010, section 256I.03, is amended by adding a subdivision
to read:

new text begin "Supplementary services" means services
provided to residents of group residential housing providers in addition to room and
board including, but not limited to, oversight and up to 24-hour supervision, medication
reminders, assistance with transportation, arranging for meetings and appointments, and
arranging for medical and social services.
new text end

Minnesota Statutes 2010, section 256I.04, subdivision 1, is amended to read:

An individual is eligible for
and entitled to a group residential housing payment to be made on the individual's behalf
if the county agency has approved the individual's residence in a group residential housing
setting and the individual meets the requirements in deleted text begin paragraph (a) or (b)deleted text end new text begin this sectionnew text end .

(a) The individual is aged, blind, or is over 18 years of age and disabled as
determined under the criteria used by the title II program of the Social Security Act,
and meets the resource restrictions and standards of the supplemental security income
program, and the individual's countable income after deducting the (1) exclusions and
disregards of the SSI program, (2) the medical assistance personal needs allowance
under section 256B.35, and (3) an amount equal to the income actually made available
to a community spouse by an elderly waiver recipient under the provisions of sections
256B.0575, paragraph (a), clause (4), and 256B.058, subdivision 2, is less than the
monthly rate specified in the county agency's agreement with the provider of group
residential housing in which the individual resides.

deleted text begin (b) The individual meets a category of eligibility under section 256D.05, subdivision
1, paragraph (a), and the individual's resources are less than the standards specified by
section 256D.08, and the individual's countable income as determined under sections
256D.01 to 256D.21, less the medical assistance personal needs allowance under section
256B.35 is less than the monthly rate specified in the county agency's agreement with the
provider of group residential housing in which the individual resides.
deleted text end

new text begin (b) Each individual with income and resources less than the standard of assistance
established by the commissioner and who is a resident of the state shall be eligible for and
entitled to group residential housing if the assistance unit is:
new text end

new text begin (1) a person who is suffering from a professionally certified permanent or temporary
illness, injury, or incapacity which is expected to continue for more than 90 days and
which prevents the person from obtaining or retaining employment;
new text end

new text begin (2) a person who has been placed in, and is residing in, a licensed or certified facility
for purposes of physical or mental health or rehabilitation, or in an approved chemical
dependency domiciliary facility, if the placement is based on illness or incapacity and is
according to a plan developed or approved by the county agency through its director or
designated representative;
new text end

new text begin (3) a person not described in clause (1) or (2) who is diagnosed by a licensed
physician, psychological practitioner, or other qualified professional, as developmentally
disabled or mentally ill, and that condition prevents the person from obtaining or retaining
employment;
new text end

new text begin (4) a person who has been assessed by a vocational specialist and, in consultation
with the county agency, has been determined to be unemployable for purposes of this
clause; a person is considered employable if there exist positions of employment in the
local labor market, regardless of the current availability of openings for those positions,
that the person is capable of performing. The person's eligibility under this category must
be reassessed at least annually. The county agency must provide notice to the person not
later than 30 days before annual eligibility under this item ends, informing the person of the
date annual eligibility will end and the need for vocational assessment if the person wishes
to continue eligibility under this clause. For purposes of establishing eligibility under this
clause, it is the applicant's or recipient's duty to obtain any needed vocational assessment;
new text end

new text begin (5) a person who is determined by the county agency, according to permanent rules
adopted by the commissioner, to have a condition that qualifies under Minnesota's special
education rules as a specific learning disability, provided that a rehabilitation plan for
the person is developed or approved by the county agency, and the person is following
the plan; or
new text end

new text begin (6) a person whose alcohol and drug addiction is a material factor that contributes
to the person's disability.
new text end

new text begin (c) As a condition of eligibility under paragraph (b), the recipient must complete an
interim assistance agreement and must apply for other maintenance benefits as specified in
section 256N.35, and must comply with efforts to determine the recipient's eligibility for
those other maintenance benefits.
new text end

new text begin (d) As a condition of eligibility under this section, the recipient must complete
at least 20 hours per month of volunteer or paid work. The county of residence shall
determine what may be included as volunteer work. Recipients must provide monthly
proof of volunteer work on the forms established by the county. A person who is unable
to obtain or retain 20 hours per month of volunteer or paid work due to a professionally
certified illness, injury, disability, or incapacity must not be made ineligible for group
residential housing under this section.
new text end

new text begin (e) The burden of providing documentation for a county agency to use to verify
eligibility under this section is upon the applicant or recipient. The county agency shall
use documents already in its possession to verify eligibility, and shall help the applicant or
recipient obtain other existing verification necessary to determine eligibility which the
applicant or recipient does not have and is unable to obtain.
new text end

new text begin This section is effective October 1, 2012.
new text end

Minnesota Statutes 2010, section 256I.04, subdivision 2b, is amended to read:

new text begin (a) new text end Agreements between county
agencies and providers of group residential housing must be in writing and must specify
the name and address under which the establishment subject to the agreement does
business and under which the establishment, or service provider, if different from the
group residential housing establishment, is licensed by the Department of Health or the
Department of Human Services; the specific license or registration from the Department
of Health or the Department of Human Services held by the provider and the number
of beds subject to that license; the address of the location or locations at which group
residential housing is provided under this agreement; the per diem and monthly rates that
are to be paid from group residential housing funds for each eligible resident at each
location; the number of beds at each location which are subject to the group residential
housing agreement; whether the license holder is a not-for-profit corporation under section
501(c)(3) of the Internal Revenue Code; and a statement that the agreement is subject to
the provisions of sections 256I.01 to 256I.06 and subject to any changes to those sections.
Group residential housing agreements may be terminated with or without cause by either
the county or the provider with two calendar months prior notice.

new text begin (b) Counties must not enter into agreements with providers of group residential
housing that are licensed as board and lodging with special services and that do not include
a residency requirement of at least 20 hours per month of volunteer or paid work. A person
who is unable to obtain or retain 20 hours per month of volunteer or paid work due to a
professionally certified illness, injury, disability, or incapacity must not be made ineligible
for group residential housing under this section. This paragraph does not apply to group
residential housing providers who serve people aged 21 or younger if the residents are
required to attend school or improve independent living skills.
new text end

new text begin This section is effective May 1, 2012.
new text end

Minnesota Statutes 2010, section 256I.05, subdivision 1a, is amended to read:

(a) Subject to the provisions of section
256I.04, subdivision 3, the county agency may negotiate a payment not to exceed $426.37
for other services necessary to provide room and board provided by the group residence
if the residence is licensed by or registered by the Department of Health, or licensed by
the Department of Human Services to provide services in addition to room and board,
and if the provider of services is not also concurrently receiving funding for services for
a recipient under a home and community-based waiver under title XIX of the Social
Security Act; or funding from the medical assistance program under section 256B.0659,
for personal care services for residents in the setting; or residing in a setting which
receives funding under Minnesota Rules, parts 9535.2000 to 9535.3000. If funding is
available for other necessary services through a home and community-based waiver, or
personal care services under section 256B.0659, then the GRH rate is limited to the rate
set in subdivision 1. Unless otherwise provided in law, in no case may the supplementary
service rate exceed $426.37. The registration and licensure requirement does not apply to
establishments which are exempt from state licensure because they are located on Indian
reservations and for which the tribe has prescribed health and safety requirements. Service
payments under this section may be prohibited under rules to prevent the supplanting of
federal funds with state funds. The commissioner shall pursue the feasibility of obtaining
the approval of the Secretary of Health and Human Services to provide home and
community-based waiver services under title XIX of the Social Security Act for residents
who are not eligible for an existing home and community-based waiver due to a primary
diagnosis of mental illness or chemical dependency and shall apply for a waiver if it is
determined to be cost-effective.

(b) The commissioner is authorized to make cost-neutral transfers from the GRH
fund for beds under this section to other funding programs administered by the department
after consultation with the county or counties in which the affected beds are located.
The commissioner may also make cost-neutral transfers from the GRH fund to county
human service agencies for beds permanently removed from the GRH census under a plan
submitted by the county agency and approved by the commissioner. The commissioner
shall report the amount of any transfers under this provision annually to the legislature.

(c) The provisions of paragraph (b) do not apply to a facility that has its
reimbursement rate established under section 256B.431, subdivision 4, paragraph (c).

new text begin (d) Counties must not negotiate supplementary service rates with providers of group
residential housing that are licensed as board and lodging with special services and that
do not encourage a policy of sobriety on their premises.
new text end

new text begin This section is effective May 1, 2012.
new text end

Minnesota Statutes 2010, section 256J.12, subdivision 1a, is amended to read:

An assistance unit is considered
to have established residency in this state only when a child or caregiver has resided in this
state for at least deleted text begin 30deleted text end new text begin 60new text end consecutive days with the intention of making the person's home
here and not for any temporary purpose. The birth of a child in Minnesota to a member
of the assistance unit does not automatically establish the residency in this state under
this subdivision of the other members of the assistance unit. Time spent in a shelter for
battered women shall count toward satisfying the deleted text begin 30-daydeleted text end new text begin 60-daynew text end residency requirement.

Minnesota Statutes 2010, section 256J.12, subdivision 2, is amended to read:

(a) deleted text begin A county shall waive the 30-day residency requirement
where unusual hardship would result from denial of assistance.
deleted text end

deleted text begin (b) For purposes of this section, unusual hardship means an assistance unit:
deleted text end

deleted text begin (1) is without alternative shelter; or
deleted text end

deleted text begin (2) is without available resources for food.
deleted text end

deleted text begin (c) For purposes of this subdivision, the following definitions apply (1) "metropolitan
statistical area" is as defined by the U.S. Census Bureau; (2) "alternative shelter" includes
any shelter that is located within the metropolitan statistical area containing the county and
for which the family is eligible, provided the assistance unit does not have to travel more
deleted text end deleted text begin than 20 miles to reach the shelter and has access to transportation to the shelter. Clause (2)
does not apply to counties in the Minneapolis-St. Paul metropolitan statistical area.
deleted text end

deleted text begin (d)deleted text end Applicants are considered to meet the residency requirement under subdivision
1a if they once resided in Minnesota and:

(1) joined the United States armed services, returned to Minnesota within 30 days of
leaving the armed services, and intend to remain in Minnesota; or

(2) left to attend school in another state, paid nonresident tuition or Minnesota
tuition rates under a reciprocity agreement, and returned to Minnesota within 30 days of
graduation with the intent to remain in Minnesota.

deleted text begin (e)deleted text end new text begin (b)new text end The deleted text begin 30-daydeleted text end new text begin 60-daynew text end residence requirement is met when:

(1) a minor child or a minor caregiver moves from another state to the residence of
a relative caregiver; and

(2) the relative caregiver has resided in Minnesota for at least deleted text begin 30deleted text end new text begin 60new text end consecutive
days and:

(i) the minor caregiver applies for and receives MFIP; or

(ii) the relative caregiver applies for assistance for the minor child but does not
choose to be a member of the MFIP assistance unit.

Minnesota Statutes 2010, section 256J.20, subdivision 3, is amended to read:

To be eligible for MFIP, the equity value of
all nonexcluded real and personal property of the assistance unit must not exceed $2,000
for applicants and $5,000 for ongoing participants. The value of assets in clauses (1) to
(19) must be excluded when determining the equity value of real and personal property:

(1) a licensed vehicle up to a loan value of less than or equal to deleted text begin $15,000deleted text end new text begin $10,000new text end . If
the assistance unit owns more than one licensed vehicle, the county agency shall determine
the loan value of all additional vehicles and exclude the combined loan value of less than
or equal to $7,500. The county agency shall apply any excess loan value as if it were
equity value to the asset limit described in this section, excluding: (i) the value of one
vehicle per physically disabled person when the vehicle is needed to transport the disabled
unit member; this exclusion does not apply to mentally disabled people; (ii) the value of
special equipment for a disabled member of the assistance unit; and (iii) any vehicle used
for long-distance travel, other than daily commuting, for the employment of a unit member.

To establish the loan value of vehicles, a county agency must use the N.A.D.A.
Official Used Car Guide, Midwest Edition, for newer model cars. When a vehicle is not
listed in the guidebook, or when the applicant or participant disputes the loan value listed
in the guidebook as unreasonable given the condition of the particular vehicle, the county
agency may require the applicant or participant document the loan value by securing a
written statement from a motor vehicle dealer licensed under section 168.27, stating
the amount that the dealer would pay to purchase the vehicle. The county agency shall
reimburse the applicant or participant for the cost of a written statement that documents
a lower loan value;

(2) the value of life insurance policies for members of the assistance unit;

(3) one burial plot per member of an assistance unit;

(4) the value of personal property needed to produce earned income, including
tools, implements, farm animals, inventory, business loans, business checking and
savings accounts used at least annually and used exclusively for the operation of a
self-employment business, and any motor vehicles if at least 50 percent of the vehicle's use
is to produce income and if the vehicles are essential for the self-employment business;

(5) the value of personal property not otherwise specified which is commonly
used by household members in day-to-day living such as clothing, necessary household
furniture, equipment, and other basic maintenance items essential for daily living;

(6) the value of real and personal property owned by a recipient of Supplemental
Security Income or Minnesota supplemental aid;

(7) the value of corrective payments, but only for the month in which the payment
is received and for the following month;

(8) a mobile home or other vehicle used by an applicant or participant as the
applicant's or participant's home;

(9) money in a separate escrow account that is needed to pay real estate taxes or
insurance and that is used for this purpose;

(10) money held in escrow to cover employee FICA, employee tax withholding,
sales tax withholding, employee worker compensation, business insurance, property rental,
property taxes, and other costs that are paid at least annually, but less often than monthly;

(11) monthly assistance payments for the current month's or short-term emergency
needs under section 256J.626, subdivision 2;

(12) the value of school loans, grants, or scholarships for the period they are
intended to cover;

(13) payments listed in section 256J.21, subdivision 2, clause (9), which are held
in escrow for a period not to exceed three months to replace or repair personal or real
property;

(14) income received in a budget month through the end of the payment month;

(15) savings from earned income of a minor child or a minor parent that are set aside
in a separate account designated specifically for future education or employment costs;

(16) the federal earned income credit, Minnesota working family credit, state and
federal income tax refunds, state homeowners and renters credits under chapter 290A,
property tax rebates and other federal or state tax rebates in the month received and the
following month;

(17) payments excluded under federal law as long as those payments are held in a
separate account from any nonexcluded funds;

(18) the assets of children ineligible to receive MFIP benefits because foster care or
adoption assistance payments are made on their behalf; and

(19) the assets of persons whose income is excluded under section 256J.21,
subdivision 2, clause (43).

new text begin This section is effective October 1, 2011.
new text end

Minnesota Statutes 2010, section 256J.37, is amended by adding a subdivision
to read:

new text begin The county shall reduce
the cash portion of the MFIP grant by $50 per adult SSI recipient who resides in the
household, and who would otherwise be included in the MFIP assistance unit under
section 256J.24, subdivision 2, but is excluded solely due to the SSI recipient status under
section 256J.24, subdivision 3, paragraph (a), clause (1). If the SSI recipient receives less
than $50 of SSI, only the amount received shall be used in calculating the MFIP cash
assistance payment. This provision does not apply to relative caregivers who could elect
to be included in the MFIP assistance unit under section 256J.24, subdivision 4, unless the
caregiver's children or stepchildren are included in the MFIP assistance unit.
new text end

new text begin This section is effective May 1, 2012.
new text end

Minnesota Statutes 2010, section 256J.49, subdivision 13, is amended to read:

new text begin (a) new text end "Work activity" means any activity in a participant's
approved employment plan that leads to employment. For purposes of the MFIP program,
this includes activities that meet the definition of work activity under the participation
requirements of TANF. Work activity includes:

(1) unsubsidized employment, including work study and paid apprenticeships or
internships;

(2) subsidized private sector or public sector employment, including grant diversion
as specified in section 256J.69, on-the-job training as specified in section 256J.66, paid
work experience, and supported work when a wage subsidy is provided;

(3) unpaid work experience, including community service, volunteer work,
the community work experience program as specified in section 256J.67, unpaid
apprenticeships or internships, and supported work when a wage subsidy is not provided.
Unpaid work experience is only an option if the participant has been unable to obtain or
maintain paid employment in the competitive labor market, and no paid work experience
programs are available to the participant. Prior to placing a participant in unpaid work,
the county must inform the participant that the participant will be notified if a paid work
experience or supported work position becomes available. Unless a participant consents in
writing to participate in unpaid work experience, the participant's employment plan may
only include unpaid work experience if including the unpaid work experience in the plan
will meet the following criteria:

(i) the unpaid work experience will provide the participant specific skills or
experience that cannot be obtained through other work activity options where the
participant resides or is willing to reside; and

(ii) the skills or experience gained through the unpaid work experience will result
in higher wages for the participant than the participant could earn without the unpaid
work experience;

(4) job search including job readiness assistance, job clubs, job placement,
job-related counseling, and job retention services;

(5) job readiness education, including English as a second language (ESL) or
functional work literacy classes as limited by the provisions of section 256J.531,
subdivision 2, general educational development (GED) course work, high school
completion, and adult basic education as limited by the provisions of section 256J.531,
subdivision 1;

(6) job skills training directly related to employment, including education and
training that can reasonably be expected to lead to employment, as limited by the
provisions of section 256J.53;

(7) providing child care services to a participant who is working in a community
service program;

(8) activities included in the employment plan that is developed under section
256J.521, subdivision 3; and

(9) preemployment activities including chemical and mental health assessments,
treatment, and services; learning disabilities services; child protective services; family
stabilization services; or other programs designed to enhance employability.

new text begin (b) "Work activity" does not include activities done for political purposes as defined
in section 211B.01, subdivision 6.
new text end

Minnesota Statutes 2010, section 256J.53, subdivision 2, is amended to read:

(a) In order for a
postsecondary education or training program to be an approved activity in an employment
plan, the deleted text begin plan must include additional work activities if the education and training
activities do not meet the minimum hours required to meet the federal work participation
rate under Code of Federal Regulations, title 45, sections 261.31 and 261.35deleted text end new text begin participant
must be working in unsubsidized employment at least 10 hours per weeknew text end .

(b) Participants seeking approval of a postsecondary education or training plan
must provide documentation that:

(1) the employment goal can only be met with the additional education or training;

(2) there are suitable employment opportunities that require the specific education or
training in the area in which the participant resides or is willing to reside;

(3) the education or training will result in significantly higher wages for the
participant than the participant could earn without the education or training;

(4) the participant can meet the requirements for admission into the program; and

(5) there is a reasonable expectation that the participant will complete the training
program based on such factors as the participant's MFIP assessment, previous education,
training, and work history; current motivation; and changes in previous circumstances.

new text begin (c) The hourly unsubsidized employment requirement does not apply for intensive
education or training programs lasting 12 weeks or less when full-time attendance is
required.
new text end

new text begin The adult assistance grant program is a capped allocation to counties that can be
spent in a flexible manner, to the extent funds are available, for adult assistance.
new text end

new text begin This section is effective October 1, 2012.
new text end

new text begin For the purposes of sections 256N.01 to 256N.80, the terms
defined in this section have the meanings given them.
new text end

new text begin "Adult assistance" means a capped allocation provided
or arranged for by county boards for ongoing emergency needs, special diets, or special
needs as determined by the county.
new text end

new text begin "Commissioner" means the commissioner of human
services.
new text end

new text begin "County board" means the board of county commissioners
in each county.
new text end

new text begin "Eligible participant" means low-income adults who
meet the residency requirements under section 256N.22, and who were previously eligible
for programs under subdivision 6 are eligible for adult assistance. The commissioner may
develop more specific eligibility criteria.
new text end

new text begin "Former programs" means funding for:
new text end

new text begin (1) general assistance;
new text end

new text begin (2) emergency general assistance;
new text end

new text begin (3) emergency supplemental aid; and
new text end

new text begin (4) Minnesota supplemental aid special needs and special diets.
new text end

new text begin This section is effective October 1, 2012.
new text end

new text begin (a) For purposes of eligibility for adult assistance, a person must be a resident of
this state.
new text end

new text begin (b) A "resident" is a person living in the state for at least 60 days with the intention of
making the person's home here and not for any temporary purpose. Time spent in a shelter
for battered women shall count toward satisfying the 60-day residency requirement. All
applicants for these programs are required to demonstrate the requisite intent and may do
so in any of the following ways:
new text end

new text begin (1) by showing that the applicant maintains a residence at a verified address, other
than a place of public accommodation. An applicant may verify a residence address by
presenting a valid state driver's license, a state identification card, a voter registration
card, or a rent receipt; or
new text end

new text begin (2) by verifying residence according to Minnesota Rules, part 9500.1219, subpart
3, item C.
new text end

new text begin (c) The county shall not deny an application solely because the applicant does not
meet at least one of the criteria in this subdivision, but shall continue to process the
application and leave the application pending until the residency requirement is met or
until eligibility or ineligibility is established.
new text end

new text begin (d) If any provision of this subdivision is enjoined from implementation or found
unconstitutional by any court of competent jurisdiction, the remaining provisions shall
remain valid and shall be given full effect.
new text end

new text begin This section is effective October 1, 2012.
new text end

new text begin Each county shall submit to the commissioner
data from the past calendar year on the outcomes and performance indicators, and
information as to how grant funds are being spent on the target population. The
commissioner shall prescribe standard methods to be used by the counties in providing
the data. The data shall be submitted no later than March 1 of each year, beginning with
March 1, 2013. The commissioner shall define outcomes and performance indicators.
new text end

new text begin Six months after the end of the first full calendar
year and biennially thereafter, the commissioner shall prepare a report on the counties'
progress in improving the outcomes of adults related to safety and well-being. This report
shall be disseminated electronically throughout the state.
new text end

new text begin This section is effective October 1, 2012.
new text end

new text begin (a) Counties may use the capped allocation for adult
assistance for individuals under section 256N.20, subdivision 2.
new text end

new text begin (b) The county agency shall, within available appropriations, provide a personal
needs allowance to individuals eligible for group residential housing under section
256I.04, subdivision 1, paragraph (b), and to other individuals who reside in licensed
residential facilities other than group residential housing. The county may determine the
amount of the personal needs allowance based on the individual's net income and need.
new text end

new text begin (c) In determining the amount of assistance, the county shall disregard the first
$150 of earned income per month. In addition, the county shall disregard additional
earned income up to a maximum of $500 per month for individuals residing in facilities or
group residential housing for whom the county agency has approved a discharge plan that
includes work. The additional amount disregarded must be placed in a separate savings
account by the eligible individual, to be used upon discharge from the residential facility
into the community, up to a maximum of $2,000.
new text end

new text begin (d) The county shall give priority to eligible individuals who are enrolled in a
12-month residential chemical dependency treatment program.
new text end

new text begin Funding for the adult assistance grant program is limited to the
appropriation. The commissioner shall allocate to counties the money appropriated for the
program based on each county agency's average share of the state's former programs under
section 256N.20, subdivision 6. The commissioner may reallocate any unspent amounts
to other counties. No county shall be allocated less than $1,000 for the fiscal year. Any
adult assistance aid expenditures by a county above the amount of the commissioner's
allocation to the county must be made from county funds.
new text end

new text begin This section is effective October 1, 2012.
new text end

new text begin (a) Any applicant, otherwise eligible for adult assistance and possibly eligible for
federal maintenance benefits from any other source shall: (1) make application for those
benefits within 30 days of the adult assistance application; and (2) execute an interim
assistance authorization on a form as directed by the commissioner.
new text end

new text begin (b) The commissioner shall review a denial of an application for other federal
maintenance benefits and may require a recipient of adult assistance to file an appeal of
the denial if appropriate.
new text end

new text begin (c) If found eligible for maintenance benefits, and maintenance benefits were
received during the period in which adult assistance was also being received, the recipient
shall be required to reimburse the state for the interim assistance paid. Reimbursement
shall not exceed the amount of adult assistance paid during the time period to which the
other maintenance benefits apply.
new text end

new text begin (d) The commissioner may contract with the county agencies, qualified agencies,
organizations, or persons to provide advocacy and support services to process claims for
federal disability benefits for applicants or recipients of services or benefits supervised by
the commissioner using money retained under this section.
new text end

new text begin (e) The commissioner may provide methods by which county agencies shall identify,
refer, and assist recipients who may be eligible for benefits under federal programs for the
disabled.
new text end

new text begin (f) The total amount of interim assistance recoveries retained under this section
for advocacy, support, and claim processing services shall not exceed 35 percent of the
interim assistance recoveries in the prior fiscal year.
new text end

new text begin This section is effective October 1, 2012.
new text end

Minnesota Statutes 2010, section 260C.157, subdivision 3, is amended to read:

(a) The responsible social services
agency shall establish a juvenile treatment screening team to conduct screenings and
prepare case plans under deleted text begin this subdivisiondeleted text end new text begin section 245.487, subdivision 3, and chapters
260C and 260D. Screenings shall be conducted within 15 days of a request for a screeningnew text end .
The team, which may be the team constituted under section 245.4885 or 256B.092 or
Minnesota Rules, parts 9530.6600 to 9530.6655, shall consist of social workers, juvenile
justice professionals, and persons with expertise in the treatment of juveniles who are
emotionally disabled, chemically dependent, or have a developmental disabilitydeleted text begin . The team
shall involve parents or guardians in the screening process as appropriatedeleted text end new text begin , and the child's
parent, guardian, or permanent legal custodian under section 260C.201, subdivision 11new text end .
The team may be the same team as defined in section 260B.157, subdivision 3.

(b) The social services agency shall determine whether a child brought to its
attention for the purposes described in this section is an Indian child, as defined in section
260C.007, subdivision 21, and shall determine the identity of the Indian child's tribe, as
defined in section 260.755, subdivision 9. When a child to be evaluated is an Indian child,
the team provided in paragraph (a) shall include a designated representative of the Indian
child's tribe, unless the child's tribal authority declines to appoint a representative. The
Indian child's tribe may delegate its authority to represent the child to any other federally
recognized Indian tribe, as defined in section 260.755, subdivision 12.

(1) for the primary purpose of treatment for an emotional disturbance, a
developmental disability, or chemical dependency in a residential treatment facility out
of state or in one which is within the state and licensed by the commissioner of human
services under chapter 245A; or

(2) in any out-of-home setting potentially exceeding 30 days in duration, including a
postdispositional placement in a facility licensed by the commissioner of corrections or
human services, the court shall ascertain whether the child is an Indian child and shall
notify the county welfare agency and, if the child is an Indian child, shall notify the Indian
child's tribe. The county's juvenile treatment screening team must either: (i) screen and
evaluate the child and file its recommendations with the court within 14 days of receipt
of the notice; or (ii) elect not to screen a given case and notify the court of that decision
within three working days.

(d) deleted text begin If the screening team has elected to screen and evaluate the child,deleted text end The child
may not be placed for the primary purpose of treatment for an emotional disturbance, a
developmental disability, or chemical dependency, in a residential treatment facility out of
state nor in a residential treatment facility within the state that is licensed under chapter
245A, unless one of the following conditions applies:

(1) a treatment professional certifies that an emergency requires the placement
of the child in a facility within the state;

(2) the screening team has evaluated the child and recommended that a residential
placement is necessary to meet the child's treatment needs and the safety needs of the
community, that it is a cost-effective means of meeting the treatment needs, and that it
will be of therapeutic value to the child; or

(3) the court, having reviewed a screening team recommendation against placement,
determines to the contrary that a residential placement is necessary. The court shall state
the reasons for its determination in writing, on the record, and shall respond specifically
to the findings and recommendation of the screening team in explaining why the
recommendation was rejected. The attorney representing the child and the prosecuting
attorney shall be afforded an opportunity to be heard on the matter.

(e) When the county's juvenile treatment screening team has elected to screen and
evaluate a child determined to be an Indian child, the team shall provide notice to the
tribe or tribes that accept jurisdiction for the Indian child or that recognize the child as a
member of the tribe or as a person eligible for membership in the tribe, and permit the
tribe's representative to participate in the screening team.

(f) When the Indian child's tribe or tribal health care services provider or Indian
Health Services provider proposes to place a child for the primary purpose of treatment
for an emotional disturbance, a developmental disability, or co-occurring emotional
disturbance and chemical dependency, the Indian child's tribe or the tribe delegated by
the child's tribe shall submit necessary documentation to the county juvenile treatment
screening team, which must invite the Indian child's tribe to designate a representative to
the screening team.

Minnesota Statutes 2010, section 260D.01, is amended to read:

(a) Sections 260D.01 to 260D.10, may be cited as the "child in voluntary foster care
for treatment" provisions of the Juvenile Court Act.

(b) The juvenile court has original and exclusive jurisdiction over a child in
voluntary foster care for treatment upon the filing of a report or petition required under
this chapter. All obligations of the agency to a child and family in foster care contained in
chapter 260C not inconsistent with this chapter are also obligations of the agency with
regard to a child in foster care for treatment under this chapter.

(c) This chapter shall be construed consistently with the mission of the children's
mental health service system as set out in section 245.487, subdivision 3, and the duties
of an agency under section 256B.092, new text begin 260C.157, new text end and Minnesota Rules, parts 9525.0004
to 9525.0016, to meet the needs of a child with a developmental disability or related
condition. This chapter:

(1) establishes voluntary foster care through a voluntary foster care agreement as the
means for an agency and a parent to provide needed treatment when the child must be in
foster care to receive necessary treatment for an emotional disturbance or developmental
disability or related condition;

(2) establishes court review requirements for a child in voluntary foster care for
treatment due to emotional disturbance or developmental disability or a related condition;

(3) establishes the ongoing responsibility of the parent as legal custodian to visit the
child, to plan together with the agency for the child's treatment needs, to be available and
accessible to the agency to make treatment decisions, and to obtain necessary medical,
dental, and other care for the child; and

(4) applies to voluntary foster care when the child's parent and the agency agree that
the child's treatment needs require foster care either:

(i) due to a level of care determination by the agency's screening team informed by
the diagnostic and functional assessment under section 245.4885; or

(ii) due to a determination regarding the level of services needed by the responsible
social services' screening team under section 256B.092, and Minnesota Rules, parts
9525.0004 to 9525.0016.

(d) This chapter does not apply when there is a current determination under section
626.556 that the child requires child protective services or when the child is in foster care
for any reason other than treatment for the child's emotional disturbance or developmental
disability or related condition. When there is a determination under section 626.556 that
the child requires child protective services based on an assessment that there are safety
and risk issues for the child that have not been mitigated through the parent's engagement
in services or otherwise, or when the child is in foster care for any reason other than
the child's emotional disturbance or developmental disability or related condition, the
provisions of chapter 260C apply.

(e) The paramount consideration in all proceedings concerning a child in voluntary
foster care for treatment is the safety, health, and the best interests of the child. The
purpose of this chapter is:

(1) to ensure a child with a disability is provided the services necessary to treat or
ameliorate the symptoms of the child's disability;

(2) to preserve and strengthen the child's family ties whenever possible and in the
child's best interests, approving the child's placement away from the child's parents only
when the child's need for care or treatment requires it and the child cannot be maintained
in the home of the parent; and

(3) to ensure the child's parent retains legal custody of the child and associated
decision-making authority unless the child's parent willfully fails or is unable to make
decisions that meet the child's safety, health, and best interests. The court may not find
that the parent willfully fails or is unable to make decisions that meet the child's needs
solely because the parent disagrees with the agency's choice of foster care facility, unless
the agency files a petition under chapter 260C, and establishes by clear and convincing
evidence that the child is in need of protection or services.

(f) The legal parent-child relationship shall be supported under this chapter by
maintaining the parent's legal authority and responsibility for ongoing planning for the
child and by the agency's assisting the parent, where necessary, to exercise the parent's
ongoing right and obligation to visit or to have reasonable contact with the child. Ongoing
planning means:

(1) actively participating in the planning and provision of educational services,
medical, and dental care for the child;

(2) actively planning and participating with the agency and the foster care facility
for the child's treatment needs; and

(3) planning to meet the child's need for safety, stability, and permanency, and the
child's need to stay connected to the child's family and community.

(g) The provisions of section 260.012 to ensure placement prevention, family
reunification, and all active and reasonable effort requirements of that section apply. This
chapter shall be construed consistently with the requirements of the Indian Child Welfare
Act of 1978, United States Code, title 25, section 1901, et al., and the provisions of the
Minnesota Indian Family Preservation Act, sections 260.751 to 260.835.

Minnesota Statutes 2010, section 393.07, subdivision 10a, is amended to read:

The commissioner of human
services shall continually monitor the expedited issuance of food stamp benefits to ensure
that each county complies with federal regulations and that households eligible for
expedited issuance of food stamps are identified, processed, and certified within the time
frames prescribed in federal regulations.

County food stamp offices shall screen deleted text begin and issue food stamps todeleted text end applicants on the
day of application. Applicants who meet the federal criteria for expedited issuance and
have an immediate need for food assistance shall receive deleted text begin either:deleted text end new text begin within five working days
new text end

deleted text begin (1) a manual Authorization to Participate (ATP) card; or
deleted text end

deleted text begin (2)deleted text end the deleted text begin immediatedeleted text end issuance of food stamp deleted text begin couponsdeleted text end new text begin benefitsnew text end .

The local food stamp agency shall conspicuously post in each food stamp office a
notice of the availability of and the procedure for applying for expedited issuance and
verbally advise each applicant of the availability of the expedited process.

Minnesota Statutes 2010, section 518A.51, is amended to read:

(a) When a recipient of IV-D services is no longer receiving assistance under the
state's title IV-A, IV-E foster care, medical assistance, or MinnesotaCare programs, the
public authority responsible for child support enforcement must notify the recipient,
within five working days of the notification of ineligibility, that IV-D services will be
continued unless the public authority is notified to the contrary by the recipient. The
notice must include the implications of continuing to receive IV-D services, including the
available services and fees, cost recovery fees, and distribution policies relating to fees.

(b) An application fee of $25 shall be paid by the person who applies for child
support and maintenance collection services, except persons who are receiving public
assistance as defined in section 256.741 and the diversionary work program under section
256J.95, persons who transfer from public assistance to nonpublic assistance status, and
minor parents and parents enrolled in a public secondary school, area learning center, or
alternative learning program approved by the commissioner of education.

(c) In the case of an individual who has never received assistance under a state
program funded under Title IV-A of the Social Security Act and for whom the public
authority has collected at least $500 of support, the public authority must impose an
annual federal collections fee of $25 for each case in which services are furnished. This
fee must be retained by the public authority from support collected on behalf of the
individual, but not from the first $500 collected.

(d) When the public authority provides full IV-D services to an obligee who has
applied for those services, upon written notice to the obligee, the public authority must
charge a cost recovery fee of one percent of the amount collected. This fee must be
deducted from the amount of the child support and maintenance collected and not assigned
under section 256.741 before disbursement to the obligee. This fee does not apply to an
obligee who:

(1) is currently receiving assistance under the state's title IV-A, IV-E foster care,
medical assistance, or MinnesotaCare programs; or

(2) has received assistance under the state's title IV-A or IV-E foster care programs,
until the person has not received this assistance for 24 consecutive months.

(e) When the public authority provides full IV-D services to an obligor who has
applied for such services, upon written notice to the obligor, the public authority must
charge a cost recovery fee of one percent of the monthly court-ordered child support and
maintenance obligation. The fee may be collected through income withholding, as well
as by any other enforcement remedy available to the public authority responsible for
child support enforcement.

(f) Fees assessed by state and federal tax agencies for collection of overdue support
owed to or on behalf of a person not receiving public assistance must be imposed on the
person for whom these services are provided. The public authority upon written notice to
the obligee shall assess a fee of $25 to the person not receiving public assistance for each
successful federal tax interception. The fee must be withheld prior to the release of the
funds received from each interception and deposited in the general fund.

(g) Federal collections fees collected under paragraph (c) and cost recovery
fees collected under paragraphs (d) and (e)new text begin , retained by the commissioner of human
services,new text end shall be considered child support program income according to Code of Federal
Regulations, title 45, section 304.50, and shall be deposited in the special revenue fund
account established under paragraph (i). The commissioner of human services must elect
to recover costs based on either actual or standardized costs.

(h) The limitations of this section on the assessment of fees shall not apply to
the extent inconsistent with the requirements of federal law for receiving funds for the
programs under Title IV-A and Title IV-D of the Social Security Act, United States Code,
title 42, sections 601 to 613 and United States Code, title 42, sections 651 to 662.

(i) The commissioner of human services is authorized to establish a special revenue
fund account to receive the federal collections fees collected under paragraph (c) and cost
recovery fees collected under paragraphs (d) and (e). A portion of the nonfederal share of
these fees may be retained for expenditures necessary to administer the fees and must be
transferred to the child support system special revenue account. deleted text begin The remaining nonfederal
share of the federal collections fees and cost recovery fees must be retained by the
commissioner and dedicated to the child support general fund county performance-based
grant account authorized under sections 256.979 and 256.9791.deleted text end new text begin The commissioner shall
distribute the remaining nonfederal share of these fees to the counties quarterly using the
methodology specified in section 256.979, subdivision 11. The funds received by the
counties must be reinvested in the child support enforcement program, and the counties
shall not reduce the funding of their child support programs by the amount of funding
distributed.
new text end

new text begin Liquor stores, tobacco stores, gambling establishments, and tattoo parlors must
negotiate with their third-party processors to block EBT card cash transactions at their
places of business and withdrawals of cash at automatic teller machines located in their
places of business.
new text end

new text begin The Minnesota EBT Business Task Force includes seven
members, appointed as follows:
new text end

new text begin (1) two members of the Minnesota house of representatives appointed by the speaker
of the house;
new text end

new text begin (2) two members of the Minnesota senate appointed by the senate majority leader;
new text end

new text begin (3) the commissioner of human services, or designee;
new text end

new text begin (4) an appointee of the Minnesota Grocers Association; and
new text end

new text begin (5) a credit card processor, appointed by the commissioner of human services.
new text end

new text begin The Minnesota EBT Business Task Force shall create a workable
strategy to eliminate the purchase of tobacco and alcoholic beverages by recipients of the
general assistance program and Minnesota supplemental aid program under Minnesota
Statutes, chapter 256D, and programs under Minnesota Statutes, chapter 256J, using EBT
cards. The task force will consider cost to the state, feasibility of execution at retail, and
ease of use and privacy for EBT cardholders.
new text end

new text begin The task force will report back to the legislative committees with
jurisdiction over health and human services policy and finance by April 1, 2012, with
recommendations related to the task force duties under subdivision 2.
new text end

new text begin The task force expires on June 30, 2012.
new text end

new text begin The commissioner of human services and county human services representatives, in
consultation with other interested parties, shall develop a streamlined alternative to current
reporting requirements related to the Children and Community Services Act service plan.
The commissioner shall submit recommendations and draft legislation to the chairs and
ranking minority members of the committees having jurisdiction over human services no
later than November 15, 2012.
new text end

new text begin The revisor of statutes shall make conforming amendments and correct statutory
cross-references as necessitated by the creation of Minnesota Statutes, chapter 256N, and
related repealers in this article.
new text end

new text begin (a) new text end new text begin Minnesota Statutes 2010, section 256.9862, subdivision 2, new text end new text begin is repealed effective
February 1, 2012.
new text end

new text begin (b) new text end new text begin Minnesota Statutes 2010, sections 256.979, subdivisions 5, 6, 7, and 10;
256.9791; 256D.01, subdivisions 1, 1a, 1b, 1e, and 2; 256D.03, subdivisions 1, 2, and 2a;
256D.05, subdivisions 1, 2, 4, 5, 6, 7, and 8; 256D.0513; 256D.06, subdivisions 1, 1b, 2,
5, 7, and 8; 256D.09, subdivisions 1, 2, 2a, 2b, 5, and 6; 256D.10; 256D.13; 256D.15;
256D.16; 256D.35, subdivision 8b; and 256D.46, new text end new text begin are repealed effective October 1, 2012.
new text end

new text begin (c) new text end new text begin Minnesota Rules, part 3400.0130, subpart 8, new text end new text begin is repealed effective September
3, 2012.
new text end

new text begin (d) new text end new text begin Minnesota Rules, part 9500.1261, subparts 3, items D and E, 4, and 5, new text end new text begin are
repealed effective November 1, 2011.
new text end

Minnesota Statutes 2010, section 62D.08, subdivision 7, is amended to read:

(a) Every health maintenance organization must directly allocate administrative expenses
to specific lines of business or products when such information is available. new text begin The definition
of administrative expenses must be consistent with that of the National Association of
Insurance Commissioners (NAIC) as provided in the most current NAIC blank. new text end Remaining
expenses that cannot be directly allocated must be allocated based on other methods, as
recommended by the Advisory Group on Administrative Expenses. Health maintenance
organizations must submit this information, including administrative expenses for dental
services, using the reporting template provided by the commissioner of health.

(b) Every health maintenance organization must allocate investment income based
on cumulative net income over time by business line or product and must submit this
information, including investment income for dental services, using the reporting template
provided by the commissioner of health.

Minnesota Statutes 2010, section 62J.04, subdivision 3, is amended to read:

The commissioner shall:

(1) establish statewide and regional cost containment goals for total health care
spending under this section and collect data as described in sections 62J.38 deleted text begin to 62J.41deleted text end new text begin and
62J.40new text end to monitor statewide achievement of the cost containment goals;

(2) divide the state into no fewer than four regions, with one of those regions being
the Minneapolis/St. Paul metropolitan statistical area but excluding Chisago, Isanti,
Wright, and Sherburne Counties, for purposes of fostering the development of regional
health planning and coordination of health care delivery among regional health care
systems and working to achieve the cost containment goals;

(3) monitor the quality of health care throughout the state and take action as
necessary to ensure an appropriate level of quality;

(4) issue recommendations regarding uniform billing forms, uniform electronic
billing procedures and data interchanges, patient identification cards, and other uniform
claims and administrative procedures for health care providers and private and public
sector payers. In developing the recommendations, the commissioner shall review the
work of the work group on electronic data interchange (WEDI) and the American National
Standards Institute (ANSI) at the national level, and the work being done at the state and
local level. The commissioner may adopt rules requiring the use of the Uniform Bill
82/92 form, the National Council of Prescription Drug Providers (NCPDP) 3.2 electronic
version, the Centers for Medicare and Medicaid Services 1500 form, or other standardized
forms or procedures;

(5) undertake health planning responsibilities;

(6) authorize, fund, or promote research and experimentation on new technologies
and health care procedures;

(7) within the limits of appropriations for these purposes, administer or contract for
statewide consumer education and wellness programs that will improve the health of
Minnesotans and increase individual responsibility relating to personal health and the
delivery of health care services, undertake prevention programs including initiatives to
improve birth outcomes, expand childhood immunization efforts, and provide start-up
grants for worksite wellness programs;

(8) undertake other activities to monitor and oversee the delivery of health care
services in Minnesota with the goal of improving affordability, quality, and accessibility of
health care for all Minnesotans; and

(9) make the cost containment goal data available to the public in a
consumer-oriented manner.

new text begin This section is effective July 1, 2011.
new text end

Minnesota Statutes 2010, section 62J.17, subdivision 4a, is amended to read:

Each hospital, outpatient surgical center,
diagnostic imaging center, and physician clinic shall report annually to the commissioner
on all major spending commitments, in the form and manner specified by the
commissioner. The report shall include the following information:

(a) a description of major spending commitments made during the previous year,
including the total dollar amount of major spending commitments and purpose of the
expenditures;

(b) the cost of land acquisition, construction of new facilities, and renovation of
existing facilities;

(d) expenditures by type for specialty care and new specialized services;

(e) information on the amount and types of added capacity for diagnostic imaging
services, outpatient surgical services, and new specialized services; and

(f) information on investments in electronic medical records systems.

For hospitals and outpatient surgical centers, this information shall be included in reports
to the commissioner that are required under section 144.698. For diagnostic imaging
centers, this information shall be included in reports to the commissioner that are required
under section 144.565. deleted text begin For physician clinics, this information shall be included in reports
to the commissioner that are required under section 62J.41.deleted text end For all other health care
providers that are subject to this reporting requirement, reports must be submitted to the
commissioner by March 1 each year for the preceding calendar year.

new text begin This section is effective July 1, 2011.
new text end

Minnesota Statutes 2010, section 62J.495, is amended by adding a subdivision
to read:

new text begin Any clinical practice with a total annual net revenue of less
than $500,000, and that has not received a state or federal grant for implementation
of electronic health records, is exempt from the requirements of subdivision 1. This
subdivision expires December 31, 2020.
new text end

Minnesota Statutes 2010, section 62J.692, is amended to read:

For purposes of this section, the following definitions
apply:

(a) "Accredited clinical training" means the clinical training provided by a
medical education program that is accredited through an organization recognized by the
Department of Education, the Centers for Medicare and Medicaid Services, or another
national body who reviews the accrediting organizations for multiple disciplines and
whose standards for recognizing accrediting organizations are reviewed and approved by
the commissioner of health in consultation with the Medical Education and Research
Advisory Committee.

(b) "Commissioner" means the commissioner of health.

(c) "Clinical medical education program" means the accredited clinical training of
physicians (medical students and residents), doctor of pharmacy practitioners, doctors
of chiropractic, dentists, advanced practice nurses (clinical nurse specialists, certified
registered nurse anesthetists, nurse practitioners, and certified nurse midwives), and
physician assistants.

(d) "Sponsoring institution" means a hospital, school, or consortium located in
Minnesota that sponsors and maintains primary organizational and financial responsibility
for a clinical medical education program in Minnesota and which is accountable to the
accrediting body.

(e) "Teaching institution" means a hospital, medical center, clinic, or other
organization that conducts a clinical medical education program in Minnesota.

(f) "Trainee" means a student or resident involved in a clinical medical education
program.

(g) "Eligible trainee FTE's" means the number of trainees, as measured by full-time
equivalent counts, that are at training sites located in Minnesota with currently active
medical assistance enrollment status and a National Provider Identification (NPI) number
where training occurs in either an inpatient or ambulatory patient care setting and where
the training is funded, in part, by patient care revenues. Training that occurs in nursing
facility settings is not eligible for funding under this section.

(a) A clinical medical education program
conducted in Minnesota by a teaching institution to train physicians, doctor of pharmacy
practitioners, dentists, chiropractors, or physician assistants is eligible for funds under
subdivision 4new text begin or 11, as appropriate,new text end if the program:

(1) is funded, in part, by patient care revenues;

(2) occurs in patient care settings that face increased financial pressure as a result
of competition with nonteaching patient care entities; and

(3) emphasizes primary care or specialties that are in undersupply in Minnesota.

deleted text begin A clinical medical education program that trains pediatricians is requested to include
in its program curriculum training in case management and medication management for
children suffering from mental illness to be eligible for funds under subdivision 4.
deleted text end

(b) A clinical medical education program for advanced practice nursing is eligible
for funds under subdivision 4new text begin or 11, as appropriate,new text end if the program meets the eligibility
requirements in paragraph (a), clauses (1) to (3), and is sponsored by the University of
Minnesota Academic Health Center, the Mayo Foundation, or institutions that are part
of the Minnesota State Colleges and Universities system or members of the Minnesota
Private College Council.

(c) Applications must be submitted to the commissioner by a sponsoring institution
on behalf of an eligible clinical medical education program and must be received by
October 31 of each year for distribution in the following year. An application for funds
must contain the following information:

(1) the official name and address of the sponsoring institution and the official
name and site address of the clinical medical education programs on whose behalf the
sponsoring institution is applying;

(2) the name, title, and business address of those persons responsible for
administering the funds;

(3) for each clinical medical education program for which funds are being sought;
the type and specialty orientation of trainees in the program; the name, site address, and
medical assistance provider numbernew text begin and national provider identification numbernew text end of each
training site used in the program; new text begin the federal tax identification number of each training site
used in the program, where available; new text end the total number of trainees at each training site; and
the total number of eligible trainee FTEs at each site; and

(4) other supporting information the commissioner deems necessary to determine
program eligibility based on the criteria in paragraphs (a) and (b) and to ensure the
equitable distribution of funds.

(d) An application must include the information specified in clauses (1) to (3) for
each clinical medical education program on an annual basis for three consecutive years.
After that time, an application must include the information specified in clauses (1) to (3)
when requested, at the discretion of the commissioner:

(1) audited clinical training costs per trainee for each clinical medical education
program when available or estimates of clinical training costs based on audited financial
data;

(2) a description of current sources of funding for clinical medical education costs,
including a description and dollar amount of all state and federal financial support,
including Medicare direct and indirect payments; and

(3) other revenue received for the purposes of clinical training.

(e) An applicant that does not provide information requested by the commissioner
shall not be eligible for funds for the current funding cycle.

(a) Following the distribution described under
paragraph (b), the commissioner shall annually distribute the available medical education
funds to all qualifying applicants based on a distribution formula that reflects a summation
of two factors:

(1) a public program volume factor, which is determined by the total volume of
public program revenue received by each training site as a percentage of all public
program revenue received by all training sites in the fund pool; and

(2) a supplemental public program volume factor, which is determined by providing
a supplemental payment of 20 percent of each training site's grant to training sites whose
public program revenue accounted for at least 0.98 percent of the total public program
revenue received by all eligible training sites. Grants to training sites whose public
program revenue accounted for less than 0.98 percent of the total public program revenue
received by all eligible training sites shall be reduced by an amount equal to the total
value of the supplemental payment.

Public program revenue for the distribution formula includes revenue from medical
assistance, prepaid medical assistance, general assistance medical care, and prepaid
general assistance medical care. Training sites that receive no public program revenue
are ineligible for funds available under this subdivision. For purposes of determining
training-site level grants to be distributed under paragraph (a), total statewide average
costs per trainee for medical residents is based on audited clinical training costs per trainee
in primary care clinical medical education programs for medical residents. Total statewide
average costs per trainee for dental residents is based on audited clinical training costs
per trainee in clinical medical education programs for dental students. Total statewide
average costs per trainee for pharmacy residents is based on audited clinical training costs
per trainee in clinical medical education programs for pharmacy students.new text begin Training sites
whose training site level grant is less than $1,000, based on the formula described in this
paragraph, are ineligible for funds available under this subdivision.
new text end

(b) deleted text begin $5,350,000deleted text end new text begin $2,680,000new text end of the available medical education funds shall be
distributed as follows:

(1) deleted text begin $1,475,000deleted text end new text begin $740,000new text end to the University of Minnesota Medical Center-Fairview;

(2) deleted text begin $2,075,000deleted text end new text begin $970,000new text end to the University of Minnesota School of Dentistry; and

(3) deleted text begin $1,800,000deleted text end new text begin $970,000new text end to the Academic Health Center. $150,000 of the funds
distributed to the Academic Health Center under this paragraph shall be used for a
program to assist internationally trained physicians who are legal residents and who
commit to serving underserved Minnesota communities in a health professional shortage
area to successfully compete for family medicine residency programs at the University
of Minnesota.

(d) Funds shall be distributed to the sponsoring institutions indicating the amount
to be distributed to each of the sponsor's clinical medical education programs based on
the criteria in this subdivision and in accordance with the commissioner's approval letter.
Each clinical medical education program must distribute funds allocated under paragraph
(a) to the training sites as specified in the commissioner's approval letter. Sponsoring
institutions, which are accredited through an organization recognized by the Department
of Education or the Centers for Medicare and Medicaid Services, may contract directly
with training sites to provide clinical training. To ensure the quality of clinical training,
those accredited sponsoring institutions must:

(1) develop contracts specifying the terms, expectations, and outcomes of the clinical
training conducted at sites; and

(2) take necessary action if the contract requirements are not met. Action may
include the withholding of payments under this section or the removal of students from
the site.

(e) Any funds not distributed in accordance with the commissioner's approval letter
must be returned to the medical education and research fund within 30 days of receiving
notice from the commissioner. The commissioner shall distribute returned funds to the
appropriate training sites in accordance with the commissioner's approval letter.

(f) A maximum of $150,000 of the funds dedicated to the commissioner under
section 297F.10, subdivision 1, clause (2), may be used by the commissioner for
administrative expenses associated with implementing this section.

(a) Sponsoring institutions receiving funds under this section
must sign and submit a medical education grant verification report (GVR) to verify that
the correct grant amount was forwarded to each eligible training site. If the sponsoring
institution fails to submit the GVR by the stated deadline, or to request and meet
the deadline for an extension, the sponsoring institution is required to return the full
amount of funds received to the commissioner within 30 days of receiving notice from
the commissioner. The commissioner shall distribute returned funds to the appropriate
training sites in accordance with the commissioner's approval letter.

(b) The reports must provide verification of the distribution of the funds and must
include:

(1) the total number of eligible trainee FTEs in each clinical medical education
program;

(2) the name of each funded program and, for each program, the dollar amount
distributed to each training site;

(3) documentation of any discrepancies between the initial grant distribution notice
included in the commissioner's approval letter and the actual distribution;

(4) a statement by the sponsoring institution stating that the completed grant
verification report is valid and accurate; and

(5) other information the commissioner, with advice from the advisory committee,
deems appropriate to evaluate the effectiveness of the use of funds for medical education.

(c) By February 15 of each year, the commissioner, with advice from the
advisory committee, shall provide an annual summary report to the legislature on the
implementation of this section.

The commissioner is authorized to distribute, in
accordance with subdivision 4new text begin or 11, as appropriatenew text end , funds made available through:

(1) voluntary contributions by employers or other entities;

(2) allocations for the commissioner of human services to support medical education
and research; and

(3) other sources as identified and deemed appropriate by the legislature for
inclusion in the fund.

Of the amount
transferred according to section 256B.69, subdivision 5c, paragraph (a), clauses (1) to (4),
$21,714,000 shall be distributed as follows:

(1) $2,157,000 shall be distributed by the commissioner to the University of
Minnesota Board of Regents for the purposes described in sections 137.38 to 137.40;

(2) $1,035,360 shall be distributed by the commissioner to the Hennepin County
Medical Center for clinical medical education;

(3) $17,400,000 shall be distributed by the commissioner to the University of
Minnesota Board of Regents for purposes of medical education;

(4) $1,121,640 shall be distributed by the commissioner to clinical medical education
dental innovation grants in accordance with subdivision 7a; and

(5) the remainder of the amount transferred according to section 256B.69,
subdivision 5c, clauses (1) to (4), shall be distributed by the commissioner annually to
clinical medical education programs that meet the qualifications of subdivision 3 based on
the formula in subdivision 4, paragraph (a)new text begin , or 11, as appropriatenew text end .

(a) The commissioner
shall award grants to teaching institutions and clinical training sites for projects that
increase dental access for underserved populations and promote innovative clinical
training of dental professionals. In awarding the grants, the commissioner, in consultation
with the commissioner of human services, shall consider the following:

(1) potential to successfully increase access to an underserved population;

(2) the long-term viability of the project to improve access beyond the period
of initial funding;

(3) evidence of collaboration between the applicant and local communities;

(4) the efficiency in the use of the funding; and

(5) the priority level of the project in relation to state clinical education, access,
and workforce goals.

(b) The commissioner shall periodically evaluate the priorities in awarding the
innovations grants in order to ensure that the priorities meet the changing workforce
needs of the state.

The commissioner of human services
shall seek to maximize federal financial participation in payments for medical education
and research costs.

The commissioner shall use physician clinic rates where possible to maximize
federal financial participation. Any additional funds that become available must be
distributed under subdivision 4, paragraph (a)new text begin , or 11, as appropriatenew text end .

new text begin (a) Upon receiving federal approval, the
commissioner shall annually distribute the available medical education funds to all
qualifying applicants based on the distribution formula provided in this subdivision, which
supersedes the formula described in subdivision 4, paragraph (a).
new text end

new text begin (1) Following the distribution of funds described under subdivision 4, paragraph
(b), the commissioner shall annually distribute the available medical education funds
to all qualifying applicants based on a distribution formula that reflects a summation
of two factors:
new text end

new text begin (i) a public program volume factor, which is determined by the total volume of
public program revenue received by each training site as a percentage of all public
program revenue received by all training sites in the fund pool; and
new text end

new text begin (ii) a supplemental public program volume factor, which is determined by providing
a supplemental payment of 20 percent of each training site's grant to training sites whose
public program revenue accounted for at least 0.98 percent of the total public program
revenue received by all eligible training sites. Grants to training sites whose public
program revenue accounted for less than 0.98 percent of the total public program revenue
received by all eligible training sites shall be reduced by an amount equal to the total
value of the supplemental payment.
new text end

new text begin Public program revenue for the distribution formula includes revenue from medical
assistance, prepaid medical assistance, general assistance medical care, and prepaid
general assistance medical care. Training sites that receive no public program revenue are
ineligible for funds available under this subdivision. For purposes of determining training
site level grants to be distributed under paragraph (a), total statewide average costs per
trainee for medical residents is based on audited clinical training costs per trainee in
primary care clinical medical education programs for medical residents. Total statewide
average costs per trainee for dental residents is based on audited clinical training costs
per trainee in clinical medical education programs for dental students. Total statewide
average costs per trainee for pharmacy residents is based on audited clinical training costs
per trainee in clinical medical education programs for pharmacy students.
new text end

new text begin (2) Ten percent of available medical education funds shall be used to create a primary
care bonus pool. Grants to eligible training sites under this clause shall be determined by
dividing the total number of eligible FTE trainees from primary care medicine, advanced
practice nursing, or physician assistant programs at all eligible training sites by the amount
of funds available in the primary care bonus pool to determine a grant per primary care
FTE; each eligible training site shall receive a grant equal to the grant per primary care
FTE multiplied by the number of eligible primary care FTE's at the training site.
new text end

new text begin (3) After determining the grant amount for each training site under clause (1), items
(i) and (ii), and clause (2), the commissioner shall calculate a grant per eligible trainee for
each training site. Any training site whose grant per eligible trainee is greater than the
95th percentile grant per eligible trainee shall have the grant amount reduced to the 95th
percentile grant per eligible trainee. Grants in excess of this amount for any training site
shall be redistributed based on the criteria in clause (4).
new text end

new text begin Any training site with fewer than 0.1 FTE eligible trainees from all programs or a
calculated grant less than $1,000 based on the formula described in clauses (1) and (2)
shall be eliminated from the distribution; the calculated grants for these training sites shall
be redistributed based on the criteria in clause (4).
new text end

new text begin (4) The commissioner shall award from available funds appropriated for this purpose
and equally divided between the following programs:
new text end

new text begin (i) the community mental health center grants program under section 145.9272; and
new text end

new text begin (ii) the community health centers development grants program under section
145.987.
new text end

new text begin If federal approval for this funding mechanism is not received for either of the grant
programs described in this paragraph, available funds will be provided to the remaining
grant program described in this paragraph. If none of the grant programs described in this
paragraph receive federal approval, available funds will be distributed to eligible training
sites based on the formula in clauses (1) to (3).
new text end

new text begin (b) Funds distributed shall not be used to displace current funding appropriations
from federal or state sources.
new text end

new text begin (c) Funds shall be distributed to the sponsoring institutions indicating the amount
to be distributed to each of the sponsor's clinical medical education programs based on
the criteria in this subdivision and according to the commissioner's approval letter. Each
clinical medical education program must distribute funds allocated under paragraph
(a) to the training sites as specified in the commissioner's approval letter. Sponsoring
institutions, which are accredited through an organization recognized by the Department
of Education or the Centers for Medicare and Medicaid Services, may contract directly
with training sites to provide clinical training. To ensure the quality of clinical training,
those accredited sponsoring institutions must:
new text end

new text begin (1) develop contracts specifying the terms, expectations, and outcomes of the clinical
training conducted at sites; and
new text end

new text begin (2) take necessary action if the contract requirements are not met. Action may
include the withholding of payments under this section or the removal of students from
the site.
new text end

new text begin (d) Any funds not distributed according to the commissioner's approval letter must
be returned to the medical education and research fund within 30 days of receiving
notice from the commissioner. The commissioner shall distribute returned funds to the
appropriate training sites according to the commissioner's approval letter.
new text end

new text begin (e) A maximum of $150,000 of the funds dedicated to the commissioner under
section 297F.10, subdivision 1, clause (2), may be used by the commissioner for
administrative expenses associated with implementing this section.
new text end

new text begin (a) By July 1, 2012, the commissioner
shall review currently available quality measures and make recommendations for future
measurement aimed at improving assessment and care related to Alzheimer's disease and
other dementia diagnoses, including improved rates and results of cognitive screening,
rates of Alzheimer's and other dementia diagnoses, and prescribed care and treatment
plans.
new text end

new text begin (b) The commissioner may contract with a private entity to complete the
requirements in this subdivision. If the commissioner contracts with a private entity
already under contract through section 62U.02, then the commissioner may use a sole
source contract and is exempt from competitive procurement processes.
new text end

new text begin By July 1, 2012, the commissioner shall
develop a health care home learning collaborative curriculum that includes screening and
education on best practices regarding identification and management of Alzheimer's and
other dementia patients under section 256B.0751, subdivision 5, for providers, clinics,
care coordinators, clinic administrators, patient partners and families, and community
resources including public health.
new text end

new text begin The commissioner, with the commissioner of human
services, the Minnesota Board on Aging, and other appropriate state offices, shall jointly
review existing and forthcoming literature in order to estimate differences in the outcomes
and costs of current practices for caring for those with Alzheimer's disease and other
dementias, compared to the outcomes and costs resulting from:
new text end

new text begin (1) earlier identification of Alzheimer's and other dementias;
new text end

new text begin (2) improved support of family caregivers; and
new text end

new text begin (3) improved collaboration between medical care management and community-based
supports.
new text end

new text begin By January 15, 2013, the commissioner must report to the
legislature on progress toward establishment and collection of quality measures required
under this section.
new text end

Minnesota Statutes 2010, section 144.1501, subdivision 1, is amended to read:

(a) For purposes of this section, the following definitions
apply.

(b) "Dentist" means an individual who is licensed to practice dentistry.

deleted text begin (1) an area in Minnesota outside the counties of Anoka, Carver, Dakota, Hennepin,
Ramsey, Scott, and Washington, excluding the cities of Duluth, Mankato, Moorhead,
Rochester, and St. Cloud; or
deleted text end

deleted text begin (2) a municipal corporation, as defined under section 471.634, that is physically
located, in whole or in part, in an area defined as a designated rural area under clause (1). deleted text end new text begin
an area defined as a small rural area or isolated rural area according to the four category
classifications of the Rural Urban Commuting Area system developed for the United
States Health Resources and Services Administration.
new text end

(d) "Emergency circumstances" means those conditions that make it impossible for
the participant to fulfill the service commitment, including death, total and permanent
disability, or temporary disability lasting more than two years.

(e) "Medical resident" means an individual participating in a medical residency in
family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry.

(f) "Midlevel practitioner" means a nurse practitioner, nurse-midwife, nurse
anesthetist, advanced clinical nurse specialist, or physician assistant.

(g) "Nurse" means an individual who has completed training and received all
licensing or certification necessary to perform duties as a licensed practical nurse or
registered nurse.

(h) "Nurse-midwife" means a registered nurse who has graduated from a program of
study designed to prepare registered nurses for advanced practice as nurse-midwives.

(i) "Nurse practitioner" means a registered nurse who has graduated from a program
of study designed to prepare registered nurses for advanced practice as nurse practitioners.

(j) "Pharmacist" means an individual with a valid license issued under chapter 151.

(k) "Physician" means an individual who is licensed to practice medicine in the areas
of family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry.

(l) "Physician assistant" means a person licensed under chapter 147A.

(m) "Qualified educational loan" means a government, commercial, or foundation
loan for actual costs paid for tuition, reasonable education expenses, and reasonable living
expenses related to the graduate or undergraduate education of a health care professional.

(n) "Underserved urban community" means a Minnesota urban area or population
included in the list of designated primary medical care health professional shortage areas
(HPSAs), medically underserved areas (MUAs), or medically underserved populations
(MUPs) maintained and updated by the United States Department of Health and Human
Services.

Minnesota Statutes 2010, section 144.396, subdivision 5, is amended to read:

(a) To the extent funds are
appropriated for the purposes of this subdivision, the commissioner of health shallnew text begin , within
available appropriations,new text end award competitive grants to eligible applicants for projects and
initiatives directed at the prevention of tobacco use. The project areas for grants include:

(1) statewide public education and information campaigns which include
implementation at the local level; and

(2) coordinated special projects, including training and technical assistance, a
resource clearinghouse, and contracts with ethnic and minority communities.

(b) Eligible applicants may include, but are not limited to, nonprofit organizations,
colleges and universities, professional health associations, community health boards, and
other health care organizations. Applicants must submit proposals to the commissioner.
The proposals must specify the strategies to be implemented to target tobacco use among
youth, and must take into account the need for a coordinated statewide tobacco prevention
effort.

(1) is research based or based on proven effective strategies;

(2) is designed to coordinate with other activities and education messages related
to other health initiatives;

(3) utilizes and enhances existing prevention activities and resources; or

(4) involves innovative approaches preventing tobacco use among youth.

Minnesota Statutes 2010, section 144.396, subdivision 6, is amended to read:

(a) The commissioner shall award
grantsnew text begin , within available appropriations,new text end to eligible applicants for local and regional
projects and initiatives directed at tobacco prevention in coordination with other health
areas aimed at reducing high-risk behaviors in youth that lead to adverse health-related
problems. The project areas for grants include:

(1) school-based tobacco prevention programs aimed at youth and parents;

(2) local public awareness and education projects aimed at tobacco prevention in
coordination with locally assessed community public health needs pursuant to chapter
145A; or

(3) local initiatives aimed at reducing high-risk behavior in youth associated with
tobacco use and the health consequences of these behaviors.

(b) Eligible applicants may include, but are not limited to, community health boards,
school districts, community clinics, Indian tribes, nonprofit organizations, and other health
care organizations. Applicants must submit proposals to the commissioner. The proposals
must specify the strategies to be implemented to target tobacco use among youth, and must
be targeted to achieve the outcomes established in subdivision 2.

(1) supported by the community in which the applicant serves;

(2) is based on research or on proven effective strategies;

(3) is designed to coordinate with other community activities related to other health
initiatives;

(4) incorporates an understanding of the role of community in influencing behavioral
changes among youth regarding tobacco use and other high-risk health-related behaviors;
or

(5) addresses disparities among populations of color related to tobacco use and
other high-risk health-related behaviors.

(d) The commissioner shall divide the state into specific geographic regions and
allocate a percentage of the money available for distribution to projects or initiatives
aimed at that geographic region. If the commissioner does not receive a sufficient number
of grant proposals from applicants that serve a particular region or the proposals submitted
do not meet the criteria developed by the commissioner, the commissioner shall provide
technical assistance and expertise to ensure the development of adequate proposals
aimed at addressing the public health needs of that region. In awarding the grants, the
commissioner shall consider locally assessed community public health needs pursuant to
chapter 145A.

Minnesota Statutes 2010, section 144.98, subdivision 2a, is amended to read:

new text begin Notwithstanding the exemptions in subdivisions 8 and 9, new text end the
commissioner shall accredit laboratories according to the most current environmental
laboratory accreditation standards under subdivision 1 and as accepted by the accreditation
bodies recognized by the National Environmental Laboratory Accreditation Program
(NELAP) of the NELAC Institute.

Minnesota Statutes 2010, section 144.98, subdivision 7, is amended to read:

(a) The
commissioner shall issue or renew accreditation after receipt of the completed application
and documentation required in this section, provided the laboratory maintains compliance
with the standards specified in subdivision 2anew text begin , notwithstanding any exemptions under
subdivisions 8 and 9new text end , and attests to the compliance on the application form.

(b) The commissioner shall prorate the fees in subdivision 3 for laboratories
applying for accreditation after December 31. The fees are prorated on a quarterly basis
beginning with the quarter in which the commissioner receives the completed application
from the laboratory.

(c) Applications for renewal of accreditation must be received by November 1 and
no earlier than October 1 of each year. The commissioner shall send annual renewal
notices to laboratories 90 days before expiration. Failure to receive a renewal notice does
not exempt laboratories from meeting the annual November 1 renewal date.

(d) The commissioner shall issue all accreditations for the calendar year for which
the application is made, and the accreditation shall expire on December 31 of that year.

(e) The accreditation of any laboratory that fails to submit a renewal application
and fees to the commissioner expires automatically on December 31 without notice or
further proceeding. Any person who operates a laboratory as accredited after expiration of
accreditation or without having submitted an application and paid the fees is in violation
of the provisions of this section and is subject to enforcement action under sections
144.989 to 144.993, the Health Enforcement Consolidation Act. A laboratory with expired
accreditation may reapply under subdivision 6.

Minnesota Statutes 2010, section 144.98, is amended by adding a subdivision
to read:

new text begin Effective January 1, 2012, a laboratory that analyzes samples for
compliance with a permit issued under section 115.03, subdivision 5, may request
exemption from the personnel requirements and specific quality control provisions for
microbiology and chemistry stated in the national standards as incorporated by reference
in subdivision 2a. The commissioner shall grant the exemption if the laboratory:
new text end

new text begin (1) complies with the methodology and quality control requirements, where
available, in the most recent, approved edition of the Standard Methods for the
Examination of Water and Wastewater as published by the Water Environment Federation;
and
new text end

new text begin (2) supplies the name of the person meeting the requirements in section 115.73, or
the personnel requirements in the national standard pursuant to subdivision 2a.
new text end

new text begin A laboratory applying for this exemption shall not apply for simultaneous
accreditation under the national standard.
new text end

Minnesota Statutes 2010, section 144.98, is amended by adding a subdivision
to read:

new text begin (a) Effective January 1, 2012, a laboratory applying for or requesting accreditation under
the exemption in subdivision 8 must obtain an acceptable proficiency test result for each
of the laboratory's accredited or requested fields of testing. The laboratory must analyze
proficiency samples selected from one of two annual proficiency testing studies scheduled
by the commissioner.
new text end

new text begin (b) If a laboratory fails to successfully complete the first scheduled proficiency
study, the laboratory shall:
new text end

new text begin (1) obtain and analyze a supplemental test sample within 15 days of receiving the
test report for the initial failed attempt; and
new text end

new text begin (2) participate in the second annual study as scheduled by the commissioner.
new text end

new text begin (c) If a laboratory does not submit results or fails two consecutive proficiency
samples, the commissioner will revoke the laboratory's accreditation for the affected
fields of testing.
new text end

new text begin (d) The commissioner may require a laboratory to analyze additional proficiency
testing samples beyond what is required in this subdivision if information available to
the commissioner indicates that the laboratory's analysis for the field of testing does not
meet the requirements for accreditation.
new text end

new text begin (e) The commissioner may collect from laboratories accredited under the exemption
in subdivision 8 any additional costs required to administer this subdivision and
subdivision 8.
new text end

Minnesota Statutes 2010, section 144A.102, is amended to read:

new text begin (a) new text end By January 2000, the commissioner of health shall work with providers to
examine state and federal rules and regulations governing the provision of care in licensed
nursing facilities and apply for federal waivers and identify necessary changes in state
law to:

(1) allow the use of civil money penalties imposed upon nursing facilities to abate
any deficiencies identified in a nursing facility's plan of correction; and

(2) stop the accrual of any fine imposed by the Health Department when a follow-up
inspection survey is not conducted by the department within the regulatory deadline.

new text begin (b) By January 2012, the commissioner of health shall work with providers and
the ombudsman for long-term care to examine state and federal rules and regulations
governing the provision of care in licensed nursing facilities and apply for federal waivers
and identify necessary changes in state law to:
new text end

new text begin (1) eliminate the requirement for written plans of correction from nursing homes for
federal deficiencies issued at a scope and severity that is not widespread, harmful, or in
immediate jeopardy; and
new text end

new text begin (2) issue the federal survey form electronically to nursing homes.
new text end

new text begin The commissioner shall issue a report to the legislative chairs of the committees
with jurisdiction over health and human services by January 31, 2012, on the status of
implementation of this paragraph.
new text end

Minnesota Statutes 2010, section 144A.61, is amended by adding a
subdivision to read:

new text begin The commissioner of health must accept
electronic transmission of applications and supporting documentation for interstate
endorsement for the nursing assistant registry.
new text end

Minnesota Statutes 2010, section 144E.123, is amended to read:

A licensee shall collect and provide
prehospital care data to the board in a manner prescribed by the board. At a minimum,
the data must include items identified by the board that are part of the National Uniform
Emergency Medical Services Data Set. A licensee shall maintain prehospital care data
for every response.

If a patient is transported to a hospital, a copy
of the ambulance report delineating prehospital medical care given shall be provided
to the receiving hospital.

Prehospital care data may be reviewed by the board or its
designees. The data shall be classified as private data on individuals under chapter 13, the
Minnesota Government Data Practices Act.

deleted text begin Failure to report all information required by the board under this
section shall constitute grounds for license revocation.
deleted text end

new text begin By October 1, 2011, the board must convene a working
group composed of six members, three of which must be appointed by the board and three
of which must be appointed by the Minnesota Ambulance Association, to redesign the
board's policies related to collection of data from licenses. The issues to be considered
include, but are not limited to, the following: user-friendly reporting requirements; data
sets; improved accuracy of reported information; appropriate use of information gathered
through the reporting system; and methods for minimizing the financial impact of data
reporting on licenses, particularly for rural volunteer services. The working group must
report its findings and recommendations to the board no later than July 1, 2012.
new text end

new text begin This section is effective the day following final enactment.
new text end

new text begin (a) For purposes of this section, the following terms
have the meanings given.
new text end

new text begin (b) "Human cloning" means human asexual reproduction accomplished by
introducing nuclear material from one or more human somatic cells into a fertilized
or unfertilized oocyte whose nuclear material has been removed or inactivated so as
to produce a living organism at any stage of development that is genetically virtually
identical to an existing or previously existing human organism.
new text end

new text begin (c) "Somatic cell" means a diploid cell, having a complete set of chromosomes,
obtained or derived from a living or deceased human body at any stage of development.
new text end

new text begin No person or entity, whether public or private,
may:
new text end

new text begin (1) perform or attempt to perform human cloning;
new text end

new text begin (2) participate in an attempt to perform human cloning;
new text end

new text begin (3) ship, import, or receive for any purpose an embryo produced by human cloning
or any product derived from such an embryo; or
new text end

new text begin (4) ship or receive, in whole or in part, any oocyte, embryo, fetus, or human somatic
cell, for the purpose of human cloning.
new text end

new text begin Nothing in this section shall restrict areas of scientific
research not specifically prohibited by this section, including research in the use of nuclear
transfer or other cloning techniques to produce molecules, DNA, cells other than human
embryos, tissues, organs, plants, or animals other than humans. In addition, nothing in this
section shall restrict, inhibit, or make unlawful the scientific field of stem cell research,
unless explicitly prohibited.
new text end

new text begin Any person or entity that knowingly or recklessly violates
subdivision 2 is guilty of a misdemeanor.
new text end

new text begin If any provision, section, subdivision, sentence, clause,
phrase, or word in this section or the application thereof to any person or circumstance is
found to be unconstitutional, the same is hereby declared to be severable and the remainder
of this section shall remain effective notwithstanding such unconstitutional provision. The
legislature declares that it would have passed this section and each provision, subdivision,
sentence, clause, phrase, or word thereof, regardless of the fact that any provision, section,
subdivision, sentence, clause, phrase, or word is declared unconstitutional.
new text end

new text begin This section is effective August 1, 2011, and applies to crimes
committed on or after that date.
new text end

Minnesota Statutes 2010, section 145.925, subdivision 1, is amended to read:

The commissioner of health maynew text begin ,
within available appropriations,new text end make special grants to cities, counties, groups of cities or
counties, or nonprofit corporations to provide prepregnancy family planning services.

Minnesota Statutes 2010, section 145.925, subdivision 2, is amended to read:

The commissioner shall not make special grants pursuant to
this section to any deleted text begin nonprofit corporation which performs abortionsdeleted text end new text begin eligible organization
that performs abortions or provides referrals for abortion servicesnew text end . No state funds shall be
used under contract from a grantee to any deleted text begin nonprofit corporation which performs abortions.
This provision shall not apply to hospitals licensed pursuant to sections 144.50 to 144.56,
or health maintenance organizations certified pursuant to chapter 62Ddeleted text end new text begin eligible organization
that performs abortions or provides referrals for abortion servicesnew text end .

new text begin The White Earth Band of Ojibwe Indians
shall establish and operate one or more health care clinics in the Minneapolis area or
greater Minnesota to serve members of the White Earth Tribe and may use funds received
under this section for application to qualify as a federally qualified health center.
new text end

new text begin Before receiving the funds under this section, the
White Earth Band of Ojibwe Indians is requested to submit to the commissioner of health
a work plan and budget that describes its annual plan for the funds. The commissioner will
incorporate the work plan and budget into a grant agreement between the commissioner
and the White Earth Band of Ojibwe Indians. Before each successive disbursement, the
White Earth Band of Ojibwe Indians is requested to submit a narrative progress report and
an expenditure report to the commissioner.
new text end

new text begin For purposes of this section, "community mental
health center" means an entity that is eligible for payment under section 256B.0625,
subdivision 5.
new text end

new text begin The commissioner of health shall distribute, from
money appropriated for this purpose, grants to community mental health centers operating
in the state on July 1 of the year 2011 and each subsequent year for community mental
health center services to low-income consumers and patients with mental illness. The
amount of each grant shall be in proportion to each community mental health center's
revenues received from state health care programs in the most recent calendar year for
which data is available.
new text end

new text begin This section is effective July 1, 2011, or upon federal
approval of the funding mechanism set out in Minnesota Statutes, section 62J.692,
subdivision 11, whichever is later.
new text end

Minnesota Statutes 2010, section 145.928, subdivision 7, is amended to read:

(a) The commissioner shallnew text begin , within available appropriations,new text end award grants to
eligible applicants for local or regional projects and initiatives directed at reducing health
disparities in one or both of the following priority areas:

(1) decreasing racial and ethnic disparities in infant mortality rates; or

(2) increasing adult and child immunization rates in nonwhite racial and ethnic
populations.

(b) The commissioner may award up to 20 percent of the funds available as planning
grants. Planning grants must be used to address such areas as community assessment,
coordination activities, and development of community supported strategies.

(c) Eligible applicants may include, but are not limited to, faith-based organizations,
social service organizations, community nonprofit organizations, community health
boards, tribal governments, and community clinics. Applicants must submit proposals to
the commissioner. A proposal must specify the strategies to be implemented to address
one or both of the priority areas listed in paragraph (a) and must be targeted to achieve the
outcomes established according to subdivision 3.

(d) The commissioner shall give priority to applicants who demonstrate that their
proposed project or initiative:

(1) is supported by the community the applicant will serve;

(2) is research-based or based on promising strategies;

(3) is designed to complement other related community activities;

(4) utilizes strategies that positively impact both priority areas;

(5) reflects racially and ethnically appropriate approaches; and

(6) will be implemented through or with community-based organizations that reflect
the race or ethnicity of the population to be reached.

Minnesota Statutes 2010, section 145.928, subdivision 8, is amended to read:

(a) The
commissioner shallnew text begin , within available appropriations,new text end award grants to eligible applicants
for local or regional projects and initiatives directed at reducing health disparities in
one or more of the following priority areas:

(1) decreasing racial and ethnic disparities in morbidity and mortality rates from
breast and cervical cancer;

(2) decreasing racial and ethnic disparities in morbidity and mortality rates from
HIV/AIDS and sexually transmitted infections;

(3) decreasing racial and ethnic disparities in morbidity and mortality rates from
cardiovascular disease;

(4) decreasing racial and ethnic disparities in morbidity and mortality rates from
diabetes; or

(5) decreasing racial and ethnic disparities in morbidity and mortality rates from
accidental injuries or violence.

(b) The commissioner may award up to 20 percent of the funds available as planning
grants. Planning grants must be used to address such areas as community assessment,
determining community priority areas, coordination activities, and development of
community supported strategies.

(c) Eligible applicants may include, but are not limited to, faith-based organizations,
social service organizations, community nonprofit organizations, community health
boards, and community clinics. Applicants shall submit proposals to the commissioner.
A proposal must specify the strategies to be implemented to address one or more of
the priority areas listed in paragraph (a) and must be targeted to achieve the outcomes
established according to subdivision 3.

(d) The commissioner shall give priority to applicants who demonstrate that their
proposed project or initiative:

(1) is supported by the community the applicant will serve;

(2) is research-based or based on promising strategies;

(3) is designed to complement other related community activities;

(4) utilizes strategies that positively impact more than one priority area;

(5) reflects racially and ethnically appropriate approaches; and

(6) will be implemented through or with community-based organizations that reflect
the race or ethnicity of the population to be reached.

new text begin (a) The commissioner of health shall award grants from money appropriated for this
purpose to expand community health centers, as defined in section 145.9269, subdivision
1, in the state through the establishment of new community health centers or sites in
areas defined as small rural areas or isolated rural areas according to the four category
classification of the Rural Urban Commuting Area system developed for the United States
Health Resources and Services Administration or serving underserved patient populations.
new text end

new text begin (b) Grant funds may be used to pay for:
new text end

new text begin (1) costs for an organization to develop and submit a proposal to the federal
government for the designation of a new community health center or site; and
new text end

new text begin (2) costs of planning, designing, remodeling, constructing, or purchasing equipment
for a new center or site.
new text end

new text begin Funds may not be used for operating costs.
new text end

new text begin (c) The commissioner shall award grants on a competitive basis.
new text end

Minnesota Statutes 2010, section 145A.17, subdivision 3, is amended to read:

(a) Community health boards
and tribal governments that receive funding under this section must submit a plan to
the commissioner describing a multidisciplinary approach to targeted home visiting for
families. The plan must be submitted on forms provided by the commissioner. At a
minimum, the plan must include the following:

(1) a description of outreach strategies to families prenatally or at birth;

(2) provisions for the seamless delivery of health, safety, and early learning services;

(3) methods to promote continuity of services when families move within the state;

(4) a description of the community demographics;

(5) a plan for meeting outcome measures; and

(6) a proposed work plan that includes:

(i) coordination to ensure nonduplication of services for children and families;

(ii) a description of the strategies to ensure that children and families at greatest risk
receive appropriate services; and

(iii) collaboration with multidisciplinary partners including public health,
ECFE, Head Start, community health workers, social workers, community home
visiting programs, school districts, and other relevant partners. Letters of intent from
multidisciplinary partners must be submitted with the plan.

(b) Each program that receives funds must accomplish the following program
requirements:

(1) use a community-based strategy to provide preventive and early intervention
home visiting services;

(2) offer a home visit by a trained home visitor. If a home visit is accepted, the first
home visit must occur prenatally or as soon after birth as possible and must include a
public health nursing assessment by a public health nurse;

(3) offer, at a minimum, information on infant care, child growth and development,
positive parenting, preventing diseases, preventing exposure to environmental hazards,
and support services available in the community;

(4) provide information on and referrals to health care services, if needed, including
information on and assistance in applying for health care coverage for which the child or
family may be eligible; and provide information on preventive services, developmental
assessments, and the availability of public assistance programs as appropriate;

(5) provide youth development programs when appropriate;

(6) recruit home visitors who will represent, to the extent possible, the races,
cultures, and languages spoken by families that may be served;

(7) train and supervise home visitors in accordance with the requirements established
under subdivision 4;

(8) maximize resources and minimize duplication by coordinating or contracting
with local social and human services organizations, education organizations, and other
appropriate governmental entities and community-based organizations and agencies;

(9) utilize appropriate racial and ethnic approaches to providing home visiting
services; and

(10) connect eligible families, as needed, to additional resources available in the
community, including, but not limited to, early care and education programs, health or
mental health services, family literacy programs, employment agencies, social services,
and child care resources and referral agencies.

(c) When available, programs that receive funds under this section must offer or
provide the family with a referral to center-based or group meetings that meet at least
once per month for those families identified with additional needs. The meetings must
focus on further enhancing the information, activities, and skill-building addressed during
home visitation; offering opportunities for parents to meet with and support each other;
and offering infants and toddlers a safe, nurturing, and stimulating environment for
socialization and supervised play with qualified teachers.

(d) Funds available under this section shall not be used for medical services. The
commissioner shall establish an administrative cost limit for recipients of funds. The
outcome measures established under subdivision 6 must be specified to recipients of
funds at the time the funds are distributed.

(e) Data collected on individuals served by the home visiting programs must remain
confidential and must not be disclosed by providers of home visiting services without a
specific informed written consent that identifies disclosures to be made. Upon request,
agencies providing home visiting services must provide recipients with information on
disclosures, including the names of entities and individuals receiving the information and
the general purpose of the disclosure. Prospective and current recipients of home visiting
services must be told and informed in writing that written consent for disclosure of data is
not required for access to home visiting services.

new text begin (f) Upon initial contact with a family, programs that receive funding under this
section must receive permission from the family to share with other family service
providers information about services the family is receiving and unmet needs of the family
in order to select a lead agency for the family and coordinate available resources. For
purposes of this paragraph, the term "family service providers" includes local public
health, social services, school districts, Head Start programs, health care providers, and
other public agencies.
new text end

Minnesota Statutes 2010, section 157.15, is amended by adding a subdivision
to read:

new text begin "Limited food establishment" means a food
and beverage service establishment that primarily provides beverages that consist of
combining dry mixes and water or ice for immediate service to the consumer. Limited
food establishments must use equipment and utensils that are nontoxic, durable, and retain
their characteristic qualities under normal use conditions and may request a variance for
plumbing requirements from the commissioner.
new text end

new text begin This section is effective July 1, 2011, and applies to
applications for licensure submitted on or after that date.
new text end

Minnesota Statutes 2010, section 157.20, is amended by adding a subdivision
to read:

new text begin (a) A person may request a variance from all parts of
Minnesota Rules, chapter 4626, except as provided in paragraph (b) or Minnesota Rules,
chapter 4626. At the time of application for plan review, the person, operator, or submitter
must be notified of the right to request variances.
new text end

new text begin (b) No variance may be requested or approved for the following parts of Minnesota
Rules, chapter 4626:
new text end

new text begin (1) Minnesota Rules, part 4626.0020, subpart 35;
new text end

new text begin (2) Minnesota Rules, parts 4626.0040 to 4626.0060;
new text end

new text begin (3) Minnesota Rules, parts 4626.0065 to 4626.0100;
new text end

new text begin (4) Minnesota Rules, parts 4626.0105 to 4626.0120;
new text end

new text begin (5) Minnesota Rules, part 4626.1565;
new text end

new text begin (6) Minnesota Rules, parts 4626.1590 and 4626.1595; and
new text end

new text begin (7) Minnesota Rules, parts 4626.1600 to 4626.1675.
new text end

Minnesota Statutes 2010, section 297F.10, subdivision 1, is amended to read:

Revenue received from cigarette
taxes, as well as related penalties, interest, license fees, and miscellaneous sources of
revenue shall be deposited by the commissioner in the state treasury and credited as
follows:

(1) $22,220,000 for fiscal year 2006 and $22,250,000 for fiscal year 2007 and each
year thereafter must be credited to the Academic Health Center special revenue fund
hereby created and is annually appropriated to the Board of Regents at the University of
Minnesota for Academic Health Center funding at the University of Minnesota; and

(2) deleted text begin $8,553,000 for fiscal year 2006 anddeleted text end $8,550,000 for fiscal deleted text begin yeardeleted text end new text begin years new text end 2007 deleted text begin and
each year thereafterdeleted text end new text begin through fiscal year 2011 and $6,244,000 each fiscal year thereafter
new text end must be credited to the medical education and research costs account hereby created in
the special revenue fund and is annually appropriated to the commissioner of health for
distribution under section 62J.692, subdivision 4new text begin or 11, as appropriatenew text end ; and

(3) the balance of the revenues derived from taxes, penalties, and interest (under
this chapter) and from license fees and miscellaneous sources of revenue shall be credited
to the general fund.

new text begin (a) The commissioner of health, in consultation with the commissioner of human
services, shall evaluate and recommend options for reorganizing health and human
services regulatory responsibilities in both agencies to provide better efficiency and
operational cost savings while maintaining the protection of the health, safety, and welfare
of the public. Regulatory responsibilities that are to be evaluated are those found in
Minnesota Statutes, chapters 62D, 62N, 62R, 62T, 144A, 144D, 144G, 146A, 146B,
149A, 153A, 245A, 245B, and 245C, and sections 62Q.19, 144.058, 144.0722, 144.50,
144.651, 148.511, 148.6401, 148.995, 256B.692, 626.556, and 626.557.
new text end

new text begin (b) The evaluation and recommendations shall be submitted in a report to the
legislative committees with jurisdiction over health and human services no later than
February 15, 2012, and shall include, at a minimum, the following:
new text end

new text begin (1) whether the regulatory responsibilities of each agency should be combined into
a separate agency;
new text end

new text begin (2) whether the regulatory responsibilities of each agency should be merged into
an existing agency;
new text end

new text begin (3) what cost savings would result by merging the activities regardless of where
they are located;
new text end

new text begin (4) what additional costs would result if the activities were merged;
new text end

new text begin (5) whether there are additional regulatory responsibilities in both agencies that
should be considered in any reorganization; and
new text end

new text begin (6) for each option recommended, projected cost and a timetable and identification
of the necessary steps and requirements for a successful transition period.
new text end

new text begin The commissioner of health shall contract with an entity with expertise in health
economics and health care delivery and quality to study the efficiency, costs, service
quality, and enrollee satisfaction of for-profit health maintenance organizations, relative to
not-for-profit health maintenance organizations operating in Minnesota and other states.
The study findings must address whether the state of Minnesota could: (1) reduce medical
assistance and MinnesotaCare costs and costs of providing coverage to state employees;
and (2) maintain or improve the quality of care provided to state health care program
enrollees and state employees if for-profit health maintenance organizations were allowed
to operate in the state. The commissioner shall require the entity under contract to report
study findings to the commissioner and the legislature by January 15, 2012.
new text end

new text begin The Minnesota Task Force on Prematurity is
established to evaluate and make recommendations on methods for reducing prematurity
and improving premature infant health care in the state.
new text end

new text begin (a) The task force shall be composed of at
least the following members, who serve at the pleasure of their appointing authority:
new text end

new text begin (1) 15 representatives of the Minnesota Prematurity Coalition including, but not
limited to, health care providers who treat pregnant women or neonates, organizations
focused on preterm births, early childhood education and development professionals, and
families affected by prematurity;
new text end

new text begin (2) one representative appointed by the commissioner of human services;
new text end

new text begin (3) two representatives appointed by the commissioner of health;
new text end

new text begin (4) one representative appointed by the commissioner of education;
new text end

new text begin (5) two members of the house of representatives, one appointed by the speaker of
the house and one appointed by the minority leader; and
new text end

new text begin (6) two members of the senate, appointed according to the rules of the senate.
new text end

new text begin (b) Members of the task force serve without compensation or payment of expenses.
new text end

new text begin (c) The commissioner of health must convene the first meeting of the Minnesota
Task Force on Prematurity by July 31, 2011. The task force must continue to meet at
least quarterly. Staffing and technical assistance shall be provided by the Minnesota
Perinatal Coalition.
new text end

new text begin The task force must report the current state of prematurity in
Minnesota and develop recommendations on strategies for reducing prematurity and
improving premature infant health care in the state by considering the following:
new text end

new text begin (1) standards of care for premature infants born less than 37 weeks gestational age,
including recommendations to improve hospital discharge and follow-up care procedures;
new text end

new text begin (2) coordination of information among appropriate professional and advocacy
organizations on measures to improve health care for infants born prematurely;
new text end

new text begin (3) identification and centralization of available resources to improve access and
awareness for caregivers of premature infants;
new text end

new text begin (4) development and dissemination of evidence-based practices through networking
and educational opportunities;
new text end

new text begin (5) a review of relevant evidence-based research regarding the causes and effects of
premature births in Minnesota;
new text end

new text begin (6) a review of relevant evidence-based research regarding premature infant health
care, including methods for improving quality of and access to care for premature infants;
new text end

new text begin (7) a review of the potential improvements in health status related to the use of
health care homes to provide and coordinate pregnancy-related services; and
new text end

new text begin (8) identification of gaps in public reporting measures and possible effects of these
measures on prematurity rates.
new text end

new text begin (a) By November 30, 2011, the task force must submit
a report on the current state of prematurity in Minnesota to the chairs of the legislative
policy committees on health and human services.
new text end

new text begin (b) By January 15, 2013, the task force must report its final recommendations,
including any draft legislation necessary for implementation, to the chairs of the legislative
policy committees on health and human services.
new text end

new text begin (c) This task force expires on January 31, 2013, or upon submission of the final
report required in paragraph (b), whichever is earlier.
new text end

new text begin The commissioner of health must work with long-term care providers, provider
associations, and consumer advocates to clarify for the benefit of providers, survey
teams, and investigators from the office of health facility complaints all of the situations
that providers must report and are required to report to the department under federal
certification regulations and to the common entry point under the Minnesota Vulnerable
Adults Act. The commissioner must produce decision trees, flow sheets, or other
reproducible materials to guide the parties and to reduce the number of unnecessary
reports.
new text end

new text begin (a) new text end new text begin Minnesota Statutes 2010, sections 62J.17, subdivisions 1, 3, 5a, 6a, and 8;
62J.321, subdivision 5a; 62J.381; 62J.41, subdivisions 1 and 2; 144.1464; 144.147; and
144.1499, new text end new text begin are repealed.
new text end

new text begin (b) new text end new text begin Minnesota Rules, parts 4651.0100, subparts 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12,
14, 15, 16, 16a, 18, 19, 20, 20a, 21, 22, and 23; 4651.0110, subparts 2, 2a, 3, 4, and 5;
4651.0120; 4651.0130; 4651.0140; and 4651.0150, new text end new text begin are repealed effective July 1, 2011.
new text end

Minnesota Statutes 2010, section 245A.14, subdivision 4, is amended to
read:

Nonresidential child care programs
serving 14 or fewer children that are conducted at a location other than the license holder's
own residence shall be licensed under this section and the rules governing family day
care or group family day care if:

(a) the license holder is the primary provider of care and the nonresidential child
care program is conducted in a dwelling that is located on a residential lot;

(b) the license holder is an employer who may or may not be the primary provider
of care, and the purpose for the child care program is to provide child care services to
children of the license holder's employees;

(d) the license holder is a community collaborative child care provider. For
purposes of this subdivision, a community collaborative child care provider is a provider
participating in a cooperative agreement with a community action agency as defined in
section 256E.31; deleted text begin or
deleted text end

(e) the license holder is a not-for-profit agency that provides child care in a dwelling
located on a residential lot and the license holder maintains two or more contracts with
community employers or other community organizations to provide child care services.
The county licensing agency may grant a capacity variance to a license holder licensed
under this paragraph to exceed the licensed capacity of 14 children by no more than five
children during transition periods related to the work schedules of parents, if the license
holder meets the following requirements:

(1) the program does not exceed a capacity of 14 children more than a cumulative
total of four hours per day;

(2) the program meets a one to seven staff-to-child ratio during the variance period;

(3) all employees receive at least an extra four hours of training per year than
required in the rules governing family child care each year;

(4) the facility has square footage required per child under Minnesota Rules, part
9502.0425;

(5) the program is in compliance with local zoning regulations;

(6) the program is in compliance with the applicable fire code as follows:

(i) if the program serves more than five children older than 2-1/2 years of age,
but no more than five children 2-1/2 years of age or less, the applicable fire code is
educational occupancy, as provided in Group E Occupancy under the Minnesota State
Fire Code 2003, Section 202; or

(ii) if the program serves more than five children 2-1/2 years of age or less, the
applicable fire code is Group I-4 Occupancies, as provided in the Minnesota State Fire
Code 2003, Section 202; and

(7) any age and capacity limitations required by the fire code inspection and square
footage determinations shall be printed on the licensedeleted text begin .deleted text end new text begin ; or
new text end

new text begin (f) the license holder is the primary provider of care and has located the licensed
child care program in a commercial space, if the license holder meets the following
requirements:
new text end

new text begin (1) the program is in compliance with local zoning regulations;
new text end

new text begin (2) the program is in compliance with the applicable fire code as follows:
new text end

new text begin (i) if the program serves more than five children older than 2-1/2 years of age,
but no more than five children 2-1/2 years of age or less, the applicable fire code is
educational occupancy, as provided in Group E Occupancy under the Minnesota State
Fire Code 2003, Section 202; or
new text end

new text begin (ii) if the program serves more than five children 2-1/2 years of age or less, the
applicable fire code is Group I-4 Occupancies, as provided under the Minnesota State Fire
Code 2003, Section 202;
new text end

new text begin (3) any age and capacity limitations required by the fire code inspection and square
footage determinations are printed on the license; and
new text end

new text begin (4) the license holder prominently displays the license issued by the commissioner
which contains the statement "This special family child care provider is not licensed as a
child care center."
new text end

Minnesota Statutes 2010, section 245C.03, is amended by adding a subdivision
to read:

new text begin The
commissioner shall conduct background studies according to this chapter when initiated
by a children's therapeutic services and supports provider under section 256B.0943.
new text end

Minnesota Statutes 2010, section 245C.10, is amended by adding a subdivision
to read:

new text begin The
commissioner shall recover the cost of background studies required under section
245C.03, subdivision 7, for the purposes of children's therapeutic services and supports
under section 256B.0943, 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.
new text end

Minnesota Statutes 2010, section 256B.04, subdivision 14a, is amended to read:

Nonemergency medical transportation
level of need determinations must be performed by a physician, a registered nurse working
under direct supervision of a physician, a physician's assistant, a nurse practitioner, a
licensed practical nurse, or a discharge planner.

Nonemergency medical transportation level of need determinations must not be
performed more than annually on any individual, unless the individual's circumstances
have sufficiently changed so as to require a new level of need determination.new text begin No entity
shall charge, and the commissioner shall pay, no more than $25 for performing a level of
need determination regarding any person receiving nonemergency medical transportation,
including special transportation.
new text end

new text begin Special transportation services to eligible persons who need a stretcher-accessible
vehicle from an inpatient or outpatient hospital are exempt from a level of need
determination if the special transportation services have been ordered by the eligible
person's physician, registered nurse working under direct supervision of a physician,
physician's assistant, nurse practitioner, licensed practical nurse, or discharge planner
pursuant to Medicare guidelines.
new text end

Individuals new text begin transported to or new text end residing in licensed nursing facilities are exempt from a
level of need determination and are eligible for special transportation services until the
individual no longer resides in a licensed nursing facility. If a person authorized by this
subdivision to perform a level of need determination determines that an individual requires
stretcher transportation, the individual is presumed to maintain that level of need until
otherwise determined by a person authorized to perform a level of need determination, or
for six months, whichever is sooner.

Minnesota Statutes 2010, section 256B.0625, subdivision 17, is amended to
read:

(a) Medical assistance covers medical
transportation costs incurred solely for obtaining emergency medical care or transportation
costs incurred by eligible persons in obtaining emergency or nonemergency medical
care when paid directly to an ambulance company, common carrier, or other recognized
providers of transportation services. Medical transportation must be provided by:

(1) an ambulance, as defined in section 144E.001, subdivision 2;

(2) special transportation; or

(3) common carrier including, but not limited to, bus, taxicab, other commercial
carrier, or private automobile.

(b) Medical assistance covers special transportation, as defined in Minnesota Rules,
part 9505.0315, subpart 1, item F, if the recipient has a physical or mental impairment that
would prohibit the recipient from safely accessing and using a bus, taxi, other commercial
transportation, or private automobile.

The commissioner may use an order by the recipient's attending physician to certify that
the recipient requires special transportation services. Special transportation providers
shall perform driver-assisted services for eligible individuals. Driver-assisted service
includes passenger pickup at and return to the individual's residence or place of business,
assistance with admittance of the individual to the medical facility, and assistance in
passenger securement or in securing of wheelchairs or stretchers in the vehicle. Special
transportation providers must obtain written documentation from the health care service
provider who is serving the recipient being transported, identifying the time that the
recipient arrived. Special transportation providers may not bill for separate base rates for
the continuation of a trip beyond the original destination. Special transportation providers
must take recipients to the nearest appropriate health care provider, using the most direct
routenew text begin as determined by a commercially available mileage software program approved by
the commissionernew text end . The minimum medical assistance reimbursement rates for special
transportation services are:

(1) (i) $17 for the base rate and $1.35 per mile for special transportation services to
eligible persons who need a wheelchair-accessible van;

(ii) $11.50 for the base rate and $1.30 per mile for special transportation services to
eligible persons who do not need a wheelchair-accessible van; and

(iii) $60 for the base rate and $2.40 per mile, and an attendant rate of $9 per trip, for
special transportation services to eligible persons who need a stretcher-accessible vehicle;

(2) the base rates for special transportation services in areas defined under RUCA
to be super rural shall be equal to the reimbursement rate established in clause (1) plus
11.3 percent; and

(3) for special transportation services in areas defined under RUCA to be rural
or super rural areas:

(i) for a trip equal to 17 miles or less, mileage reimbursement shall be equal to 125
percent of the respective mileage rate in clause (1); and

(ii) for a trip between 18 and 50 miles, mileage reimbursement shall be equal to
112.5 percent of the respective mileage rate in clause (1).

(c) For purposes of reimbursement rates for special transportation services under
paragraph (b), the zip code of the recipient's place of residence shall determine whether
the urban, rural, or super rural reimbursement rate applies.

(d) For purposes of this subdivision, "rural urban commuting area" or "RUCA"
means a census-tract based classification system under which a geographical area is
determined to be urban, rural, or super rural.

Minnesota Statutes 2010, section 256B.0943, is amended by adding a
subdivision to read:

new text begin The requirements for background studies under
this section may be met by a children's therapeutic services and supports services agency
through the commissioner's NETStudy system as provided under sections 245C.03,
subdivision 7, and 245C.10, subdivision 8.
new text end

Minnesota Statutes 2010, section 256B.14, is amended by adding a subdivision
to read:

new text begin (a) For purposes of this subdivision, the following
terms have the meanings given:
new text end

new text begin (1) "commissioner" means the commissioner of human services;
new text end

new text begin (2) "community spouse" means the spouse, who lives in the community, of an
individual receiving long-term care services in a long-term care facility or home care
services pursuant to the Medicaid waiver for elderly services under section 256B.0915
or the alternative care program under section 256B.0913. A community spouse does not
include a spouse living in the community who receives a monthly income allowance under
section 256B.058, subdivision 2, or who receives home and community-based services
under section 256B.0915, 256B.092, or 256B.49, or the alternative care program under
section 256B.0913;
new text end

new text begin (3) "cost of care" means the actual fee-for-service costs or capitated payments for
the long-term care spouse;
new text end

new text begin (4) "department" means the Department of Human Services;
new text end

new text begin (5) "disabled child" means a blind or permanently and totally disabled son or
daughter of any age based on the Social Security Administration disability standards;
new text end

new text begin (6) "income" means earned and unearned income, attributable to the community
spouse, used to calculate the adjusted gross income on the prior year's income tax return.
Evidence of income includes, but is not limited to, W-2 and 1099 forms; and
new text end

new text begin (7) "long-term care spouse" means the spouse who is receiving long-term care
services in a long-term care facility or home and community based services pursuant
to the Medicaid waiver for elderly services under section 256B.0915 or the alternative
care program under section 256B.0913.
new text end

new text begin (b) The community spouse of a long-term care spouse who receives medical
assistance or alternative care services has an obligation to contribute to the cost of care.
The community spouse must pay a monthly fee on a sliding fee scale based on the
community spouse's income. If a minor or disabled child resides with and receives care
from the community spouse, then no fee shall be assessed.
new text end

new text begin (c) For a community spouse with an income equal to or greater than 250 percent of
the federal poverty guidelines for a family of two and less than 545 percent of the federal
poverty guidelines for a family of two, the spousal contribution shall be determined using
a sliding fee scale established by the commissioner that begins at 7.5 percent of the
community spouse's income and increases to 15 percent for those with an income of up to
545 percent of the federal poverty guidelines for a family of two.
new text end

new text begin (d) For a community spouse with an income equal to or greater than 545 percent of
the federal poverty guidelines for a family of two and less than 750 percent of the federal
poverty guidelines for a family of two, the spousal contribution shall be determined using
a sliding fee scale established by the commissioner that begins at 15 percent of the
community spouse's income and increases to 25 percent for those with an income of up to
750 percent of the federal poverty guidelines for a family of two.
new text end

new text begin (e) For a community spouse with an income equal to or greater than 750 percent of
the federal poverty guidelines for a family of two and less than 975 percent of the federal
poverty guidelines for a family of two, the spousal contribution shall be determined using
a sliding fee scale established by the commissioner that begins at 25 percent of the
community spouse's income and increases to 33 percent for those with an income of up to
975 percent of the federal poverty guidelines for a family of two.
new text end

new text begin (f) For a community spouse with an income equal to or greater than 975 percent of
the federal poverty guidelines for a family of two, the spousal contribution shall be 33
percent of the community spouse's income.
new text end

new text begin (g) The spousal contribution shall be explained in writing at the time eligibility
for medical assistance or alternative care is being determined. In addition to explaining
the formula used to determine the fee, the county or tribal agency shall provide written
information describing how to request a variance for undue hardship, how a contribution
may be reviewed or redetermined, the right to appeal a contribution determination, and
that the consequences for not complying with a request to provide information shall be
an assessment against the community spouse for the full cost of care for the long-term
care spouse.
new text end

new text begin (h) The contribution shall be assessed for each month the long-term care spouse
has a community spouse and is eligible for medical assistance payment of long-term
care services or alternative care.
new text end

new text begin (i) The spousal contribution shall be reviewed at least once every 12 months and
when there is a loss or gain in income in excess of ten percent. Thirty days prior to a
review or redetermination, written notice must be provided to the community spouse
and must contain the amount the spouse is required to contribute, notice of the right to
redetermination and appeal, and the telephone number of the division at the agency that is
responsible for redetermination and review. If, after review, the contribution amount is to
be adjusted, the county or tribal agency shall mail a written notice to the community spouse
30 days in advance of the effective date of the change in the amount of the contribution.
new text end

new text begin (1) The spouse shall notify the county or tribal agency within 30 days of a gain or
loss in income in excess of ten percent and provide the agency supporting documentation
to verify the need for redetermination of the fee.
new text end

new text begin (2) When a spouse requests a review or redetermination of the contribution amount,
a request for information shall be sent to the spouse within ten calendar days after the
county or tribal agency receives the request for review.
new text end

new text begin (3) No action shall be taken on a review or redetermination until the required
information is received by the county or tribal agency.
new text end

new text begin (4) The review of the spousal contribution shall be completed within ten days after
the county or tribal agency receives completed information that verifies a loss or gain in
income in excess of ten percent.
new text end

new text begin (5) An increase in the contribution amount is effective in the month in which the
increase in income occurs.
new text end

new text begin (6) A decrease in the contribution amount is effective in the month the spouse
verifies the reduction in income, retroactive to no longer than six months.
new text end

new text begin (j) In no case shall the spousal contribution exceed the amount of medical assistance
expended or the cost of alternative care services for the care of the long-term care spouse.
Annually, upon redetermination, or at termination of eligibility, the total amount of
medical assistance paid or costs of alternative care for the care of the long-term care spouse
and the total amount of the spousal contribution shall be compared. If the total amount
of the spousal contribution exceeds the total amount of medical assistance expended or
cost of alternative care, then the agency shall reimburse the community spouse the excess
amount if the long-term care spouse is no longer receiving services, or apply the excess
amount to the spousal contribution due until the excess amount is exhausted.
new text end

new text begin (k) A community spouse may request a variance by submitting a written request
and supporting documentation that payment of the calculated contribution would cause
an undue hardship. An undue hardship is defined as the inability to pay the calculated
contribution due to medical expenses incurred by the community spouse. Documentation
must include proof of medical expenses incurred by the community spouse since the last
annual redetermination of the contribution amount that are not reimbursable by any public
or private source, and are a type, regardless of amount, that would be allowable as a
federal tax deduction under the Internal Revenue Code.
new text end

new text begin (1) A spouse who requests a variance from a notice of an increase in the amount
of spousal contribution shall continue to make monthly payments at the lower amount
pending determination of the variance request. A spouse who requests a variance from
the initial determination shall not be required to make a payment pending determination
of the variance request. Payments made pending outcome of the variance request that
result in overpayment must be returned to the spouse, if the long-term care spouse is no
longer receiving services, or applied to the spousal contribution in the current year. If the
variance is denied, the spouse shall pay the additional amount due from the effective date
of the increase or the total amount due from the effective date of the original notice of
determination of the spousal contribution.
new text end

new text begin (2) A spouse who is granted a variance shall sign a written agreement in which the
spouse agrees to report to the county or tribal agency any changes in circumstances that
gave rise to the undue hardship variance.
new text end

new text begin (3) When the county or tribal agency receives a request for a variance, written notice
of a grant or denial of the variance shall be mailed to the spouse within 30 calendar days
after the county or tribal agency receives the financial information required in this clause.
The granting of a variance will necessitate a written agreement between the spouse and the
county or tribal agency with regard to the specific terms of the variance. The variance
will not become effective until the written agreement is signed by the spouse. If the
county or tribal agency denies in whole or in part the request for a variance, the denial
notice shall set forth in writing the reasons for the denial that address the specific hardship
and right to appeal.
new text end

new text begin (4) If a variance is granted, the term of the variance shall not exceed 12 months
unless otherwise determined by the county or tribal agency.
new text end

new text begin (5) Undue hardship does not include action taken by a spouse which divested or
diverted income in order to avoid being assessed a spousal contribution.
new text end

new text begin (l) A spouse aggrieved by an action under this subdivision has the right to appeal
under subdivision 4. If the spouse appeals on or before the effective date of an increase
in the spousal fee, the spouse shall continue to make payments to the county or tribal
agency in the lower amount while the appeal is pending. A spouse appealing an initial
determination of a spousal contribution shall not be required to make monthly payments
pending an appeal decision. Payments made that result in an overpayment shall be
reimbursed to the spouse if the long-term care spouse is no longer receiving services, or
applied to the spousal contribution remaining in the current year. If the county or tribal
agency's determination is affirmed, the community spouse shall pay within 90 calendar
days of the order the total amount due from the effective date of the original notice of
determination of the spousal contribution. The commissioner's order is binding on the
spouse and the agency and shall be implemented subject to section 256.045, subdivision 7.
No additional notice is required to enforce the commissioner's order.
new text end

new text begin (m) If the county or tribal agency finds that notice of the payment obligation was
given to the community spouse and the spouse was determined to be able to pay, but that
the spouse failed or refused to pay, a cause of action exists against the community spouse
for that portion of medical assistance payment of long-term care services or alternative
care services granted after notice was given to the community spouse. The action may be
brought by the county or tribal agency in the county where assistance was granted for the
assistance together with the costs of disbursements incurred due to the action. In addition
to granting the county or tribal agency a money judgment, the court may, upon a motion or
order to show cause, order continuing contributions by a community spouse found able to
repay the county or tribal agency. The order shall be effective only for the period of time
during which a contribution shall be assessed.
new text end

new text begin (n) Counties and tribes are entitled to one-half of the nonfederal share of
contributions made under this section for long-term care spouses on medical assistance
that are directly attributed to county or tribal efforts. Counties and tribes are entitled to
25 percent of the contributions made under this section for long-term care spouses on
alternative care directly attributed to county or tribal efforts.
new text end

new text begin This section is effective July 1, 2012.
new text end

Minnesota Statutes 2010, section 326B.175, is amended to read:

new text begin Except as provided in section 326B.188, new text end it shall be the duty of the department and
the licensing authority of any municipality which adopts any such ordinance whenever
it finds any such elevator under its jurisdiction in use in violation of any provision of
sections 326B.163 to 326B.178 to seal the entrances of such elevator and attach a notice
forbidding the use of such elevator until the provisions thereof are complied with.

new text begin (a) This section applies to code requirements for existing elevators and related
devices under Minnesota Rules, chapter 1307, where the deadline set by law for meeting
the code requirements is January 29, 2012, or later.
new text end

new text begin (b) If the department or municipality conducting elevator inspections within its
jurisdiction notifies the owner of an existing elevator or related device of the code
requirements before the effective date of this section, the owner may submit a compliance
plan by December 30, 2011. If the department or municipality does not notify the owner
of an existing elevator or related device of the code requirements before the effective
date of this section, the department or municipality shall notify the owner of the code
requirements and permit the owner to submit a compliance plan by December 30, 2011, or
within 60 days after the date of notification, whichever is later.
new text end

new text begin (c) Any compliance plan submitted under this section must result in compliance with
the code requirements by the later of January 29, 2012, or three years after submission of
the compliance plan. Elevators and related devices that are not in compliance with the
code requirements by the later of January 29, 2012, or three years after the submission of
the compliance plan may be taken out of service as provided in section 326B.175.
new text end

new text begin (a) The commissioner of human services shall develop a proposal to create a single
administrative structure for providing nonemergency medical transportation services to
fee-for-service medical assistance recipients. This proposal must consolidate access and
special transportation into one administrative structure with the goal of standardizing
eligibility determination processes, scheduling arrangements, billing procedures, data
collection, and oversight mechanisms in order to enhance coordination, improve
accountability, and lessen confusion.
new text end

new text begin (b) In developing the proposal, the commissioner shall:
new text end

new text begin (1) examine the current responsibilities performed by the counties and the
Department of Human Services and consider the shift in costs if these responsibilities are
changed;
new text end

new text begin (2) identify key performance measures to assess the cost effectiveness of
nonemergency medical transportation statewide, including a process to collect, audit,
and report data;
new text end

new text begin (3) develop a statewide complaint system for medical assistance recipients using
special transportation;
new text end

new text begin (4) establish a standardized billing process;
new text end

new text begin (5) establish a process that provides public input from interested parties before
special transportation eligibility policies are implemented or significantly changed;
new text end

new text begin (6) establish specific eligibility criteria that include the frequency of eligibility
assessments and the length of time a recipient remains eligible for special transportation;
new text end

new text begin (7) develop a reimbursement method to compensate volunteers for no-load miles
when transporting recipients to or from health-related appointments; and
new text end

new text begin (8) establish specific eligibility criteria to maximize the use of public transportation
by recipients who are without a physical, mental, or other impairment that would prohibit
safely accessing and using public transportation.
new text end

new text begin (c) In developing the proposal, the commissioner shall consult with the
nonemergency medical transportation advisory council established under paragraph (d).
new text end

new text begin (d) The commissioner shall establish the nonemergency medical transportation
advisory council to assist the commissioner in developing a single administrative structure
for providing nonemergency medical transportation services. The council shall be
comprised of:
new text end

new text begin (1) one representative each from the departments of human services and
transportation;
new text end

new text begin (2) one representative each from the following organizations: the Minnesota State
Council on Disability, the Minnesota Consortium for Citizens with Disabilities, ARC
of Minnesota, the Association of Minnesota Counties, the Metropolitan Inter-County
Association, the R-80 Medical Transportation Coalition, the Minnesota Paratransit
Association, legal aid, the Minnesota Ambulance Association, the National Alliance on
Mental Illness, Medical Transportation Management, and other transportation providers;
and
new text end

new text begin (3) four members from the house of representatives, two from the majority party
and two from the minority party, appointed by the speaker, and four members from the
senate, two from the majority party and two from the minority party, appointed by the
Subcommittee on Committees of the Committee on Rules and Administration.
new text end

new text begin The council is governed by Minnesota Statutes, section 15.509, except that members
shall not receive per diems. The commissioner of human services shall fund all costs
related to the council from existing resources.
new text end

new text begin (e) The commissioner shall submit the proposal and draft legislation necessary for
implementation to the chairs and ranking minority members of the senate and house of
representatives committees or divisions with jurisdiction over health care policy and
finance by January 15, 2012.
new text end

Minnesota Statutes 2010, section 148.07, subdivision 1, is amended to read:

All persons practicing chiropractic within this state,
or licensed so to do, shall pay, on or before the date of expiration of their licenses, to the
Board of Chiropractic Examiners a renewal fee set deleted text begin by the boarddeleted text end new text begin in accordance with section
16A.1283new text end , with a penalty deleted text begin set by the boarddeleted text end for each month or portion thereof for which a
license fee is in arrears and upon payment of the renewal and upon compliance with all the
rules of the board, shall be entitled to renewal of their license.

Minnesota Statutes 2010, section 148.108, is amended by adding a subdivision
to read:

new text begin (a) Animal chiropractic registration fee is $125.
new text end

new text begin (b) Animal chiropractic registration renewal fee is $75.
new text end

new text begin (c) Animal chiropractic inactive renewal fee is $25.
new text end

Minnesota Statutes 2010, section 148.191, subdivision 2, is amended to read:

(a) The board is authorized to adopt and, from time to time, revise
rules not inconsistent with the law, as may be necessary to enable it to carry into effect the
provisions of sections 148.171 to 148.285. The board shall prescribe by rule curricula
and standards for schools and courses preparing persons for licensure under sections
148.171 to 148.285. It shall conduct or provide for surveys of such schools and courses
at such times as it may deem necessary. It shall approve such schools and courses as
meet the requirements of sections 148.171 to 148.285 and board rules. It shall examine,
license, and renew the license of duly qualified applicants. It shall hold examinations
at least once in each year at such time and place as it may determine. It shall by rule
adopt, evaluate, and periodically revise, as necessary, requirements for licensure and for
registration and renewal of registration as defined in section 148.231. It shall maintain a
record of all persons licensed by the board to practice professional or practical nursing and
all registered nurses who hold Minnesota licensure and registration and are certified as
advanced practice registered nurses. It shall cause the prosecution of all persons violating
sections 148.171 to 148.285 and have power to incur such necessary expense therefor.
It shall register public health nurses who meet educational and other requirements
established by the board by rule, including payment of a fee. deleted text begin Prior to the adoption of rules,
the board shall use the same procedures used by the Department of Health to certify public
health nurses.deleted text end It shall have power to issue subpoenas, and to compel the attendance of
witnesses and the production of all necessary documents and other evidentiary material.
Any board member may administer oaths to witnesses, or take their affirmation. It shall
keep a record of all its proceedings.

(b) The board shall have access to hospital, nursing home, and other medical records
of a patient cared for by a nurse under review. If the board does not have a written consent
from a patient permitting access to the patient's records, the nurse or facility shall delete
any data in the record that identifies the patient before providing it to the board. The board
shall have access to such other records as reasonably requested by the board to assist the
board in its investigation. Nothing herein may be construed to allow access to any records
protected by section 145.64. The board shall maintain any records obtained pursuant to
this paragraph as investigative data under chapter 13.

new text begin (c) The board may accept and expend grants or gifts of money or in-kind services
from a person, a public or private entity, or any other source for purposes consistent with
the board's role and within the scope of its statutory authority.
new text end

new text begin (d) The board may accept registration fees for meetings and conferences conducted
for the purposes of board activities that are within the scope of its authority.
new text end

Minnesota Statutes 2010, section 148.212, subdivision 1, is amended to read:

Upon receipt of the applicable licensure or reregistration
fee and permit fee, and in accordance with rules of the board, the board may issue
a nonrenewable temporary permit to practice professional or practical nursing to an
applicant for licensure or reregistration who is not the subject of a pending investigation
or disciplinary action, nor disqualified for any other reason, under the following
circumstances:

(a) deleted text begin The applicant for licensure by examination under section 148.211, subdivision
1, has graduated from an approved nursing program within the 60 days preceding board
receipt of an affidavit of graduation or transcript and has been authorized by the board to
write the licensure examination for the first time in the United States. The permit holder
must practice professional or practical nursing under the direct supervision of a registered
nurse. The permit is valid from the date of issue until the date the board takes action on
the application or for 60 days whichever occurs first.
deleted text end

deleted text begin (b)deleted text end The applicant for licensure by endorsement under section 148.211, subdivision 2,
is currently licensed to practice professional or practical nursing in another state, territory,
or Canadian province. The permit is valid deleted text begin from submission of a proper requestdeleted text end until the
date of board action on the applicationnew text begin or for 60 days, whichever comes firstnew text end .

deleted text begin (c)deleted text end new text begin (b)new text end The applicant for licensure by endorsement under section 148.211,
subdivision 2, or for reregistration under section 148.231, subdivision 5, is currently
registered in a formal, structured refresher course or its equivalent for nurses that includes
clinical practice.

deleted text begin (d) The applicant for licensure by examination under section 148.211, subdivision
1, who graduated from a nursing program in a country other than the United States or
Canada has completed all requirements for licensure except registering for and taking the
nurse licensure examination for the first time in the United States. The permit holder must
practice professional nursing under the direct supervision of a registered nurse. The permit
is valid from the date of issue until the date the board takes action on the application or for
60 days, whichever occurs first.
deleted text end

Minnesota Statutes 2010, section 148.231, is amended to read:

Every person licensed to practice professional or
practical nursing must maintain with the board a current registration for practice as a
registered nurse or licensed practical nurse which must be renewed at regular intervals
established by the board by rule. No deleted text begin certificate ofdeleted text end registration shall be issued by the board
to a nurse until the nurse has submitted satisfactory evidence of compliance with the
procedures and minimum requirements established by the board.

The fee for periodic registration for practice as a nurse shall be determined by the
board by deleted text begin ruledeleted text end new text begin lawnew text end . deleted text begin A penalty fee shall be added for any application received after the
required date as specified by the board by rule.deleted text end Upon receipt of the application and the
required fees, the board shall verify the application and the evidence of completion of
continuing education requirements in effect, and thereupon issue to the nurse deleted text begin a certificate
ofdeleted text end registration for the next renewal period.

Any person licensed under the provisions of sections
148.171 to 148.285 who fails to register within the required period shall not be entitled to
practice nursing in this state as a registered nurse or licensed practical nurse.

A person whose registration has lapsed desiring to
resume practice shall make application for reregistration, submit satisfactory evidence of
compliance with the procedures and requirements established by the board, and pay the
deleted text begin registrationdeleted text end new text begin reregistrationnew text end fee for the current period to the board. A penalty fee shall be
required from a person who practiced nursing without current registration. Thereupon,deleted text begin thedeleted text end
registration deleted text begin certificatedeleted text end shall be issued to the person who shall immediately be placed on
the practicing list as a registered nurse or licensed practical nurse.

A person licensed under the provisions of sections 148.171 to
148.285 who requests the board to verify a Minnesota license to another state, territory,
or country or to an agency, facility, school, or institution shall pay a fee deleted text begin to the boarddeleted text end
for each verification.

new text begin The fees specified in section 148.243 are nonrefundable and must be deposited in
the state government special revenue fund.
new text end

new text begin The fee for licensure by examination is
$105.
new text end

new text begin The reexamination fee is $60.
new text end

new text begin The fee for licensure by endorsement is $105.
new text end

new text begin The fee for registration renewal is $85.
new text end

new text begin The fee for reregistration is $105.
new text end

new text begin The fee for a replacement license is $20.
new text end

new text begin The fee for public health nurse
certification is $30.
new text end

new text begin The Drug Enforcement Administration verification for
APRN is $50.
new text end

new text begin The fee for
verification of licensure status other than through Nursys verification is $20.
new text end

new text begin The fee for verification of
examination scores is $20.
new text end

new text begin The fee for a copy of
microfilmed licensure application materials is $20.
new text end

new text begin The fee for the initial
application for nursing business registration is $100.
new text end

new text begin The fee for the
annual application for nursing business registration is $25.
new text end

new text begin The fee for practicing without
current registration is two times the amount of the current registration renewal fee for any
part of the first calendar month, plus the current registration renewal fee for any part of
any subsequent month up to 24 months.
new text end

new text begin The fee for practicing
without current APRN certification is $200 for the first month or any part thereof, plus
$100 for each subsequent month or part thereof.
new text end

new text begin The service fee for a dishonored check is as
provided in section 604.113.
new text end

new text begin The initial application fee for border state
registration is $50. Any subsequent notice of employment change to remain or be
reinstated on the registry is $50.
new text end

new text begin The Nurse Licensure Compact is enacted into law and entered into with all other
jurisdictions legally joining in it, in the form substantially as follows:
new text end

new text begin ARTICLE 1
new text end

new text begin DEFINITIONS
new text end

new text begin As used in this compact:
new text end

new text begin (a) "Adverse action" means a home or remote state action.
new text end

new text begin (b) "Alternative program" means a voluntary, nondisciplinary monitoring program
approved by a nurse licensing board.
new text end

new text begin (c) "Coordinated licensure information system" means an integrated process for
collecting, storing, and sharing information on nurse licensure and enforcement activities
related to nurse licensure laws, which is administered by a nonprofit organization
composed of and controlled by state nurse licensing boards.
new text end

new text begin (d) "Current significant investigative information" means:
new text end

new text begin (1) investigative information that a licensing board, after a preliminary inquiry that
includes notification and an opportunity for the nurse to respond if required by state law,
has reason to believe is not groundless and, if proved true, would indicate more than a
minor infraction; or
new text end

new text begin (2) investigative information that indicates that the nurse represents an immediate
threat to public health and safety regardless of whether the nurse has been notified and
had an opportunity to respond.
new text end

new text begin (e) "Home state" means the party state which is the nurse's primary state of residence.
new text end

new text begin (f) "Home state action" means any administrative, civil, equitable, or criminal
action permitted by the home state's laws which are imposed on a nurse by the home
state's licensing board or other authority including actions against an individual's license
such as revocation, suspension, probation, or any other action which affects a nurse's
authorization to practice.
new text end

new text begin (g) "Licensing board" means a party state's regulatory body responsible for issuing
nurse licenses.
new text end

new text begin (h) "Multistate licensure privilege" means current, official authority from a
remote state permitting the practice of nursing as either a registered nurse or a licensed
practical/vocational nurse in the party state. All party states have the authority, according
to existing state due process law, to take actions against the nurse's privilege such as
revocation, suspension, probation, or any other action which affects a nurse's authorization
to practice.
new text end

new text begin (i) "Nurse" means a registered nurse or licensed practical/vocational nurse as those
terms are defined by each party state's practice laws.
new text end

new text begin (j) "Party state" means any state that has adopted this compact.
new text end

new text begin (k) "Remote state" means a party state other than the home state:
new text end

new text begin (1) where the patient is located at the time nursing care is provided; or
new text end

new text begin (2) in the case of the practice of nursing not involving a patient, in the party state
where the recipient of nursing practice is located.
new text end

new text begin (l) "Remote state action" means:
new text end

new text begin (1) any administrative, civil, equitable, or criminal action permitted by a remote
state's laws which are imposed on a nurse by the remote state's licensing board or other
authority including actions against an individual's multistate licensure privilege to practice
in the remote state; and
new text end

new text begin (2) cease and desist and other injunctive or equitable orders issued by remote states
or the licensing boards of those states.
new text end

new text begin (m) "State" means a state, territory, or possession of the United States, the District of
Columbia, or the Commonwealth of Puerto Rico.
new text end

new text begin (n) "State practice laws" means individual party state laws and regulations that
govern the practice of nursing, define the scope of nursing practice, and create the
methods and grounds for imposing discipline. State practice laws does not include the
initial qualifications for licensure or requirements necessary to obtain and retain a license,
except for qualifications or requirements of the home state.
new text end

new text begin ARTICLE 2
new text end

new text begin GENERAL PROVISIONS AND JURISDICTION
new text end

new text begin (a) A license to practice registered nursing issued by a home state to a resident in
that state will be recognized by each party state as authorizing a multistate licensure
privilege to practice as a registered nurse in the party state. A license to practice licensed
practical/vocational nursing issued by a home state to a resident in that state will be
recognized by each party state as authorizing a multistate licensure privilege to practice
as a licensed practical/vocational nurse in the party state. In order to obtain or retain a
license, an applicant must meet the home state's qualifications for licensure and license
renewal as well as all other applicable state laws.
new text end

new text begin (b) Party states may, according to state due process laws, limit or revoke the
multistate licensure privilege of any nurse to practice in their state and may take any other
actions under their applicable state laws necessary to protect the health and safety of
their citizens. If a party state takes such action, it shall promptly notify the administrator
of the coordinated licensure information system. The administrator of the coordinated
licensure information system shall promptly notify the home state of any such actions by
remote states.
new text end

new text begin (c) Every nurse practicing in a party state must comply with the state practice laws of
the state in which the patient is located at the time care is rendered. In addition, the practice
of nursing is not limited to patient care, but shall include all nursing practice as defined by
the state practice laws of the party state. The practice of nursing will subject a nurse to the
jurisdiction of the nurse licensing board, the courts, and the laws in the party state.
new text end

new text begin (d) This compact does not affect additional requirements imposed by states for
advanced practice registered nursing. However, a multistate licensure privilege to practice
registered nursing granted by a party state shall be recognized by other party states as a
license to practice registered nursing if one is required by state law as a precondition for
qualifying for advanced practice registered nurse authorization.
new text end

new text begin (e) Individuals not residing in a party state shall continue to be able to apply for
nurse licensure as provided for under the laws of each party state. However, the license
granted to these individuals will not be recognized as granting the privilege to practice
nursing in any other party state unless explicitly agreed to by that party state.
new text end

new text begin ARTICLE 3
new text end

new text begin APPLICATIONS FOR LICENSURE IN A PARTY STATE
new text end

new text begin (a) Upon application for a license, the licensing board in a party state shall ascertain,
through the coordinated licensure information system, whether the applicant has ever held
or is the holder of a license issued by any other state, whether there are any restrictions
on the multistate licensure privilege, and whether any other adverse action by a state
has been taken against the license.
new text end

new text begin (b) A nurse in a party state shall hold licensure in only one party state at a time,
issued by the home state.
new text end

new text begin (c) A nurse who intends to change primary state of residence may apply for licensure
in the new home state in advance of the change. However, new licenses will not be
issued by a party state until after a nurse provides evidence of change in primary state of
residence satisfactory to the new home state's licensing board.
new text end

new text begin (d) When a nurse changes primary state of residence by:
new text end

new text begin (1) moving between two party states, and obtains a license from the new home state,
the license from the former home state is no longer valid;
new text end

new text begin (2) moving from a nonparty state to a party state, and obtains a license from the new
home state, the individual state license issued by the nonparty state is not affected and will
remain in full force if so provided by the laws of the nonparty state; or
new text end

new text begin (3) moving from a party state to a nonparty state, the license issued by the prior
home state converts to an individual state license, valid only in the former home state,
without the multistate licensure privilege to practice in other party states.
new text end

new text begin ARTICLE 4
new text end

new text begin ADVERSE ACTIONS
new text end

new text begin In addition to the general provisions described in article 2, the provisions in this
article apply.
new text end

new text begin (a) The licensing board of a remote state shall promptly report to the administrator
of the coordinated licensure information system any remote state actions including the
factual and legal basis for the action, if known. The licensing board of a remote state shall
also promptly report any significant current investigative information yet to result in a
remote state action. The administrator of the coordinated licensure information system
shall promptly notify the home state of any reports.
new text end

new text begin (b) The licensing board of a party state shall have the authority to complete any
pending investigation for a nurse who changes primary state of residence during the
course of the investigation. The board shall also have the authority to take appropriate
action, and shall promptly report the conclusion of the investigation to the administrator
of the coordinated licensure information system. The administrator of the coordinated
licensure information system shall promptly notify the new home state of any action.
new text end

new text begin (c) A remote state may take adverse action affecting the multistate licensure
privilege to practice within that party state. However, only the home state shall have the
power to impose adverse action against the license issued by the home state.
new text end

new text begin (d) For purposes of imposing adverse actions, the licensing board of the home state
shall give the same priority and effect to reported conduct received from a remote state as
it would if the conduct had occurred within the home state. In so doing, it shall apply its
own state laws to determine appropriate action.
new text end

new text begin (e) The home state may take adverse action based on the factual findings of the
remote state, provided each state follows its own procedures for imposing the adverse
action.
new text end

new text begin (f) Nothing in this compact shall override a party state's decision that participation
in an alternative program may be used in lieu of licensure action and that participation
shall remain nonpublic if required by the party state's laws.
new text end

new text begin Party states must require nurses who enter any alternative programs to agree not to
practice in any other party state during the term of the alternative program without prior
authorization from the other party state.
new text end

new text begin ARTICLE 5
new text end

new text begin ADDITIONAL AUTHORITIES INVESTED IN
new text end

new text begin PARTY STATE NURSE LICENSING BOARDS
new text end

new text begin Notwithstanding any other laws, party state nurse licensing boards shall have the
authority to:
new text end

new text begin (1) if otherwise permitted by state law, recover from the affected nurse the costs of
investigation and disposition of cases resulting from any adverse action taken against
that nurse;
new text end

new text begin (2) issue subpoenas for both hearings and investigations which require the attendance
and testimony of witnesses, and the production of evidence. Subpoenas issued by a nurse
licensing board in a party state for the attendance and testimony of witnesses, and the
production of evidence from another party state, shall be enforced in the latter state by
any court of competent jurisdiction according to the practice and procedure of that court
applicable to subpoenas issued in proceedings pending before it. The issuing authority
shall pay any witness fees, travel expenses, mileage, and other fees required by the service
statutes of the state where the witnesses and evidence are located;
new text end

new text begin (3) issue cease and desist orders to limit or revoke a nurse's authority to practice
in the nurse's state; and
new text end

new text begin (4) adopt uniform rules and regulations as provided for in article 7, paragraph (c).
new text end

new text begin ARTICLE 6
new text end

new text begin COORDINATED LICENSURE INFORMATION SYSTEM
new text end

new text begin (a) All party states shall participate in a cooperative effort to create a coordinated
database of all licensed registered nurses and licensed practical/vocational nurses. This
system shall include information on the licensure and disciplinary history of each
nurse, as contributed by party states, to assist in the coordination of nurse licensure and
enforcement efforts.
new text end

new text begin (b) Notwithstanding any other provision of law, all party states' licensing boards shall
promptly report adverse actions, actions against multistate licensure privileges, any current
significant investigative information yet to result in adverse action, denials of applications,
and the reasons for the denials to the coordinated licensure information system.
new text end

new text begin (c) Current significant investigative information shall be transmitted through the
coordinated licensure information system only to party state licensing boards.
new text end

new text begin (d) Notwithstanding any other provision of law, all party states' licensing boards
contributing information to the coordinated licensure information system may designate
information that may not be shared with nonparty states or disclosed to other entities or
individuals without the express permission of the contributing state.
new text end

new text begin (e) Any personally identifiable information obtained by a party state's licensing
board from the coordinated licensure information system may not be shared with nonparty
states or disclosed to other entities or individuals except to the extent permitted by the
laws of the party state contributing the information.
new text end

new text begin (f) Any information contributed to the coordinated licensure information system that
is subsequently required to be expunged by the laws of the party state contributing that
information shall also be expunged from the coordinated licensure information system.
new text end

new text begin (g) The compact administrators, acting jointly with each other and in consultation
with the administrator of the coordinated licensure information system, shall formulate
necessary and proper procedures for the identification, collection, and exchange of
information under this compact.
new text end

new text begin ARTICLE 7
new text end

new text begin COMPACT ADMINISTRATION AND
new text end

new text begin INTERCHANGE OF INFORMATION
new text end

new text begin (a) The head or designee of the nurse licensing board of each party state shall be the
administrator of this compact for that state.
new text end

new text begin (b) The compact administrator of each party state shall furnish to the compact
administrator of each other party state any information and documents including, but not
limited to, a uniform data set of investigations, identifying information, licensure data, and
disclosable alternative program participation information to facilitate the administration of
this compact.
new text end

new text begin (c) Compact administrators shall have the authority to develop uniform rules to
facilitate and coordinate implementation of this compact. These uniform rules shall be
adopted by party states under the authority in article 5, clause (4).
new text end

new text begin ARTICLE 8
new text end

new text begin IMMUNITY
new text end

new text begin A party state or the officers, employees, or agents of a party state's nurse licensing
board who acts in good faith according to the provisions of this compact shall not be
liable for any act or omission while engaged in the performance of their duties under
this compact. Good faith shall not include willful misconduct, gross negligence, or
recklessness.
new text end

new text begin ARTICLE 9
new text end

new text begin ENACTMENT, WITHDRAWAL, AND AMENDMENT
new text end

new text begin (a) This compact shall become effective for each state when it has been enacted by
that state. Any party state may withdraw from this compact by repealing the nurse licensure
compact, but no withdrawal shall take effect until six months after the withdrawing state
has given notice of the withdrawal to the executive heads of all other party states.
new text end

new text begin (b) No withdrawal shall affect the validity or applicability by the licensing boards
of states remaining party to the compact of any report of adverse action occurring prior
to the withdrawal.
new text end

new text begin (c) Nothing contained in this compact shall be construed to invalidate or prevent any
nurse licensure agreement or other cooperative arrangement between a party state and a
nonparty state that is made according to the other provisions of this compact.
new text end

new text begin (d) This compact may be amended by the party states. No amendment to this
compact shall become effective and binding upon the party states until it is enacted into
the laws of all party states.
new text end

new text begin ARTICLE 10
new text end

new text begin CONSTRUCTION AND SEVERABILITY
new text end

new text begin (a) This compact shall be liberally construed to effectuate the purposes of the
compact. The provisions of this compact shall be severable and if any phrase, clause,
sentence, or provision of this compact is declared to be contrary to the constitution of any
party state or of the United States or the applicability thereof to any government, agency,
person, or circumstance is held invalid, the validity of the remainder of this compact and
the applicability of it to any government, agency, person, or circumstance shall not be
affected by it. If this compact is held contrary to the constitution of any party state, the
compact shall remain in full force and effect for the remaining party states and in full force
and effect for the party state affected as to all severable matters.
new text end

new text begin (b) In the event party states find a need for settling disputes arising under this
compact:
new text end

new text begin (1) the party states may submit the issues in dispute to an arbitration panel which
shall be comprised of an individual appointed by the compact administrator in the home
state, an individual appointed by the compact administrator in the remote states involved,
and an individual mutually agreed upon by the compact administrators of the party states
involved in the dispute; and
new text end

new text begin (2) the decision of a majority of the arbitrators shall be final and binding.
new text end

new text begin (a) A nurse practicing professional or practical nursing in Minnesota under the
authority of section 148.2855 shall have the same obligations, privileges, and rights as if
the nurse was licensed in Minnesota. Notwithstanding any contrary provisions in section
148.2855, the Board of Nursing shall comply with and follow all laws and rules with
respect to registered and licensed practical nurses practicing professional or practical
nursing in Minnesota under the authority of section 148.2855, and all such individuals
shall be governed and regulated as if they were licensed by the board.
new text end

new text begin (b) Section 148.2855 does not relieve employers of nurses from complying with
statutorily imposed obligations.
new text end

new text begin (c) Section 148.2855 does not supersede existing state labor laws.
new text end

new text begin (d) For purposes of the Minnesota Government Data Practices Act, chapter 13,
an individual not licensed as a nurse under sections 148.171 to 148.285 who practices
professional or practical nursing in Minnesota under the authority of section 148.2855 is
considered to be a licensee of the board.
new text end

new text begin (e) Uniform rules developed by the compact administrators shall not be subject
to the provisions of sections 14.05 to 14.389, except for sections 14.07, 14.08, 14.101,
14.131, 14.18, 14.22, 14.23, 14.27, 14.28, 14.365, 14.366, 14.37, and 14.38.
new text end

new text begin (f) Proceedings brought against an individual's multistate privilege shall be
adjudicated following the procedures listed in sections 14.50 to 14.62 and shall be subject
to judicial review as provided for in sections 14.63 to 14.69.
new text end

new text begin (g) For purposes of sections 62M.09, subdivision 2; 121A.22, subdivision 4;
144.051; 144.052; 145A.02, subdivision 18; 148.975; 151.37; 152.12; 154.04; 256B.0917,
subdivision 8; 595.02, subdivision 1, paragraph (g); 604.20, subdivision 5; and 631.40,
subdivision 2; and chapters 319B and 364, holders of a multistate privilege who are
licensed as registered or licensed practical nurses in the home state shall be considered
to be licensees in Minnesota. If any of the statutes listed in this paragraph are limited to
registered nurses or the practice of professional nursing, then only holders of a multistate
privilege who are licensed as registered nurses in the home state shall be considered
licensees.
new text end

new text begin (h) The reporting requirements of sections 144.4175, 148.263, 626.52, and 626.557
apply to individuals not licensed as registered or licensed practical nurses under sections
148.171 to 148.285 who practice professional or practical nursing in Minnesota under
the authority of section 148.2855.
new text end

new text begin (i) The board may take action against an individual's multistate privilege based on
the grounds listed in section 148.261, subdivision 1, and any other statute authorizing or
requiring the board to take corrective or disciplinary action.
new text end

new text begin (j) The board may take all forms of disciplinary action provided for in section
148.262, subdivision 1, and corrective action provided for in section 214.103, subdivision
6, against an individual's multistate privilege.
new text end

new text begin (k) The immunity provisions of section 148.264, subdivision 1, apply to individuals
who practice professional or practical nursing in Minnesota under the authority of section
148.2855.
new text end

new text begin (l) The cooperation requirements of section 148.265 apply to individuals who
practice professional or practical nursing in Minnesota under the authority of section
148.2855.
new text end

new text begin (m) The provisions of section 148.283 shall not apply to individuals who practice
professional or practical nursing in Minnesota under the authority of section 148.2855.
new text end

new text begin (n) Complaints against individuals who practice professional or practical nursing
in Minnesota under the authority of section 148.2855 shall be handled as provided in
sections 214.10 and 214.103.
new text end

new text begin (o) All provisions of section 148.2855 authorizing or requiring the board to provide
data to party states are authorized by section 214.10, subdivision 8, paragraph (d).
new text end

new text begin (p) Except as provided in section 13.41, subdivision 6, the board shall not report to a
remote state any active investigative data regarding a complaint investigation against a
nurse licensed under sections 148.171 to 148.285, unless the board obtains reasonable
assurances from the remote state that the data will be maintained with the same protections
as provided in Minnesota law.
new text end

new text begin (q) The provisions of sections 214.17 to 214.25 apply to individuals who practice
professional or practical nursing in Minnesota under the authority of section 148.2855
when the practice involves direct physical contact between the nurse and a patient.
new text end

new text begin (r) A nurse practicing professional or practical nursing in Minnesota under the
authority of section 148.2855 must comply with any criminal background check required
under Minnesota law.
new text end

new text begin The governor may withdraw the state from the compact in section 148.2855 if
the Board of Nursing notifies the governor that a party state to the compact changed
the party state's requirements for nurse licensure after July 1, 2009, and that the party
state's requirements, as changed, are substantially lower than the requirements for nurse
licensure in this state.
new text end

new text begin (a) For the purposes of section 148.2855, "head of the Nurse Licensing Board"
means the executive director of the board.
new text end

new text begin (b) The Board of Nursing shall have the authority to recover from a nurse practicing
professional or practical nursing in Minnesota under the authority of section 148.2855
the costs of investigation and disposition of cases resulting from any adverse action
taken against the nurse.
new text end

new text begin (c) The board may implement a system of identifying individuals who practice
professional or practical nursing in Minnesota under the authority of section 148.2855.
new text end

new text begin A Nurse Licensure Compact Advisory
Committee is established to advise the compact administrator in the implementation of
section 148.2855. Members of the advisory committee shall be appointed by the board
and shall be composed of representatives of Minnesota nursing organizations, Minnesota
licensed nurses who practice in nursing facilities or hospitals, Minnesota licensed nurses
who provide home care, Minnesota licensed advanced practice registered nurses, and
public members as defined in section 214.02.
new text end

new text begin The advisory committee shall advise the compact administrator in
the implementation of section 148.2855.
new text end

new text begin The advisory committee shall be organized and
administered under section 15.059.
new text end

Minnesota Statutes 2010, section 148B.17, is amended to read:

deleted text begin Each board shall
by rule establishdeleted text end new text begin The board'snew text end fees, including late fees, for licenses and renewalsnew text begin are
establishednew text end so that the total fees collected by the board will as closely as possible equal
anticipated expenditures during the fiscal biennium, as provided in section 16A.1285.
Fees must be credited to deleted text begin accountsdeleted text end new text begin the board's accountnew text end in thenew text begin state governmentnew text end special
revenue fund.

new text begin Nonrefundable licensure and application
fees charged by the board are as follows:
new text end

new text begin (1) application fee for national examination is $220;
new text end

new text begin (2) application fee for Licensed Marriage and Family Therapist (LMFT) state
examination is $110;
new text end

new text begin (3) initial LMFT license fee is prorated, but cannot exceed $125;
new text end

new text begin (4) annual renewal fee for LMFT license is $125;
new text end

new text begin (5) late fee for initial Licensed Associate Marriage and Family Therapist LAMFT
license renewal is $50;
new text end

new text begin (6) application fee for LMFT licensure by reciprocity is $340;
new text end

new text begin (7) fee for initial Licensed Associate Marriage and Family Therapist (LAMFT)
license is $75;
new text end

new text begin (8) annual renewal fee for LAMFT license is $75;
new text end

new text begin (9) late fee for LAMFT renewal is $50;
new text end

new text begin (10) fee for reinstatement of license is $150; and
new text end

new text begin (11) fee for emeritus status is $125.
new text end

new text begin Other fees charged by the board are as follows:
new text end

new text begin (1) sponsor application fee for approval of a continuing education course is $60;
new text end

new text begin (2) fee for license verification by mail is $10;
new text end

new text begin (3) duplicate license fee is $25;
new text end

new text begin (4) duplicate renewal card fee is $10;
new text end

new text begin (5) fee for licensee mailing list is $60;
new text end

new text begin (6) fee for a rule book is $10; and
new text end

new text begin (7) fees as authorized by section 148B.175, subdivision 6, clause (7).
new text end

Minnesota Statutes 2010, section 148B.33, subdivision 2, is amended to read:

Each applicant shall pay a nonrefundable application fee deleted text begin set by
the boarddeleted text end new text begin under section 148B.17new text end .

Minnesota Statutes 2010, section 148B.52, is amended to read:

(a) The Board of Behavioral Health and Therapy shall:

(1) establish by rule appropriate techniques, including examinations and other
methods, for determining whether applicants and licensees are qualified under sections
148B.50 to 148B.593;

(2) establish by rule standards for professional conduct, including adoption of a
Code of Professional Ethics and requirements for continuing education and supervision;

(3) issue licenses to individuals qualified under sections 148B.50 to 148B.593;

(4) establish by rule standards for initial education including coursework for
licensure and content of professional education;

(5) establish, maintain, and publish annually a register of current licensees and
approved supervisors;

(6) establish initial and renewal application and examination fees sufficient to cover
operating expenses of the board and its agentsnew text begin in accordance with section 16A.1283new text end ;

(7) educate the public about the existence and content of the laws and rules for
licensed professional counselors to enable consumers to file complaints against licensees
who may have violated the rules; and

(8) periodically evaluate its rules in order to refine the standards for licensing
professional counselors and to improve the methods used to enforce the board's standards.

(b) The board may appoint a professional discipline committee for each occupational
licensure regulated by the board, and may appoint a board member as chair. The
professional discipline committee shall consist of five members representative of the
licensed occupation and shall provide recommendations to the board with regard to rule
techniques, standards, procedures, and related issues specific to the licensed occupation.

Minnesota Statutes 2010, section 150A.091, subdivision 2, is amended to read:

Each applicant shall submit with a licensenew text begin , advanced
dental therapist certificate,new text end or permit application a nonrefundable fee in the following
amounts in order to administratively process an application:

(1) dentist, $140;

new text begin (2) full faculty dentist, $140;
new text end

deleted text begin (2)deleted text end new text begin (3)new text end limited faculty dentist, $140;

deleted text begin (3)deleted text end new text begin (4)new text end resident dentistnew text begin or dental providernew text end , $55;

new text begin (5) advanced dental therapist, $100;
new text end

deleted text begin (4)deleted text end new text begin (6)new text end dental therapist, $100;

deleted text begin (5)deleted text end new text begin (7)new text end dental hygienist, $55;

deleted text begin (6)deleted text end new text begin (8)new text end licensed dental assistant, $55; and

deleted text begin (7)deleted text end new text begin (9)new text end dental assistant with a permit as described in Minnesota Rules, part
3100.8500, subpart 3, $15.

Minnesota Statutes 2010, section 150A.091, subdivision 3, is amended to read:

Along with the application fee, each of the
following applicants shall submit a separate prorated initial license or permit fee. The
prorated initial fee shall be established by the board based on the number of months of the
applicant's initial term as described in Minnesota Rules, part 3100.1700, subpart 1a, not to
exceed the following monthly fee amounts:

(1) dentistnew text begin or full faculty dentistnew text end , $14 times the number of months of the initial term;

(2) dental therapist, $10 times the number of months of the initial term;

(3) dental hygienist, $5 times the number of months of the initial term;

(4) licensed dental assistant, $3 times the number of months of the initial term; and

(5) dental assistant with a permit as described in Minnesota Rules, part 3100.8500,
subpart 3, $1 times the number of months of the initial term.

Minnesota Statutes 2010, section 150A.091, subdivision 4, is amended to read:

Each limited faculty or resident dentist shall submit
with an annual license renewal application a fee established by the board not to exceed
the following amounts:

(1) limited faculty dentist, $168; and

(2) resident dentistnew text begin or dental providernew text end , $59.

Minnesota Statutes 2010, section 150A.091, subdivision 5, is amended to read:

Each of the following applicants shall
submit with a biennial license or permit renewal application a fee as established by the
board, not to exceed the following amounts:

(1) dentistnew text begin or full faculty dentistnew text end , $336;

(2) dental therapist, $180;

(3) dental hygienist, $118;

(4) licensed dental assistant, $80; and

(5) dental assistant with a permit as described in Minnesota Rules, part 3100.8500,
subpart 3, $24.

Minnesota Statutes 2010, section 150A.091, subdivision 8, is amended to read:

Each applicant shall submit, with
a request for issuance of a duplicate of the original license, or of an annual or biennial
renewal certificate for a license or permit, a fee in the following amounts:

(1) original dentist,new text begin full faculty dentist,new text end dental therapist, dental hygiene, or dental
assistant license, $35; and

(2) annual or biennial renewal certificates, $10.

Minnesota Statutes 2010, section 150A.091, is amended by adding a
subdivision to read:

new text begin A licensee shall
submit a fee as established by the board not to exceed the amount of $250 after failing
two consecutive professional development portfolio audits and, thereafter, for each failed
professional development portfolio audit under Minnesota Rules, part 3100.5300.
new text end

new text begin Application fees for licensure and registration
are as follows:
new text end

new text begin (1) pharmacist licensed by examination, $130;
new text end

new text begin (2) pharmacist licensed by reciprocity, $225;
new text end

new text begin (3) pharmacy intern, $30;
new text end

new text begin (4) pharmacy technician, $30;
new text end

new text begin (5) pharmacy, $190;
new text end

new text begin (6) drug wholesaler, legend drugs only, $200;
new text end

new text begin (7) drug wholesaler, legend and nonlegend drugs, $200;
new text end

new text begin (8) drug wholesaler, nonlegend drugs, veterinary legend drugs, or both, $175;
new text end

new text begin (9) drug wholesaler, medical gases, $150;
new text end

new text begin (10) drug wholesaler, also licensed as a pharmacy in Minnesota, $125;
new text end

new text begin (11) drug manufacturer, legend drugs only, $200;
new text end

new text begin (12) drug manufacturer, legend and nonlegend drugs, $200;
new text end

new text begin (13) drug manufacturer, nonlegend or veterinary legend drugs, $175;
new text end

new text begin (14) drug manufacturer, medical gases, $150;
new text end

new text begin (15) drug manufacturer, also licensed as a pharmacy in Minnesota, $125;
new text end

new text begin (16) medical gas distributor, $75;
new text end

new text begin (17) controlled substance researcher, $50; and
new text end

new text begin (18) pharmacy professional corporation, $100.
new text end

new text begin The pharmacist original licensure fee, $130.
new text end

new text begin Annual licensure and registration renewal fees
are as follows:
new text end

new text begin (1) pharmacist, $130;
new text end

new text begin (2) pharmacy technician, $30;
new text end

new text begin (3) pharmacy, $190;
new text end

new text begin (4) drug wholesaler, legend drugs only, $200;
new text end

new text begin (5) drug wholesaler, legend and nonlegend drugs, $200;
new text end

new text begin (6) drug wholesaler, nonlegend drugs, veterinary legend drugs, or both, $175;
new text end

new text begin (7) drug wholesaler, medical gases, $150;
new text end

new text begin (8) drug wholesaler, also licensed as a pharmacy in Minnesota, $125;
new text end

new text begin (9) drug manufacturer, legend drugs only, $200;
new text end

new text begin (10) drug manufacturer, legend and nonlegend drugs, $200;
new text end

new text begin (11) drug manufacturer, nonlegend, veterinary legend drugs, or both, $175;
new text end

new text begin (12) drug manufacturer, medical gases, $150;
new text end

new text begin (13) drug manufacturer, also licensed as a pharmacy in Minnesota, $125;
new text end

new text begin (14) medical gas distributor, $75;
new text end

new text begin (15) controlled substance researcher, $50; and
new text end

new text begin (16) pharmacy professional corporation, $45.
new text end

new text begin Fees for issuance of affidavits and duplicate licenses
and certificates are as follows:
new text end

new text begin (1) intern affidavit, $15;
new text end

new text begin (2) duplicate small license, $15; and
new text end

new text begin (3) duplicate large certificate, $25.
new text end

new text begin All annual renewal fees are subject to a 50 percent late fee if
the renewal fee and application are not received by the board prior to the date specified
by the board.
new text end

new text begin (a) A pharmacist who has allowed the pharmacist's
license to lapse may reinstate the license with board approval and upon payment of any
fees and late fees in arrears, up to a maximum of $1,000.
new text end

new text begin (b) A pharmacy technician who has allowed the technician's registration to lapse
may reinstate the registration with board approval and upon payment of any fees and late
fees in arrears, up to a maximum of $90.
new text end

new text begin (c) An owner of a pharmacy, a drug wholesaler, a drug manufacturer, or a medical
gas distributor who has allowed the license of the establishment to lapse may reinstate the
license with board approval and upon payment of any fees and late fees in arrears.
new text end

new text begin (d) A controlled substance researcher who has allowed the researcher's registration
to lapse may reinstate the registration with board approval and upon payment of any fees
and late fees in arrears.
new text end

new text begin (e) A pharmacist owner of a professional corporation who has allowed the
corporation's registration to lapse may reinstate the registration with board approval and
upon payment of any fees and late fees in arrears.
new text end

Minnesota Statutes 2010, section 151.07, is amended to read:

The board shall meet at times as may be necessary and as it may determine to
examine applicants for licensure and to transact its other business, giving reasonable
notice of all examinations by mail to known applicants therefor. The secretary shall record
the names of all persons licensed by the board, together with the grounds upon which
the right of each to licensure was claimed. The fee for examination shall be in deleted text begin suchdeleted text end new text begin the
new text end amount deleted text begin as the board may determinedeleted text end new text begin specified in section 151.065new text end , which fee may in the
discretion of the board be returned to applicants not taking the examination.

Minnesota Statutes 2010, section 151.101, is amended to read:

new text begin Upon payment of the fee specified in section 151.065, new text end the board may deleted text begin licensedeleted text end new text begin registernew text end
as an intern any natural persons who have satisfied the board that they are of good moral
character, not physically or mentally unfit, and who have successfully completed the
educational requirements for intern deleted text begin licensuredeleted text end new text begin registrationnew text end prescribed by the board. The
board shall prescribe standards and requirements for interns, pharmacist-preceptors, and
internship training but may not require more than one year of such training.

The board in its discretion may accept internship experience obtained in another
state provided the internship requirements in such other state are in the opinion of the
board equivalent to those herein provided.

Minnesota Statutes 2010, section 151.102, is amended by adding a subdivision
to read:

new text begin The board shall not register an individual as a pharmacy
technician unless all applicable fees specified in section 151.065 have been paid.
new text end

Minnesota Statutes 2010, section 151.12, is amended to read:

The board may in its discretion grant licensure without examination to any
pharmacist licensed by the Board of Pharmacy or a similar board of another state which
accords similar recognition to licensees of this state; provided, the requirements for
licensure in such other state are in the opinion of the board equivalent to those herein
provided. The fee for licensure shall be in deleted text begin suchdeleted text end new text begin thenew text end amount deleted text begin as the board may determine by
ruledeleted text end new text begin specified in section 151.065new text end .

Minnesota Statutes 2010, section 151.13, subdivision 1, is amended to read:

Every person licensed by the board new text begin as a pharmacist
new text end shall pay to the board deleted text begin adeleted text end new text begin the annualnew text end renewal fee deleted text begin to be fixed by itdeleted text end new text begin specified in section
151.065new text end . The board may deleted text begin promulgate by rule adeleted text end charge deleted text begin to be assessed for the delinquent
payment of a fee.deleted text end new text begin the late fee specified in section 151.065 if the renewal fee and
application are not received by the board prior to the date specified by the board.new text end It shall
be unlawful for any person licensed as a pharmacist who refuses or fails to pay deleted text begin suchdeleted text end new text begin any
applicable new text end renewal new text begin or late new text end fee to practice pharmacy in this state. Every certificate and
license shall expire at the time therein prescribed.

Minnesota Statutes 2010, section 151.19, is amended to read:

The board shall require and provide for the
annual registration of every pharmacy now or hereafter doing business within this state.
Upon the payment of deleted text begin adeleted text end new text begin any applicable new text end fee deleted text begin to be set by the boarddeleted text end new text begin specified in section
151.065new text end , the board shall issue a registration certificate in such form as it may prescribe to
such persons as may be qualified by law to conduct a pharmacy. Such certificate shall be
displayed in a conspicuous place in the pharmacy for which it is issued and expire on the
30th day of June following the date of issue. It shall be unlawful for any person to conduct
a pharmacy unless such certificate has been issued to the person by the board.

The board shall require and provide for an
annual nonresident special pharmacy registration for all pharmacies located outside of this
state that regularly dispense medications for Minnesota residents and mail, ship, or deliver
prescription medications into this state. Nonresident special pharmacy registration shall
be granted by the board upon new text begin payment of any applicable fee specified in section 151.065
and new text end the disclosure and certification by a pharmacy:

(1) that it is licensed in the state in which the dispensing facility is located and from
which the drugs are dispensed;

(2) the location, names, and titles of all principal corporate officers and all
pharmacists who are dispensing drugs to residents of this state;

(3) that it complies with all lawful directions and requests for information from
the Board of Pharmacy of all states in which it is licensed or registered, except that it
shall respond directly to all communications from the board concerning emergency
circumstances arising from the dispensing of drugs to residents of this state;

(4) that it maintains its records of drugs dispensed to residents of this state so that the
records are readily retrievable from the records of other drugs dispensed;

(5) that it cooperates with the board in providing information to the Board of
Pharmacy of the state in which it is licensed concerning matters related to the dispensing
of drugs to residents of this state;

(6) that during its regular hours of operation, but not less than six days per week, for
a minimum of 40 hours per week, a toll-free telephone service is provided to facilitate
communication between patients in this state and a pharmacist at the pharmacy who has
access to the patients' records; the toll-free number must be disclosed on the label affixed
to each container of drugs dispensed to residents of this state; and

(7) that, upon request of a resident of a long-term care facility located within the
state of Minnesota, the resident's authorized representative, or a contract pharmacy or
licensed health care facility acting on behalf of the resident, the pharmacy will dispense
medications prescribed for the resident in unit-dose packaging or, alternatively, comply
with the provisions of section 151.415, subdivision 5.

The board shall require and
provide for the annual registration of every person or establishment not licensed as a
pharmacy or a practitioner engaged in the retail sale or distribution of federally restricted
medical gases. Upon the payment of deleted text begin adeleted text end new text begin any applicable new text end fee deleted text begin to be set by the boarddeleted text end new text begin specified
in section 151.065new text end , the board shall issue a registration certificate in such form as it may
prescribe to those persons or places that may be qualified to sell or distribute federally
restricted medical gases. The certificate shall be displayed in a conspicuous place in the
business for which it is issued and expire on the date set by the board. It is unlawful for
a person to sell or distribute federally restricted medical gases unless a certificate has
been issued to that person by the board.

Minnesota Statutes 2010, section 151.25, is amended to read:

The board shall require and provide for the annual registration of every person
engaged in manufacturing drugs, medicines, chemicals, or poisons for medicinal purposes,
now or hereafter doing business with accounts in this state. Upon a payment of deleted text begin adeleted text end new text begin any
applicablenew text end fee deleted text begin as set by the boarddeleted text end new text begin specified in section 151.065new text end , the board shall issue a
registration certificate in such form as it may prescribe to such manufacturer. Such
registration certificate shall be displayed in a conspicuous place in such manufacturer's
or wholesaler's place of business for which it is issued and expire on the date set by the
board. It shall be unlawful for any person to manufacture drugs, medicines, chemicals,
or poisons for medicinal purposes unless such a certificate has been issued to the person
by the board. It shall be unlawful for any person engaged in the manufacture of drugs,
medicines, chemicals, or poisons for medicinal purposes, or the person's agent, to sell
legend drugs to other than a pharmacy, except as provided in this chapter.

Minnesota Statutes 2010, section 151.47, subdivision 1, is amended to read:

All wholesale drug distributors are subject to the
requirements in paragraphs (a) to (f).

(a) No person or distribution outlet shall act as a wholesale drug distributor without
first obtaining a license from the board and paying deleted text begin the requireddeleted text end new text begin any applicable new text end feenew text begin
specified in section 151.065new text end .

(b) No license shall be issued or renewed for a wholesale drug distributor to operate
unless the applicant agrees to operate in a manner prescribed by federal and state law and
according to the rules adopted by the board.

(c) The board may require a separate license for each facility directly or indirectly
owned or operated by the same business entity within the state, or for a parent entity
with divisions, subsidiaries, or affiliate companies within the state, when operations
are conducted at more than one location and joint ownership and control exists among
all the entities.

(d) As a condition for receiving and retaining a wholesale drug distributor license
issued under sections 151.42 to 151.51, an applicant shall satisfy the board that it has
and will continuously maintain:

(1) adequate storage conditions and facilities;

(2) minimum liability and other insurance as may be required under any applicable
federal or state law;

(3) a viable security system that includes an after hours central alarm, or comparable
entry detection capability; restricted access to the premises; comprehensive employment
applicant screening; and safeguards against all forms of employee theft;

(4) a system of records describing all wholesale drug distributor activities set forth
in section 151.44 for at least the most recent two-year period, which shall be reasonably
accessible as defined by board regulations in any inspection authorized by the board;

(5) principals and persons, including officers, directors, primary shareholders,
and key management executives, who must at all times demonstrate and maintain their
capability of conducting business in conformity with sound financial practices as well
as state and federal law;

(6) complete, updated information, to be provided to the board as a condition for
obtaining and retaining a license, about each wholesale drug distributor to be licensed,
including all pertinent corporate licensee information, if applicable, or other ownership,
principal, key personnel, and facilities information found to be necessary by the board;

(7) written policies and procedures that assure reasonable wholesale drug distributor
preparation for, protection against, and handling of any facility security or operation
problems, including, but not limited to, those caused by natural disaster or government
emergency, inventory inaccuracies or product shipping and receiving, outdated product
or other unauthorized product control, appropriate disposition of returned goods, and
product recalls;

(8) sufficient inspection procedures for all incoming and outgoing product
shipments; and

(9) operations in compliance with all federal requirements applicable to wholesale
drug distribution.

(e) An agent or employee of any licensed wholesale drug distributor need not seek
licensure under this section.

(f) A wholesale drug distributor shall file with the board an annual report, in a
form and on the date prescribed by the board, identifying all payments, honoraria,
reimbursement or other compensation authorized under section 151.461, clauses (3) to
(5), paid to practitioners in Minnesota during the preceding calendar year. The report
shall identify the nature and value of any payments totaling $100 or more, to a particular
practitioner during the year, and shall identify the practitioner. Reports filed under this
provision are public data.

Minnesota Statutes 2010, section 151.48, is amended to read:

(a) It is unlawful for an out-of-state wholesale drug distributor to conduct business
in the state without first obtaining a license from the board and paying deleted text begin the requireddeleted text end new text begin any
applicablenew text end feenew text begin specified in section 151.065new text end .

(b) Application for an out-of-state wholesale drug distributor license under this
section shall be made on a form furnished by the board.

(c) No person acting as principal or agent for any out-of-state wholesale drug
distributor may sell or distribute drugs in the state unless the distributor has obtained
a license.

(d) The board may adopt regulations that permit out-of-state wholesale drug
distributors to obtain a license on the basis of reciprocity to the extent that an out-of-state
wholesale drug distributor:

(1) possesses a valid license granted by another state under legal standards
comparable to those that must be met by a wholesale drug distributor of this state as
prerequisites for obtaining a license under the laws of this state; and

(2) can show that the other state would extend reciprocal treatment under its own
laws to a wholesale drug distributor of this state.

Minnesota Statutes 2010, section 152.12, subdivision 3, is amended to read:

Any qualified person
may use controlled substances in the course of a bona fide research project but cannot
administer or dispense such drugs to human beings unless such drugs are prescribed,
dispensed and administered by a person lawfully authorized to do so. Every person
who engages in research involving the use of such substances shall apply annually for
registration by the state Board of Pharmacy new text begin and shall pay any applicable fee specified in
section 151.065, new text end provided that such registration shall not be required if the person is
covered by and has complied with federal laws covering such research projects.

new text begin An administrative services unit is established
for the health-related licensing boards in section 214.01, subdivision 2, to perform
administrative, financial, and management functions common to all the boards in a manner
that streamlines services, reduces expenditures, targets the use of state resources, and
meets the mission of public protection.
new text end

new text begin The administrative services unit shall act as an agent of the
boards.
new text end

new text begin (a) The administrative service unit shall apportion among the
health-related licensing boards an amount to be allocated to each health-related licensing
board. The amount apportioned to each board shall equal each board's share of the annual
operating costs for the unit and shall be deposited into the state government special
revenue fund.
new text end

new text begin (b) The administrative services unit may receive and expend reimbursements for
services performed for other agencies.
new text end

new text begin Sections 8 to 12 are effective upon implementation of the coordinated licensure
information system defined in Minnesota Statutes, section 148.2855, but no sooner than
July 1, 2012.
new text end

new text begin This section shall be known as and may be cited as the
"Freedom of Choice in Health Care Act."
new text end

new text begin (a) For purposes of this section, the following terms have
the meaning given them.
new text end

new text begin (b) "Health care service" means any service, treatment, or provision of a product for
the care of a physical or mental disease, illness, injury, defect, or condition, or to otherwise
maintain or improve physical or mental health, subject to all laws and rules regulating
health service providers and products within the state of Minnesota.
new text end

new text begin (c) "Mode of securing" means to purchase directly or on credit or by trade, or to
contract for third-party payment by insurance or other legal means as authorized by the
state of Minnesota, or to apply for or accept employer-sponsored or government-sponsored
health care benefits under such conditions as may legally be required as a condition of
such benefits, or any combination of the same.
new text end

new text begin (d) "Penalty" means any civil or criminal fine, tax, salary or wage withholding,
surcharge, fee, or any other imposed consequence established by law or rule of a
government or its subdivision or agency that is used to punish or discourage the exercise
of rights protected under this section.
new text end

new text begin (a) The power to require or regulate a person's
choice in the mode of securing health care services, or to impose a penalty related to that
choice, is not found in the Constitution of the United States of America, and is therefore a
power reserved to the people pursuant to the Ninth Amendment, and to the several states
pursuant to the Tenth Amendment. The state of Minnesota hereby exercises its sovereign
power to declare the public policy of the state of Minnesota regarding the right of all
persons residing in the state in choosing the mode of securing health care services.
new text end

new text begin (b) It is hereby declared that the public policy of the state of Minnesota, consistent
with our constitutionally recognized and inalienable rights of liberty, is that every person
within the state of Minnesota is and shall be free to choose or decline to choose any mode
of securing health care services without penalty or threat of penalty.
new text end

new text begin (c) The policy stated under this section shall not be applied to impair any right of
contract related to the provision of health care services to any person or group.
new text end

new text begin (a) No public official, employee, or agent of the state of
Minnesota or any of its political subdivisions shall act to impose, collect, enforce, or
effectuate any penalty in the state of Minnesota that violates the public policy set forth
in this section.
new text end

new text begin (b) The attorney general shall take any action as is provided in this section or section
8.31 in the defense or prosecution of rights protected under this section.
new text end

Minnesota Statutes 2010, section 8.31, subdivision 1, is amended to read:

new text begin (a) new text end The attorney general shall investigate violations of the
law of this state respecting unfair, discriminatory, and other unlawful practices in business,
commerce, or trade, and specifically, but not exclusively, the Nonprofit Corporation Act
(sections 317A.001 to 317A.909), the Act Against Unfair Discrimination and Competition
(sections 325D.01 to 325D.07), the Unlawful Trade Practices Act (sections 325D.09 to
325D.16), the Antitrust Act (sections 325D.49 to 325D.66), section 325F.67 and other
laws against false or fraudulent advertising, the antidiscrimination acts contained in
section 325D.67, the act against monopolization of food products (section 325D.68),
the act regulating telephone advertising services (section 325E.39), the Prevention of
Consumer Fraud Act (sections 325F.68 to 325F.70), and chapter 53A regulating currency
exchanges and assist in the enforcement of those laws as in this section provided.

new text begin (b) The attorney general shall seek injunctive and any other appropriate relief as
expeditiously as possible to preserve the rights and property of the residents of Minnesota,
and to defend as necessary the state of Minnesota, its officials, employees, and agents in
the event that any law or regulation violating the public policy set forth in the Freedom
of Choice in Health Care Act in this section is enacted by any government, subdivision,
or agency thereof.
new text end

new text begin (c) The attorney general shall seek injunctive and any other appropriate relief
as expeditiously as possible in the event that any law or regulation violating the public
policy set forth in the Freedom of Choice in Health Care Act in this section is enacted
without adequate federal funding to the state to ensure affordable health care coverage
is available to the residents of Minnesota.
new text end

Minnesota Statutes 2010, section 8.31, subdivision 3a, is amended to read:

In addition to the remedies otherwise provided by law,
any person injured by a violation of any of the laws referred to in subdivision 1 new text begin or a
violation of the public policy in section 1.06 new text end may bring a civil action and recover damages,
together with costs and disbursements, including costs of investigation and reasonable
attorney's fees, and receive other equitable relief as determined by the court. The court
may, as appropriate, enter a consent judgment or decree without the finding of illegality.
In any action brought by the attorney general pursuant to this section, the court may award
any of the remedies allowable under this subdivision.new text begin An action under this subdivision
for any violation of section 1.06 is in the public interest.
new text end

Minnesota Statutes 2010, section 62E.08, subdivision 1, is amended to read:

The association shall establish the following
maximum premiums to be charged for membership in the comprehensive health insurance
plan:

(a) the premium for the number one qualified plan shall range from a minimum of
101 percent to a maximum of 125 percent of the weighted average of rates charged by
those insurers and health maintenance organizations with individuals enrolled in:

(1) $1,000 annual deductible individual plans of insurance in force in Minnesota;

(2) individual health maintenance organization contracts of coverage with a $1,000
annual deductible which are in force in Minnesota; and

(3) other plans of coverage similar to plans offered by the association based on
generally accepted actuarial principles;

(b) the premium for the number two qualified plan shall range from a minimum of
101 percent to a maximum of 125 percent of the weighted average of rates charged by
those insurers and health maintenance organizations with individuals enrolled in:

(1) $500 annual deductible individual plans of insurance in force in Minnesota;

(2) individual health maintenance organization contracts of coverage with a $500
annual deductible which are in force in Minnesota; and

(3) other plans of coverage similar to plans offered by the association based on
generally accepted actuarial principles;

(c) the premiums for the plans with a $2,000, $5,000, or $10,000 annual deductible
shall range from a minimum of 101 percent to a maximum of 125 percent of the weighted
average of rates charged by those insurers and health maintenance organizations with
individuals enrolled in:

(1) $2,000, $5,000, or $10,000 annual deductible individual plans, respectively, in
force in Minnesota; and

(2) individual health maintenance organization contracts of coverage with a $2,000,
$5,000, or $10,000 annual deductible, respectively, which are in force in Minnesota; or

(3) other plans of coverage similar to plans offered by the association based on
generally accepted actuarial principles;

(d) the premium for each type of Medicare supplement plan required to be offered
by the association pursuant to section 62E.12 shall range from a minimum of 101 percent
to a maximum of 125 percent of the weighted average of rates charged by those insurers
and health maintenance organizations with individuals enrolled in:

(1) Medicare supplement plans in force in Minnesota;

(2) health maintenance organization Medicare supplement contracts of coverage
which are in force in Minnesota; and

(3) other plans of coverage similar to plans offered by the association based on
generally accepted actuarial principles; deleted text begin and
deleted text end

(e) the charge for health maintenance organization coverage shall be based on
generally accepted actuarial principlesdeleted text begin .deleted text end new text begin ; and
new text end

new text begin (f) the premium for a high-deductible, basic plan offered under section 62E.121 shall
range from a minimum of 101 percent to a maximum of 125 percent of the weighted
average of rates charged by those insurers and health maintenance organizations offering
comparable plans outside of the Minnesota Comprehensive Health Association.
new text end

The list of insurers and health maintenance organizations whose rates are used to
establish the premium for coverage offered by the association pursuant to paragraphs (a)
to (d) new text begin and (f) new text end shall be established by the commissioner on the basis of information which
shall be provided to the association by all insurers and health maintenance organizations
annually at the commissioner's request. This information shall include the number of
individuals covered by each type of plan or contract specified in paragraphs (a) to (d) new text begin and
(f) new text end that is sold, issued, and renewed by the insurers and health maintenance organizations,
including those plans or contracts available only on a renewal basis. The information shall
also include the rates charged for each type of plan or contract.

In establishing premiums pursuant to this section, the association shall utilize
generally accepted actuarial principles, provided that the association shall not discriminate
in charging premiums based upon sex. In order to compute a weighted average for each
type of plan or contract specified under paragraphs (a) to (d)new text begin and (f)new text end , the association
shall, using the information collected pursuant to this subdivision, list insurers and health
maintenance organizations in rank order of the total number of individuals covered by
each insurer or health maintenance organization. The association shall then compute
a weighted average of the rates charged for coverage by all the insurers and health
maintenance organizations by:

(1) multiplying the numbers of individuals covered by each insurer or health
maintenance organization by the rates charged for coverage;

(2) separately summing both the number of individuals covered by all the insurers
and health maintenance organizations and all the products computed under clause (1); and

(3) dividing the total of the products computed under clause (1) by the total number
of individuals covered.

The association may elect to use a sample of information from the insurers and
health maintenance organizations for purposes of computing a weighted average. In no
case, however, may a sample used by the association to compute a weighted average
include information from fewer than the two insurers or health maintenance organizations
highest in rank order.

new text begin The Minnesota Comprehensive Health
Association shall offer a high-deductible, basic plan that meets the requirements specified
in this section. The high-deductible, basic plan is a one-person plan. Any dependents
must be covered separately.
new text end

new text begin (a) The plan shall provide
the following in-network annual deductible options: $3,000, $6,000, $9,000, and $12,000.
The in-network annual out-of-pocket maximum for each annual deductible option shall be
$1,000 greater than the amount of the annual deductible.
new text end

new text begin (b) The deductible is subject to an annual increase based on the change in the
Consumer Price Index (CPI).
new text end

new text begin The following co-payments shall
apply for each of the first three office visits per calendar year for nonpreventive care:
new text end

new text begin (1) $30 per visit for the $3,000 annual deductible option;
new text end

new text begin (2) $40 per visit for the $6,000 annual deductible option;
new text end

new text begin (3) $50 per visit for the $9,000 annual deductible option; and
new text end

new text begin (4) $60 per visit for the $12,000 annual deductible option.
new text end

new text begin For the fourth and subsequent visits during the calendar year, 80 percent coverage is
provided under all deductible options, after the deductible is met.
new text end

new text begin One hundred percent coverage is provided for preventive
care, and no co-payment, coinsurance, or deductible requirements apply.
new text end

new text begin A $10 co-payment applies to preferred generic drugs.
Preferred brand-name drugs require an enrollee payment of 100 percent of the health
plan's discounted rate.
new text end

new text begin A $20 co-payment applies for the first
three convenience care center visits during a calendar year. For the fourth and subsequent
visits during a calendar year, 80 percent coverage is provided after the deductible is met.
new text end

new text begin A $100 co-payment applies for the first urgent
care center visit during a calendar year. For the second and subsequent visits during a
calendar year, 80 percent coverage is provided after the deductible is met.
new text end

new text begin A $200 co-payment applies for the first
emergency room visit during a calendar year. For the second and subsequent visits during
a calendar year, 80 percent coverage is provided after the deductible is met.
new text end

new text begin Lab and x-ray
services, hospital services, ambulance services, and surgery are covered at 80 percent
after the deductible is met.
new text end

new text begin The health plan pays up to $50 per calendar year for eyewear.
new text end

new text begin Maternity, labor and delivery, and postpartum care are not
covered. One hundred percent coverage is provided for prenatal care and no deductible
applies.
new text end

new text begin Other eligible health care services
are covered at 80 percent after the deductible is met.
new text end

new text begin Enrollees have the option of removing mental health and substance abuse coverage in
exchange for a reduced premium.
new text end

new text begin Enrollees have
the option to upgrade prescription drug coverage to include coverage for preferred
brand-name drugs with a $50 co-payment and coverage for nonpreferred drugs with a
$100 co-payment in exchange for an increased premium.
new text end

new text begin (a) The out-of-network annual deductible is
double the in-network annual deductible.
new text end

new text begin (b) There is no out-of-pocket maximum for out-of-network services.
new text end

new text begin (c) Benefits for out-of-network services are covered at 60 percent after the deductible
is met.
new text end

new text begin (d) The lifetime maximum benefit for out-of-network services is $1,000,000.
new text end

new text begin Services not covered include: custodial care
or rest care; most dental services; cosmetic services; refractive eye surgery; infertility
services; and services that are investigational, not medically necessary, or received while
on military duty.
new text end

Minnesota Statutes 2010, section 62E.14, is amended by adding a subdivision
to read:

new text begin A person may enroll in the comprehensive plan with
a waiver of the preexisting condition limitation in subdivision 3 if the person is eligible for
the healthy Minnesota contribution program, and has been denied coverage as described
under section 256L.031, subdivision 6.
new text end

Minnesota Statutes 2010, section 62J.04, subdivision 9, is amended to read:

The commissioners of health and
human services shall establish a rate methodology for Medicare and Medicaid risk-based
contracting with health plan companies that is consistent with statewide growth limits.
deleted text begin The methodology shall be presented for review by the Minnesota Health Care Commission
and the Legislative Commission on Health Care Access prior to the submission of a
waiver request to the Centers for Medicare and Medicaid Services and subsequent
implementation of the methodology.
deleted text end

Minnesota Statutes 2010, section 62J.692, subdivision 7, is amended to read:

Of the amount
transferred according to section 256B.69, subdivision 5c, paragraph (a), clauses (1) to (4),
$21,714,000 shall be distributed as follows:

(1) $2,157,000 shall be distributed by the commissioner to the University of
Minnesota Board of Regents for the purposes described in sections 137.38 to 137.40;

(2) $1,035,360 shall be distributed by the commissioner to the Hennepin County
Medical Center for clinical medical education;

(3) $17,400,000 shall be distributed by the commissioner to the University of
Minnesota Board of Regents for purposes of medical education;

(4) $1,121,640 shall be distributed by the commissioner to clinical medical education
dental innovation grants in accordance with subdivision 7a; and

Minnesota Statutes 2010, section 62J.692, subdivision 9, is amended to read:

The commissioner and the Medical
Education and Research Costs Advisory Committee may review provider groups included
in the definition of a clinical medical education program to assure that the distribution of
the funds continue to be consistent with the purpose of this section. The results of any
such reviews must be reported to the deleted text begin Legislative Commission on Health Care Accessdeleted text end new text begin
chairs and ranking minority members of the legislative committees with jurisdiction over
health care policy and financenew text end .

new text begin A health care provider shall not bill a patient, and shall not be reimbursed, for
any operation, treatment, or other care that is provided to reverse, correct, or otherwise
minimize the affects of an adverse health care event, as described in section 144.7065,
subdivisions 2 to 7, for which that health care provider is responsible.
new text end

Minnesota Statutes 2010, section 62Q.32, is amended to read:

County board or community health service agencies may establish an office of
ombudsperson to provide a system of consumer advocacy for persons receiving health
care services through a health plan company. The ombudsperson's functions may include,
but are not limited to:

(a) mediation or advocacy on behalf of a person accessing the complaint and appeal
procedures to ensure that necessary medical services are provided by the health plan
company; and

(b) investigation of the quality of services provided to a person and determine the
extent to which quality assurance mechanisms are needed or any other system change
may be needed. deleted text begin The commissioner of health shall make recommendations for funding
these functions including the amount of funding needed and a plan for distribution. The
commissioner shall submit these recommendations to the Legislative Commission on
Health Care Access by January 15, 1996.
deleted text end

Minnesota Statutes 2010, section 62U.04, subdivision 3, is amended to read:

(a) The commissioner shall develop a peer
grouping system for providers based on a combined measure that incorporates both
provider risk-adjusted cost of care and quality of care, and for specific conditions as
determined by the commissioner. In developing this system, the commissioner shall
consult and coordinate with health care providers, health plan companies, state agencies,
and organizations that work to improve health care quality in Minnesota. For purposes of
the final establishment of the peer grouping system, the commissioner shall not contract
with any private entity, organization, or consortium of entities that has or will have a direct
financial interest in the outcome of the system.

(b) By no later than October 15, 2010, the commissioner shall disseminate
information to providers on their total cost of care, total resource use, total quality of care,
and the total care results of the grouping developed under this subdivision in comparison
to an appropriate peer group. Any analyses or reports that identify providers may only be
published after the provider has been provided the opportunity by the commissioner to
review the underlying data and submit comments. Providers may be given any data for
which they are the subject of the data. The provider shall have 30 days to review the data
for accuracy and initiate an appeal as specified in paragraph (d).

(c) By no later than January 1, 2011, the commissioner shall disseminate information
to providers on their condition-specific cost of care, condition-specific resource use,
condition-specific quality of care, and the condition-specific results of the grouping
developed under this subdivision in comparison to an appropriate peer group. Any
analyses or reports that identify providers may only be published after the provider has
been provided the opportunity by the commissioner to review the underlying data and
submit comments. Providers may be given any data for which they are the subject of the
data. The provider shall have 30 days to review the data for accuracy and initiate an
appeal as specified in paragraph (d).

(d) The commissioner shall establish an appeals process to resolve disputes from
providers regarding the accuracy of the data used to develop analyses or reports. When
a provider appeals the accuracy of the data used to calculate the peer grouping system
results, the provider shall:

(1) clearly indicate the reason they believe the data used to calculate the peer group
system results are not accurate;

(2) provide evidence and documentation to support the reason that data was not
accurate; and

(3) cooperate with the commissioner, including allowing the commissioner access to
data necessary and relevant to resolving the dispute.

If a provider does not meet the requirements of this paragraph, a provider's appeal shall be
considered withdrawn. The commissioner shall not publish results for a specific provider
under paragraph (e) or (f) while that provider has an unresolved appeal.

(e) Beginning January 1, 2011, the commissioner shall, no less than annually,
publish information on providers' total cost, total resource use, total quality, and the results
of the total care portion of the peer grouping process. The results that are published must
be on a risk-adjusted basis.

(f) Beginning March 30, 2011, the commissioner shall no less than annually publish
information on providers' condition-specific cost, condition-specific resource use, and
condition-specific quality, and the results of the condition-specific portion of the peer
grouping process. The results that are published must be on a risk-adjusted basis.

(g) Prior to disseminating data to providers under paragraph (b) or (c) or publishing
information under paragraph (e) or (f), the commissioner shall ensure the scientific
validity and reliability of the results according to the standards described in paragraph (h).
If additional time is needed to establish the scientific validity and reliability of the results,
the commissioner may delay the dissemination of data to providers under paragraph (b)
or (c), or the publication of information under paragraph (e) or (f). If the delay is more
than 60 days, the commissioner shall report in writing to the deleted text begin Legislative Commission on
Health Care Accessdeleted text end new text begin chairs and ranking minority members of the legislative committees
with jurisdiction over health care policy and financenew text end the following information:

(1) the reason for the delay;

(2) the actions being taken to resolve the delay and establish the scientific validity
and reliability of the results; and

(3) the new dates by which the results shall be disseminated.

If there is a delay under this paragraph, the commissioner must disseminate the
information to providers under paragraph (b) or (c) at least 90 days before publishing
results under paragraph (e) or (f).

(h) The commissioner's assurance of valid and reliable clinic and hospital peer
grouping performance results shall include, at a minimum, the following:

(1) use of the best available evidence, research, and methodologies; and

(2) establishment of an explicit minimum reliability threshold developed in
collaboration with the subjects of the data and the users of the data, at a level not below
nationally accepted standards where such standards exist.

In achieving these thresholds, the commissioner shall not aggregate clinics that are not
part of the same system or practice group. The commissioner shall consult with and solicit
feedback from representatives of physician clinics and hospitals during the peer grouping
data analysis process to obtain input on the methodological options prior to final analysis
and on the design, development, and testing of provider reports.

Minnesota Statutes 2010, section 62U.04, subdivision 9, is amended to read:

(a) deleted text begin By no later than 12 months after the commissioner
publishes the information in subdivision 3, paragraph (e):deleted text end new text begin For product renewals or for
new products that are offered, after 12 months have elapsed from publication by the
commissioner of the information in subdivision 3, paragraph (e):
new text end

(1) the commissioner of management and budget shall use the information and
methods developed under subdivision 3 to strengthen incentives for members of the state
employee group insurance program to use high-quality, low-cost providers;

(2) all political subdivisions, as defined in section 13.02, subdivision 11, that offer
health benefits to their employees must offer plans that differentiate providers on their
cost and quality performance and create incentives for members to use better-performing
providers;

(3) all health plan companies shall use the information and methods developed
under subdivision 3 to develop products that encourage consumers to use high-quality,
low-cost providers; and

(4) health plan companies that issue health plans in the individual market or the
small employer market must offer at least one health plan that uses the information
developed under subdivision 3 to establish financial incentives for consumers to choose
higher-quality, lower-cost providers through enrollee cost-sharing or selective provider
networks.

(b) By January 1, 2011, the commissioner of health shall report to the governor
and the legislature on recommendations to encourage health plan companies to promote
widespread adoption of products that encourage the use of high-quality, low-cost providers.
The commissioner's recommendations may include tax incentives, public reporting of
health plan performance, regulatory incentives or changes, and other strategies.

Minnesota Statutes 2010, section 62U.06, subdivision 2, is amended to read:

Beginning January 15, 2009, the commissioner
of health shall submit to the deleted text begin Legislative Commission on Health Care Accessdeleted text end new text begin chairs and
ranking minority members of the legislative committees with jurisdiction over health care
policy and financenew text end periodic progress reports on the implementation of this chapter and
sections 256B.0751 to 256B.0754.

Minnesota Statutes 2010, section 256.01, subdivision 2b, is amended to read:

deleted text begin The commissioner shall develop and implement
a pay-for-performance system to provide performance payments to eligible medical
groups and clinics that demonstrate optimum care in serving individuals with chronic
diseases who are enrolled in health care programs administered by the commissioner under
chapters 256B, 256D, and 256L.deleted text end The commissioner may receive any federal matching
money that is made available through the medical assistance program for managed care
oversight contracted through vendors, including consumer surveys, studies, and external
quality reviews as required by the federal Balanced Budget Act of 1997, Code of Federal
Regulations, title 42, part 438-managed care, subpart E-external quality review. Any
federal money received for managed care oversight is appropriated to the commissioner
for this purpose. The commissioner may expend the federal money received in either
year of the biennium.

Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision
to read:

new text begin (a) When the commissioner enters into
a contingency-based contract for the purpose of recovering medical assistance or
MinnesotaCare funds, the commissioner may retain that portion of the recovered funds
equal to the amount of the contingency fee.
new text end

new text begin (b) Amounts attributed to new recoveries under this subdivision are appropriated
to the commissioner to the extent they fulfill the payment terms of the contract with the
vendor and shall be deposited into an account in a fund other than the general fund for
purposes of fulfilling the terms of the vendor contract.
new text end

Minnesota Statutes 2010, section 256.969, subdivision 2b, is amended to read:

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. For the first 24 months of the rebased
period beginning January 1, 2011, rates shall not be rebased, except that a Minnesota
long-term hospital shall be rebased effective January 1, 2011, based on its most recent
Medicare cost report ending on or before September 1, 2008, with the provisions under
subdivisions 9 and 23, based on the rates in effect on December 31, 2010. For subsequent
rate setting periods in which the base years are updated, a Minnesota long-term hospital's
base year shall remain within the same period as other hospitals. deleted text begin Effective January 1,
2013, rates shall be rebased at full valuedeleted text end new text begin Rates must not be rebased to more current data
for the first six months of the rebased period beginning January 1, 2013new text end . 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.

Minnesota Statutes 2010, section 256B.04, subdivision 18, is amended to read:

new text begin (a) new text end The state agency may
take applications for medical assistance and conduct eligibility determinations for
MinnesotaCare enrollees.

new text begin (b) The commissioner of human services shall modify the Minnesota health care
programs application form to add a question asking applicants whether they have ever
served in the United States military.
new text end

new text begin This section is effective August 1, 2011.
new text end

Minnesota Statutes 2010, section 256B.056, subdivision 3, is amended to read:

deleted text begin (a)deleted text end To be eligible for
medical assistance, a person must not individually own more than $3,000 in assets, or if a
member of a household with two family members, husband and wife, or parent and child,
the household must not own more than $6,000 in assets, plus $200 for each additional
legal dependent. In addition to these maximum amounts, an eligible individual or family
may accrue interest on these amounts, but they must be reduced to the maximum at the
time of an eligibility redetermination. The accumulation of the clothing and personal
needs allowance according to section 256B.35 must also be reduced to the maximum at
the time of the eligibility redetermination. The value of assets that are not considered in
determining eligibility for medical assistance is the value of those assets excluded under
the supplemental security income program for aged, blind, and disabled persons, with
the following exceptions:

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

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

(3) motor vehicles are excluded to the same extent excluded by the supplemental
security income program;

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

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

deleted text begin (b) No asset limit shall apply to persons eligible under section 256B.055, subdivision
15.
deleted text end

new text begin This section is effective October 1, 2011.
new text end

Minnesota Statutes 2010, section 256B.056, subdivision 4, is amended to read:

(a) To be eligible for medical assistance, a person eligible under
section 256B.055, subdivisions 7, 7a, and 12, may have income up to 100 percent of
the federal poverty guidelines. Effective January 1, 2000, and each successive January,
recipients of supplemental security income may have an income up to the supplemental
security income standard in effect on that date.

(b) To be eligible for medical assistance, families and children may have an income
up to 133-1/3 percent of the AFDC income standard in effect under the July 16, 1996,
AFDC state plan. Effective July 1, 2000, the base AFDC standard in effect on July 16,
1996, shall be increased by three percent.

(c) Effective July 1, 2002, to be eligible for medical assistance, families and children
may have an income up to 100 percent of the federal poverty guidelines for the family size.

deleted text begin (d) To be eligible for medical assistance under section 256B.055, subdivision 15, a
person may have an income up to 75 percent of federal poverty guidelines for the family
size.
deleted text end

deleted text begin (e)deleted text end new text begin (d)new text end In computing income to determine eligibility of persons under paragraphs
(a) to deleted text begin (d)deleted text end new text begin (c)new text end who are not residents of long-term care facilities, the commissioner shall
disregard increases in income as required by Public Law Numbers 94-566, section 503;
99-272; and 99-509. Veterans aid and attendance benefits and Veterans Administration
unusual medical expense payments are considered income to the recipient.

new text begin This section is effective October 1, 2011.
new text end

Minnesota Statutes 2010, section 256B.06, subdivision 4, is amended to read:

(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) deleted text begin 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.
deleted text end

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.

deleted text begin 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).
deleted text end

deleted text begin Notwithstanding paragraph (j),deleted text end Beginning July 1, 2010, children and pregnant
women who are noncitizens described in paragraph (b) or deleted text begin (e)deleted text end new text begin who are lawfully in the
United States as defined in Code of Federal Regulations, title 8, section 103.12, and who
otherwise meet eligibility requirements of this chapternew 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.

deleted text begin (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.
deleted text end

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

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

deleted text begin (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).
deleted text end

deleted text begin (f)deleted text end new text begin (e)new text end Nonimmigrants who otherwise meet the eligibility requirements of this
chapter are eligible for the benefits as provided in paragraphs deleted text begin (g)deleted text end new text begin (f) new text end to deleted text begin (i)deleted text end new text begin (h)new text end . 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).

deleted text begin (g)deleted text end new text begin (f)new text end 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 conditiondeleted text begin , except for organ transplants and related care and services
and routine prenatal caredeleted text end .

deleted text begin (h)deleted text end new text begin (g)new text end 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).

new text begin (h)(1) Notwithstanding paragraph (g), services that are necessary for the treatment
of an emergency medical condition are limited to the following:
new text end

new text begin (i) services delivered in an emergency room or by an ambulance service licensed
under chapter 144E that are directly related to the treatment of an emergency medical
condition;
new text end

new text begin (ii) services delivered in an inpatient hospital setting following admission from an
emergency room or clinic for an acute emergency condition; and
new text end

new text begin (iii) follow-up services that are directly related to the original service provided
to treat the emergency medical condition and are covered by the global payment made
to the provider.
new text end

new text begin (2) Services for the treatment of emergency medical conditions do not include:
new text end

new text begin (i) services delivered in an emergency room or inpatient setting to treat a
nonemergency condition;
new text end

new text begin (ii) organ transplants and related care;
new text end

new text begin (iii) services for routine prenatal care;
new text end

new text begin (iv) continuing care, including long-term care, nursing facility services, home health
care, adult day care, day training, or supportive living services;
new text end

new text begin (v) elective surgery;
new text end

new text begin (vi) outpatient prescription drugs, unless the drugs are administered or dispensed as
part of an emergency room visit;
new text end

new text begin (vii) preventative health care and family planning services;
new text end

new text begin (viii) dialysis;
new text end

new text begin (ix) chemotherapy or therapeutic radiation services;
new text end

new text begin (x) rehabilitation services;
new text end

new text begin (xi) physical, occupational, or speech therapy;
new text end

new text begin (xii) transportation services;
new text end

new text begin (xiii) case management;
new text end

new text begin (xiv) prosthetics, orthotics, durable medical equipment, or medical supplies;
new text end

new text begin (xv) dental services;
new text end

new text begin (xvi) hospice care;
new text end

new text begin (xvii) audiology services and hearing aids;
new text end

new text begin (xviii) podiatry services;
new text end

new text begin (xix) chiropractic services;
new text end

new text begin (xx) immunizations;
new text end

new text begin (xxi) vision services and eyeglasses;
new text end

new text begin (xxii) waiver services;
new text end

new text begin (xxiii) individualized education programs; or
new text end

new text begin (xxiv) chemical dependency treatment.
new text end

(i) Beginning July 1, 2009, pregnant noncitizens who are undocumented,
nonimmigrants, or lawfully present deleted text begin as designated in paragraph (e) and whodeleted text end new text begin in the United
States as defined in Code of Federal Regulations, title 8, section 103.12, new text end 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.

deleted text begin (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.
deleted text end

deleted text begin (k)deleted text end new text begin (j)new text end 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.

Minnesota Statutes 2010, section 256B.0625, is amended by adding a
subdivision to read:

new text begin (a) The commissioner shall
implement a program to reduce the number of elective inductions of labor prior to 39
weeks' gestation. In this subdivision, the term "elective induction of labor" means the
use of artificial means to stimulate labor in a woman without the presence of a medical
condition affecting the woman or the child that makes the onset of labor a medical
necessity. The program must promote the implementation of policies within hospitals
providing services to recipients of medical assistance or MinnesotaCare that prohibit the
use of elective inductions prior to 39 weeks' gestation, and adherence to such policies by
the attending providers.
new text end

new text begin (b) For all births covered by medical assistance or MinnesotaCare on or after
January 1, 2012, a payment for professional services associated with the delivery of a
child in a hospital must not be made unless the provider has submitted information about
the nature of the labor and delivery including any induction of labor that was performed
in conjunction with that specific birth. The information must be on a form prescribed by
the commissioner.
new text end

new text begin (c) The requirements in paragraph (b) must not apply to deliveries performed
at a hospital that has policies and processes in place that have been approved by the
commissioner which prohibit elective inductions prior to 39 weeks' gestation. A process
for review of hospital induction policies must be established by the commissioner and
review of policies must occur at the discretion of the commissioner. The commissioner's
decision to approve or rescind approval must include verification and review of items
including, but not limited to:
new text end

new text begin (1) policies that prohibit use of elective inductions for gestation less than 39 weeks;
new text end

new text begin (2) policies that encourage providers to document and communicate with patients a
final expected date of delivery by 20 weeks' gestation that includes data from ultrasound
measurements as applicable;
new text end

new text begin (3) policies that encourage patient education regarding elective inductions, and
requires documentation of the processes used to educate patients;
new text end

new text begin (4) ongoing quality improvement review as determined by the commissioner; and
new text end

new text begin (5) any data that has been collected by the commissioner.
new text end

new text begin (d) All hospitals must report annually to the commissioner induction information
for all births that were covered by medical assistance or MinnesotaCare in a format and
manner to be established by the commissioner.
new text end

new text begin (e) The commissioner at any time may choose not to implement or may discontinue
any or all aspects of the program if the commissioner is able to determine that hospitals
representing at least 90 percent of births covered by medical assistance or MinnesotaCare
have approved policies in place.
new text end

new text begin This section is effective January 1, 2012.
new text end

Minnesota Statutes 2010, section 256B.0625, subdivision 8, is amended to
read:

new text begin (a) new text end Medical assistance covers physical therapy and
related servicesdeleted text begin , including specialized maintenance therapydeleted text end .new text begin Specialized maintenance
therapy is covered for recipients age 20 and under.
new text end

new text begin (b)new text end Authorization by the commissioner is required to provide medically necessary
services to a recipient beyond any of the following onetime service thresholds, or a lower
threshold where one has been established by the commissioner for a specified service: (1)
80 units of any approved CPT code other than modalities; (2) 20 modality sessions; and
(3) three evaluations or reevaluations. Services provided by a physical therapy assistant
shall be reimbursed at the same rate as services performed by a physical therapist when
the services of the physical therapy assistant are provided under the direction of a physical
therapist who is on the premises. Services provided by a physical therapy assistant that
are provided under the direction of a physical therapist who is not on the premises shall
be reimbursed at 65 percent of the physical therapist rate.

new text begin This section is effective July 1, 2011, for services provided
on a fee-for-service basis, and January 1, 2012, for services provided by a managed care
plan or county-based purchasing plan.
new text end

Minnesota Statutes 2010, section 256B.0625, subdivision 8a, is amended to
read:

new text begin (a) new text end Medical assistance covers occupational
therapy and related servicesdeleted text begin , including specialized maintenance therapydeleted text end .new text begin Specialized
maintenance therapy is covered for recipients age 20 and under.
new text end

new text begin (b)new text end Authorization by the commissioner is required to provide medically necessary
services to a recipient beyond any of the following onetime service thresholds, or a lower
threshold where one has been established by the commissioner for a specified service:
(1) 120 units of any combination of approved CPT codes; and (2) two evaluations or
reevaluations. Services provided by an occupational therapy assistant shall be reimbursed
at the same rate as services performed by an occupational therapist when the services of
the occupational therapy assistant are provided under the direction of the occupational
therapist who is on the premises. Services provided by an occupational therapy assistant
that are provided under the direction of an occupational therapist who is not on the
premises shall be reimbursed at 65 percent of the occupational therapist rate.

Minnesota Statutes 2010, section 256B.0625, subdivision 8b, is amended to
read:

new text begin (a) new text end Medical
assistance covers speech-language pathology and related servicesdeleted text begin , including specialized
maintenance therapydeleted text end .new text begin Specialized maintenance therapy is covered for recipients age
20 and under.
new text end

new text begin (b)new text end Authorization by the commissioner is required to provide medically necessarynew text begin
speech-language pathologynew text end services to a recipient beyond any of the following
onetime service thresholds, or a lower threshold where one has been established by the
commissioner for a specified service: (1) 50 treatment sessions with any combination of
approved CPT codes; and (2) one evaluation.

new text begin (c) new text end Medical assistance covers audiology services and related services. Services
provided by a person who has been issued a temporary registration under section
148.5161 shall be reimbursed at the same rate as services performed by a speech-language
pathologist or audiologist as long as the requirements of section 148.5161, subdivision
3, are met.

Minnesota Statutes 2010, section 256B.0625, subdivision 8c, is amended to
read:

(a) Effective July 1, 1999,
onetime thresholds shall replace annual thresholds for provision of rehabilitation services
described in subdivisions 8, 8a, and 8b. The onetime thresholds will be the same in
amount and description as the thresholds prescribed by the Department of Human Services
health care programs provider manual for calendar year 1997, except they will not be
renewed annually, and they will include sensory skills and cognitive training skills.

(b) A care management approach for authorization ofnew text begin rehabilitationnew text end services beyond
the thresholdnew text begin described in subdivisions 8, 8a, and 8b new text end shall be instituted in conjunction
with the onetime thresholds. The care management approach shall require the provider
and the department rehabilitation reviewer to work together directly through written
communication, or telephone communication when appropriate, to establish a medically
necessary care management plan. Authorization for rehabilitation services shall include
approval for up to 12 months of services at a time without additional documentation from
the provider during the extended period, when the rehabilitation services are medically
necessary due to an ongoing health condition.

(c) The commissioner shall implement an expedited five-day turnaround time to
review authorization requests for recipients who need emergency rehabilitation services
and who have exhausted their onetime threshold limit for those services.

new text begin This section is effective July 1, 2011.
new text end

Minnesota Statutes 2010, section 256B.0625, subdivision 8e, is amended to
read:

Payment for chiropractic services is limited to
one annual evaluation and deleted text begin 12deleted text end new text begin 24new text end visits per year unless prior authorization of a greater
number of visits is obtained.

Minnesota Statutes 2010, section 256B.0625, is amended by adding a
subdivision to read:

new text begin Medical assistance covers acupuncture, as defined
in section 147B.01, subdivision 3, only when provided by a licensed acupuncturist or by
another Minnesota licensed practitioner for whom acupuncture is within the practitioner's
scope of practice and who has specific acupuncture training or credentialing.
new text end

Minnesota Statutes 2010, section 256B.0625, subdivision 13e, is amended to
read:

(a) The basis for determining the amount of payment
shall be the lower of the actual acquisition costs of the drugs deleted text begin plus a fixed dispensing fee;deleted text end new text begin
ornew text end the maximum allowable cost deleted text begin set by the federal government ordeleted text end by the commissioner
plus the fixed dispensing fee; or the usual and customary price charged to the public. The
amount of payment basis must be reduced to reflect all discount amounts applied to the
charge by any provider/insurer agreement or contract for submitted charges to medical
assistance programs. The net submitted charge may not be greater than the patient liability
for the service. The pharmacy dispensing fee shall be $3.65, except that the dispensing fee
for intravenous solutions which must be compounded by the pharmacist shall be $8 per
bag, $14 per bag for cancer chemotherapy products, and $30 per bag for total parenteral
nutritional products dispensed in one liter quantities, or $44 per bag for total parenteral
nutritional products dispensed in quantities greater than one liter. Actual acquisition cost
includes quantity and other special discounts except time and cash discounts. deleted text begin Effective
July 1, 2009,deleted text end The actual acquisition cost of a drug shall be estimated by the commissionerdeleted text begin ,deleted text end
at deleted text begin average wholesale price minus 15 percent. The actual acquisition cost of antihemophilic
factor drugs shall be estimated at the average wholesale price minus 30 percent.deleted text end new text begin wholesale
acquisition cost plus four percent for independently owned pharmacies located in a
designated rural area within Minnesota, and at wholesale acquisition cost plus two percent
for all other pharmacies. A pharmacy is "independently owned" if it is one of four or
fewer pharmacies under the same ownership nationally. A "designated rural area" means
an area defined as a small rural area or isolated rural area according to the four-category
classification of the Rural Urban Commuting Area system developed for the United States
Health Resources and Services Administration. Wholesale acquisition cost is defined as
the manufacturer's list price for a drug or biological to wholesalers or direct purchasers
in the United States, not including prompt pay or other discounts, rebates, or reductions
in price, for the most recent month for which information is available, as reported in
wholesale price guides or other publications of drug or biological pricing data. new text end The
maximum allowable cost of a multisource drug may be set by the commissioner and it
shall be comparable to, but no higher than, the maximum amount paid by other third-party
payors in this state who have maximum allowable cost programs. Establishment of the
amount of payment for drugs shall not be subject to the requirements of the Administrative
Procedure Act.

(b) An additional dispensing fee of $.30 may be added to the dispensing fee paid
to pharmacists for legend drug prescriptions dispensed to residents of long-term care
facilities when a unit dose blister card system, approved by the department, is used. Under
this type of dispensing system, the pharmacist must dispense a 30-day supply of drug.
The National Drug Code (NDC) from the drug container used to fill the blister card must
be identified on the claim to the department. The unit dose blister card containing the
drug must meet the packaging standards set forth in Minnesota Rules, part 6800.2700,
that govern the return of unused drugs to the pharmacy for reuse. The pharmacy provider
will be required to credit the department for the actual acquisition cost of all unused
drugs that are eligible for reuse. Over-the-counter medications must be dispensed in the
manufacturer's unopened package. The commissioner may permit the drug clozapine to be
dispensed in a quantity that is less than a 30-day supply.

(c) Whenever a maximum allowable cost has been set for a multisource drug,
payment shall be deleted text begin on the basis ofdeleted text end new text begin the lower of the usual and customary price charged
to the public ornew text end the maximum allowable cost established by the commissioner unless
prior authorization for the brand name product has been granted according to the criteria
established by the Drug Formulary Committee as required by subdivision 13f, paragraph
(a), and the prescriber has indicated "dispense as written" on the prescription in a manner
consistent with section 151.21, subdivision 2.

(d) The basis for determining the amount of payment for drugs administered in an
outpatient setting shall be the lower of the usual and customary cost submitted by the
provider or deleted text begin the amount established for Medicare by thedeleted text end new text begin 106 percent of the average sales
price as determined by the new text end United States Department of Health and Human Services
pursuant to title XVIII, section 1847a of the federal Social Security Act.new text begin If average sales
price is unavailable, the amount of payment must be lower of the usual and customary cost
submitted by the provider or the wholesale acquisition cost.
new text end

(e) The commissioner may negotiate lower reimbursement rates for specialty
pharmacy products than the rates specified in paragraph (a). The commissioner may
require individuals enrolled in the health care programs administered by the department
to obtain specialty pharmacy products from providers with whom the commissioner has
negotiated lower reimbursement rates. Specialty pharmacy products are defined as those
used by a small number of recipients or recipients with complex and chronic diseases
that require expensive and challenging drug regimens. Examples of these conditions
include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis
C, growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms
of cancer. Specialty pharmaceutical products include injectable and infusion therapies,
biotechnology drugs, new text begin antihemophilic factor products, new text end high-cost therapies, and therapies
that require complex care. The commissioner shall consult with the formulary committee
to develop a list of specialty pharmacy products subject to this paragraph. In consulting
with the formulary committee in developing this list, the commissioner shall take into
consideration the population served by specialty pharmacy products, the current delivery
system and standard of care in the state, and access to care issues. The commissioner shall
have the discretion to adjust the reimbursement rate to prevent access to care issues.

(f) Home infusion therapy services provided by home infusion therapy pharmacies
must be paid at rates according to subdivision 8d.

new text begin This section is effective July 1, 2011, or upon federal
approval, whichever is later.
new text end

Minnesota Statutes 2010, section 256B.0625, subdivision 13h, is amended to
read:

(a) Medical assistance
and general assistance medical care cover medication therapy management services for
a recipient taking deleted text begin fourdeleted text end new text begin threenew text end or more prescriptions to treat or prevent deleted text begin twodeleted text end new text begin onenew text end or more
chronic medical conditionsdeleted text begin , ordeleted text end new text begin ;new text end a recipient with a drug therapy problem that is identifiednew text begin
by the commissioner or identified by a pharmacist and approved by the commissioner;new text end 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, deleted text begin excludingdeleted text end new text begin includingnew text end long-term care deleted text begin anddeleted text end new text begin settings,new text end group homes,
deleted text begin if the service is ordered by the provider-directed care coordination teamdeleted text end new text begin and facilities
providing assisted living services, but excluding skilled nursing facilitiesnew text end ; 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) If there are no pharmacists who meet the requirements of paragraph (b) practicing
within a reasonable geographic distance of the patient, a pharmacist who meets the
requirements may provide the services via two-way interactive video. Reimbursement
shall be at the same rates and under the same conditions that would otherwise apply to
the services provided. To qualify for reimbursement under this paragraph, the pharmacist
providing the services must meet the requirements of paragraph (b), and must be located
within an ambulatory care setting approved by the commissioner. The patient must also
be located within an ambulatory care setting approved by the commissioner. Services
provided under this paragraph may not be transmitted into the patient's residence.

(e) 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.
The pilot project must begin by January 1, 2010, and end June 30, 2012.

new text begin This section is effective July 1, 2011.
new text end

Minnesota Statutes 2010, section 256B.0625, subdivision 17, is amended to
read:

(1) an ambulance, as defined in section 144E.001, subdivision 2;

(2) special transportation; or

(3) common carrier including, but not limited to, bus, taxicab, other commercial
carrier, or private automobile.

The commissioner may use an order by the recipient's attending physician to certify that
the recipient requires special transportation services. Special transportation providers shall
perform driver-assisted services for eligible individuals. Driver-assisted service includes
passenger pickup at and return to the individual's residence or place of business, assistance
with admittance of the individual to the medical facility, and assistance in passenger
securement or in securing of wheelchairs or stretchers in the vehicle. Special transportation
providers must obtain written documentation from the health care service provider who
is serving the recipient being transported, identifying the time that the recipient arrived.
Special transportation providers may not bill for separate base rates for the continuation of
a trip beyond the original destination. Special transportation providers must take recipients
to the nearest appropriate health care provider, using the most direct route. The minimum
medical assistance reimbursement rates for special transportation services are:

(1) (i) $17 for the base rate and $1.35 per mile for special transportation services to
eligible persons who need a wheelchair-accessible van;

(ii) $11.50 for the base rate and $1.30 per mile for special transportation services to
eligible persons who do not need a wheelchair-accessible van; and

(iii) $60 for the base rate and $2.40 per mile, and an attendant rate of $9 per trip, for
special transportation services to eligible persons who need a stretcher-accessible vehicle;

(2) the base rates for special transportation services in areas defined under RUCA
to be super rural shall be equal to the reimbursement rate established in clause (1) plus
11.3 percent; and

(3) for special transportation services in areas defined under RUCA to be rural
or super rural areas:

(i) for a trip equal to 17 miles or less, mileage reimbursement shall be equal to 125
percent of the respective mileage rate in clause (1); and

(ii) for a trip between 18 and 50 miles, mileage reimbursement shall be equal to
112.5 percent of the respective mileage rate in clause (1).

new text begin (e) Effective for services provided on or after July 1, 2011, nonemergency
transportation rates, including special transportation, taxi, and other commercial carriers,
are reduced 4.5 percent. Payments made to managed care plans and county-based
purchasing plans must be reduced for services provided on or after January 1, 2012,
to reflect this reduction.
new text end

Minnesota Statutes 2010, section 256B.0625, subdivision 17a, is amended to
read:

new text begin (a) new text end Medical assistance covers
ambulance services. Providers shall bill ambulance services according to Medicare
criteria. Nonemergency ambulance services shall not be paid as emergencies. Effective
for services rendered on or after July 1, 2001, medical assistance payments for ambulance
services shall be paid at the Medicare reimbursement rate or at the medical assistance
payment rate in effect on July 1, 2000, whichever is greater.

new text begin (b) Effective for services provided on or after July 1, 2011, ambulance services
payment rates are reduced 4.5 percent. Payments made to managed care plans and
county-based purchasing plans must be reduced for services provided on or after January
1, 2012, to reflect this reduction.
new text end

Minnesota Statutes 2010, section 256B.0625, subdivision 18, is amended to
read:

To the extent authorized by rule of the
state agency, medical assistance covers deleted text begin costs ofdeleted text end the most appropriate and cost-effective
form of transportation incurred by any ambulatory eligible person for obtaining
nonemergency medical care.

Minnesota Statutes 2010, section 256B.0625, is amended by adding a
subdivision to read:

new text begin (a) Except as otherwise
allowed under this subdivision or required under federal or state regulations, the
commissioner must not consider a request for authorization of a service when the recipient
has coverage from a third-party payer unless the provider requesting authorization has
made a good faith effort to receive payment or authorization from the third-party payer.
A good faith effort is established by supplying with the authorization request to the
commissioner the following:
new text end

new text begin (1) a determination of payment for the service from the third-party payer, a
determination of authorization for the service from the third-party payer, or a verification
of noncoverage of the service by the third-party payer; and
new text end

new text begin (2) the information or records required by the department to document the reason for
the determination or to validate noncoverage from the third-party payer.
new text end

new text begin (b) A provider requesting authorization for services covered by Medicare is not
required to bill Medicare before requesting authorization from the commissioner if the
provider has reason to believe that a service covered by Medicare is not eligible for
payment. The provider must document that, because of recent claim experiences with
Medicare or because of written communication from Medicare, coverage is not available
for the service.
new text end

new text begin (c) Authorization is not required if a third-party payer has made payment that is
equal to or greater than 60 percent of the maximum payment amount for the service
allowed under medical assistance.
new text end

Minnesota Statutes 2010, section 256B.0625, subdivision 31a, is amended to
read:

(a) Medical
assistance covers augmentative and alternative communication systems consisting of
electronic or nonelectronic devices and the related components necessary to enable a
person with severe expressive communication limitations to produce or transmit messages
or symbols in a manner that compensates for that disability.

(b) deleted text begin Until the volume of systems purchased increases to allow a discount price, the
commissioner shall reimburse augmentative and alternative communication manufacturers
and vendors at the manufacturer's suggested retail price for augmentative and alternative
communication systems and related components. The commissioner shall separately
reimburse providers for purchasing and integrating individual communication systems
which are unavailable as a package from an augmentative and alternative communication
vendor.deleted text end new text begin Augmentative and alternative communication systems must be paid the lower
of the:
new text end

new text begin (1) submitted charge; or
new text end

new text begin (2)(i) manufacturer's suggested retail price minus 20 percent for providers that are
manufacturers of augmentative and alternative communication systems; or
new text end

new text begin (ii) manufacturer's invoice charge plus 20 percent for providers that are not
manufacturers of augmentative and alternative communication systems.
new text end

(c) Reimbursement rates established by this purchasing program are not subject to
Minnesota Rules, part 9505.0445, item S or T.

Minnesota Statutes 2010, section 256B.0625, is amended by adding a
subdivision to read:

new text begin (a) Except when specifically
prohibited by the commissioner or federal law, a provider may seek payment from the
recipient for services not eligible for payment under the medical assistance program when
the provider, prior to delivering the service, reviews and considers all other available
covered alternatives with the recipient and obtains a signed acknowledgment from the
recipient of the potential of the recipient's liability. The signed acknowledgment must be
in a form approved by the commissioner.
new text end

new text begin (b) Conditions under which a provider must not request payment from the recipient
include, but are not limited to:
new text end

new text begin (1) a service that requires prior authorization, unless authorization has been denied
as not medically necessary and all other therapeutic alternatives have been reviewed;
new text end

new text begin (2) a service for which payment has been denied for reasons relating to billing
requirements;
new text end

new text begin (3) standard shipping or delivery and setup of medical equipment or medical
supplies;
new text end

new text begin (4) services that are included in the recipient's long term care per diem;
new text end

new text begin (5) the recipient is enrolled in the Restricted Recipient Program and the provider is
one of a provider type designated for the recipient's health care services; and
new text end

new text begin (6) the noncovered service is a prescriptive drug identified by the commissioner as
having the potential for abuse and overuse, except where payment by the recipient is
specifically approved by the commissioner on the date of service based upon compelling
evidence supplied by the prescribing provider that establishes medical necessity for that
particular drug.
new text end

new text begin (c) The payment requested from recipients for noncovered services under this
subdivision must not exceed the provider's usual and customary charge for the actual
service received by the recipient. A recipient must not be billed for the difference between
what medical assistance paid for the service or would pay for a less costly alternative
service.
new text end

Minnesota Statutes 2010, section 256B.0625, is amended by adding a
subdivision to read:

new text begin (a) Medical assistance covers in-reach
community-based service coordination that is performed in a hospital emergency
department as an eligible procedure under a state healthcare program or private insurance
for a frequent user. A frequent user is defined as an individual who has frequented the
hospital emergency department for services three or more times in the previous four
consecutive months. In-reach community-based service coordination includes navigating
services to address a client's mental health, chemical health, social, economic, and housing
needs, or any other activity targeted at reducing the incidence of emergency room and
other nonmedically necessary health care utilization.
new text end

new text begin (b) Reimbursement must be made in 15-minute increments under current Medicaid
mental health social work reimbursement methodology and allowed for up to 60 days
posthospital discharge based upon the specific identified emergency department visit or
inpatient admitting event. A frequent user who is participating in care coordination within
a health care home framework is ineligible for reimbursement under this subdivision.
Eligible in-reach service coordinators must hold a minimum of a bachelor's degree in
social work, public health, corrections, or a related field. The commissioner shall submit
any necessary application for waivers to the Centers for Medicare and Medicaid Services
to implement this subdivision.
new text end

new text begin (c) For the purposes of this subdivision, "in-reach community-based service
coordination" means the practice of a community-based worker with training, knowledge,
skills, and ability to access a continuum of services, including housing, transportation,
chemical and mental health treatment, employment, and peer support services, by working
with an organization's staff to transition an individual back into the individual's living
environment. In-reach community-based service coordination includes working with the
individual during their discharge and for up to a defined amount of time in the individual's
living environment, reducing the individual's need for readmittance.
new text end

Minnesota Statutes 2010, section 256B.0625, is amended by adding a
subdivision to read:

new text begin Effective for services
provided on or after January 1, 2012, medical assistance payment for an enrollee's cost
sharing associated with Medicare Part B is limited to an amount up to the medical
assistance total allowed, when the medical assistance rate exceeds the amount paid by
Medicare.
new text end

new text begin This section is effective January 1, 2012.
new text end

Minnesota Statutes 2010, section 256B.0625, is amended by adding a
subdivision to read:

new text begin Medical assistance covers early and periodic screening, diagnosis, and treatment services
(EPSDT). The payment amount for a complete EPSDT screening shall not exceed the rate
established per Minnesota Rules, part 9505.0445, item M, effective October 1, 2010.
new text end

Minnesota Statutes 2010, section 256B.0625, is amended by adding a
subdivision to read:

new text begin Medical assistance covers services provided by advanced dental therapists
and dental therapists when provided within the scope of practice identified in sections
150A.105 and 150A.106.
new text end

Minnesota Statutes 2010, section 256B.0631, subdivision 1, is amended to
read:

(a) Except as provided in subdivision
2, the medical assistance benefit plan shall include the following deleted text begin co-paymentsdeleted text end new text begin cost-sharingnew text end
for all recipients, effective for services provided on or after deleted text begin October 1, 2003, and before
January 1, 2009deleted text end new text begin July 1, 2011new text end :

(1) $3 per nonpreventive visitnew text begin , except as provided in paragraph (c)new text end . 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;

(2) $3 for eyeglasses;

(3) deleted text begin $6deleted text end new text begin $3.50new text end for nonemergency visits to a hospital-based emergency roomnew text begin , except
that this co-payment shall be increased to $20 upon federal approvalnew text end ; deleted text begin and
deleted text end

(4) $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 illnessdeleted text begin .deleted text end new text begin ;
new text end

new text begin (5) a family deductible equal to the maximum amount allowed under Code of
Federal Regulations, title 42, part 447.54; and
new text end

deleted text begin (b) Except as provided in subdivision 2, the medical assistance benefit plan shall
include the following co-payments for all recipients, effective for services provided on
or after January 1, 2009:
deleted text end

deleted text begin (1) $3.50 for nonemergency visits to a hospital-based emergency room;
deleted text end

deleted text begin (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; and
deleted text end

deleted text begin (3)deleted text end new text begin (6)new text end for individuals identified by the commissioner with income at or below 100
percent of the federal poverty guidelines, total monthly deleted text begin co-paymentsdeleted text end new text begin cost-sharingnew text end must
not exceed five percent of family income. For purposes of this paragraph, family income
is the total earned and unearned income of the individual and the individual's spouse, if
the spouse is enrolled in medical assistance and also subject to the five percent limit on
deleted text begin co-paymentsdeleted text end new text begin cost-sharingnew text end .

deleted text begin (c)deleted text end new text begin (b)new text end Recipients of medical assistance are responsible for all co-payments new text begin and
deductibles new text end in this subdivision.

new text begin (c) Effective January 1, 2012, or upon federal approval, whichever is later, the
following co-payments for nonpreventive visits shall apply to providers included in
provider peer grouping:
new text end

new text begin (1) $3 for visits to providers whose average, risk-adjusted, total annual cost of
care per medical assistance enrollee is at the 60th percentile or lower for providers of
the same type;
new text end

new text begin (2) $6 for visits to providers whose average, risk-adjusted, total annual cost of care
per medical assistance enrollee is greater than the 60th percentile but does not exceed the
80th percentile for providers of the same type; and
new text end

new text begin (3) $10 for visits to providers whose average, risk-adjusted, total annual cost of
care per medical assistance enrollee is greater than the 80th percentile for providers of
the same type.
new text end

new text begin Each managed care and county-based purchasing plan shall calculate the average,
risk-adjusted, total annual cost of care for providers under this paragraph using a
methodology approved by the commissioner. The commissioner shall develop a
methodology for calculating the average, risk-adjusted, total annual cost of care for
fee-for-service providers.
new text end

new text begin (d) The commissioner shall seek any federal waivers and approvals necessary to
increase the co-payment for nonemergency visits to a hospital-based emergency room
under paragraph (a), clause (3), and to implement paragraph (c).
new text end

Minnesota Statutes 2010, section 256B.0631, subdivision 2, is amended to
read:

Co-paymentsnew text begin and deductiblesnew text end shall be subject to the following
exceptions:

(1) children under the age of 21;

(2) pregnant women for services that relate to the pregnancy or any other medical
condition that may complicate the pregnancy;

(3) recipients expected to reside for at least 30 days in a hospital, nursing home, or
intermediate care facility for the developmentally disabled;

(4) recipients receiving hospice care;

(5) 100 percent federally funded services provided by an Indian health service;

(6) emergency services;

(7) family planning services;

(8) services that are paid by Medicare, resulting in the medical assistance program
paying for the coinsurance and deductible; and

(9) co-payments that exceed one per day per provider for nonpreventive visits,
eyeglasses, and nonemergency visits to a hospital-based emergency room.

Minnesota Statutes 2010, section 256B.0631, subdivision 3, is amended to
read:

(a) The medical assistance reimbursement to the provider shall
be reduced by the amount of the co-paymentnew text begin or deductiblenew text end , except that reimbursements
shall not be reduced:

(1) once a recipient has reached the $12 per month maximum deleted text begin or the $7 per month
maximum effective January 1, 2009,deleted text end for prescription drug co-payments; or

(2) for a recipient identified by the commissioner under 100 percent of the federal
poverty guidelines who has met their monthly five percent deleted text begin co-paymentdeleted text end new text begin cost-sharingnew text end limit.

(b) The provider collects the co-paymentnew text begin or deductiblenew text end from the recipient. Providers
may not deny services to recipients who are unable to pay the co-paymentnew text begin or deductiblenew text end .

(c) Medical assistance reimbursement to fee-for-service providers and payments to
managed care plans shall not be increased as a result of the removal of co-payments new text begin or
deductibles new text end effective on or after January 1, 2009.

Minnesota Statutes 2010, section 256B.0644, is amended to read:

(a) A vendor of medical care, as defined in section 256B.02, subdivision 7, and a
health maintenance organization, as defined in chapter 62D, must participate as a provider
or contractor in the medical assistance program, general assistance medical care program,
and MinnesotaCare as a condition of participating as a provider in health insurance plans
and programs or contractor for state employees established under section 43A.18, the
public employees insurance program under section 43A.316, for health insurance plans
offered to local statutory or home rule charter city, county, and school district employees,
the workers' compensation system under section 176.135, and insurance plans provided
through the Minnesota Comprehensive Health Association under sections 62E.01 to
62E.19. The limitations on insurance plans offered to local government employees shall
not be applicable in geographic areas where provider participation is limited by managed
care contracts with the Department of Human Services.

(b) For providers other than health maintenance organizations, participation in the
medical assistance program means that:

(1) the provider accepts new medical assistance, general assistance medical care,
and MinnesotaCare patients;

(2) for providers other than dental service providers, at least 20 percent of the
provider's patients are covered by medical assistance, general assistance medical care,
and MinnesotaCare as their primary source of coverage; or

(3) for dental service providers, at least ten percent of the provider's patients are
covered by medical assistance, general assistance medical care, and MinnesotaCare as
their primary source of coverage, or the provider accepts new medical assistance and
MinnesotaCare patients who are children with special health care needs. For purposes
of this section, "children with special health care needs" means children up to age 18
who: (i) require health and related services beyond that required by children generally;
and (ii) have or are at risk for a chronic physical, developmental, behavioral, or emotional
condition, including: bleeding and coagulation disorders; immunodeficiency disorders;
cancer; endocrinopathy; developmental disabilities; epilepsy, cerebral palsy, and other
neurological diseases; visual impairment or deafness; Down syndrome and other genetic
disorders; autism; fetal alcohol syndrome; and other conditions designated by the
commissioner after consultation with representatives of pediatric dental providers and
consumers.

(c) Patients seen on a volunteer basis by the provider at a location other than
the provider's usual place of practice may be considered in meeting the participation
requirement in this section. The commissioner shall establish participation requirements
for health maintenance organizations. The commissioner shall provide lists of participating
medical assistance providers on a quarterly basis to the commissioner of management and
budget, the commissioner of labor and industry, and the commissioner of commerce. Each
of the commissioners shall develop and implement procedures to exclude as participating
providers in the program or programs under their jurisdiction those providers who do
not participate in the medical assistance program. The commissioner of management
and budget shall implement this section through contracts with participating health and
dental carriers.

(d) For purposes of paragraphs (a) and (b), participation in the general assistance
medical care program applies only to pharmacy providers.

new text begin (e) A provider described in section 256B.76, subdivision 5, may limit the eligibility
of new medical assistance, general assistance medical care, and MinnesotaCare patients
for specific categories of rehabilitative services, if medical assistance, general assistance
medical care, and MinnesotaCare patients served by the provider in the aggregate exceed
30 percent of the provider's overall patient population.
new text end

Minnesota Statutes 2010, section 256B.0751, subdivision 4, is amended to
read:

new text begin (a) new text end Nothing in this
section shall preclude the continued development of existing medical or health care
home projects currently operating or under development by the commissioner of human
services or preclude the commissioner from establishing alternative models and payment
mechanisms for persons who are enrolled in integrated Medicare and Medicaid programs
under section 256B.69, subdivisions 23 and 28, are enrolled in managed care long-term
care programs under section 256B.69, subdivision 6b, are dually eligible for Medicare and
medical assistance, are in the waiting period for Medicare, or who have other primary
coverage.

new text begin (b) The commissioner of health shall waive health care home certification
requirements if an applicant demonstrates that compliance with a certification requirement
will create a major financial hardship or is not feasible, and the applicant establishes an
alternative way to accomplish the objectives of the certification requirement.
new text end

Minnesota Statutes 2010, section 256B.0751, is amended by adding a
subdivision to read:

new text begin The health care home and the county
shall coordinate care and services provided to patients enrolled with a health care home
who have complex medical needs or a disability, and who need and are eligible for
additional local services administered by counties, including but not limited to waivered
services, mental health services, social services, public health services, transportation, and
housing. The coordination of care and services must be as provided in the plan established
by the patient and health care home.
new text end

Minnesota Statutes 2010, section 256B.69, subdivision 5a, is amended to read:

(a) Managed care contracts under this section
and section 256L.12 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 and 256L is responsible for complying with the terms of its
contract with the commissioner. Requirements applicable to managed care programs
under chapters 256B 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 and
county-based purchasing plan payments under section 256B.692 for the prepaid medical
assistance program 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.

(d) Effective for services rendered on or after January 1, 2009, through December
31, 2009, the commissioner shall withhold three percent of managed care plan payments
under this section and county-based purchasing plan payments under section 256B.692
for the prepaid medical assistance program. 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.

(e) Effective for services provided on or after January 1, 2010, the commissioner
shall require that managed care plans use the assessment and authorization processes,
forms, timelines, standards, documentation, and data reporting requirements, protocols,
billing processes, and policies consistent with medical assistance fee-for-service or the
Department of Human Services contract requirements consistent with medical assistance
fee-for-service or the Department of Human Services contract requirements for all
personal care assistance services under section 256B.0659.

(f) Effective for services rendered on or after January 1, 2010, through December
31, 2010, the commissioner shall withhold 4.5 percent of managed care plan payments
under this section and county-based purchasing plan payments under section 256B.692
for the prepaid medical assistance program. 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.

(g) Effective for services rendered on or after January 1, 2011, the commissioner
shall include as part of the performance targets described in paragraph (c) a reduction in
the health plan's emergency room utilization rate for state health care program enrollees
by a measurable rate of five percent from the plan's utilization rate for state health care
program enrollees for the previous calendar year.

The withheld funds must be returned no sooner than July 1 and no later than July 31
of the following calendar year if the managed care plan demonstrates to the satisfaction of
the commissioner that a reduction in the utilization rate was achieved.

The withhold described in this paragraph shall continue for each consecutive
contract period until the plan's emergency room utilization rate for state health care
program enrollees is reduced by 25 percent of the plan's emergency room utilization
rate for state health care program enrollees for calendar year 2009. Hospitals shall
cooperate with the health plans in meeting this performance target and shall accept
payment withholds that may be returned to the hospitals if the performance target is
achieved. The commissioner shall structure the withhold so that the commissioner returns
a portion of the withheld funds in amounts commensurate with achieved reductions in
utilization less than the targeted amount. The withhold in this paragraph does not apply to
county-based purchasing plans.

new text begin (h) Effective for services rendered on or after January 1, 2012, the commissioner
shall include as part of the performance targets described in paragraph (c) a reduction in
the plan's hospitalization rates or subsequent hospitalizations within 30 days of a previous
hospitalization of a patient regardless of the reason for the hospitalization for state health
care program enrollees by a measurable rate of five percent from the plan's utilization rate
for state health care program enrollees for the previous calendar year.
new text end

new text begin The withheld funds must be returned no sooner than July 1 and no later than July 31
of the following calendar year if the managed care plan or county-based purchasing plan
demonstrates to the satisfaction of the commissioner that a reduction in the hospitalization
rate was achieved.
new text end

new text begin The withhold described in this paragraph must continue for each consecutive
contract period until the plan's subsequent hospitalization rate for state health care
program enrollees is reduced by 25 percent of the plan's subsequent hospitalization rate
for state health care program enrollees for calendar year 2010. Hospitals shall cooperate
with the plans in meeting this performance target and shall accept payment withholds that
must be returned to the hospitals if the performance target is achieved. The commissioner
shall structure the withhold so that the commissioner returns a portion of the withheld
funds in amounts commensurate with achieved reductions in utilization less than the
targeted amount.
new text end

deleted text begin (h)deleted text end new text begin (i)new text end Effective for services rendered on or after January 1, 2011, through December
31, 2011, the commissioner shall withhold 4.5 percent of managed care plan payments
under this section and county-based purchasing plan payments under section 256B.692
for the prepaid medical assistance program. 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.

deleted text begin (i)deleted text end new text begin (j)new text end Effective for services rendered on or after January 1, 2012, through December
31, 2012, the commissioner shall withhold 4.5 percent of managed care plan payments
under this section and county-based purchasing plan payments under section 256B.692
for the prepaid medical assistance program. 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.

deleted text begin (j)deleted text end new text begin (k)new text end Effective for services rendered on or after January 1, 2013, through December
31, 2013, the commissioner shall withhold 4.5 percent of managed care plan payments
under this section and county-based purchasing plan payments under section 256B.692
for the prepaid medical assistance program. 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.

deleted text begin (k)deleted text end new text begin (l)new text end Effective for services rendered on or after January 1, 2014, the commissioner
shall withhold three percent of managed care plan payments under this section and
county-based purchasing plan payments under section 256B.692 for the prepaid medical
assistance program. 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.

deleted text begin (l)deleted text end new text begin (m)new text end 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 section that is reasonably expected to be returned.

deleted text begin (m)deleted text end new text begin (n)new text end 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.

deleted text begin (n)deleted text end new text begin (o)new text end The return of the withhold under paragraphs (d), (f), and (h) to (k) is not
subject to the requirements of paragraph (c).

Minnesota Statutes 2010, section 256B.69, subdivision 5c, is amended to read:

(a) The commissioner of human
services shall transfer each year to the medical education and research fund established
under section 62J.692, new text begin an amount specified in this subdivision. The commissioner shall
calculate new text end the following:

(1) an amount equal to the reduction in the prepaid medical assistance payments as
specified in this clause. Until January 1, 2002, the county medical assistance capitation
base rate prior to plan specific adjustments and after the regional rate adjustments under
subdivision 5b is reduced 6.3 percent for Hennepin County, two percent for the remaining
metropolitan counties, and no reduction for nonmetropolitan Minnesota counties; and after
January 1, 2002, the county medical assistance capitation base rate prior to plan specific
adjustments is reduced 6.3 percent for Hennepin County, two percent for the remaining
metropolitan counties, and 1.6 percent for nonmetropolitan Minnesota counties. Nursing
facility and elderly waiver payments and demonstration project payments operating
under subdivision 23 are excluded from this reduction. The amount calculated under
this clause shall not be adjusted for periods already paid due to subsequent changes to
the capitation payments;

(2) beginning July 1, 2003, $4,314,000 from the capitation rates paid under this
section;

(3) beginning July 1, 2002, an additional $12,700,000 from the capitation rates
paid under this section; and

(4) beginning July 1, 2003, an additional $4,700,000 from the capitation rates paid
under this section.

(b) This subdivision shall be effective upon approval of a federal waiver which
allows federal financial participation in the medical education and research fund. deleted text begin Effective
July 1, 2009, and thereafter,deleted text end The deleted text begin transfers required bydeleted text end new text begin amount specified under new text end paragraph
(a), clauses (1) to (4), shall not exceed the total amount transferred for fiscal year 2009.
Any excess shall first reduce the amounts deleted text begin otherwise required to be transferreddeleted text end new text begin specified
new text end under paragraph (a), clauses (2) to (4). Any excess following this reduction shall
proportionally reduce the deleted text begin transfersdeleted text end new text begin amount specified new text end under paragraph (a), clause (1).

(c) Beginning July 1, deleted text begin 2009deleted text end new text begin 2011new text end , of the deleted text begin amountsdeleted text end new text begin amountnew text end in paragraph (a), the
commissioner shall transfer $21,714,000 each fiscal year to the medical education and
research fund. deleted text begin The balance of the transfers under paragraph (a) shall be transferred to the
medical education and research fund no earlier than July 1 of the following fiscal year.
deleted text end

new text begin (d) Beginning July 1, 2011, of the amount in paragraph (a), following the transfer
under paragraph (c), the commissioner shall transfer to the medical education research
fund $4,024,000 in fiscal year 2012 and $4,626,000 in fiscal year 2013 and thereafter.
new text end

Minnesota Statutes 2010, section 256B.69, subdivision 28, is amended to read:

(a) The commissioner may contract with qualified Medicare-approved special needs
plans to provide medical assistance basic health care services to persons with disabilities,
including those with developmental disabilities. Basic health care services include:

(1) those services covered by the medical assistance state plan except for ICF/MR
services, home and community-based waiver services, case management for persons with
developmental disabilities under section 256B.0625, subdivision 20a, and personal care
and certain home care services defined by the commissioner in consultation with the
stakeholder group established under paragraph (d); and

(2) basic health care services may also include risk for up to 100 days of nursing
facility services for persons who reside in a noninstitutional setting and home health
services related to rehabilitation as defined by the commissioner after consultation with
the stakeholder group.

The commissioner may exclude other medical assistance services from the basic
health care benefit set. Enrollees in these plans can access any excluded services on the
same basis as other medical assistance recipients who have not enrolled.

deleted text begin Unless a person is otherwise required to enroll in managed care, enrollment in these
plans for Medicaid services must be voluntary. For purposes of this subdivision, automatic
enrollment with an option to opt out is not voluntary enrollment.
deleted text end

(b) Beginning January 1, 2007, the commissioner may contract with qualified
Medicare special needs plans to provide basic health care services under medical
assistance to persons who are dually eligible for both Medicare and Medicaid and those
Social Security beneficiaries eligible for Medicaid but in the waiting period for Medicare.
The commissioner shall consult with the stakeholder group under paragraph (d) in
developing program specifications for these services. The commissioner shall report to
the chairs of the house of representatives and senate committees with jurisdiction over
health and human services policy and finance by February 1, 2007, on implementation
of these programs and the need for increased funding for the ombudsman for managed
care and other consumer assistance and protections needed due to enrollment in managed
care of persons with disabilities. Payment for Medicaid services provided under this
subdivision for the months of May and June will be made no earlier than July 1 of the
same calendar year.

(c) new text begin Notwithstanding subdivision 4, new text end beginning January 1, deleted text begin 2008deleted text end new text begin 2012new text end , the
commissioner deleted text begin may expand contracting under this subdivision to alldeleted text end new text begin shall enroll new text end persons
with disabilities deleted text begin not otherwise required to enrolldeleted text end in managed carenew text begin under this section,
unless the individual chooses to opt out of enrollment. The commissioner shall establish
enrollment and opt out procedures consistent with applicable enrollment procedures under
this subdivisionnew text end .

(d) The commissioner shall establish a state-level stakeholder group to provide
advice on managed care programs for persons with disabilities, including both MnDHO
and contracts with special needs plans that provide basic health care services as described
in paragraphs (a) and (b). The stakeholder group shall provide advice on program
expansions under this subdivision and subdivision 23, including:

(1) implementation efforts;

(2) consumer protections; and

(3) program specifications such as quality assurance measures, data collection and
reporting, and evaluation of costs, quality, and results.

(e) Each plan under contract to provide medical assistance basic health care services
shall establish a local or regional stakeholder group, including representatives of the
counties covered by the plan, members, consumer advocates, and providers, for advice on
issues that arise in the local or regional area.

(f) The commissioner is prohibited from providing the names of potential enrollees
to health plans for marketing purposes. The commissioner deleted text begin maydeleted text end new text begin shallnew text end mail new text begin no more than
two sets of new text end marketing materials new text begin per contract year new text end to potential enrollees on behalf of health
plans, deleted text begin in which casedeleted text end new text begin at the health plan's request. The marketing materials shall be mailed
by the commissioner within 30 days of receipt of these materials from the health plan.new text end The
health plans shall cover any costs incurred by the commissioner for mailing marketing
materials.

Minnesota Statutes 2010, section 256B.69, is amended by adding a
subdivision to read:

new text begin (a) Each managed care and county-based plan
shall, by October 1, 2011, array all providers within each provider type, employed by or
under contract with the plan, by their average total annual cost of care for serving medical
assistance and MinnesotaCare enrollees for the most recent reporting year for which data
is available, risk-adjusted for enrollee demographics and health status.
new text end

new text begin (b) Beginning January 1, 2012, and each contract year thereafter, each managed
care and county-based purchasing plan shall implement a progressive payment withhold
methodology for each provider type, under which the withhold for a provider increases
proportionally as the provider's risk-adjusted total annual cost increases, relative to other
providers of the same type. For purposes of this paragraph, the risk-adjusted total annual
cost of care is the dollar amount calculated under paragraph (a).
new text end

new text begin (c) At the end of each contract year, each plan shall array all providers within each
provider type by their average total annual cost of care for serving medical assistance and
MinnesotaCare enrollees for that contract year, risk-adjusted for enrollee demographics
and health status. For each provider whose risk-adjusted total annual cost of care is at or
below the 70th percentile of providers of the same type or specialty, the plan shall return
the full amount of any withhold. For each provider whose risk-adjusted total annual cost
of care is above the 70th percentile, the plan shall return only the portion of the withhold
sufficient to bring the provider's payment rate to the average for providers within the
provider type whose risk-adjusted total annual cost of care is at the 70th percentile. Each
plan shall reduce provider payments only as allowed under paragraph (f).
new text end

new text begin (d) Each managed care and county-based purchasing plan must establish an appeals
process to allow providers to appeal determinations of risk-adjusted total annual cost of
care. Each plan's appeals process must be approved by the commissioner.
new text end

new text begin (e) The commissioner shall require each plan to submit to the commissioner, in
the form and manner specified by the commissioner, all provider payment data and
information on the withhold methodology that the commissioner determines is necessary
to verify compliance with this subdivision.
new text end

new text begin (f) The commissioner, for the contract year beginning January 1, 2012, shall reduce
plan capitation rates by ten percent from the rates that would otherwise apply, absent
application of this subdivision. The reduced rate shall be the historical base rate for
negotiating capitation rates for future contract years. The commissioner may recommend
additional reductions in capitation rates for future contract years to the legislature, if the
commissioner determines this is necessary to ensure that health care providers under
contract with managed care and county-based purchasing plans practice in an efficient
manner. Effective for services rendered on or after January 1, 2012, managed care plans
and county-based purchasing plans contracted with the state to administer the health
care programs provided under sections 256B.69, 256B.692, and 256L.12, may reduce
payments made to providers employed or under contract with the plan. However, a
managed care or county-based purchasing plan is prohibited from: (1) reducing payments
made to providers whose risk-adjusted total annual cost of care is at or below the 70th
percentile of providers of the same type or specialty, or at or below the 80th percentile
for provider types or specialties currently subject to plan care management requirements
that in the aggregate are more extensive than those that apply to other provider types or
specialties, or for which a majority of services are currently subject to prior authorization
by the plan and (2) reducing payments to hospitals described under the Social Security
Act, title 18, section 1886, subsection (d), paragraph (l), and subparagraph (B), clause (iii).
new text end

new text begin (g) The commissioner of human services, in consultation with the commissioner of
health, shall develop and provide to managed care and county-based purchasing plans, by
September 1, 2011, standard criteria and definitions necessary for consistent calculation
of the total annual risk-adjusted cost of care across plans. The commissioner may use
encounter data to implement this subdivision, and may provide encounter data or analyses
to plans.
new text end

new text begin (h) For purposes of this subdivision, "provider" means a vendor of medical care
as defined in section 256B.02, subdivision 7, for which sufficient encounter data on
utilization and costs is available to implement this subdivision.
new text end

new text begin (i) A managed care or county-based purchasing plan must use the methodology
described in paragraphs (a) to (e), unless the plan develops an alternative model consistent
with the purpose of this subdivision.
new text end

new text begin This section is effective the day following final enactment.
new text end

Minnesota Statutes 2010, section 256B.69, is amended by adding a
subdivision to read:

new text begin The commissioner shall require managed care and
county-based purchasing plans, as a condition of contract, to provide health education,
wellness training, and information about the availability and benefits of preventive
services to all medical assistance and MinnesotaCare enrollees, beginning January 1,
2012. Plan initiatives developed or implemented to comply with this requirement must be
approved by the commissioner.
new text end

Minnesota Statutes 2010, section 256B.76, subdivision 4, is amended to read:

(a) Effective for dental services
rendered on or after January 1, 2002, the commissioner shall increase reimbursements
to dentists and dental clinics deemed by the commissioner to be critical access dental
providers. For dental services rendered on or after July 1, 2007, the commissioner shall
increase reimbursement by 30 percent above the reimbursement rate that would otherwise
be paid to the critical access dental provider. The commissioner shall pay the managed
care plans and county-based purchasing plans in amounts sufficient to reflect increased
reimbursements to critical access dental providers as approved by the commissioner.

(b) The commissioner shall designate the following dentists and dental clinics as
critical access dental providers:

(1) nonprofit community clinics that:

(i) have nonprofit status in accordance with chapter 317A;

(ii) have tax exempt status in accordance with the Internal Revenue Code, section
501(c)(3);

(iii) are established to provide oral health services to patients who are low income,
uninsured, have special needs, and are underserved;

(iv) have professional staff familiar with the cultural background of the clinic's
patients;

(v) charge for services on a sliding fee scale designed to provide assistance to
low-income patients based on current poverty income guidelines and family size;

(vi) do not restrict access or services because of a patient's financial limitations
or public assistance status; and

(vii) have free care available as needed;

(2) federally qualified health centers, rural health clinics, and public health clinics;

(3) county owned and operated hospital-based dental clinics;

(4) a dental clinic or dental group owned and operated by a nonprofit corporation in
accordance with chapter 317A with more than 10,000 patient encounters per year with
patients who are uninsured or covered by medical assistance, general assistance medical
care, or MinnesotaCare; and

(5) a dental clinic deleted text begin associated with an oral health or dental education programdeleted text end new text begin owned
andnew text end operated by the University of Minnesota or deleted text begin an institution withindeleted text end the Minnesota State
Colleges and Universities system.

(c) The commissioner may designate a dentist or dental clinic as a critical access
dental provider if the dentist or dental clinic is willing to provide care to patients covered
by medical assistance, general assistance medical care, or MinnesotaCare at a level which
significantly increases access to dental care in the service area.

(d) Notwithstanding paragraph (a), critical access payments must not be made for
dental services provided from April 1, 2010, through June 30, 2010.

new text begin (e) Notwithstanding section 256B.04, subdivision 2, the commissioner of human
services shall not adopt rules governing this section or section 256L.11, subdivision 7.
new text end

new text begin This section is effective July 1, 2011.
new text end

new text begin The commissioner of
human services, in consultation with the commissioner of health, shall contract
with a Minnesota-based academic and research institution specializing in providing
complementary and alternative medicine education and clinical services to establish and
implement a five-year demonstration project in conjunction with federally qualified health
centers and federally qualified health center look-alikes as defined in section 145.9269, to
improve the quality and cost-effectiveness of care provided under medical assistance to
enrollees with neck and back problems. The demonstration project must maximize the use
of complementary and alternative medicine-oriented primary care providers, including but
not limited to physicians and chiropractors. The demonstration project must be designed
to significantly improve physical and mental health for enrollees who present with
neck and back problems while decreasing medical treatment costs. The commissioner,
in consultation with the commissioner of health, shall deliver services through the
demonstration project beginning July 1, 2011, or upon federal approval, whichever is later.
new text end

new text begin The commissioner, in consultation with the
commissioner of health, shall develop and issue a request for proposal (RFP) for the
demonstration project. The RFP must require the academic and research institution
selected to demonstrate a proven track record over at least five years of conducting
high-quality, federally funded clinical research. The RFP shall specify the state costs
directly related to the requirements of this section and shall require that the selected
institution pay those costs to the state. The institution and the federally qualified health
centers and federally qualified health center look-alikes shall also:
new text end

new text begin (1) provide patient education, provider education, and enrollment training
components on health and lifestyle issues in order to promote enrollee responsibility for
health care decisions, enhance productivity, prepare enrollees to reenter the workforce,
and reduce future health care expenditures;
new text end

new text begin (2) use high-quality and cost-effective integrated disease management that includes
the best practices of traditional and complementary and alternative medicine;
new text end

new text begin (3) incorporate holistic medical care, appropriate nutrition, exercise, medications,
and conflict resolution techniques;
new text end

new text begin (4) include a provider education component that makes use of professional
organizations representing chiropractors, nurses, and other primary care providers
and provides appropriate educational materials and activities in order to improve the
integration of traditional medical care with licensed chiropractic services and other
alternative health care services and achieve program enrollment objectives; and
new text end

new text begin (5) provide to the commissioner the information and data necessary for the
commissioner to prepare the annual reports required under subdivision 6.
new text end

new text begin Enrollees from the program shall be selected by the
commissioner from current enrollees in the prepaid medical assistance program who
have, or are determined to be at significant risk of developing, neck and back problems.
Participation in the demonstration project shall be voluntary. The commissioner shall
seek to enroll, over the term of the demonstration project, ten percent of current and
future medical assistance enrollees who have, or are determined to be at significant risk
of developing, neck and back problems.
new text end

new text begin The commissioner shall seek any federal waivers and
approvals necessary to implement the demonstration project.
new text end

new text begin The commissioner shall require the academic and research
institution selected, federally qualified health centers, and federally qualified health center
look-alikes to fund all costs of the demonstration project. Amounts received under
subdivision 2 are appropriated to the commissioner for the purposes of this section.
new text end

new text begin The commissioner, in consultation with the commissioner
of health, beginning December 15, 2011, and each December 15 thereafter through
December 15, 2015, shall report annually to the legislature on the functional and mental
improvements of the populations served by the demonstration project, patient satisfaction,
and the cost-effectiveness of the program. The reports must also include data on hospital
admissions, days in hospital, rates of outpatient surgery and other services, and drug
utilization. The report, due December 15, 2015, must include recommendations on
whether the demonstration project should be continued and expanded.
new text end

new text begin It is the intent of the legislature that medical assistance be:
new text end

new text begin (1) a sustainable, cost-effective, person-centered, and opportunity-driven program
utilizing competitive and value-based purchasing to maximize available service options;
and
new text end

new text begin (2) a results-oriented system of coordinated care that focuses on independence
and choice, promotes accountability and transparency, encourages and rewards healthy
outcomes and responsible choices, and promotes efficiency.
new text end

new text begin (a) By September 1, 2011, the commissioner of
human services shall apply for a waiver and any necessary state plan amendments from
the secretary of the United States Department of Health and Human Services, including,
but not limited to, a waiver of the appropriate sections of title XIX of the federal Social
Security Act, United States Code, title 42, section 1396 et seq., or other provisions of
federal law that provide program flexibility and under which Minnesota will operate
all facets of the state's medical assistance program. For purposes of this section, and
256B.842, and 256B.843, this waiver shall be known as the Minnesota Consumer Health
Opportunities and Innovative Care Excellence (CHOICE) waiver.
new text end

new text begin (b) The commissioner of human services shall provide the legislative committees
with jurisdiction over health and human services finance and policy with the CHOICE
waiver application and financial and other related materials, at least ten days prior to
submitting the application and materials to the federal Centers for Medicare and Medicaid
Services.
new text end

new text begin (c) If the state's CHOICE waiver application is approved, the commissioner of
human services shall:
new text end

new text begin (1) notify the chairs of the legislative committees with jurisdiction over health and
human services finance and policy and allow the legislative committees with jurisdiction
over health and human services finance and policy to review the terms of the CHOICE
waiver; and
new text end

new text begin (2) not implement the CHOICE waiver until ten legislative days have passed
following notification of the chairs.
new text end

new text begin Upon acceptance of the terms of the
CHOICE waiver, the commissioner of human services shall:
new text end

new text begin (1) adopt rules to implement the CHOICE waiver; and
new text end

new text begin (2) propose any legislative changes necessary to implement the terms of the
CHOICE waiver.
new text end

new text begin (a) After acceptance of the
terms of the CHOICE waiver, the governor shall establish a joint commission on CHOICE
waiver implementation. The commission shall consist of eight members; four of whom
shall be members of the senate, not more than three from the same political party, to be
appointed by the Subcommittee on Committees of the senate Committee on Rules and
Administration, and four of whom shall be members of the house of representatives, not
more than three from the same political party, to be appointed by the speaker of the house.
new text end

new text begin (b) The commission shall:
new text end

new text begin (1) oversee implementation of the CHOICE waiver;
new text end

new text begin (2) confer as necessary with state agency commissioners;
new text end

new text begin (3) make recommendations on services covered under the medical assistance
program;
new text end

new text begin (4) monitor and make recommendations on quality and access to care under the
CHOICE waiver; and
new text end

new text begin (5) make recommendations for the efficient and cost-effective administration of the
medical assistance program under the terms of the CHOICE waiver.
new text end

new text begin In developing the CHOICE waiver application
and implementing the CHOICE waiver, the commissioner of human services shall ensure
that the reformed medical assistance program is a person-centered, financially sustainable,
and cost-effective program.
new text end

new text begin The reformed medical assistance
program established through the CHOICE waiver must:
new text end

new text begin (1) empower consumers to make informed and cost-effective choices about their
health and offer consumers rewards for healthy decisions;
new text end

new text begin (2) ensure adequate access to needed services;
new text end

new text begin (3) enable consumers to receive individualized health care that is outcome-oriented
and focused on prevention, disease management, recovery, and maintaining independence;
new text end

new text begin (4) promote competition between health care providers to ensure best value
purchasing, leverage resources, and to create opportunities for improving service quality
and performance;
new text end

new text begin (5) redesign purchasing and payment methods and encourage and reward
high-quality and cost-effective care by incorporating and expanding upon current payment
reform and quality of care initiatives including, but not limited to, those initiatives
authorized under chapter 62U; and
new text end

new text begin (6) continually improve technology to take advantage of recent innovations and
advances that help decision makers, consumers, and providers make informed and
cost-effective decisions regarding health care.
new text end

new text begin The commissioner of human services shall annually
submit a report to the governor and the legislature, beginning December 1, 2012, and each
December 1 thereafter, describing the status of the administration and implementation
of the CHOICE waiver.
new text end

new text begin The commissioner
shall seek federal approval to:
new text end

new text begin (1) enter into a five-year agreement with the United States Department of Health and
Human Services and Centers for Medicaid and Medicare Services (CMS) under section
1115a to waive, as part of the CHOICE waiver, provisions of title XIX of the federal
Social Security Act, United States Code, title 42, section 1396 et seq., requiring:
new text end

new text begin (i) statewideness to allow for the provision of different services in different areas or
regions of the state;
new text end

new text begin (ii) comparability of services to allow for the provision of different services to
members of the same or different coverage groups;
new text end

new text begin (iii) no prohibitions restricting the amount, duration, and scope of services included
in the medical assistance state plan;
new text end

new text begin (iv) no prohibitions limiting freedom of choice of providers; and
new text end

new text begin (v) retroactive payment for medical assistance, at the state's discretion;
new text end

new text begin (2) waive the applicable provisions of title XIX of the federal Social Security Act,
United States Code, title 42, section 1396 et seq., in order to:
new text end

new text begin (i) expand cost sharing requirements above the five percent of income threshold for
beneficiaries in certain populations;
new text end

new text begin (ii) establish health savings or power accounts that encourage and reward
beneficiaries who reach certain prevention and wellness targets; and
new text end

new text begin (iii) implement a tiered set of parameters to use as the basis for determining
long-term service care and setting needs;
new text end

new text begin (3) modify income and resource rules in a manner consistent with the goals of the
reformed program;
new text end

new text begin (4) provide enrollees with a choice of appropriate private sector health coverage
options, with full federal financial participation;
new text end

new text begin (5) treat payments made toward the cost of care as a monthly premium for
beneficiaries receiving home and community-based services when applicable;
new text end

new text begin (6) provide health coverage and services to individuals over the age of 65 that are
limited in scope and are available only in the home and community-based setting;
new text end

new text begin (7) consolidate all home and community-based services currently provided under
title XIX of the federal Social Security Act, United States Code, title 42, section 1915(c),
into a single program of home and community-based services that include options for
consumer direction and shared living;
new text end

new text begin (8) expand disease management, care coordination, and wellness programs for all
medical assistance recipients; and
new text end

new text begin (9) empower and encourage able-bodied medical assistance recipients to work,
whenever possible.
new text end

new text begin The commissioner shall establish an intraagency
assessment and coordination unit to ensure that decision making and program planning for
recipients who may need long-term care, residential placement, and community support
services are coordinated. The assessment and coordination unit shall determine level of
care, develop service plans and a service budget, make referrals to appropriate settings,
provide education and choice counseling to consumers and providers, track utilization,
and monitor outcomes.
new text end

Minnesota Statutes 2010, section 256D.03, subdivision 3, is amended to read:

(a) Beginning deleted text begin April 1,
2010deleted text end new text begin October 1, 2011new text end , the general assistance medical care program shall be administered
according to section 256D.031, unless otherwise stated, except for outpatient prescription
drug coverage, which shall continue to be administered under this section and funded
under section 256D.031, subdivision 9deleted text begin , beginning June 1, 2010deleted text end .

(b) Outpatient prescription drug coverage under general assistance medical care is
limited to prescription drugs that:

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

(2) are provided by manufacturers that have fully executed general assistance
medical care rebate agreements with the commissioner and comply with the agreements.
Outpatient 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 13h.

deleted text begin (d) For the period beginning April 1, 2010, to May 31, 2010, general assistance
medical care covers the services listed in subdivision 4.
deleted text end

new text begin This section is effective October 1, 2011.
new text end

Minnesota Statutes 2010, section 256D.031, subdivision 1, is amended to read:

(a) Except as provided under subdivision 2, general
assistance medical care may be paid for any individual 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, and who:

(1) is receiving assistance under section 256D.05, except for families with children
who are eligible under the 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

deleted text begin (2) is a resident of Minnesota and has gross countable income not in excess of 75
percent of 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.
deleted text end

new text begin (2) is a resident of Minnesota and has gross countable income that is equal to or less
than 125 percent of the federal poverty guidelines for the family size, using a six-month
budget period, and who meets the asset limit specified in section 256L.17, subdivision 2.
new text end

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,
except that 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.

(b) 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.

Minnesota Statutes 2010, section 256D.031, subdivision 6, is amended to read:

(a) Effective deleted text begin June 1, 2010deleted text end new text begin October
1, 2011new text end , the commissioner shall contract with hospitals or groups of hospitalsnew text begin , or
county-based purchasing plans,new text end that qualify under paragraph (b) and agree to deliver
services according to this subdivision. Contracting hospitals new text begin or plans new text end shall develop
and implement a coordinated care delivery system to provide health care services to
individuals who are eligible for general assistance medical care under this section and who
either choose to receive services through the coordinated care delivery system or who are
enrolled by the commissioner under paragraph (c). The health care services provided by
the system must include: (1) the services described in subdivision 4 with the exception
of outpatient prescription drug coverage but shall include drugs administered in a clinic
or other outpatient setting; or (2) a set of comprehensive and medically necessary health
services that the recipients might reasonably require to be maintained in good health and
that has been approved by the commissioner, including at a minimum, but not limited
to, emergency care, medical transportation services, inpatient hospital and physician
care, outpatient health services, preventive health services, mental health services,
and prescription drugs administered in a clinic or other outpatient setting. Outpatient
prescription drug coverage is covered on a fee-for-service basis in accordance with section
256D.03, subdivision 3, and funded under subdivision 9. A hospital new text begin or plan new text end establishing a
coordinated care delivery system under this subdivision must ensure that the requirements
of this subdivision are met.

(b) A hospital or group of hospitalsnew text begin , or a county-based purchasing plan established
under section 256B.692,new text end may contract with the commissioner to develop and implement a
coordinated care delivery system deleted text begin as follows:deleted text end new text begin if the hospital or group of hospitals or plan
agrees to satisfy the requirements of this subdivision.
new text end

deleted text begin (1) effective June 1, 2010, a hospital qualifies under this subdivision if: (i) during
calendar year 2008, it received fee-for-service payments for services to general assistance
medical care recipients (A) equal to or greater than $1,500,000, or (B) equal to or greater
than 1.3 percent of net patient revenue; or (ii) a contract with the hospital is necessary to
provide geographic access or to ensure that at least 80 percent of enrollees have access to
a coordinated care delivery system; and
deleted text end

deleted text begin (2) effective December 1, 2010, a Minnesota hospital not qualified under clause
(1) may contract with the commissioner under this subdivision if it agrees to satisfy the
requirements of this subdivision.
deleted text end

Participation by hospitals new text begin or plans new text end shall become effective quarterly on deleted text begin June 1, September
1, December 1, or March 1deleted text end new text begin October 1, January 1, April 1, or July 1new text end . Hospital new text begin or plan
new text end participation is effective for a period of 12 months and may be renewed for successive
12-month periods.

(c) Applicants and recipients may enroll in any available coordinated care delivery
system statewide. If more than one coordinated care delivery system is available, the
applicant or recipient shall be allowed to choose among the systems. The commissioner
may assign an applicant or recipient to a coordinated care delivery system if no choice
is made by the applicant or recipient. The commissioner shall consider a recipient's zip
code, city of residence, county of residence, or distance from a participating coordinated
care delivery system when determining default assignment. An applicant or recipient
may decline enrollment in a coordinated care delivery systemnew text begin but services excluding
outpatient prescription drug coverage are only available through a coordinated care
delivery systemnew text end . Upon enrollment into a coordinated care delivery system, the recipient
must agree to receive all nonemergency services through the coordinated care delivery
system. Enrollment in a coordinated care delivery system is for six months and may be
renewed for additional six-month periods, except that initial enrollment is for six months
or until the end of a recipient's period of general assistance medical care eligibility,
whichever occurs first. deleted text begin A recipient who continues to meet the eligibility requirements of
this section is not eligible to enroll in MinnesotaCare during a period of enrollment in a
coordinated care delivery system. From June 1, 2010, to February 28, 2011, applicants
and recipients not enrolled in a coordinated care delivery system may seek services from
a hospital eligible for reimbursement under the temporary uncompensated care pool
established under subdivision 8. After February 28, 2011, services are available only
through a coordinated care delivery system.
deleted text end

(d) The hospital new text begin or plan new text end may contract and coordinate with providers and clinics
for the delivery of services and shall contract with essential community providers as
defined under section 62Q.19, subdivision 1, paragraph (a), clauses (1) and (2), to the
extent practicable. new text begin When contracting with providers and clinics, the hospital or plan
shall give preference to providers and clinics certified as health care homes under section
256B.0751. The hospital or plan must contract with federally qualified health centers or
federally qualified health center look-alikes, as defined in section 145.9269, subdivision 1,
and essential community providers as defined in section 62Q.19, that agree to accept the
terms, conditions, and payment rates offered by the hospital or plan to similarly situated
providers, except that reimbursement to federally qualified health centers and federally
qualified health center look-alikes must comply with federal law. new text end If a provider or clinic new text begin or
health center new text end contracts with a hospital new text begin or plan new text end to provide services through the coordinated
care delivery system, the provider may not refuse to provide services to any recipient
enrolled in the system, and payment for services shall be negotiated with the hospital new text begin or
plan new text end and paid by the hospital new text begin or plan new text end from the system's allocation under subdivision 7.

(e) A coordinated care delivery system must:

(1) provide the covered services required under paragraph (a) to recipients enrolled
in the coordinated care delivery system, and comply with the requirements of subdivision
4, paragraphs (b) to (g);

(2) establish a process to monitor enrollment and ensure the quality of care provided;

(3) in cooperation with counties, coordinate the delivery of health care services with
existing homeless prevention, supportive housing, and rent subsidy programs and funding
administered by the Minnesota Housing Finance Agency under chapter 462A; and

(4) adopt innovative and cost-effective methods of care delivery and coordination,
which may include the use of allied health professionals, telemedicine, patient educators,
care coordinators, and community health workers.

(f) The hospital new text begin or plan new text end may require a recipient to designate a primary care provider
or a primary care clinic. The hospital new text begin or plan new text end may limit the delivery of services to a
network of providers who have contracted with the hospital new text begin or plan new text end to deliver services in
accordance with this subdivision, and require a recipient to seek services only within this
network. The hospital new text begin or plan new text end may also require a referral to a provider before the service
is eligible for payment. A coordinated care delivery system is not required to provide
payment to a provider who is not employed by or under contract with the system for
services provided to a recipient enrolled in the system, except in cases of an emergency.
For purposes of this section, emergency services are defined in accordance with Code of
Federal Regulations, title 42, section 438.114 (a).

(g) A recipient enrolled in a coordinated care delivery system has the right to appeal
to the commissioner according to section 256.045.

(h) The state shall not be liable for the payment of any cost or obligation incurred
by the coordinated care delivery system.

(i) The hospital new text begin or plan new text end must provide the commissioner with data necessary for
assessing enrollment, quality of care, cost, and utilization of services. Each hospital new text begin or
plan new text end must provide, on a quarterly basis on a form prescribed by the commissioner for each
recipient served by the coordinated care delivery system, the services provided, the cost of
services provided, and the actual payment amount for the services provided and any other
information the commissioner deems necessary to claim federal Medicaid match. The
commissioner must provide this data to the legislature on a quarterly basis.

(j) deleted text begin Effective June 1, 2010,deleted text end The provisions of section 256.9695, subdivision 2,
paragraph (b), do not apply to general assistance medical care provided under this section.

(k) Notwithstanding any other provision in this section to the contrary, deleted text begin for
participation beginning September 1, 2010,deleted text end the commissioner deleted text begin shall offer the same contract
terms related todeleted text end new text begin shall negotiate new text end an enrollment threshold formula and financial liability
protections deleted text begin todeleted text end new text begin withnew text end a hospital or group of hospitals new text begin or plan new text end qualified under this subdivision
to develop and implement a coordinated care delivery system deleted text begin as those contained in the
coordinated care delivery system contracts effective June 1, 2010deleted text end .

deleted text begin (l) If sections 256B.055, subdivision 15, and 256B.056, subdivisions 3 and 4, are
implemented effective July 1, 2010, this subdivision must not be implemented.
deleted text end

new text begin This section is effective October 1, 2011.
new text end

Minnesota Statutes 2010, section 256D.031, subdivision 7, is amended to read:

(a) Effective for general assistance medical care services, with the exception
of outpatient prescription drug coveragedeleted text begin , provided on or after June 1, 2010,deleted text end through a
coordinated care delivery system, the commissioner shall allocate the annual appropriation
for the coordinated care delivery system to hospitals new text begin or plans new text end participating under
subdivision 6 in quarterly payments, beginning on the first scheduled warrant on or after
deleted text begin June 1, 2010deleted text end new text begin October 1, 2011new text end . The payment shall be allocated among all hospitals new text begin or
plans new text end qualified to participate on the allocation date deleted text begin as follows:deleted text end new text begin based upon the enrollment
thresholds negotiated with the commissioner.
new text end

deleted text begin (1) each hospital or group of hospitals shall be allocated an initial amount based on
the hospital's or group of hospitals' pro rata share of calendar year 2008 payments for
general assistance medical care services to all participating hospitals;
deleted text end

deleted text begin (2) the initial allocations to Hennepin County Medical Center; Regions Hospital;
Saint Mary's Medical Center; and the University of Minnesota Medical Center, Fairview,
shall be increased to 110 percent of the value determined in clause (1);
deleted text end

deleted text begin (3) the initial allocation to hospitals not listed in clause (2) shall be reduced a pro rata
amount in order to keep the allocations within the limit of available appropriations; and
deleted text end

deleted text begin (4) the amounts determined under clauses (1) to (3) shall be allocated to participating
hospitals.
deleted text end

The commissioner may prospectively reallocate payments to participating hospitals
new text begin or plans new text end on a biannual basis to ensure that final allocations reflect actual coordinated
care delivery system enrollment. deleted text begin The 2008 base year shall be updated by one calendar
year each June 1, beginning June 1, 2011deleted text end .

deleted text begin (b) Beginning June 1, 2010, and every quarter beginning in June thereafter, the
commissioner shall make one-third of the quarterly payment in June and the remaining
two-thirds of the quarterly payment in July to each participating hospital or group of
hospitals.
deleted text end

deleted text begin (c)deleted text end new text begin (b)new text end In order to be reimbursed under this section, nonhospital providers of health
care services shall contract with one or more hospitalsnew text begin or plansnew text end described in paragraph (a)
to provide services to general assistance medical care recipients through the coordinated
care delivery system established by the hospitalnew text begin or plannew text end . The hospitalnew text begin or plannew text end shall
reimburse bills submitted by nonhospital providers participating under this paragraph at a
rate negotiated between the hospitalnew text begin or plannew text end and the nonhospital provider.

deleted text begin (d)deleted text end new text begin (c)new text end The commissioner shall apply for federal matching funds under section
256B.199, paragraphs (a) to (d), for expenditures under this subdivision.

deleted text begin (e)deleted text end new text begin (d)new text end Outpatient prescription drug coverage is provided in accordance with section
256D.03, subdivision 3, and paid on a fee-for-service basis under subdivision 9.

new text begin This section is effective October 1, 2011.
new text end

Minnesota Statutes 2010, section 256D.031, subdivision 9, is amended to read:

(a) The commissioner shall establish an outpatient
prescription drug pool, effective deleted text begin June 1, 2010deleted text end new text begin October 1, 2011new text end . Money in the pool must
be used to reimburse pharmacies and other pharmacy service providers as defined in
Minnesota Rules, part 9505.0340, for the covered outpatient prescription drugs dispensed
to recipients. Payment for drugs shall be on a fee-for-service basis according to the rates
established in section 256B.0625, subdivision 13e. Outpatient prescription drug coverage
is subject to the availability of funds in the pool. If the commissioner forecasts that
expenditures under this subdivision will exceed the appropriation for this purpose, the
commissioner may bring recommendations to the Legislative Advisory Commission on
methods to resolve the shortfall.

(b) Effective deleted text begin June 1, 2010deleted text end new text begin January 1, 2012new text end , coordinated care delivery systems
established under subdivision 6 shall pay to the commissioner, on a quarterly basis, an
assessment equal to 20 percent of payments for the prescribed drugs for recipients of
services through that coordinated care delivery system, as calculated by the commissioner
based on the most recent available data.

Minnesota Statutes 2010, section 256D.031, subdivision 10, is amended to
read:

Hospitalsnew text begin and plansnew text end participating in the
coordinated care delivery system under subdivision 6 shall consult with counties, county
veterans service officers, and the Veterans Administration to identify other programs for
which general assistance medical care recipients enrolled in their system are qualified.

Minnesota Statutes 2010, section 256L.01, subdivision 4a, is amended to read:

(a) "Gross individual or gross
family income" for nonfarm self-employed means income calculated for the deleted text begin 12-monthdeleted text end new text begin
six-monthnew text end 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.

(b) "Gross individual or gross family income" for farm self-employed means
income calculated for the deleted text begin 12-monthdeleted text end new text begin six-monthnew text end period of eligibility using as the baseline
the adjusted gross income reported on the applicant's federal income tax form for the
previous year.

(c) "Gross individual or gross family income" means the total income for all family
members, calculated for the deleted text begin 12-monthdeleted text end new text begin six-monthnew text end period of eligibility.

Minnesota Statutes 2010, section 256L.02, subdivision 3, is amended to read:

(a) The commissioner shall manage spending for
the MinnesotaCare program in a manner that maintains a minimum reserve. As part of
each state revenue and expenditure forecast, the commissioner must make an assessment
of the expected expenditures for the covered services for the remainder of the current
biennium and for the following biennium. The estimated expenditure, including the
reserve, shall be compared to an estimate of the revenues that will be available in the health
care access fund. Based on this comparison, and after consulting with the chairs of the
house of representatives Ways and Means Committee and the senate Finance Committee,
deleted text begin and the Legislative Commission on Health Care Access,deleted text end the commissioner shall, as
necessary, make the adjustments specified in paragraph (b) to ensure that expenditures
remain within the limits of available revenues for the remainder of the current biennium
and for the following biennium. The commissioner shall not hire additional staff using
appropriations from the health care access fund until the commissioner of management
and budget makes a determination that the adjustments implemented under paragraph (b)
are sufficient to allow MinnesotaCare expenditures to remain within the limits of available
revenues for the remainder of the current biennium and for the following biennium.

(b) The adjustments the commissioner shall use must be implemented in this order:
first, stop enrollment of single adults and households without children; second, upon 45
days' notice, stop coverage of single adults and households without children already
enrolled in the MinnesotaCare program; third, upon 90 days' notice, decrease the premium
subsidy amounts by ten percent for families with gross annual income above 200 percent
of the federal poverty guidelines; fourth, upon 90 days' notice, decrease the premium
subsidy amounts by ten percent for families with gross annual income at or below 200
percent; and fifth, require applicants to be uninsured for at least six months prior to
eligibility in the MinnesotaCare program. If these measures are insufficient to limit the
expenditures to the estimated amount of revenue, the commissioner shall further limit
enrollment or decrease premium subsidies.

Minnesota Statutes 2010, section 256L.03, subdivision 5, is amended to read:

(a) Except as provided in
paragraphs (b) deleted text begin anddeleted text end new text begin ,new text end (c),new text begin and (h),new text end the MinnesotaCare benefit plan shall include the following
deleted text begin co-payments and coinsurancedeleted text end new text begin cost-sharingnew text end 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;

(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; deleted text begin and
deleted text end

(5) $6 for nonemergency visits to a hospital-based emergency room for services
provided through December 31, 2010, and $3.50 effective January 1, 2011new text begin ; and
new text end

new text begin (6) a family deductible equal to the maximum amount allowed under Code of
Federal Regulations, title 42, part 447.54new text end .

(b) Paragraph (a), clause (1), deleted text begin doesdeleted text end new text begin and paragraph (e) donew text end not apply to parents and
relative caretakers of 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.

(g) MinnesotaCare reimbursements to fee-for-service providers and payments to
managed care plans or county-based purchasing plans shall not be increased as a result of
the reduction of the co-payments in paragraph (a), clause (5), effective January 1, 2011.

new text begin (h) Effective January 1, 2012, the following co-payments for nonpreventive visits
shall apply to enrollees who are adults without children eligible under section 256L.04,
subdivision 7:
new text end

new text begin (1) $3 for visits to providers whose average, risk-adjusted, total annual cost of care
per MinnesotaCare enrollee is at the 60th percentile or lower for providers of the same
type;
new text end

new text begin (2) $6 for visits to providers whose average, risk-adjusted, total annual cost of care
per MinnesotaCare enrollee is greater than the 60th percentile but does not exceed the
80th percentile for providers of the same type; and
new text end

new text begin (3) $10 for visits to providers whose average, risk-adjusted, total annual cost of
care per MinnesotaCare enrollee is greater than the 80th percentile for providers of the
same type.
new text end

new text begin (a) Beginning January 1, 2012,
the commissioner shall provide each MinnesotaCare enrollee eligible under section
256L.04, subdivision 7, with family income greater than 125 percent of the federal poverty
guidelines with a monthly defined contribution to purchase health coverage under a health
plan as defined in section 62A.011, subdivision 3.
new text end

new text begin (b) Beginning January 1, 2012, the commissioner shall provide each MinnesotaCare
adult enrollee eligible under section 256L.04, subdivision 1, with family income greater
than 133 percent of the federal poverty guidelines with a monthly defined contribution to
purchase health coverage under a health plan as defined in section 62A.011, subdivision 3,
offered by a health plan company as defined in section 62Q.01, subdivision 4.
new text end

new text begin (c) Enrollees eligible under paragraph (a) or (b) shall not be charged premiums
under section 256L.15 and are exempt from the managed care enrollment requirement
of section 256L.12.
new text end

new text begin (d) Sections 256L.03; 256L.05, subdivision 3; and 256L.11 do not apply to enrollees
eligible under paragraph (a) or (b) unless otherwise provided in this section. Covered
services, cost sharing, disenrollment for nonpayment of premium, enrollee appeal rights
and complaint procedures, and the effective date of coverage for enrollees eligible under
paragraph (a) shall be as provided under the terms of the health plan purchased by the
enrollee.
new text end

new text begin (e) Unless otherwise provided in this section, all MinnesotaCare requirements
related to eligibility, income and asset methodology, income reporting, and program
administration, continue to apply to enrollees obtaining coverage under this section.
new text end

new text begin (a) An enrollee
may use up to the monthly defined contribution to pay premiums for coverage under a
health plan as defined in section 62A.011, subdivision 3.
new text end

new text begin (b) An enrollee must select a health plan within three calendar months of approval of
MinnesotaCare eligibility. If a health plan is not selected and purchased within this time
period, the enrollee must reapply and must meet all eligibility criteria.
new text end

new text begin (c) A health plan purchased under this section must:
new text end

new text begin (1) provide coverage for mental health and chemical dependency treatment services;
and
new text end

new text begin (2) comply with the coverage limitations specified in section 256L.03, subdivision
1, the second paragraph.
new text end

new text begin (a) The commissioner
shall determine the defined contribution sliding scale using the base contribution specified
in paragraph (b) for the specified age ranges. The commissioner shall use a sliding scale
for defined contributions that provides:
new text end

new text begin (1) persons with the lowest eligible household income with a defined contribution
of 110 percent of the base contribution;
new text end

new text begin (2) persons with household incomes equal to 175 percent of the federal poverty
guidelines with a defined contribution of 100 percent of the base contribution;
new text end

new text begin (3) persons with household incomes equal to or greater than 250 percent of
the federal poverty guidelines with a defined contribution of 80 percent of the base
contribution; and
new text end

new text begin (4) persons with household incomes in evenly spaced increments between the
percentages of the federal poverty guideline or income level specified in clauses (1) to (3)
with a base contribution that is a percentage interpolated from the defined contribution
percentages specified in clauses (1) to (3).
new text end

new text begin Under 19 new text end	new text begin $105 new text end
new text begin 19-29 new text end	new text begin $125 new text end
new text begin 30-34 new text end	new text begin $135 new text end
new text begin 35-39 new text end	new text begin $140 new text end
new text begin 40-44 new text end	new text begin $175 new text end
new text begin 45-49 new text end	new text begin $215 new text end
new text begin 50-54 new text end	new text begin $295 new text end
new text begin 55-59 new text end	new text begin $345 new text end
new text begin 60+ new text end	new text begin $360 new text end

new text begin (b) The commissioner shall multiply the defined contribution amounts developed
under paragraph (a) by 1.20 for enrollees who are denied coverage under an individual
health plan by a health plan company and who purchase coverage through the Minnesota
Comprehensive Health Association.
new text end

new text begin (a) The commissioner shall administer
the defined contributions. The commissioner shall:
new text end

new text begin (1) calculate and process defined contributions for enrollees; and
new text end

new text begin (2) pay the defined contribution amount to health plan companies or the Minnesota
Comprehensive Health Association, as applicable, for enrollee health plan coverage.
new text end

new text begin (b) Nonpayment of a health plan premium shall result in disenrollment from
MinnesotaCare effective the first day of the calendar month following the calendar month
for which the premium was due. Persons disenrolled for nonpayment or who voluntarily
terminate coverage may not reenroll until four calendar months have elapsed.
new text end

new text begin The commissioner of human services, in
consultation with the commissioner of commerce, shall develop an efficient and
cost-effective method of referring eligible applicants to professional insurance agent
associations.
new text end

new text begin Beginning
January 1, 2012, MinnesotaCare enrollees who are denied coverage in the individual
health market by a health plan company in accordance with section 62A.65 are eligible
for coverage through a health plan offered by the Minnesota Comprehensive Health
Association and may enroll in MCHA in accordance with section 62E.14. Any difference
between the revenue and covered losses to the MCHA related to implementation of this
section shall be paid to the MCHA from the health care access fund.
new text end

new text begin The commissioner shall seek all federal waivers and
approvals necessary to implement coverage under this section for MinnesotaCare enrollees
eligible under subdivision 1. The commissioner shall seek the continuation of federal
financial participation for the adult enrollees eligible under section 256L.04, subdivision 1.
new text end

Minnesota Statutes 2010, section 256L.04, subdivision 1, is amended to read:

(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) deleted text begin Beginning July 1, 2010, or upon federal approval, whichever is later,deleted text end Parents are
not eligible for MinnesotaCare if their gross income exceeds deleted text begin $57,500deleted text end new text begin $50,000new text end .

deleted text begin (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.
deleted text end

(f) [Reserved.]

Minnesota Statutes 2010, section 256L.04, subdivision 7, is amended to read:

(a) The definition of
eligible personsnew text begin , through September 30, 2011, new text end includes all individuals and households
with no children who have gross family incomes that are equal to or less than deleted text begin 200deleted text end new text begin 250
new text end percent of the federal poverty guidelines.

(b) Effective deleted text begin July 1, 2009deleted text end new text begin October 1, 2011new text end , the definition of eligible persons includes
all individuals and households with no children who have gross family incomes that are
new text begin greater than 125 percent of the federal poverty guidelines and new text end equal to or less than 250
percent of the federal poverty guidelines.

new text begin This section is effective October 1, 2011.
new text end

Minnesota Statutes 2010, section 256L.04, subdivision 10, is amended to read:

Eligibility for MinnesotaCare is limited to
citizens or nationals of the United States, qualified noncitizensdeleted text begin , and other persons residing
lawfully in the United States as described in section 256B.06, subdivision 4, paragraphs
(a) to (e) and (j)deleted text end new text begin who are eligible for medical assistance with federal participation
according to United States Code, title 8, section 1612new text end . Undocumented noncitizens and
nonimmigrants are ineligible for MinnesotaCare. 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. Families with children who are 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.

new text begin This section is effective January 1, 2012.
new text end

Minnesota Statutes 2010, section 256L.05, subdivision 2, is amended to read:

new text begin (a) new text end The commissioner or county agency shall
use electronic verification as the primary method of income verification. If there is a
discrepancy between reported income and electronically verified income, an individual
may be required to submit additional verification. In addition, the commissioner shall
perform random audits to verify reported income and eligibility. The commissioner
may execute data sharing arrangements with the Department of Revenue and any other
governmental agency in order to perform income verification related to eligibility and
premium payment under the MinnesotaCare program.

new text begin (b) In determining eligibility for MinnesotaCare, the commissioner shall require
applicants and enrollees seeking renewal of eligibility to verify both earned and unearned
income. The commissioner shall also require applicants and enrollees , and their spouses
or parents, who are age 21 and over and employed 20 or more hours per week by any one
employer, to verify that they do not have access to employer-subsidized coverage as
described in section 256L.07, subdivision 2. Data collected is nonpublic data as defined
in section 13.02, subdivision 9.
new text end

Minnesota Statutes 2010, section 256L.05, subdivision 3a, is amended to read:

(a) Beginning July 1, deleted text begin 2007deleted text end new text begin 2011new text end , an enrollee's
eligibility must be renewed every deleted text begin 12deleted text end new text begin sixnew text end months. deleted text begin The 12-month period begins in the
month after the month the application is approved.
deleted text end

(b) Each new period of eligibility must take into account any changes in
circumstances that impact eligibility and premium amount. An enrollee must provide all
the information needed to redetermine eligibility by the first day of the month that ends
the eligibility period. If there is no change in circumstances, the enrollee may renew
eligibility at designated locations that include community clinics and health care providers'
offices. The designated sites shall forward the renewal forms to the commissioner. The
commissioner may establish criteria and timelines for sites to forward applications to the
commissioner or county agencies. The premium for the new period of eligibility must be
received as provided in section 256L.06 in order for eligibility to continue.

(c) An enrollee who fails to submit renewal forms and related documentation
necessary for verification of continued eligibility in a timely manner shall remain eligible
for one additional month beyond the end of the current eligibility period before being
disenrolled. The enrollee remains responsible for MinnesotaCare premiums for the
additional month.

Minnesota Statutes 2010, section 256L.05, is amended by adding a subdivision
to read:

new text begin The commissioner shall ensure that all applicants
for MinnesotaCare who identify themselves as veterans are referred to a county veterans
service officer for assistance in applying to the United States Department of Veterans
Affairs for any veterans benefits for which they may be eligible.
new text end

Minnesota Statutes 2010, section 256L.07, subdivision 1, is amended to read:

(a) Children enrolled in the original
children's health plan as of September 30, 1992, children who enrolled in the
MinnesotaCare program after September 30, 1992, pursuant to Laws 1992, chapter 549,
article 4, section 17, and children who have family gross incomes that are equal to or
less than 150 percent of the federal poverty guidelines are eligible without meeting
the requirements of subdivision 2 and the four-month requirement in subdivision 3, as
long as they maintain continuous coverage in the MinnesotaCare program or medical
assistance. Children who apply for MinnesotaCare on or after the implementation date
of the employer-subsidized health coverage program as described in Laws 1998, chapter
407, article 5, section 45, who have family gross incomes that are equal to or less than 150
percent of the federal poverty guidelines, must meet the requirements of subdivision 2 to
be eligible for MinnesotaCare.

new text begin (b) new text end Families enrolled in MinnesotaCare under section 256L.04, subdivision 1, whose
income increases above deleted text begin 275 percent of the federal poverty guidelinesdeleted text end new text begin the limits described
in section 256L.04, subdivision 1new text end , are no longer eligible for the program and shall be
disenrolled by the commissioner. deleted text begin Beginning January 1, 2008,
deleted text end

new text begin (c)new text end Individuals enrolled in MinnesotaCare under section 256L.04, subdivision 7,
whose income increases above 200 percent of the federal poverty guidelines or 250
percent of the federal poverty guidelines on or after July 1, 2009, are no longer eligible for
the program and shall be disenrolled by the commissioner.

new text begin (d)new text end For persons disenrolled under this subdivision, MinnesotaCare coverage
terminates the last day of the calendar month following the month in which the
commissioner determines that the income of a family or individual exceeds program
income limits.

deleted text begin (b)deleted text end new text begin (e)new text end Notwithstanding paragraph deleted text begin (a)deleted text end new text begin (b)new text end , children may remain enrolled in
MinnesotaCare if ten percent of their gross individual or gross family income as defined
in section 256L.01, subdivision 4, is less than the deleted text begin annualdeleted text end premium for a new text begin six-month
new text end policy with a $500 deductible available through the Minnesota Comprehensive Health
Association. Children who are no longer eligible for MinnesotaCare under this clause shall
be given a 12-month notice period from the date that ineligibility is determined before
disenrollment. The premium for children remaining eligible under this clause shall be the
maximum premium determined under section 256L.15, subdivision 2, paragraph (b).

deleted text begin (c)deleted text end new text begin (f)new text end Notwithstanding paragraphs (a) and deleted text begin (b)deleted text end new text begin (e)new text end , parents are not eligible for
MinnesotaCare if gross household income exceeds deleted text begin $57,500 for the 12-monthdeleted text end new text begin $25,000 for
the six-monthnew text end period of eligibility.

Minnesota Statutes 2010, section 256L.11, subdivision 7, is amended to read:

Effective for dental services provided to
MinnesotaCare enrollees on or after deleted text begin January 1, 2007,deleted text end new text begin July 1, 2011,new text end the commissioner shall
increase payment rates to dentists and dental clinics deemed by the commissioner to be
critical access providers under section 256B.76, subdivision 4, by deleted text begin 50deleted text end new text begin 30new text end percent above
the payment rate that would otherwise be paid to the provider. The commissioner shall
pay the prepaid health plans under contract with the commissioner amounts sufficient to
reflect this rate increase. The prepaid health plan must pass this rate increase to providers
who have been identified by the commissioner as critical access dental providers under
section 256B.76, subdivision 4.

Minnesota Statutes 2010, section 256L.12, subdivision 9, is amended to read:

(a) Rates will be prospective,
per capita, where possible. The commissioner may allow health plans to arrange for
inpatient hospital services on a risk or nonrisk basis. The commissioner shall consult with
an independent actuary to determine appropriate rates.

(b) For services rendered on or after January 1, 2004, the commissioner shall
withhold five percent of managed care plan payments and county-based purchasing
plan payments under this section 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, such as characteristics of the plan's enrollee population. The
withheld funds must be returned no sooner than July 1 and no later than July 31 of the
following calendar year if performance targets in the contract are achieved.

(c) For services rendered on or after January 1, 2011, the commissioner shall
withhold an additional three percent of managed care plan or county-based purchasing
plan payments under this section. The withheld funds must be returned no sooner than
July 1 and no later than July 31 of the following calendar year. The return of the withhold
under this paragraph is not subject to the requirements of paragraph (b).

(d) Effective for services rendered on or after January 1, 2011, the commissioner
shall include as part of the performance targets described in paragraph (b) a reduction in
the plan's emergency room utilization rate for state health care program enrollees by a
measurable rate of five percent from the plan's utilization rate for the previous calendar
year.

The withhold described in this paragraph shall continue for each consecutive
contract period until the plan's emergency room utilization rate for state health care
program enrollees is reduced by 25 percent of the plan's emergency room utilization rate
for state health care program enrollees for calendar year 2009. Hospitals shall cooperate
with the health plans in meeting this performance target and shall accept payment
withholds that may be returned to the hospitals if the performance target is achieved. The
commissioner shall structure the withhold so that the commissioner returns a portion of
the withheld funds in amounts commensurate with achieved reductions in utilization less
than the targeted amount. The withhold described in this paragraph does not apply to
county-based purchasing plans.

new text begin (e) Effective for services provided on or after January 1, 2012, the commissioner
shall include as part of the performance targets described in paragraph (b) a reduction in
the plan's hospitalization rate for a subsequent hospitalization within 30 days of a previous
hospitalization of a patient regardless of the reason for the hospitalization for state health
care program enrollees by a measurable rate of five percent from the plan's hospitalization
rate for the previous calendar year.
new text end

deleted text begin (e)deleted text end new text begin (f)new text end 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 section that is reasonably expected to be returned.

Minnesota Statutes 2010, section 256L.15, subdivision 1a, is amended to read:

The commissioner may offer the following payment
options to an enrollee:

(1) payment by check;

(2) payment by credit card;

(3) payment by recurring automatic checking withdrawal;

(4) payment by onetime electronic transfer of funds;

(5) payment by wage withholding with the consent of the employer and the
employee; or

(6) payment by using state tax refund payments.

new text begin The commissioner shall include information about the payment options on each
premium notice. new text end At application or reapplication, a MinnesotaCare applicant or enrollee
may authorize the commissioner to use the Revenue Recapture Act in chapter 270A to
collect funds from the applicant's or enrollee's refund for the purposes of meeting all or
part of the applicant's or enrollee's MinnesotaCare premium obligation. The applicant or
enrollee may authorize the commissioner to apply for the state working family tax credit
on behalf of the applicant or enrollee. The setoff due under this subdivision shall not be
subject to the $10 fee under section 270A.07, subdivision 1.

new text begin The commissioner of human services shall develop and submit to the legislature
by December 15, 2011, a plan to provide care coordination to medical assistance and
MinnesotaCare enrollees who are children with high-cost mental health conditions. For
purposes of this section, a child has a "high-cost mental health condition" if mental health
and medical expenses over the past year totalled $100,000 or more. For purposes of this
section, "care coordination" means collaboration between an advanced practice nurse and
primary care physicians and specialists to manage care; development of mental health
management plans for recurrent mental health issues; oversight and coordination of all
aspects of care in partnership with families; organization of medical, treatment, and
therapy information into a summary of critical information; coordination and appropriate
sequencing of evaluations and multiple appointments; information and assistance with
accessing resources; and telephone triage for behavior or other problems.
new text end

new text begin The
commissioner of management and budget shall convene a regulatory simplification and
report reduction work group of persons designated by the commissioners of health, human
services, and commerce to eliminate redundant, unnecessary, and obsolete state mandated
reporting or data submittal requirements for health care providers or group purchasers
related to health care costs, quality, utilization, access, or patient encounters or related to
provider or group purchaser, monitoring, finances, and regulation. For purposes of this
section, the term "health care providers or group purchasers" has the meaning provided
in Minnesota Statutes, section 62J.03, subdivisions 6 and 8, except that it also includes
nursing homes.
new text end

new text begin (a) The commissioner of
management and budget, in consultation with the work group, shall develop a plan for
regulatory simplification and report reduction activities of the commissioners of health,
human services, and commerce that considers collection and regulation of the following
in a coordinated manner:
new text end

new text begin (1) encounter data;
new text end

new text begin (2) group purchaser provider network data;
new text end

new text begin (3) financial reporting;
new text end

new text begin (4) reporting and documentation requirements relating to member communications
and marketing materials;
new text end

new text begin (5) state regulation and oversight of group purchasers;
new text end

new text begin (6) requirements and procedures for denial, termination, or reduction of services
and member appeals and grievances; and
new text end

new text begin (7) state performance improvement projects, requirements, and procedures.
new text end

new text begin (b) The commissioners of health, human services, and commerce, following
consultation with the work group, shall present to the legislature by January 1, 2012,
proposals to implement their recommendations.
new text end

new text begin (a) The commissioner of management
and budget, in consultation with the work group and the commissioners of health, human
services, and commerce, shall develop criteria to be used by the commissioners in
determining whether to establish new reporting and data submittal requirements. These
criteria must support the establishment of new reporting and data submittal requirements
only:
new text end

new text begin (1) if required by a federal agency or state statute;
new text end

new text begin (2) if needed for a state regulatory audit or corrective action plan;
new text end

new text begin (3) if needed to monitor or protect public health;
new text end

new text begin (4) if needed to manage the cost and quality of Minnesota's public health insurance
programs; or
new text end

new text begin (5) if a review and analysis by the commissioner of the relevant agency has
documented the necessity, importance, and administrative cost of the requirement, and
has determined that the information sought cannot be efficiently obtained through another
state or federal report.
new text end

new text begin (b) The commissioners of health, human services, and commerce, following
consultation with the work group, may propose to the legislature new provider and group
purchaser reporting and data submittal requirements to take effect on or after July 1, 2012.
These proposals shall include an analysis of the extent to which the requirements meet
the criteria developed under paragraph (a).
new text end

new text begin The commissioner of human services shall evaluate whether providing medical
assistance coverage for specialized maintenance therapy for enrollees with serious and
persistent mental illness who are at risk of hospitalization will improve the quality of
care and lower medical assistance spending by reducing rates of hospitalization. The
commissioner shall present findings and recommendations to the chairs and ranking
minority members of the legislative committees with jurisdiction over health and human
services finance and policy by December 15, 2011.
new text end

new text begin The commissioner of human services shall analyze and provide recommendations
for state plan amendments that would provide different benefits for different demographic
populations under the medical assistance program as permitted under federal law, with the
goal of tailoring more cost-effective coverage based on unique needs of the demographic
population. The commissioner shall report these recommendations to the chairs and
ranking minority members of the senate and house health and human services committees
by January 15, 2012.
new text end

new text begin The commissioner of human services, by January 15, 2012, shall present
recommendations to the legislature to reduce hospitalization rates for state health care
program enrollees who are children with high-cost medical conditions.
new text end

new text begin By October 31, 2011, the commissioner
of human services shall issue a request for proposals to prevent and detect Medicaid
fraud and mispayment. The request for proposals shall require the vendor to provide
data analytics capabilities, including, but not limited to, predictive modeling techniques
and other forms of advanced analytics, technical assistance, claims review, and medical
record and documentation investigations, to detect and investigate improper payments
both before and after payments are made.
new text end

new text begin The selected vendor, at no cost to the state, shall
be required to apply its analytics and investigations on a subset of data provided by the
commissioner to demonstrate the direct recoveries of the solution.
new text end

new text begin Data provided by the commissioner to the vendor
under this section must maintain the confidentiality of the information.
new text end

new text begin The request for proposal must require the
commissioner to implement the recommendations provided by the vendor if the work
done under the requirements of subdivision 2 provides recoveries directly related to the
investigations to the state. After full implementation, the vendor shall be paid from
recoveries directly attributable to the work done by the vendor, according to the terms and
performance measures negotiated in the contract.
new text end

new text begin The commissioner of human services shall select a
vendor from the responses to the request for proposal by January 31, 2012.
new text end

new text begin The commissioner shall provide a report describing the
progress made under this section to the governor and the chairs and ranking minority
members of the legislative committees with jurisdiction over the Department of Human
Services by June 15, 2012. The report shall provide a dynamic scoring analysis of the
work described in the report.
new text end

new text begin The commissioner of human services, through the health services policy committee
established under Minnesota Statutes, section 256B.0625, subdivision 3c, shall study
the effectiveness of new strategies for wound care treatment for medical assistance and
MinnesotaCare enrollees with diabetes, including but not limited to the use of new wound
care technologies, assessment tools, and reporting programs. The commissioner shall
present recommendations by December 15, 2011, to the legislature on whether these
new strategies for wound care treatment should be covered under medical assistance
and MinnesotaCare.
new text end

new text begin State funds must not be expended in the planning or implementation of the Patient
Protection and Affordable Care Act, Public Law 111-148, as amended by the Health Care
and Education Affordability and Reconciliation Act of 2010, Public Law 111-152, and no
provisions of the act may be implemented, until the constitutionality of the act has been
affirmed by the United States Supreme Court.
new text end

new text begin This section is effective the day following final enactment.
new text end

new text begin (a) Effective October 1, 2011, the commissioner of human services shall suspend
implementation and administration of Minnesota Statutes 2010, sections 256B.055,
subdivision 15; 256B.056, subdivision 3, paragraph (b); and 256B.056, subdivision 4,
paragraph (d). The commissioner shall refer persons enrolled under these provisions, and
applicants for coverage under these provisions, to the general assistance medical care
program established under Minnesota Statutes, section 256D.031.
new text end

new text begin (b) The commissioner shall seek all federal approvals and waivers necessary
to implement Minnesota Statutes, section 256D.031, and to ensure federal financial
participation for the population covered under Minnesota Statutes, section 256D.031.
new text end

new text begin Notwithstanding their contingent repeal in Laws 2010, First Special Session chapter
1, article 16, section 47, the following statutes are revived and have the force of law
effective October 1, 2011:
new text end

new text begin (1) Minnesota Statutes 2010, section 256D.03, subdivisions 3, 3a, 6, 7, and 8;
new text end

new text begin (2) Minnesota Statutes 2010, section 256D.031, subdivisions 1, 2, 3, 4, 6, 7, 9,
and 10; and
new text end

new text begin (3) Laws 2010, chapter 200, article 1, section 18.
new text end

new text begin (a) new text end new text begin Minnesota Statutes 2010, section 62J.07, subdivisions 1, 2, and 3, new text end new text begin are repealed.
new text end

new text begin (b) new text end new text begin Minnesota Statutes 2010, section 256L.07, subdivision 7, new text end new text begin exempting eligibility
for children formally under medical assistance, is repealed retroactively from October
1, 2008, and federal approval is no longer necessary.
new text end

new text begin (c) The amendment in new text end new text begin Laws 2009, chapter 79, article 5, section 55, as amended by
Laws 2009, chapter 173, article 1, section 36, new text end new text begin (256L.04, subdivision 1, children deemed
eligible are exempt from eligibility requirements) is repealed retroactively from January
1, 2009, and federal approval is no longer necessary.
new text end

new text begin (d) new text end new text begin Laws 2009, chapter 79, article 5, section 56, new text end new text begin (256L.04, subdivision 1b,
exemption from income limit for children) is repealed retroactively from July 1, 2009,
and federal approval is no longer necessary.
new text end

new text begin (e) new text end new text begin Laws 2009, chapter 79, article 5, section 60, new text end new text begin (256L.05, subdivision 1c, open
enrollment and streamlined application) is repealed retroactively from July 1, 2009,
and federal approval is no longer necessary.
new text end

new text begin (f) new text end new text begin Laws 2009, chapter 79, article 5, section 66, new text end new text begin (256L.07, subdivision 8, automatic
eligibility certain children) is repealed retroactively from July 1, 2009, and federal
approval is no longer necessary.
new text end

new text begin (g) The amendment in new text end new text begin Laws 2009, chapter 79, article 5, section 57, new text end new text begin (256L.04,
subdivision 7a, ineligibility for adults with certain income) is repealed retroactively
from July 1, 2009, and federal approval is no longer necessary.
new text end

new text begin (h) The amendment in new text end new text begin Laws 2009, chapter 79, article 5, section 61, new text end new text begin (256L.05,
subdivision 3, children eligibility following termination from foster care) is repealed
retroactively from July 1, 2009, and federal approval is no longer necessary.
new text end

new text begin (i) The amendment in new text end new text begin Laws 2009, chapter 79, article 5, section 62, new text end new text begin (256L.05,
subdivision 3a, exemption from cancellation for nonrenewal for children) is repealed
retroactively from July 1, 2009, and federal approval is no longer necessary.
new text end

new text begin (j) The amendment in new text end new text begin Laws 2009, chapter 79, article 5, section 63, new text end new text begin (256L.07,
subdivision 1, children whose gross family income is greater than 275 percent FPG
may remain enrolled) is repealed retroactively from July 1, 2009, and federal approval is
no longer necessary.
new text end

new text begin (k) The amendment in new text end new text begin Laws 2009, chapter 79, article 5, section 64, new text end new text begin (256L.07,
subdivision 2, exempts children from requirement not to have employer-subsidized
coverage) is repealed retroactively from July 1, 2009, and federal approval is no longer
necessary.
new text end

new text begin (l) The amendment in new text end new text begin Laws 2009, chapter 79, article 5, section 65, new text end new text begin (256L.07,
subdivision 3, requires children with family gross income over 200 percent of FPG
to have had no health coverage for four months prior to application) is repealed
retroactively from July 1, 2009, and federal approval is no longer necessary.
new text end

new text begin (m) The amendment in new text end new text begin Laws 2009, chapter 79, article 5, section 68, new text end new text begin (256L.15,
subdivision 2, children in families with income less than 200 percent FPG pay no
premium) is repealed retroactively from July 1, 2009, and federal approval is no longer
necessary.
new text end

new text begin (n) The amendment in new text end new text begin Laws 2009, chapter 79, article 5, section 69, new text end new text begin (256L.15,
subdivision 3, exempts children with family income below 200 percent FPG from
sliding fee scale) is repealed retroactively from July 1, 2009, and federal approval is
no longer necessary.
new text end

new text begin (o) new text end new text begin Laws 2009, chapter 79, article 5, section 79, new text end new text begin (uncoded federal approval) is
repealed the day following final enactment.
new text end

new text begin (p) new text end new text begin Minnesota Statutes 2010, section 256B.057, subdivision 2c, new text end new text begin (extended medical
assistance for certain children) is repealed.
new text end

new text begin (q) The amendments in new text end new text begin Laws 2008, chapter 358, article 3, sections 8; and 9,
new text end new text begin (renewal rolling month and premium grace month) are repealed.
new text end

new text begin Minnesota Statutes 2010, sections 256B.055, subdivision 15; and 256B.0756, new text end new text begin are
repealed effective October 1, 2011.
new text end

new text begin The governor may designate one or more programs
within the Department of Human Services and within up to two other executive branch
state agencies whose missions involve people with disabilities as performance-based
organizations. The goal of the performance-based organization designation is to provide
the best services in the most cost-effective manner to people with disabilities. For a
program that is designated as a performance-based organization, the agency providing
services or another governmental or private organization under contract with the agency
may enter into a performance-based agreement that allows the agency or the entity under
contract with the agency more flexibility in its operations in exchange for a greater level of
accountability. With any required legislative approval, a performance-based organization
agreement may exempt an agency or an outside entity providing services from one or
more procedural laws, rules, or policies that otherwise would govern the program.
new text end

new text begin Designation of a
performance-based organization must be implemented through a performance-based
organization agreement. A performance-based organization agreement may be between
the governor and an agency, if an agency is to provide services under the agreement, or
between an agency and an outside entity, if the outside entity is to provide the services. A
performance-based organization agreement must:
new text end

new text begin (1) describe the programs subject to the agreement;
new text end

new text begin (2) specify the procedural laws, rules, or policies that will not apply to the
performance-based organization, why waiver or variance from these laws, rules, or
policies is necessary to achieve desired outcomes, and a description of alternative means
of accomplishing the purposes of those laws, rules, or policies;
new text end

new text begin (3) contain procedures for oversight of the performance-based organization,
including requirements and procedures for program and financial audits;
new text end

new text begin (4) if the performance-based organization involves a nonstate entity, contain
provisions governing assumption of liability, and types and amounts of insurance coverage
to be obtained;
new text end

new text begin (5) specify the duration of the agreement; and
new text end

new text begin (6) specify measurable performance-based outcomes for achieving program
goals, time periods during which these outcomes will be measured and reported, and
consequences for not meeting the performance-based outcomes.
new text end

new text begin (a) A performance-based
organization agreement may be up to three years and may be renewed.
new text end

new text begin (b) The chief executive of the state agency whose program is subject to a
performance-based organization must report to the chairs and ranking minority members
of legislative policy and finance committees with jurisdiction over the program on the
proposed content of the performance-based organization, and specifically describing
any procedural laws, rules, and policies that will not apply. The legislature must
approve a performance-based organization before the state agency may enter into a
performance-based agreement.
new text end

Minnesota Statutes 2010, section 252.27, subdivision 2a, is amended to read:

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

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

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

(2) if the adjusted gross income is equal to or greater than 175 percent of federal
poverty guidelines and less than or equal to deleted text begin 545deleted text end new text begin 525new text end percent of federal poverty guidelines,
the parental contribution shall be determined using a sliding fee scale established by the
commissioner of human services which begins at one percent of adjusted gross income at
175 percent of federal poverty guidelines and increases to deleted text begin 7.5deleted text end new text begin eightnew text end percent of adjusted
gross income for those with adjusted gross income up to deleted text begin 545deleted text end new text begin 525new text end percent of federal
poverty guidelines;

(3) if the adjusted gross income is greater than deleted text begin 545deleted text end new text begin 525new text end percent of federal
poverty guidelines and less than 675 percent of federal poverty guidelines, the parental
contribution shall be deleted text begin 7.5deleted text end new text begin 9.5new text end percent of adjusted gross income;

(4) if the adjusted gross income is equal to or greater than 675 percent of federal
poverty guidelines and less than deleted text begin 975deleted text end new text begin 900new text end percent of federal poverty guidelines, the parental
contribution shall be determined using a sliding fee scale established by the commissioner
of human services which begins at deleted text begin 7.5deleted text end new text begin 9.5new text end percent of adjusted gross income at 675 percent
of federal poverty guidelines and increases to deleted text begin tendeleted text end new text begin 12new text end percent of adjusted gross income for
those with adjusted gross income up to deleted text begin 975deleted text end new text begin 900new text end percent of federal poverty guidelines; and

(5) if the adjusted gross income is equal to or greater than deleted text begin 975deleted text end new text begin 900new text end percent of
federal poverty guidelines, the parental contribution shall be deleted text begin 12.5deleted text end new text begin 13.5new text end percent of adjusted
gross income.

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

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

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

(e) The contribution shall be explained in writing to the parents at the time eligibility
for services is being determined. The contribution shall be made on a monthly basis
effective with the first month in which the child receives services. Annually upon
redetermination or at termination of eligibility, if the contribution exceeded the cost of
services provided, the local agency or the state shall reimburse that excess amount to
the parents, either by direct reimbursement if the parent is no longer required to pay a
contribution, or by a reduction in or waiver of parental fees until the excess amount is
exhausted. All reimbursements must include a notice that the amount reimbursed may be
taxable income if the parent paid for the parent's fees through an employer's health care
flexible spending account under the Internal Revenue Code, section 125, and that the
parent is responsible for paying the taxes owed on the amount reimbursed.

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

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

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

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

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

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

(2) the insurer denied insurance;

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

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

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

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

deleted text begin (j) Notwithstanding paragraph (b), for the period from July 1, 2010, to June 30,
2013, the parental contribution shall be computed by applying the following contribution
schedule to the adjusted gross income of the natural or adoptive parents:
deleted text end

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

deleted text begin (2) if the adjusted gross income is equal to or greater than 175 percent of federal
poverty guidelines and less than or equal to 525 percent of federal poverty guidelines,
the parental contribution shall be determined using a sliding fee scale established by the
commissioner of human services which begins at one percent of adjusted gross income
at 175 percent of federal poverty guidelines and increases to eight percent of adjusted
gross income for those with adjusted gross income up to 525 percent of federal poverty
guidelines;
deleted text end

deleted text begin (3) if the adjusted gross income is greater than 525 percent of federal poverty
guidelines and less than 675 percent of federal poverty guidelines, the parental contribution
shall be 9.5 percent of adjusted gross income;
deleted text end

deleted text begin (4) if the adjusted gross income is equal to or greater than 675 percent of federal
poverty guidelines and less than 900 percent of federal poverty guidelines, the parental
contribution shall be determined using a sliding fee scale established by the commissioner
of human services which begins at 9.5 percent of adjusted gross income at 675 percent of
federal poverty guidelines and increases to 12 percent of adjusted gross income for those
with adjusted gross income up to 900 percent of federal poverty guidelines; and
deleted text end

deleted text begin (5) if the adjusted gross income is equal to or greater than 900 percent of federal
poverty guidelines, the parental contribution shall be 13.5 percent of adjusted gross
income. If the child lives with the parent, the annual adjusted gross income is reduced by
$2,400 prior to calculating the parental contribution. If the child resides in an institution
specified in section 256B.35, the parent is responsible for the personal needs allowance
specified under that section in addition to the parental contribution determined under this
section. The parental contribution is reduced by any amount required to be paid directly to
the child pursuant to a court order, but only if actually paid.
deleted text end

Minnesota Statutes 2010, section 256.01, subdivision 24, is amended to read:

The commissioner shall establish the Disability
Linkage Line, deleted text begin adeleted text end new text begin to serve as Minnesota's neutral access point for new text end statewide deleted text begin consumerdeleted text end new text begin
disabilitynew text end informationdeleted text begin , referral,deleted text end and assistance deleted text begin system for people with disabilities and
chronic illnesses thatdeleted text end new text begin . The Disability Linkage Line shallnew text end :

new text begin (1) deliver information and assistance based on national and state standards;
new text end

deleted text begin (1) providesdeleted text end new text begin (2) providenew text end information about state and federal eligibility requirements,
benefits, and service options;

new text begin (3) provide benefits and options counseling;
new text end

deleted text begin (2) makesdeleted text end new text begin (4) makenew text end referrals to appropriate support entities;

deleted text begin (3) delivers information and assistance based on national and state standards;
deleted text end

deleted text begin (4) assistsdeleted text end new text begin (5) educatenew text end people deleted text begin todeleted text end new text begin on their options so they cannew text end make well-informed
deleted text begin decisionsdeleted text end new text begin choicesnew text end ; deleted text begin and
deleted text end

deleted text begin (5) supportsdeleted text end new text begin (6) help supportnew text end the timely resolution of service access and benefit
issuesdeleted text begin .deleted text end new text begin ;
new text end

new text begin (7) inform people of their long-term community services and supports;
new text end

new text begin (8) provide necessary resources and supports that can lead to employment and
increased economic stability of people with disabilities; and
new text end

new text begin (9) serve as the technical assistance and help center for the Web-based tool,
Minnesota's Disability Benefits 101.org.
new text end

new text begin This section is effective July 1, 2011.
new text end

Minnesota Statutes 2010, section 256.01, subdivision 29, is amended to read:

(a) To ensure the timely processing of
determinations of disability by the commissioner's state medical review team under
sections 256B.055, subdivision 7, paragraph (b), 256B.057, subdivision 9, deleted text begin paragraph
(j),deleted text end and 256B.055, subdivision 12, the commissioner shall review all medical evidence
submitted by county agencies with a referral and seek additional information from
providers, applicants, and enrollees to support the determination of disability where
necessary. Disability shall be determined according to the rules of title XVI and title
XIX of the Social Security Act and pertinent rules and policies of the Social Security
Administration.

(b) Prior to a denial or withdrawal of a requested determination of disability due
to insufficient evidence, the commissioner shall (1) ensure that the missing evidence is
necessary and appropriate to a determination of disability, and (2) assist applicants and
enrollees to obtain the evidence, including, but not limited to, medical examinations
and electronic medical records.

(c) The commissioner shall provide the chairs of the legislative committees with
jurisdiction over health and human services finance and budget the following information
on the activities of the state medical review team by February 1 of each year:

(1) the number of applications to the state medical review team that were denied,
approved, or withdrawn;

(2) the average length of time from receipt of the application to a decision;

(3) the number of appeals, appeal results, and the length of time taken from the date
the person involved requested an appeal for a written decision to be made on each appeal;

(4) for applicants, their age, health coverage at the time of application, hospitalization
history within three months of application, and whether an application for Social Security
or Supplemental Security Income benefits is pending; and

(5) specific information on the medical certification, licensure, or other credentials
of the person or persons performing the medical review determinations and length of
time in that position.

(d) Any appeal made under section 256.045, subdivision 3, of a disability
determination made by the state medical review team must be decided according to the
timelines under section 256.0451, subdivision 22, paragraph (a). If a written decision is
not issued within the timelines under section 256.0451, subdivision 22, paragraph (a), the
appeal must be immediately reviewed by the chief appeals referee.

new text begin This section is effective July 1, 2011.
new text end

Minnesota Statutes 2010, section 256B.04, is amended by adding a subdivision
to read:

new text begin In
accordance with federal law governing Money Follows the Person Rebalancing funds,
amounts equal to the value of enhanced federal funding resulting from the operation of the
demonstration project grant must be transferred from the medical assistance account in
the general fund to an account in the special revenue fund. Funds in the special revenue
fund account do not cancel and are appropriated to the commissioner to carry out the
goals of the Money Follows the Person Rebalancing demonstration project as required
under the approved federal plan for the use of the funds, and may be transferred to the
medical assistance account if applicable.
new text end

Minnesota Statutes 2010, section 256B.05, is amended by adding a subdivision
to read:

new text begin The local agency must act on an application for medical
assistance within ten working days of receipt of all information needed to act on the
application but no later than required under Minnesota Rules, part 9505.0090, subparts
2 and 3.
new text end

Minnesota Statutes 2010, section 256B.056, subdivision 3, is amended to read:

(a) To be eligible for
medical assistance, a person must not individually own more than $3,000 in assets, or if a
member of a household with two family members, husband and wife, or parent and child,
the household must not own more than $6,000 in assets, plus $200 for each additional
legal dependent. In addition to these maximum amounts, an eligible individual or family
may accrue interest on these amounts, but they must be reduced to the maximum at the
time of an eligibility redetermination. The accumulation of the clothing and personal
needs allowance according to section 256B.35 must also be reduced to the maximum at
the time of the eligibility redetermination. The value of assets that are not considered in
determining eligibility for medical assistance is the value of those assets excluded under
the supplemental security income program for aged, blind, and disabled persons, with
the following exceptions:

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

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

(3) motor vehicles are excluded to the same extent excluded by the supplemental
security income program;

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

(b) No asset limit shall apply to persons eligible under section 256B.055, subdivision
15.

new text begin This section is effective January 1, 2014.
new text end

Minnesota Statutes 2010, section 256B.057, subdivision 9, is amended to read:

(a) Medical assistance may be paid
for a person who is employed and who:

(1) but for excess earnings or assets, meets the definition of disabled under the
Supplemental Security Income program;

(2) is at least 16 but less than 65 years of age;

(3) meets the asset limits in paragraph deleted text begin (c)deleted text end new text begin (d)new text end ; and

(4) pays a premium and other obligations under paragraph (e).

new text begin (b) For purposes of eligibility, there is a $65 earned income disregard. To be eligible
for medical assistance under this subdivision, a person must have more than $65 of earned
income. Earned income must have Medicare, Social Security, and applicable state and
federal taxes withheld. The person must document earned income tax withholding. new text end Any
spousal income or assets shall be disregarded for purposes of eligibility and premium
determinations.

deleted text begin (b)deleted text end new text begin (c)new text end After the month of enrollment, a person enrolled in medical assistance under
this subdivision who:

(1) is temporarily unable to work and without receipt of earned income due to a
medical condition, as verified by a physiciandeleted text begin , may retain eligibility for up to four calendar
monthsdeleted text end ; or

(2) deleted text begin effective January 1, 2004,deleted text end loses employment for reasons not attributable to the
enrollee, new text begin and is without receipt of earned income new text end may retain eligibility for up to four
consecutive months after the month of job loss. To receive a four-month extension,
enrollees must verify the medical condition or provide notification of job loss. All other
eligibility requirements must be met and the enrollee must pay all calculated premium
costs for continued eligibility.

deleted text begin (c)deleted text end new text begin (d)new text end For purposes of determining eligibility under this subdivision, a person's
assets must not exceed $20,000, excluding:

(1) all assets excluded under section 256B.056;

(2) retirement accounts, including individual accounts, 401(k) plans, 403(b) plans,
Keogh plans, and pension plans; deleted text begin and
deleted text end

(3) medical expense accounts set up through the person's employerdeleted text begin .deleted text end new text begin ; and
new text end

new text begin (4) spousal assets, including spouse's share of jointly held assets.
new text end

deleted text begin (d)(1) Effective January 1, 2004, for purposes of eligibility, there will be a $65
earned income disregard. To be eligible, a person applying for medical assistance under
this subdivision must have earned income above the disregard level.
deleted text end

deleted text begin (2) Effective January 1, 2004, to be considered earned income, Medicare, Social
Security, and applicable state and federal income taxes must be withheld. To be eligible,
a person must document earned income tax withholding.
deleted text end

deleted text begin (e)(1) A person whose earned and unearned income is equal to or greater than 100
percent of federal poverty guidelines for the applicable family size must pay a premium
to be eligible for medical assistance under this subdivision. deleted text end new text begin (e) All enrollees must pay a
premium to be eligible for medical assistance under this subdivision, except as provided
under section 256.01, subdivision 18b.
new text end

new text begin (1) An enrollee must pay the greater of a $65 premium ornew text end the premium deleted text begin shall bedeleted text end new text begin
calculatednew text end based on the person's gross earned and unearned income and the applicable
family size using a sliding fee scale established by the commissioner, which begins at
one percent of income at 100 percent of the federal poverty guidelines and increases
to 7.5 percent of income for those with incomes at or above 300 percent of the federal
poverty guidelines.

new text begin (2) new text end Annual adjustments in the premium schedule based upon changes in the federal
poverty guidelines shall be effective for premiums due in July of each year.

deleted text begin (2) Effective January 1, 2004, all enrollees must pay a premium to be eligible for
medical assistance under this subdivision. An enrollee shall pay the greater of a $35
premium or the premium calculated in clause (1).
deleted text end

(3) deleted text begin Effective November 1, 2003,deleted text end All enrollees who receive unearned income must
pay deleted text begin one-half of onedeleted text end new text begin fivenew text end percent of unearned income in addition to the premium amountnew text begin ,
except as provided under section 256.01, subdivision 18bnew text end .

deleted text begin (4) Effective November 1, 2003, for enrollees whose income does not exceed 200
percent of the federal poverty guidelines and who are also enrolled in Medicare, the
commissioner must reimburse the enrollee for Medicare Part B premiums under section
256B.0625, subdivision 15, paragraph (a).
deleted text end

deleted text begin (5)deleted text end new text begin (4)new text end Increases in benefits under title II of the Social Security Act shall not be
counted as income for purposes of this subdivision until July 1 of each year.

(f) A person's eligibility and premium shall be determined by the local county
agency. Premiums must be paid to the commissioner. All premiums are dedicated to
the commissioner.

(g) Any required premium shall be determined at application and redetermined at
the enrollee's six-month income review or when a change in income or household size is
reported. Enrollees must report any change in income or household size within ten days
of when the change occurs. A decreased premium resulting from a reported change in
income or household size shall be effective the first day of the next available billing month
after the change is reported. Except for changes occurring from annual cost-of-living
increases, a change resulting in an increased premium shall not affect the premium amount
until the next six-month review.

(h) Premium payment is due upon notification from the commissioner of the
premium amount required. Premiums may be paid in installments at the discretion of
the commissioner.

(i) Nonpayment of the premium shall result in denial or termination of medical
assistance unless the person demonstrates good cause for nonpayment. Good cause exists
if the requirements specified in Minnesota Rules, part 9506.0040, subpart 7, items B to
D, are met. Except when an installment agreement is accepted by the commissioner,
all persons disenrolled for nonpayment of a premium must pay any past due premiums
as well as current premiums due prior to being reenrolled. Nonpayment shall include
payment with a returned, refused, or dishonored instrument. The commissioner may
require a guaranteed form of payment as the only means to replace a returned, refused,
or dishonored instrument.

(j) The commissioner shall notify enrollees annually beginning at least 24 months
before the person's 65th birthday of the medical assistance eligibility rules affecting
income, assets, and treatment of a spouse's income and assets that will be applied upon
reaching age 65.

new text begin (k) For enrollees whose income does not exceed 200 percent of the federal poverty
guidelines and who are also enrolled in Medicare, the commissioner shall reimburse
the enrollee for Medicare part B premiums under section 256B.0625, subdivision 15,
paragraph (a).
new text end

new text begin This section is effective January 1, 2014, for adults age 21 or
older, and October 1, 2019, for children age 16 to before the child's 21st birthday.
new text end

Minnesota Statutes 2010, section 256B.0659, subdivision 11, is amended to
read:

(a) A personal care assistant
must meet the following requirements:

(1) be at least 18 years of age with the exception of persons who are 16 or 17 years
of age with these additional requirements:

(i) supervision by a qualified professional every 60 days; and

(ii) employment by only one personal care assistance provider agency responsible
for compliance with current labor laws;

(2) be employed by a personal care assistance provider agency;

(3) enroll with the department as a personal care assistant after clearing a background
study. Except as provided in subdivision 11a, before a personal care assistant provides
services, the personal care assistance provider agency must initiate a background study on
the personal care assistant under chapter 245C, and the personal care assistance provider
agency must have received a notice from the commissioner that the personal care assistant
is:

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

(ii) is disqualified, but the personal care assistant has received a set aside of the
disqualification under section 245C.22;

(4) be able to effectively communicate with the recipient and personal care
assistance provider agency;

(5) be able to provide covered personal care assistance services according to the
recipient's personal care assistance care plan, respond appropriately to recipient needs,
and report changes in the recipient's condition to the supervising qualified professional
or physician;

(6) not be a consumer of personal care assistance services;

(7) maintain daily written records including, but not limited to, time sheets under
subdivision 12;

(8) effective January 1, 2010, complete standardized training as determined
by the commissioner before completing enrollment. The training must be available
in languages other than English and to those who need accommodations due to
disabilities. Personal care assistant training must include successful completion of the
following training components: basic first aid, vulnerable adult, child maltreatment,
OSHA universal precautions, basic roles and responsibilities of personal care assistants
including information about assistance with lifting and transfers for recipients, emergency
preparedness, orientation to positive behavioral practices, fraud issues, and completion of
time sheets. Upon completion of the training components, the personal care assistant must
demonstrate the competency to provide assistance to recipients;

(9) complete training and orientation on the needs of the recipient within the first
seven days after the services begin; and

(10) be limited to providing and being paid for up to 275 hours per month, except
that this limit shall be 275 hours per month for the period July 1, 2009, through June 30,
2011, of personal care assistance services regardless of the number of recipients being
served or the number of personal care assistance provider agencies enrolled with. The
number of hours worked per day shall not be disallowed by the department unless in
violation of the law.

(b) A legal guardian may be a personal care assistant if the guardian is not being paid
for the guardian services and meets the criteria for personal care assistants in paragraph (a).

(c) deleted text begin Effective January 1, 2010,deleted text end Persons who do not qualify as a personal care assistant
include parents and stepparents of minors, spouses, paid legal guardians, family foster
care providers, except as otherwise allowed in section 256B.0625, subdivision 19a, or
staff of a residential setting.new text begin When the personal care assistant is a relative of the recipient,
the commissioner shall pay 80 percent of the provider rate. For purposes of this section,
relative means the parent or adoptive parent of an adult child, a sibling aged 16 years or
older, an adult child, a grandparent, or a grandchild.
new text end

new text begin This section is effective October 1, 2011.
new text end

Minnesota Statutes 2010, section 256B.0659, subdivision 28, is amended to
read:

new text begin (a) new text end Required documentation must be completed and kept in the personal care assistance
provider agency file or the recipient's home residence. The required documentation
consists of:

(1) employee files, including:

(i) applications for employment;

(ii) background study requests and results;

(iii) orientation records about the agency policies;

(iv) trainings completed with demonstration of competence;

(v) supervisory visits;

(vi) evaluations of employment; and

(vii) signature on fraud statement;

(2) recipient files, including:

(i) demographics;

(ii) emergency contact information and emergency backup plan;

(iii) personal care assistance service plan;

(iv) personal care assistance care plan;

(v) month-to-month service use plan;

(vi) all communication records;

(vii) start of service information, including the written agreement with recipient; and

(viii) date the home care bill of rights was given to the recipient;

(3) agency policy manual, including:

(i) policies for employment and termination;

(ii) grievance policies with resolution of consumer grievances;

(iii) staff and consumer safety;

(iv) staff misconduct; and

(v) staff hiring, service delivery, staff and consumer safety, staff misconduct, and
resolution of consumer grievances;

(4) time sheets for each personal care assistant along with completed activity sheets
for each recipient served; deleted text begin and
deleted text end

(5) agency marketing and advertising materials and documentation of marketing
activities and costsnew text begin ; and
new text end

new text begin (6) for each personal care assistant, whether or not the personal care assistant is
providing care to a relative as defined in subdivision 11new text end .

new text begin (b) The commissioner may assess a fine of up to $500 on provider agencies that do
not consistently comply with the requirements of this subdivision.
new text end

Minnesota Statutes 2010, section 256B.0911, subdivision 1a, is amended to
read:

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 an institutional level of
care under subdivision 4a;

(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 sections 256B.0625, subdivisions
6, 7, and 19, paragraphs (a) and (c), and 256B.0657, based on assessment and support
plan development with appropriate referrals, including the option for deleted text begin consumer-directed
communitydeleted text end new text begin self-directed new text end supports;

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

(9) assistance to transition people back to community settings after facility
admissionnew text begin ; and
new text end

new text begin (10) providing notice to the individual or legal representative of the annual and
monthly average authorized amount for traditional agency services and self-directed
services under section 256B.0657 for which the recipient is found eligiblenew text end .

(b) "Long-term care 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.

new text begin This section is effective January 1, 2012.
new text end

Minnesota Statutes 2010, section 256B.0911, subdivision 3a, is amended to
read:

(a) Persons requesting assessment,
services planning, or other assistance intended to support community-based living,
including persons who need assessment in order to determine waiver or alternative
care program eligibility, must be visited by a long-term care consultation team within
deleted text begin 15 calendardeleted text end new text begin 20 calendarnew text end days after the date on which an assessment was requested or
recommended. After January 1, 2011, these requirements also apply to personal care
assistance services, private duty nursing, and home health agency services, on timelines
established in subdivision 5. Face-to-face assessments must be conducted according
to paragraphs (b) to (i).

(b) The county may utilize a team of either the social worker or public health nurse,
or both. After January 1, 2011, lead agencies shall use certified assessors to conduct the
assessment in a face-to-face interview. The consultation team members must confer
regarding the most appropriate care for each individual screened or assessed.

(c) The assessment must be comprehensive and include a person-centered
assessment of the health, psychological, functional, environmental, and social needs of
referred individuals and provide information necessary to develop a support plan that
meets the consumers needs, using an assessment form provided by the commissioner.

(d) The assessment must be conducted in a face-to-face interview with the person
being assessed and the person's legal representative, as required by legally executed
documents, and other individuals as requested by the person, who can provide information
on the needs, strengths, and preferences of the person necessary to develop a support
plan that ensures the person's health and safety, but who is not a provider of service or
has any financial interest in the provision of services.new text begin For persons who are to be assessed
for elderly waiver customized living services under section 256B.0915, and with the
permission of the person being assessed or the persons' designated or legal representative,
the client's current or proposed provider of services may submit a copy of the provider's
nursing assessment or written report outlining their recommendations regarding the
client's care needs. The person conducting the assessment will notify the provider of the
date by which this information is to be submitted. This information shall be provided to
the person conducting the assessment prior to the assessment.
new text end

(e) The person, or the person's legal representative, must be provided with
written recommendations for community-based services, including deleted text begin consumer-directeddeleted text end new text begin
self-directed new text end options, or institutional care that include documentation that the most
cost-effective alternatives available were offered to the individual. For purposes of
this requirement, "cost-effective alternatives" means community services and living
arrangements that cost the same as or less than institutional care.new text begin For persons determined
eligible for services defined under subdivision 1a, paragraph (a), clauses (7) to (9), the
community support plan must also include the estimated annual and monthly average
authorized budget amount for those services.
new text end

(f)new text begin (1)new text end If the person chooses to use community-based services, the person or the
person's legal representative must be provided with a written community support plan,
regardless of whether the individual is eligible for Minnesota health care programs. new text begin The
written community support plan must include:
new text end

new text begin (i) a summary of assessed needs as defined in paragraphs (c) and (d);
new text end

new text begin (ii) the individual's options and choices to meet identified needs, including all
available options for case management services and providers;
new text end

new text begin (iii) identification of health and safety risks and how those risks will be addressed,
including personal risk management strategies;
new text end

new text begin (iv) referral information; and
new text end

new text begin (v) informal caregiver supports, if applicable.
new text end

new text begin (2) For persons determined eligible for services defined under subdivision 1a,
paragraph (a), clauses (7) to (10), the community support plan must also include:
new text end

new text begin (i) identification of individual goals;
new text end

new text begin (ii) identification of short-term and long-term service outcomes. Short-term service
outcomes are defined as achievable within six months;
new text end

new text begin (iii) a recommended schedule for case management visits. When achievement of
short-term service outcomes may affect the amount of service required, the schedule must
be at least every six months and must reflect evaluation and progress toward identified
short-term service outcomes; and
new text end

new text begin (iv) the estimated annual and monthly budget amount for services.
new text end

new text begin (3) In addition, for persons determined eligible for state plan home care under
subdivision 1a, paragraph (a), clause (8), the person or person's representative must also
receive a copy of the home care service plan developed by a certified assessor.
new text end

new text begin (4) new text end A person may request assistance in identifying community supports without
participating in a complete assessment. Upon a request for assistance identifying
community support, the person must be transferred or referred to the services available
under sections 256.975, subdivision 7, and 256.01, subdivision 24, for telephone
assistance and follow up.

(g) The person has the right to make the final decision between institutional
placement and community placement after the recommendations have been provided,
except as provided in subdivision 4a, paragraph (c).

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

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

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

(3) information about Minnesota health care programs;

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

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

(6) the long-term care consultant's decision regarding the person's need for
institutional level of care as determined under criteria established in section 144.0724,
subdivision 11, or 256B.092; and

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

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

new text begin This section is effective January 1, 2012.
new text end

Minnesota Statutes 2010, section 256B.0913, subdivision 4, is amended to
read:

(a) Funding for services under the alternative care program is available to persons who
meet the following criteria:

(1) the person has been determined by a community assessment under section
256B.0911 to be a person who would require the level of care provided in a nursing
facility, but for the provision of services under the alternative care program. Effective
January 1, 2011, this determination must be made according to the criteria established in
section 144.0724, subdivision 11;

(2) the person is age 65 or older;

(3) the person would be eligible for medical assistance within 135 days of admission
to a nursing facility;

(4) the person is not ineligible for the payment of long-term care services by the
medical assistance program due to an asset transfer penalty under section 256B.0595 or
equity interest in the home exceeding $500,000 as stated in section 256B.056;

(5) the person needs long-term care services that are not funded through other
state or federal funding, or other health insurance or other third-party insurance such as
long-term care insurance;

(6) except for individuals described in clause (7), the monthly cost of the alternative
care services funded by the program for this person does not exceed 75 percent of the
monthly limit described under section 256B.0915, subdivision 3a. This monthly limit
does not prohibit the alternative care client from payment for additional services, but in no
case may the cost of additional services purchased under this section exceed the difference
between the client's monthly service limit defined under section 256B.0915, subdivision
3, and the alternative care program monthly service limit defined in this paragraph. If
care-related supplies and equipment or environmental modifications and adaptations are or
will be purchased for an alternative care services recipient, the costs may be prorated on a
monthly basis for up to 12 consecutive months beginning with the month of purchase.
If the monthly cost of a recipient's other alternative care services exceeds the monthly
limit established in this paragraph, the annual cost of the alternative care services shall be
determined. In this event, the annual cost of alternative care services shall not exceed 12
times the monthly limit described in this paragraph;

(7) for individuals assigned a case mix classification A as described under section
256B.0915, subdivision 3a, paragraph (a), with (i) no dependencies in activities of daily
living, new text begin or new text end (ii) deleted text begin only one dependencydeleted text end new text begin up to two dependenciesnew text end in bathing, dressing, grooming,
deleted text begin ordeleted text end walking, deleted text begin or (iii) a dependency score of less than three if eating is the only dependencydeleted text end new text begin
and eating when the dependency score in eating is three or greaternew text end as determined by
an assessment performed under section 256B.0911, the monthly cost of alternative
care services funded by the program cannot exceed deleted text begin $600deleted text end new text begin $593new text end per month for all new
participants enrolled in the program on or after July 1, deleted text begin 2009deleted text end new text begin 2011new text end . This monthly limit
shall be applied to all other participants who meet this criteria at reassessment. This
monthly limit shall be increased annually as described in section 256B.0915, subdivision
3a, paragraph (a). This monthly limit does not prohibit the alternative care client from
payment for additional services, but in no case may the cost of additional services
purchased exceed the difference between the client's monthly service limit defined in this
clause and the limit described in clause (6) for case mix classification A; and

(8) the person is making timely payments of the assessed monthly fee.

A person is ineligible if payment of the fee is over 60 days past due, unless the person
agrees to:

(i) the appointment of a representative payee;

(ii) automatic payment from a financial account;

(iii) the establishment of greater family involvement in the financial management of
payments; or

(iv) another method acceptable to the lead agency to ensure prompt fee payments.

The lead agency may extend the client's eligibility as necessary while making
arrangements to facilitate payment of past-due amounts and future premium payments.
Following disenrollment due to nonpayment of a monthly fee, eligibility shall not be
reinstated for a period of 30 days.

(b) Alternative care funding under this subdivision is not available for a person
who is a medical assistance recipient or who would be eligible for medical assistance
without a spenddown or waiver obligation. A person whose initial application for medical
assistance and the elderly waiver program is being processed may be served under the
alternative care program for a period up to 60 days. If the individual is found to be eligible
for medical assistance, medical assistance must be billed for services payable under the
federally approved elderly waiver plan and delivered from the date the individual was
found eligible for the federally approved elderly waiver plan. Notwithstanding this
provision, alternative care funds may not be used to pay for any service the cost of which:
(i) is payable by medical assistance; (ii) is used by a recipient to meet a waiver obligation;
or (iii) is used to pay a medical assistance income spenddown for a person who is eligible
to participate in the federally approved elderly waiver program under the special income
standard provision.

(c) Alternative care funding is not available for a person who resides in a licensed
nursing home, certified boarding care home, hospital, or intermediate care facility, except
for case management services which are provided in support of the discharge planning
process for a nursing home resident or certified boarding care home resident to assist with
a relocation process to a community-based setting.

(d) Alternative care funding is not available for a person whose income is greater
than the maintenance needs allowance under section 256B.0915, subdivision 1d, but equal
to or less than 120 percent of the federal poverty guideline effective July 1 in the fiscal
year for which alternative care eligibility is determined, who would be eligible for the
elderly waiver with a waiver obligation.

Minnesota Statutes 2010, section 256B.0915, subdivision 3a, is amended to
read:

(a) The monthly limit for the cost of
waivered services to an individual elderly waiver client except for individuals described
in paragraph (b) shall be the weighted average monthly nursing facility rate of the case
mix resident class to which the elderly waiver client would be assigned under Minnesota
Rules, parts 9549.0050 to 9549.0059, less the recipient's maintenance needs allowance
as described in subdivision 1d, paragraph (a), until the first day of the state fiscal year in
which the resident assessment system as described in section 256B.438 for nursing home
rate determination is implemented. Effective on the first day of the state fiscal year in
which the resident assessment system as described in section 256B.438 for nursing home
rate determination is implemented and the first day of each subsequent state fiscal year, the
monthly limit for the cost of waivered services to an individual elderly waiver client shall
be the rate of the case mix resident class to which the waiver client would be assigned
under Minnesota Rules, parts 9549.0050 to 9549.0059, in effect on the last day of the
previous state fiscal year, adjusted by deleted text begin the greater ofdeleted text end any legislatively adopted home and
community-based services percentage rate deleted text begin increase or the average statewide percentage
increase in nursing facility payment ratesdeleted text end new text begin adjustmentnew text end .

(b) The monthly limit for the cost of waivered services to an individual elderly
waiver client assigned to a case mix classification A under paragraph (a) withnew text begin :
new text end

(1) no dependencies in activities of daily livingdeleted text begin ,deleted text end new text begin ; or
new text end

(2) deleted text begin only one dependencydeleted text end new text begin up to two dependenciesnew text end in bathing, dressing, grooming, deleted text begin ordeleted text end
walking, deleted text begin or (3) a dependency score of less than three if eating is the only dependency,deleted text end new text begin
and eating when the dependency score in eating is three or greater as determined by an
assessment performed under section 256B.0911
new text end

shall be deleted text begin the lower of the case mix classification amount for case mix A as determined
under paragraph (a) or the case mix classification amount for case mix Adeleted text end new text begin $1,750 per
month new text end effective on deleted text begin Octoberdeleted text end new text begin Julynew text end 1, deleted text begin 2008deleted text end new text begin 2011new text end , deleted text begin per monthdeleted text end for all new participants enrolled
in the program on or after July 1, deleted text begin 2009deleted text end new text begin 2011new text end . This monthly limit shall be applied to all
other participants who meet this criteria at reassessment.new text begin This monthly limit shall be
increased annually as described in paragraph (a).
new text end

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

Minnesota Statutes 2010, section 256B.0915, subdivision 3b, is amended to
read:

(a) For a person who is a nursing facility resident at the time of requesting a
determination of eligibility for elderly waivered services, a monthly conversion new text begin budget
new text end limit for the cost of elderly waivered services may be requested. The monthly conversion
new text begin budget new text end limit for the cost of elderly waiver services shall be the resident class assigned
under Minnesota Rules, parts 9549.0050 to 9549.0059, for that resident in the nursing
facility where the resident currently resides until July 1 of the state fiscal year in which
the resident assessment system as described in section 256B.438 for nursing home rate
determination is implemented. Effective on July 1 of the state fiscal year in which the
resident assessment system as described in section 256B.438 for nursing home rate
determination is implemented, the monthly conversion new text begin budget new text end limit for the cost of elderly
waiver services shall be new text begin based on new text end the per diem nursing facility rate as determined by the
resident assessment system as described in section 256B.438 for deleted text begin that residentdeleted text end new text begin residentsnew text end
in the nursing facility where the deleted text begin residentdeleted text end new text begin elderly waiver applicantnew text end currently resides
deleted text begin multiplieddeleted text end new text begin . The monthly conversion budget limit shall be calculated by multiplying the
per diemnew text end by 365 deleted text begin anddeleted text end new text begin , new text end divided by 12, deleted text begin lessdeleted text end new text begin and reduced by new text end the recipient's maintenance needs
allowance as described in subdivision 1d. The initially approved new text begin monthly new text end conversion deleted text begin rate
maydeleted text end new text begin budget limit shallnew text end be adjusted deleted text begin by the greater of any subsequent legislatively adopted
home and community-based services percentage rate increase or the average statewide
percentage increase in nursing facility payment ratesdeleted text end new text begin annually as described in subdivision
3a, paragraph (a)new text end . The limit under this subdivision only applies to persons discharged from
a nursing facility after a minimum 30-day stay and found eligible for waivered services
on or after July 1, 1997. For conversions from the nursing home to the elderly waiver
with consumer directed community support services, the deleted text begin conversion rate limit is equal to
thedeleted text end nursing facility deleted text begin ratedeleted text end new text begin per diem used to calculate the monthly conversion budget limit
must benew text end reduced by a percentage equal to the percentage difference between the consumer
directed services budget limit that would be assigned according to the federally approved
waiver plan and the corresponding community case mix cap, but not to exceed 50 percent.

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

(1) cost of all waivered services, including deleted text begin extended medicaldeleted text end new text begin specializednew text end supplies
and equipment and environmental deleted text begin modifications anddeleted text end new text begin accessibilitynew text end adaptations; and

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

Minnesota Statutes 2010, section 256B.0915, subdivision 3e, is amended to
read:

(a) Payment for customized living
services shall be a monthly rate authorized by the lead agency within the parameters
established by the commissioner. The payment agreement must delineate the amount of
each component service included in the recipient's customized living service plan. The
lead agency shall ensure that there is a documented need within the parameters established
by the commissioner for all component customized living services authorized.

(b) The payment rate must be based on the amount of component services to be
provided utilizing component rates established by the commissioner. Counties and tribes
shall use tools issued by the commissioner to develop and document customized living
service plans and rates.

(c) Component service rates must not exceed payment rates for comparable elderly
waiver or medical assistance services and must reflect economies of scale. Customized
living services must not include rent or raw food costs.

(d) new text begin With the exception of individuals described in subdivision 3a, paragraph (b), new text end the
individualized monthly authorized payment for the customized living service plan shall
not exceed 50 percent of the greater of either the statewide or any of the geographic
groups' weighted average monthly nursing facility rate of the case mix resident class
to which the elderly waiver eligible client would be assigned under Minnesota Rules,
parts 9549.0050 to 9549.0059, less the maintenance needs allowance as described
in subdivision 1d, paragraph (a), until the July 1 of the state fiscal year in which the
resident assessment system as described in section 256B.438 for nursing home rate
determination is implemented. Effective on July 1 of the state fiscal year in which
the resident assessment system as described in section 256B.438 for nursing home
rate determination is implemented and July 1 of each subsequent state fiscal year, the
individualized monthly authorized payment for the services described in this clause shall
not exceed the limit which was in effect on June 30 of the previous state fiscal year
updated annually based on legislatively adopted changes to all service rate maximums for
home and community-based service providers.

new text begin (e) Effective July 1, 2011, the individualized monthly payment for the customized
living service plan for individuals described in subdivision 3a, paragraph (b), must be the
monthly authorized payment limit for customized living for individuals classified as case
mix A, reduced by 25 percent. This rate limit must be applied to all new participants
enrolled in the program on or after July 1, 2011, who meet the criteria described in
subdivision 3a, paragraph (b). This monthly limit also applies to all other participants who
meet the criteria described in subdivision 3a, paragraph (b), at reassessment.
new text end

deleted text begin (e)deleted text end new text begin (f)new text end Customized living services are delivered by a provider licensed by the
Department of Health as a class A or class F home care provider and provided in a
building that is registered as a housing with services establishment under chapter 144D.new text begin
Licensed home care providers are subject to section 256B.0651, subdivision 14.
new text end

new text begin (g) A provider may not bill or otherwise charge an elderly waiver participant or their
family for additional units of any allowable component service beyond those available
under the service rate limits described in paragraph (d), nor for additional units of any
allowable component service beyond those approved in the service plan by the lead agency.
new text end

Minnesota Statutes 2010, section 256B.0915, subdivision 3h, is amended to
read:

(a) The
payment rate for 24-hour customized living services is a monthly rate authorized by the
lead agency within the parameters established by the commissioner of human services.
The payment agreement must delineate the amount of each component service included in
each recipient's customized living service plan. The lead agency shall ensure that there is a
documented need within the parameters established by the commissioner for all component
customized living services authorized. The lead agency shall not authorize 24-hour
customized living services unless there is a documented need for 24-hour supervision.

(b) For purposes of this section, "24-hour supervision" means that the recipient
requires assistance due to needs related to one or more of the following:

(1) intermittent assistance with toileting, positioning, or transferring;

(2) cognitive or behavioral issues;

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

(4) for all new participants enrolled in the program on or after deleted text begin Januarydeleted text end new text begin Julynew text end 1, 2011,
and all other participants at their first reassessment after deleted text begin Januarydeleted text end new text begin Julynew text end 1, 2011, dependency
in at least deleted text begin twodeleted text end new text begin threenew text end of the following activities of daily living as determined by assessment
under section 256B.0911: bathing; dressing; grooming; walking; or eatingnew text begin when the
dependency score in eating is three or greaternew text end ; and needs medication management and at
least 50 hours of service per month. The lead agency shall ensure that the frequency and
mode of supervision of the recipient and the qualifications of staff providing supervision
are described and meet the needs of the recipient.

(c) The payment rate for 24-hour customized living services must be based on the
amount of component services to be provided utilizing component rates established by the
commissioner. Counties and tribes will use tools issued by the commissioner to develop
and document customized living plans and authorize rates.

(d) Component service rates must not exceed payment rates for comparable elderly
waiver or medical assistance services and must reflect economies of scale.

(e) The individually authorized 24-hour customized living payments, in combination
with the payment for other elderly waiver services, including case management, must not
exceed the recipient's community budget cap specified in subdivision 3a. Customized
living services must not include rent or raw food costs.

(f) The individually authorized 24-hour customized living payment rates shall not
exceed the 95 percentile of statewide monthly authorizations for 24-hour customized
living services in effect and in the Medicaid management information systems on March
31, 2009, for each case mix resident class under Minnesota Rules, parts 9549.0050
to 9549.0059, to which elderly waiver service clients are assigned. When there are
fewer than 50 authorizations in effect in the case mix resident class, the commissioner
shall multiply the calculated service payment rate maximum for the A classification by
the standard weight for that classification under Minnesota Rules, parts 9549.0050 to
9549.0059, to determine the applicable payment rate maximum. Service payment rate
maximums shall be updated annually based on legislatively adopted changes to all service
rates for home and community-based service providers.

(g) Notwithstanding the requirements of paragraphs (d) and (f), the commissioner
may establish alternative payment rate systems for 24-hour customized living services in
housing with services establishments which are freestanding buildings with a capacity of
16 or fewer, by applying a single hourly rate for covered component services provided
in either:

(1) licensed corporate adult foster homes; or

(2) specialized dementia care units which meet the requirements of section 144D.065
and in which:

(i) each resident is offered the option of having their own apartment; or

(ii) the units are licensed as board and lodge establishments with maximum capacity
of eight residents, and which meet the requirements of Minnesota Rules, part 9555.6205,
subparts 1, 2, 3, and 4, item A.

new text begin (h) A provider may not bill or otherwise charge an elderly waiver participant or their
family for additional units of any allowable component service beyond those available
under the service rate limits described in paragraph (e), nor for additional units of any
allowable component service beyond those approved in the service plan by the lead agency.
new text end

Minnesota Statutes 2010, section 256B.0915, subdivision 10, is amended to
read:

The
commissioner shall adjust the elderly waiver capitation payment rates for managed care
organizations paid under section 256B.69, subdivisions 6a and 23, to reflect the maximum
service rate limits for customized living services and 24-hour customized living services
under subdivisions 3e and 3h deleted text begin for the contract period beginning October 1, 2009deleted text end . Medical
assistance rates paid to customized living providers by managed care organizations under
this section shall not exceed the maximum service rate limits new text begin and component rates as
new text end determined by the commissioner under subdivisions 3e and 3h.

Minnesota Statutes 2010, section 256B.0916, subdivision 6a, is amended to
read:

(a) The commissioner shall submit to the federal Health Care Financing
Administration by August 1, 2001, an amendment to the home and community-based
waiver deleted text begin for persons with developmental disabilitiesdeleted text end new text begin under section 256B.092 and by April 1,
2005, for waivers under sections 256B.0915 and 256B.49, new text end to make deleted text begin consumer-directed
communitydeleted text end new text begin self-directed new text end support services available in every county of the state deleted text begin by January
1, 2002deleted text end .

(b) new text begin Until the waiver amendment for self-directed community supports is effective, new text end if
a county declines to meet the requirements for provision of deleted text begin consumer-directed communitydeleted text end
new text begin self-directed new text end supports, the commissioner shall contract with another county, a group of
counties, or a private agency to plan for and administer deleted text begin consumer-directed communitydeleted text end new text begin
self-directed new text end supports in that county.

(c) The state of Minnesota, county agencies, tribal governments, or administrative
entities under contract to participate in the implementation and administration of the home
and community-based waiver for persons with developmental disabilities, shall not be
liable for damages, injuries, or liabilities sustained through the purchase of support by the
individual, the individual's family, legal representative, or the authorized representative
with funds received through the deleted text begin consumer-directed communitydeleted text end new text begin self-directednew text end support
service under this section. Liabilities include but are not limited to: workers' compensation
liability, the Federal Insurance Contributions Act (FICA), or the Federal Unemployment
Tax Act (FUTA).

new text begin This section is effective July 1, 2011.
new text end

Minnesota Statutes 2010, section 256B.092, subdivision 1b, is amended to
read:

deleted text begin The
individual servicedeleted text end new text begin Each recipient of case management services and any legal representative
shall be provided a written copy of the coordinated services and supportnew text end plan deleted text begin mustdeleted text end new text begin , whichnew text end :

(1) deleted text begin includedeleted text end new text begin is developed within ten working days after the case manager receives the
community support plan from the certified assessor under section 256B.0911;
new text end

new text begin (2) includes new text end the results of the assessment information on the person's need for
service, including identification of service needs that will be or that are met by the person's
relatives, friends, and others, as well as community services used by the general public;

new text begin (3) reasonably assures the health, safety, and welfare of the recipient;
new text end

deleted text begin (2) identifydeleted text end new text begin (4) identifies new text end the person's preferences for services as stated by the person,
the person's legal guardian or conservator, or the parent if the person is a minor;

new text begin (5) provides for an informed choice, as defined in section 256B.77, subdivision 2,
paragraph (o), of service and support providers;
new text end

deleted text begin (3) identifydeleted text end new text begin (6) identifies new text end long- and short-range goals for the person;

deleted text begin (4) identifydeleted text end new text begin (7) identifiesnew text end specific services and the amount and frequency of the
services to be provided to the person based on assessed needs, preferences, deleted text begin anddeleted text end available
resourcesdeleted text begin . The individual service plan shall also specify other services the person needs
that are not availabledeleted text end new text begin , and other services the person needs that are not available. The
individual coordinated services and support plan shall also specify service outcomes and
the provider's responsibility to monitor the achievement of the service outcomesnew text end ;

deleted text begin (5) identifydeleted text end new text begin (8) identifiesnew text end the need for an deleted text begin individual programdeleted text end new text begin individual's provider
new text end plan to be developed by the provider according to the respective state and federal licensing
and certification standards, and additional assessments to be completed or arranged by the
provider after service initiation;

deleted text begin (6) identifydeleted text end new text begin (9) identifiesnew text end provider responsibilities to implement and make
recommendations for modification to the deleted text begin individual servicedeleted text end new text begin coordinated services and
support new text end plan;

deleted text begin (7) includedeleted text end new text begin (10) includes new text end notice of the right to new text begin have assessments completed and
service plans developed within specified time periods, the right to appeal action or
inaction, and the right to new text end request deleted text begin a conciliation conference or a hearingdeleted text end new text begin an appealnew text end under
section 256.045;

deleted text begin (8) bedeleted text end new text begin (11) isnew text end agreed upon and signed by the person, the person's legal guardian
or conservator, or the parent if the person is a minor, and the authorized county
representative; and

deleted text begin (9) bedeleted text end new text begin (12) isnew text end reviewed by a health professional if the person has overriding medical
needs that impact the delivery of services.

deleted text begin Service planning formats developed for interagency planning such as transition,
vocational, and individual family service plans may be substituted for service planning
formats developed by county agencies.
deleted text end

new text begin This section is effective January 1, 2013.
new text end

Minnesota Statutes 2010, section 256B.092, subdivision 1e, is amended to
read:

(a) If the deleted text begin individual servicedeleted text end new text begin coordinated services and
support new text end plan identifies the need for individual deleted text begin programdeleted text end new text begin provider new text end plans for authorized
services, the case deleted text begin managerdeleted text end new text begin management service provider new text end shall assure that deleted text begin individual
programdeleted text end new text begin the individual provider new text end plans are developed by the providers according to clauses
(2) to (5). The providers shall assure that the individual deleted text begin programdeleted text end new text begin provider new text end plans:

(1) are developed according to the respective state and federal licensing and
certification requirements;

(2) are designed to achieve the goals of the individual service plan;

(3) are consistent with other aspects of the deleted text begin individual servicedeleted text end new text begin coordinated services
and supportnew text end plan;

(4) assure the health and safety of the person; and

(5) are developed with consistent and coordinated approaches to services new text begin and service
outcomesnew text end among the various service providers.

(b) The case deleted text begin managerdeleted text end new text begin management service provider new text end shall monitor the provision of
services:

(1) to assure that the deleted text begin individual servicedeleted text end new text begin coordinated services and supportnew text end plan is
being followed according to paragraph (a);

(2) to identify any changes or modifications that might be needed in the deleted text begin individual
servicedeleted text end new text begin coordinated services and supportnew text end plan, including changes resulting from
recommendations of current service providers;

(3) to determine if the person's legal rights are protected, and if not, notify the
person's legal guardian or conservator, or the parent if the person is a minor, protection
services, or licensing agencies as appropriate; and

(4) to determine if the person, the person's legal guardian or conservator, or the
parent if the person is a minor, is satisfied with the services provided.

(c) If the provider fails to develop or carry out the individual deleted text begin programdeleted text end new text begin providernew text end plan
according to paragraph (a), the case manager shall notify the person's legal guardian or
conservator, or the parent if the person is a minor, the provider, the respective licensing
and certification agencies, and the county board where the services are being provided. In
addition, the case manager shall identify other steps needed to assure the person receives
the services identified in the deleted text begin individual servicedeleted text end new text begin coordinated services and supportnew text end plan.

new text begin This section is effective January 1, 2012.
new text end

Minnesota Statutes 2010, section 256B.092, subdivision 1g, is amended to
read:

Unless otherwise required by federal law, the
county agency is not required to complete deleted text begin an individual servicedeleted text end new text begin a coordinated services and
supportnew text end plan as defined in subdivision 1b for:

(1) persons whose families are requesting respite care for their family member who
resides with them, or whose families are requesting a family support grant and are not
requesting purchase or arrangement of habilitative services; and

(2) persons with developmental disabilities, living independently without authorized
services or receiving funding for services at a rehabilitation facility as defined in section
268A.01, subdivision 6, and not in need of or requesting additional services.

new text begin This section is effective January 1, 2012.
new text end

Minnesota Statutes 2010, section 256B.092, subdivision 3, is amended to read:

deleted text begin County agency case managersdeleted text end new text begin
Lead agenciesnew text end , under rules of the commissioner, shall authorize and terminate services
of community and regional treatment center providers according to deleted text begin individual servicedeleted text end new text begin
coordinated services and supportnew text end plans. Services provided to persons with developmental
disabilities may only be authorized and terminated deleted text begin by case managersdeleted text end according to (1)
rules of the commissioner and (2) the deleted text begin individual servicedeleted text end new text begin coordinated services and supportnew text end
plan as defined in subdivision 1b. Medical assistance services not needed shall not be
authorized by deleted text begin countydeleted text end new text begin leadnew text end agencies or funded by the commissioner. When purchasing or
arranging for unlicensed respite care services for persons with overriding health needs, the
county agency shall seek the advice of a health care professional in assessing provider
staff training needs and skills necessary to meet the medical needs of the person.

new text begin This section is effective January 1, 2012.
new text end

Minnesota Statutes 2010, section 256B.092, subdivision 8, is amended to read:

The deleted text begin screening teamdeleted text end
new text begin certified assessor new text end shall:

(1) review diagnostic data;

(2) review health, social, and developmental assessment data using a deleted text begin uniform
screeningdeleted text end new text begin comprehensive assessment new text end tool specified by the commissioner;

(3) identify the level of services appropriate to maintain the person in the most
normal and least restrictive setting that is consistent with the person's treatment needs;

(4) identify other noninstitutional public assistance or social service that may prevent
or delay long-term residential placement;

(5) assess whether a person is in need of long-term residential care;

(6) make recommendations regarding deleted text begin placementdeleted text end new text begin services new text end and payment for: (i) social
service or public assistance support, or both, to maintain a person in the person's own home
or other place of residence; (ii) training and habilitation service, vocational rehabilitation,
and employment training activities; (iii) community residential deleted text begin placementdeleted text end new text begin servicesnew text end ; deleted text begin (iv)
regional treatment center placement;deleted text end or deleted text begin (v)deleted text end new text begin (iv) new text end a home and community-based service
alternative to community residential placement or regional treatment center placement;

(7) evaluate the availability, location, and quality of the services listed in clause
(6), including the impact of deleted text begin placement alternativesdeleted text end new text begin services and supports options new text end on the
person's ability to maintain or improve existing patterns of contact and involvement with
parents and other family members;

(8) identify the cost implications of recommendations in clause (6)new text begin and provide
written notice of the annual and monthly average authorized amount to be spent for
services for the recipientnew text end ;

(9) make recommendations to a court as may be needed to assist the court in making
decisions regarding commitment of persons with developmental disabilities; and

(10) inform the person and the person's legal guardian or conservator, or the parent if
the person is a minor, that appeal may be made to the commissioner pursuant to section
256.045.

new text begin This section is effective January 1, 2012.
new text end

new text begin (a) In order to improve the quality of services provided to
Minnesotans with disabilities and to meet the requirements of the federally approved
home and community-based waivers under section 1915c of the Social Security Act, a
State Quality Assurance, Quality Improvement, and Licensing System for Minnesotans
receiving disability services is enacted. This system is a partnership between the
Department of Human Services and the State Quality Council established under
subdivision 3.
new text end

new text begin (b) This system is a result of the recommendations from the Department of Human
Services' licensing and alternative quality assurance study mandated under Laws 2005,
First Special Session chapter 4, article 7, section 57, and presented to the legislature
in February 2007.
new text end

new text begin (c) The disability services eligible under this section include:
new text end

new text begin (1) the home and community-based services waiver programs for persons with
developmental disabilities under section 256B.092, subdivision 4, or section 256B.49,
including traumatic brain injuries and services for those who qualify for nursing facility
level of care or hospital facility level of care;
new text end

new text begin (2) home care services under section 256B.0651;
new text end

new text begin (3) family support grants under section 252.32;
new text end

new text begin (4) consumer support grants under section 256.476;
new text end

new text begin (5) semi-independent living services under section 252.275; and
new text end

new text begin (6) services provided through an intermediate care facility for the developmentally
disabled.
new text end

new text begin (d) For purposes of this section, the following definitions apply:
new text end

new text begin (1) "commissioner" means the commissioner of human services;
new text end

new text begin (2) "council" means the State Quality Council under subdivision 3;
new text end

new text begin (3) "Quality Assurance Commission" means the commission under section
256B.0951; and
new text end

new text begin (4) "system" means the State Quality Assurance, Quality Improvement and
Licensing System under this section.
new text end

new text begin (a) The commissioner of
human services shall establish the State Quality Council under subdivision 3.
new text end

new text begin (b) The commissioner shall initially delegate authority to perform licensing
functions and activities according to section 245A.16 to a host county in Region 10. The
commissioner must not license or reimburse a participating facility, program, or service
located in Region 10 if the commissioner has received notification from the host county
that the facility, program, or service has failed to qualify for licensure.
new text end

new text begin (c) The commissioner may conduct random licensing inspections based on outcomes
adopted under section 256B.0951, subdivision 3, at facilities or programs, and of services
eligible under this section. The role of the random inspections is to verify that the system
protects the safety and well-being of persons served and maintains the availability of
high-quality services for persons with disabilities.
new text end

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

new text begin (e) The commissioner shall seek a federal waiver by July 1, 2012 to allow
intermediate care facilities for persons with developmental disabilities to participate in
this system.
new text end

new text begin (a) There is hereby created a State Quality
Council which must define regional quality councils, and carry out a community-based,
person-directed quality review component, and a comprehensive system for effective
incident reporting, investigation, analysis, and follow-up.
new text end

new text begin (b) By August 1, 2011, the commissioner of human services shall appoint the
members of the initial State Quality Council. Members shall include representatives
from the following groups:
new text end

new text begin (1) disability service recipients and their family members;
new text end

new text begin (2) during the first two years of the State Quality Council, there must be at least three
members from the Region 10 stakeholders. As regional quality councils are formed under
subdivision 4, each regional quality council shall appoint one member;
new text end

new text begin (3) disability service providers;
new text end

new text begin (4) disability advocacy groups; and
new text end

new text begin (5) county human services agencies and staff from the Department of Human
Services and Ombudsman for Mental Health and Developmental Disabilities.
new text end

new text begin (c) Members of the council who do not receive a salary or wages from an employer
for time spent on council duties may receive a per diem payment when performing council
duties and functions.
new text end

new text begin (d) The State Quality Council shall:
new text end

new text begin (1) assist the Department of Human Services in fulfilling federally mandated
obligations by monitoring disability service quality and quality assurance and
improvement practices in Minnesota; and
new text end

new text begin (2) establish state quality improvement priorities with methods for achieving results
and provide an annual report to the legislative committees with jurisdiction over policy
and funding of disability services on the outcomes, improvement priorities, and activities
undertaken by the commission during the previous state fiscal year.
new text end

new text begin (e) The State Quality Council, in partnership with the commissioner, shall:
new text end

new text begin (1) approve and direct implementation of the community-based, person-directed
system established in this section;
new text end

new text begin (2) recommend an appropriate method of funding this system, and determine the
feasibility of the use of Medicaid, licensing fees, as well as other possible funding options;
new text end

new text begin (3) approve measurable outcomes in the areas of health and safety, consumer
evaluation, education and training, providers, and systems;
new text end

new text begin (4) establish variable licensure periods not to exceed three years based on outcomes
achieved; and
new text end

new text begin (5) in cooperation with the Quality Assurance Commission, design a transition plan
for licensed providers from Region 10 into the alternative licensing system by July 1, 2013.
new text end

new text begin (f) The State Quality Council shall notify the commissioner of human services that a
facility, program, or service has been reviewed by quality assurance team members under
subdivision 4, paragraph (b), clause (13), and qualifies for a license.
new text end

new text begin (g) The State Quality Council, in partnership with the commissioner, shall establish
an ongoing review process for the system. The review shall take into account the
comprehensive nature of the system which is designed to evaluate the broad spectrum of
licensed and unlicensed entities that provide services to persons with disabilities. The
review shall address efficiencies and effectiveness of the system.
new text end

new text begin (h) The State Quality Council may recommend to the commissioner certain
variances from the standards governing licensure of programs for persons with disabilities
in order to improve the quality of services so long as the recommended variances do
not adversely affect the health or safety of persons being served or compromise the
qualifications of staff to provide services.
new text end

new text begin (i) The safety standards, rights, or procedural protections referenced under
subdivision 2, paragraph (c), shall not be varied. The State Quality Council may make
recommendations to the commissioner or to the legislature in the report required under
paragraph (c) regarding alternatives or modifications to the safety standards, rights, or
procedural protections referenced under subdivision 2, paragraph (c).
new text end

new text begin (j) The State Quality Council may hire staff to perform the duties assigned in this
subdivision.
new text end

new text begin (a) The commissioner shall establish, as
selected by the State Quality Council, regional quality councils of key stakeholders,
including regional representatives of:
new text end

new text begin (1) disability service recipients and their family members;
new text end

new text begin (2) disability service providers;
new text end

new text begin (3) disability advocacy groups; and
new text end

new text begin (4) county human services agencies and staff from the Department of Human
Services and Ombudsman for Mental Health and Developmental Disabilities.
new text end

new text begin (b) Each regional quality council shall:
new text end

new text begin (1) direct and monitor the community-based, person-directed quality assurance
system in this section;
new text end

new text begin (2) approve a training program for quality assurance team members under clause
(13);
new text end

new text begin (3) review summary reports from quality assurance team reviews and make
recommendations to the State Quality Council regarding program licensure;
new text end

new text begin (4) make recommendations to the State Quality Council regarding the system;
new text end

new text begin (5) resolve complaints between the quality assurance teams, counties, providers,
persons receiving services, their families, and legal representatives;
new text end

new text begin (6) analyze and review quality outcomes and critical incident data reporting
incidents of life safety concerns immediately to the Department of Human Services
licensing division;
new text end

new text begin (7) provide information and training programs for persons with disabilities and their
families and legal representatives on service options and quality expectations;
new text end

new text begin (8) disseminate information and resources developed to other regional quality
councils;
new text end

new text begin (9) respond to state-level priorities;
new text end

new text begin (10) establish regional priorities for quality improvement;
new text end

new text begin (11) submit an annual report to the State Quality Council on the status, outcomes,
improvement priorities, and activities in the region;
new text end

new text begin (12) choose a representative to participate on the State Quality Council and assume
other responsibilities consistent with the priorities of the State Quality Council; and
new text end

new text begin (13) recruit, train, and assign duties to members of quality assurance teams, taking
into account the size of the service provider, the number of services to be reviewed,
the skills necessary for the team members to complete the process, and ensure that no
team member has a financial, personal, or family relationship with the facility, program,
or service being reviewed or with anyone served at the facility, program, or service.
Quality assurance teams must be comprised of county staff, persons receiving services
or the person's families, legal representatives, members of advocacy organizations,
providers, and other involved community members. Team members must complete
the training program approved by the regional quality council and must demonstrate
performance-based competency. Team members may be paid a per diem and reimbursed
for expenses related to their participation in the quality assurance process.
new text end

new text begin (c) The commissioner shall monitor the safety standards, rights, and procedural
protections for the monitoring of psychotropic medications and those identified under
sections 245.825; 245.91 to 245.97; 245A.09, subdivision 2, paragraph (c), clauses (2)
and (5); 245A.12; 245A.13; 252.41, subdivision 9; 256B.092, subdivision 1b, clause
(7); 626.556; and 626.557.
new text end

new text begin (d) The regional quality councils may hire staff to perform the duties assigned in
this subdivision.
new text end

new text begin (e) The regional quality councils may charge fees for their services.
new text end

new text begin (f) The quality assurance process undertaken by a regional quality council consists of
an evaluation by a quality assurance team of the facility, program, or service. The process
must include an evaluation of a random sample of persons served. The sample must be
representative of each service provided. The sample size must be at least five percent but
not less than two persons served. All persons must be given the opportunity to be included
in the quality assurance process in addition to those chosen for the random sample.
new text end

new text begin (g) A facility, program, or service may contest a licensing decision of the regional
quality council as permitted under chapter 245A.
new text end

new text begin The commissioner, in consultation
with the State Quality Council, shall conduct an annual independent statewide survey
of service recipients, randomly selected, to determine the effectiveness and quality
of disability services. The survey must be consistent with the system performance
expectations of the Centers for Medicare and Medicaid Services (CMS) Quality
Framework. The survey must analyze whether desired outcomes for persons with different
demographic, diagnostic, health, and functional needs, who are receiving different types
of services in different settings and with different costs, have been achieved. Annual
statewide and regional reports of the results must be published and used to assist regions,
counties, and providers to plan and measure the impact of quality improvement activities.
new text end

new text begin Members of the State Quality Council under
subdivision 3, the regional quality councils under subdivision 4, and quality assurance
team members under subdivision 4, paragraph (b), clause (13), are mandated reporters as
defined in sections 626.556, subdivision 3, and 626.5572, subdivision 16.
new text end

new text begin (a) Subdivisions 1 to 6 are effective July 1, 2011.
new text end

new text begin (b) The jurisdictions of the regional quality councils in subdivision 4 must be
defined, with implementation dates, by July 1, 2012. During the biennium beginning July
1, 2011, the Quality Assurance Commission shall continue to implement the alternative
licensing system under this section.
new text end

Minnesota Statutes 2010, section 256B.431, subdivision 2r, is amended to
read:

new text begin (a) new text end Effective July 1, 1993, the
commissioner shall limit payment for leave days in a nursing facility to 79 percent of that
nursing facility's total payment rate for the involved resident.

new text begin (b) new text end For services rendered on or after July 1, 2003, for facilities reimbursed under this
section or section 256B.434, the commissioner shall limit payment for leave days in a
nursing facility to 60 percent of that nursing facility's total payment rate for the involved
resident.

new text begin (c) For services rendered on or after July 1, 2011, for facilities reimbursed under
this chapter, the commissioner shall limit payment for leave days in a nursing facility
to 30 percent of that nursing facility's total payment rate for the involved resident, and
shall allow this payment only when the occupancy of the nursing facility, inclusive of
bed hold days, is equal to or greater than 96 percent, notwithstanding Minnesota Rules,
part 9505.0415.
new text end

Minnesota Statutes 2010, section 256B.431, subdivision 32, is amended to
read:

(a) deleted text begin For rate years beginning on or after
July 1, 2001, the total payment rate for a facility reimbursed under this section, section
256B.434, or any other section for the first 90 paid days after admission shall be:
deleted text end

deleted text begin (1) for the first 30 paid days, the rate shall be 120 percent of the facility's medical
assistance rate for each case mix class;
deleted text end

deleted text begin (2) for the next 60 paid days after the first 30 paid days, the rate shall be 110 percent
of the facility's medical assistance rate for each case mix class;
deleted text end

deleted text begin (3) beginning with the 91st paid day after admission, the payment rate shall be the
rate otherwise determined under this section, section 256B.434, or any other section; and
deleted text end

deleted text begin (4) payments under this paragraph apply to admissions occurring on or after July 1,
2001, and before July 1, 2003, and to resident days occurring before July 30, 2003.
deleted text end

deleted text begin (b)deleted text end For rate years beginning on or after July 1, deleted text begin 2003deleted text end new text begin 2011new text end , the total payment rate for
a facility reimbursed under this section, section 256B.434, or any other section shall be:

(1) for the first 30 calendar days after admission, the rate shall be 120 percent of
the facility's medical assistance rate for each RUG class;

(2) beginning with the 31st calendar day after admission, the payment rate shall be
the rate otherwise determined under this section, section 256B.434, or any other section;
and

(3) payments under this paragraph apply to admissions occurring on or after July
1, deleted text begin 2003deleted text end new text begin 2011new text end .

deleted text begin (c) Effective January 1, 2004,deleted text end new text begin (b) new text end The enhanced rates under this subdivision shall not
be allowed if a resident has resided during the previous 30 calendar days in:

(1) the same nursing facility;

(2) a nursing facility owned or operated by a related party; or

(3) a nursing facility or part of a facility that closed or was in the process of closing.

Minnesota Statutes 2010, section 256B.434, subdivision 4, is amended to read:

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

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

(c) A nursing facility's case mix payment rates for the second and subsequent years
of a facility's contract under this section are the previous rate year's contract payment
rates plus an inflation adjustment and, for facilities reimbursed under this section or
section 256B.431, an adjustment to include the cost of any increase in Health Department
licensing fees for the facility taking effect on or after July 1, 2001. The index for the
inflation adjustment must be based on the change in the Consumer Price Index-All Items
(United States City average) (CPI-U) forecasted by the commissioner of management and
budget's national economic consultant, as forecasted in the fourth quarter of the calendar
year preceding the rate year. The inflation adjustment must be based on the 12-month
period from the midpoint of the previous rate year to the midpoint of the rate year for
which the rate is being determined. For the rate years beginning on July 1, 1999, July 1,
2000, July 1, 2001, July 1, 2002, July 1, 2003, July 1, 2004, July 1, 2005, July 1, 2006,
July 1, 2007, July 1, 2008, October 1, 2009, new text begin and new text end October 1, 2010, deleted text begin October 1, 2011, and
October 1, 2012.deleted text end this paragraph shall apply only to the property-related payment ratedeleted text begin ,
except that adjustments to include the cost of any increase in Health Department licensing
fees taking effect on or after July 1, 2001, shall be provideddeleted text end .new text begin For the rate years beginning
on October 1, 2011, and October 1, 2012, the rate adjustment under this paragraph shall
be suspended.new text end Beginning in 2005, adjustment to the property payment rate under this
section and section 256B.431 shall be effective on October 1. In determining the amount
of the property-related payment rate adjustment under this paragraph, the commissioner
shall determine the proportion of the facility's rates that are property-related based on the
facility's most recent cost report.

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

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

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

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

(4) reduced acute care costs; and

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

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

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

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

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

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

Minnesota Statutes 2010, section 256B.437, subdivision 6, is amended to read:

(a) The commissioner of human
services shall calculate the amount of the planned closure rate adjustment available under
subdivision 3, paragraph (b), for up to 5,140 beds according to clauses (1) to (4):

(1) the amount available is the net reduction of nursing facility beds multiplied
by $2,080;

(2) the total number of beds in the nursing facility or facilities receiving the planned
closure rate adjustment must be identified;

(3) capacity days are determined by multiplying the number determined under
clause (2) by 365; and

(4) the planned closure rate adjustment is the amount available in clause (1), divided
by capacity days determined under clause (3).

(b) A planned closure rate adjustment under this section is effective on the first day
of the month following completion of closure of the facility designated for closure in the
application and becomes part of the nursing facility's total operating payment rate.

(c) Applicants may use the planned closure rate adjustment to allow for a property
payment for a new nursing facility or an addition to an existing nursing facility or as an
operating payment rate adjustment. Applications approved under this subdivision are
exempt from other requirements for moratorium exceptions under section 144A.073,
subdivisions 2 and 3.

(d) Upon the request of a closing facility, the commissioner must allow the facility a
closure rate adjustment as provided under section 144A.161, subdivision 10.

(e) A facility that has received a planned closure rate adjustment may reassign it
to another facility that is under the same ownership at any time within three years of its
effective date. The amount of the adjustment shall be computed according to paragraph (a).

(f) If the per bed dollar amount specified in paragraph (a), clause (1), is increased,
the commissioner shall recalculate planned closure rate adjustments for facilities that
delicense beds under this section on or after July 1, 2001, to reflect the increase in the per
bed dollar amount. The recalculated planned closure rate adjustment shall be effective
from the date the per bed dollar amount is increased.

(g) For planned closures approved after June 30, 2009, the commissioner of human
services shall calculate the amount of the planned closure rate adjustment available under
subdivision 3, paragraph (b), according to paragraph (a), clauses (1) to (4).

new text begin (h) Beginning July 16, 2011, the commissioner shall no longer accept applications
for planned closure rate adjustments under subdivision 3.
new text end

Minnesota Statutes 2010, section 256B.441, subdivision 50a, is amended to
read:

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

(1) determine the difference between the limits;

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

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

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

new text begin (b) Effective October 1, 2011, nursing facilities located no more than one-quarter
mile from a peer group with higher limits under either subdivision 50 or 51, may receive
an operating rate adjustment. The operating payment rates of a lower-limit peer group
facility must be adjusted to be equal to those of the nearest facility in a higher-limit peer
group if that facility's RUG rate with a weight of 1.00 is higher than the lower-limit peer
group facility. Peer groups are those defined in subdivision 30. The nearest facility must
be determined by the most direct driving route.
new text end

Minnesota Statutes 2010, section 256B.441, is amended by adding a
subdivision to read:

new text begin Effective October 1, 2011,
operating payment rates of all nursing facilities that are reimbursed under this section or
section 256B.434 shall be increased for a resource utilization group rate with a weight
of 1.00 by up to 2.45 percent, but not to exceed for the same resource utilization group
weight the rate of the facility at the 18th percentile of all nursing facilities in the state. The
percentage of the operating payment rate for each facility to be case-mix adjusted shall be
equal to the percentage that is case-mix adjusted in that facility's operating payment rate
on the preceding September 30.
new text end

Minnesota Statutes 2010, section 256B.48, subdivision 1, is amended to read:

A nursing facility is not eligible to receive
medical assistance payments unless it refrains from all of the followingdeleted text begin :deleted text end new text begin .
new text end

(a) Charging private paying residents rates for similar services which exceed those
which are approved by the state agency for medical assistance recipients as determined by
the prospective desk audit rate, except under the following circumstances:

new text begin (1) new text end the nursing facility maynew text begin :
new text end

deleted text begin (1)deleted text end new text begin (i)new text end charge private paying residents a higher rate for a private roomdeleted text begin ,deleted text end new text begin ;new text end and

deleted text begin (2)deleted text end new text begin (ii)new text end charge for special services which are not included in the daily rate if medical
assistance residents are charged separately at the same rate for the same services in
addition to the daily rate paid by the commissionernew text begin ;
new text end

new text begin (2) effective July 1, 2011, through September 30, 2012, nursing facilities may
charge private paying residents rates up to two percent higher than the allowable medical
assistance payment rate determined by the commissioner for the RUGS group currently
assigned to the resident; and
new text end

new text begin (3) effective for rate years beginning October 1, 2012, and after, nursing facilities
may charge private paying residents rates greater than the allowable medical assistance
payment rate determined by the commissioner for the RUGS group currently assigned
to the resident by up to two percent more than the differential in effect on the prior
September 30. Nothing in this section precludes a nursing facility from charging a rate
allowable under the facility's single room election option under Minnesota Rules, part
9549.0060, subpart 11, or the enhanced rates under section 256B.431, subdivision 32new text end .
Services covered by the payment rate must be the same regardless of payment source.
Special services, if offered, must be available to all residents in all areas of the nursing
facility and charged separately at the same rate. Residents are free to select or decline
special services. Special services must not include services which must be provided by
the nursing facility in order to comply with licensure or certification standards and that
if not provided would result in a deficiency or violation by the nursing facility. Services
beyond those required to comply with licensure or certification standards must not be
charged separately as a special service if they were included in the payment rate for the
previous reporting year. A nursing facility that charges a private paying resident a rate in
violation of this deleted text begin clausedeleted text end new text begin paragraphnew text end is subject to an action by the state of Minnesota or any of
its subdivisions or agencies for civil damages. A private paying resident or the resident's
legal representative has a cause of action for civil damages against a nursing facility that
charges the resident rates in violation of this deleted text begin clausedeleted text end new text begin paragraphnew text end . The damages awarded shall
include three times the payments that result from the violation, together with costs and
disbursements, including reasonable deleted text begin attorneys'deleted text end new text begin attorneynew text end fees or their equivalent. A private
paying resident or the resident's legal representative, the state, subdivision or agency, or a
nursing facility may request a hearing to determine the allowed rate or rates at issue in
the cause of action. Within 15 calendar days after receiving a request for such a hearing,
the commissioner shall request assignment of an administrative law judge under sections
14.48 to 14.56 to conduct the hearing as soon as possible or according to agreement by
the parties. The administrative law judge shall issue a report within 15 calendar days
following the close of the hearing. The prohibition set forth in this deleted text begin clausedeleted text end new text begin paragraphnew text end shall
not apply to facilities licensed as boarding care facilities which are not certified as skilled
or intermediate care facilities level I or II for reimbursement through medical assistance.

(b)(1) Charging, soliciting, accepting, or receiving from an applicant for admission
to the facility, or from anyone acting in behalf of the applicant, as a condition of admission,
expediting the admission, or as a requirement for the individual's continued stay, any fee,
deposit, gift, money, donation, or other consideration not otherwise required as payment
under the state plannew text begin . For residents on medical assistance, medical assistance payments
according to the state plan must be accepted as payment in full for continued stay, except
where otherwise provided for under statutenew text end ;

(2) requiring an individual, or anyone acting in behalf of the individual, to loan
any money to the nursing facility;

(3) requiring an individual, or anyone acting in behalf of the individual, to promise
to leave all or part of the individual's estate to the facility; or

(4) requiring a third-party guarantee of payment to the facility as a condition of
admission, expedited admission, or continued stay in the facility.

Nothing in this paragraph would prohibit discharge for nonpayment of services in
accordance with state and federal regulations.

(c) Requiring any resident of the nursing facility to utilize a vendor of health care
services chosen by the nursing facility. A nursing facility may require a resident to use
pharmacies that utilize unit dose packing systems approved by the Minnesota Board of
Pharmacy, and may require a resident to use pharmacies that are able to meet the federal
regulations for safe and timely administration of medications such as systems with specific
number of doses, prompt delivery of medications, or access to medications on a 24-hour
basis. Notwithstanding the provisions of this paragraph, nursing facilities shall not restrict
a resident's choice of pharmacy because the pharmacy utilizes a specific system of unit
dose drug packing.

(d) Providing differential treatment on the basis of status with regard to public
assistance.

(e) Discriminating in admissions, services offered, or room assignment on the
basis of status with regard to public assistance deleted text begin or refusal to purchase special servicesdeleted text end .
new text begin Discrimination in new text end admissions deleted text begin discriminationdeleted text end new text begin , services offered, or room assignmentnew text end shall
include, but is not limited to:

(1) basing admissions decisions upon deleted text begin assurance by the applicant to the nursing
facility, or the applicant's guardian or conservator, that the applicant is neither eligible for
nor will seekdeleted text end new text begin information or assurances regarding current or future eligibility fornew text end public
assistance for payment of nursing facility care deleted text begin costsdeleted text end ; and

(2) engaging in preferential selection from waiting lists based on an applicant's
ability to pay privately or an applicant's refusal to pay for a special service.

The collection and use by a nursing facility of financial information of any applicant
pursuant to a preadmission screening program established by law shall not raise an
inference that the nursing facility is utilizing that information for any purpose prohibited
by this paragraph.

(f) Requiring any vendor of medical care as defined by section 256B.02, subdivision
7, who is reimbursed by medical assistance under a separate fee schedule, to pay any
amount based on utilization or service levels or any portion of the vendor's fee to the
nursing facility except as payment for renting or leasing space or equipment or purchasing
support services from the nursing facility as limited by section 256B.433. All agreements
must be disclosed to the commissioner upon request of the commissioner. Nursing
facilities and vendors of ancillary services that are found to be in violation of this provision
shall each be subject to an action by the state of Minnesota or any of its subdivisions or
agencies for treble civil damages on the portion of the fee in excess of that allowed by
this provision and section 256B.433. Damages awarded must include three times the
excess payments together with costs and disbursements including reasonable attorney's
fees or their equivalent.

(g) Refusing, for more than 24 hours, to accept a resident returning to the same
bed or a bed certified for the same level of care, in accordance with a physician's order
authorizing transfer, after receiving inpatient hospital services.

new text begin (h) new text end For a period not to exceed 180 days, the commissioner may continue to make
medical assistance payments to a nursing facility or boarding care home which is in
violation of this section if extreme hardship to the residents would result. In these cases
the commissioner shall issue an order requiring the nursing facility to correct the violation.
The nursing facility shall have 20 days from its receipt of the order to correct the violation.
If the violation is not corrected within the 20-day period the commissioner may reduce
the payment rate to the nursing facility by up to 20 percent. The amount of the payment
rate reduction shall be related to the severity of the violation and shall remain in effect
until the violation is corrected. The nursing facility or boarding care home may appeal the
commissioner's action pursuant to the provisions of chapter 14 pertaining to contested
cases. An appeal shall be considered timely if written notice of appeal is received by the
commissioner within 20 days of notice of the commissioner's proposed action.

In the event that the commissioner determines that a nursing facility is not eligible
for reimbursement for a resident who is eligible for medical assistance, the commissioner
may authorize the nursing facility to receive reimbursement on a temporary basis until the
resident can be relocated to a participating nursing facility.

Certified beds in facilities which do not allow medical assistance intake on July 1,
1984, or after shall be deemed to be decertified for purposes of section 144A.071 only.

Minnesota Statutes 2010, section 256B.49, subdivision 13, is amended to read:

(a) Each recipient of a home and community-based
waiver new text begin under this section new text end shall be provided case management services new text begin according to
section 256B.092, subdivisions 1a, 1b, and 1e, new text end by qualified vendors as described in the
federally approved waiver application. deleted text begin The case management service activities provided
will include:
deleted text end

deleted text begin (1) assessing the needs of the individual within 20 working days of a recipient's
request;
deleted text end

deleted text begin (2) developing the written individual service plan within ten working days after the
assessment is completed;
deleted text end

deleted text begin (3) informing the recipient or the recipient's legal guardian or conservator of service
options;
deleted text end

deleted text begin (4) assisting the recipient in the identification of potential service providers;
deleted text end

deleted text begin (5) assisting the recipient to access services;
deleted text end

deleted text begin (6) coordinating, evaluating, and monitoring of the services identified in the service
plan;
deleted text end

deleted text begin (7) completing the annual reviews of the service plan; and
deleted text end

deleted text begin (8) informing the recipient or legal representative of the right to have assessments
completed and service plans developed within specified time periods, and to appeal county
action or inaction under section 256.045, subdivision 3, including the determination of
nursing facility level of care.
deleted text end

(b) The case manager may delegate certain aspects of the case management service
activities to another individual provided there is oversight by the case manager. The case
manager may not delegate those aspects which require professional judgment including
assessments, reassessments, and care plan development.

new text begin This section is effective January 1, 2012.
new text end

Minnesota Statutes 2010, section 256B.49, subdivision 14, is amended to read:

(a) Assessments of each recipient's
strengths, informal support systems, and need for services shall be completed within 20
working days of the recipient's requestnew text begin as provided in section 256B.0911new text end . Reassessment
of each recipient's strengths, support systems, and need for services shall be conducted
at least every 12 months and at other times when there has been a significant change in
the recipient's functioning.

(b) There must be a determination that the client requires a hospital level of care or a
nursing facility level of care as defined in section 144.0724, subdivision 11, at initial and
subsequent assessments to initiate and maintain participation in the waiver program.

(c) Regardless of other assessments identified in section 144.0724, subdivision 4, as
appropriate to determine nursing facility level of care for purposes of medical assistance
payment for nursing facility services, only face-to-face assessments conducted according
to section 256B.0911, subdivisions 3a, 3b, and 4d, that result in a hospital level of care
determination or a nursing facility level of care determination must be accepted for
purposes of initial and ongoing access to waiver services payment.

(d) Persons with developmental disabilities who apply for services under the nursing
facility level waiver programs shall be screened for the appropriate level of care according
to section 256B.092.

(e) Recipients who are found eligible for home and community-based services under
this section before their 65th birthday may remain eligible for these services after their
65th birthday if they continue to meet all other eligibility factors.

new text begin (f) The commissioner shall develop criteria to identify recipients whose level of
functioning is reasonably expected to improve and reassess these recipients to establish
a baseline assessment. Recipients who meet these criteria must have a comprehensive
transitional service plan developed under subdivision 15, paragraphs (b) and (c), and be
reassessed every six months until there has been no significant change in the recipient's
functioning for at least 12 months. After there has been no significant change in the
recipient's functioning for at least 12 months, reassessments of the recipient's strengths,
informal support systems, and need for services shall be conducted at least every 12
months and at other times when there has been a significant change in the recipient's
functioning. Counties, case managers, and service providers are responsible for conducting
these reassessments and shall complete the reassessments out of existing funds.
new text end

new text begin This section is effective January 1, 2012, except for paragraph
(f), which is effective July 1, 2013.
new text end

Minnesota Statutes 2010, section 256B.49, subdivision 15, is amended to read:

(a) Each recipient
of home and community-based waivered services shall be provided a copy of the written
deleted text begin servicedeleted text end new text begin coordinated services and supportnew text end plan deleted text begin which:deleted text end new text begin that complies with the requirements
of section 256B.092, subdivisions 1b and 1e.
new text end

deleted text begin (1) is developed and signed by the recipient within ten working days of the
completion of the assessment;
deleted text end

deleted text begin (2) meets the assessed needs of the recipient;
deleted text end

deleted text begin (3) reasonably ensures the health and safety of the recipient;
deleted text end

deleted text begin (4) promotes independence;
deleted text end

deleted text begin (5) allows for services to be provided in the most integrated settings; and
deleted text end

deleted text begin (6) provides for an informed choice, as defined in section 256B.77, subdivision 2,
paragraph (p), of service and support providers.
deleted text end

new text begin (b) In developing the comprehensive transitional service plan, the individual
receiving services, the case manager, and the guardian, if applicable, will identify
the transitional service plan fundamental service outcome and anticipated timeline to
achieve this outcome. Within the first 20 days following a recipient's request for an
assessment or reassessment, the transitional service planning team must be identified. A
team leader must be identified who will be responsible for assigning responsibility and
communicating with team members to ensure implementation of the transition plan and
ongoing assessment and communication process. The team leader should be an individual,
such as the case manager or guardian, who has the opportunity to follow the recipient to
the next level of service.
new text end

new text begin Within ten days following an assessment, a comprehensive transitional service plan
must be developed incorporating elements of a comprehensive functional assessment and
including short-term measurable outcomes and timelines for achievement of and reporting
on these outcomes. Functional milestones must also be identified and reported according
to the timelines agreed upon by the transitional service planning team. In addition, the
comprehensive transitional service plan must identify additional supports that may assist
in the achievement of the fundamental service outcome such as the development of greater
natural community support, increased collaboration among agencies, and technological
supports.
new text end

new text begin The timelines for reporting on functional milestones will prompt a reassessment of
services provided, the units of services, rates, and appropriate service providers. It is
the responsibility of the transitional service planning team leader to review functional
milestone reporting to determine if the milestones are consistent with observable skills
and that milestone achievement prompts any needed changes to the comprehensive
transitional service plan.
new text end

new text begin For those whose fundamental transitional service outcome involves the need to
procure housing, a plan for the recipient to seek the resources necessary to secure the least
restrictive housing possible should be incorporated into the plan, including employment
and public supports such as housing access and shelter needy funding.
new text end

new text begin (c) Counties and other agencies responsible for funding community placement and
ongoing community supportive services are responsible for the implementation of the
comprehensive transitional service plans. Oversight responsibilities include both ensuring
effective transitional service delivery and efficient utilization of funding resources.
new text end

new text begin (d) Following one year of transitional services, the transitional services planning
team will make a determination as to whether or not the individual receiving services
requires the current level of continuous and consistent support in order to maintain the
recipient's current level of functioning. Recipients who are determined to have not had
a significant change in functioning for 12 months must move from a transitional to a
maintenance service plan. Recipients on a maintenance service plan must be reassessed
to determine if the recipient would benefit from a transitional service plan at least every
12 months and at other times when there has been a significant change in the recipient's
functioning. This assessment should consider any changes to technological or natural
community supports.
new text end

deleted text begin (b)deleted text end new text begin (e)new text end When a county is evaluating denials, reductions, or terminations of home
and community-based services under section 256B.49 for an individual, the case manager
shall offer to meet with the individual or the individual's guardian in order to discuss the
prioritization of service needs within the individualized service plannew text begin , comprehensive
transitional service plan, or maintenance service plannew text end . The reduction in the authorized
services for an individual due to changes in funding for waivered services may not exceed
the amount needed to ensure medically necessary services to meet the individual's health,
safety, and welfare.

new text begin This section is effective January 1, 2012, except for
paragraphs (b), (c), and (d), which are effective July 1, 2013.
new text end

Minnesota Statutes 2010, section 256B.5012, is amended by adding a
subdivision to read:

new text begin Effective July 1, 2011, the commissioner shall
increase the daily rate to $138.23 at an intermediate care facility for the developmentally
disabled located in Clearwater County and classified as a class A facility with 15 beds.
new text end

new text begin This section is effective July 1, 2011.
new text end

Minnesota Statutes 2010, section 256B.5012, is amended by adding a
subdivision to read:

new text begin For each facility reimbursed under this
section, except for a facility located in Clearwater County and classified as a class A
facility with 15 beds, the commissioner shall decrease operating payment rates equal
to 0.095 percent of the operating payment rates in effect on June 30, 2011. For each
facility, the commissioner shall apply the rate reduction, based on occupied beds, using the
percentage specified in this subdivision multiplied by the total payment rate, including the
variable rate but excluding the property-related payment rate, in effect on the preceding
date. The total rate reduction shall include the adjustment provided in section 256B.501,
subdivision 12.
new text end

Minnesota Statutes 2010, section 256G.02, subdivision 6, is amended to read:

"Excluded time" means:

(a) any period an applicant spends in a hospital, sanitarium, nursing home, shelter
other than an emergency shelter, halfway house, foster home, semi-independent living
domicile or services program, residential facility offering care, board and lodging facility
or other institution for the hospitalization or care of human beings, as defined in section
144.50, 144A.01, or 245A.02, subdivision 14; maternity home, battered women's shelter,
or correctional facility; or any facility based on an emergency hold under sections
253B.05, subdivisions 1 and 2, and 253B.07, subdivision 6;

(b) any period an applicant spends on a placement basis in a training and habilitation
program, including a rehabilitation facility or work or employment program as defined
in section 268A.01; deleted text begin or receiving personal care assistance services pursuant to section
256B.0659;deleted text end semi-independent living services provided under section 252.275, and
Minnesota Rules, parts 9525.0500 to 9525.0660; new text begin ornew text end day training and habilitation programs
and assisted living services; and

new text begin This section is effective July 1, 2011.
new text end

Laws 2009, chapter 79, article 13, section 3, subdivision 8, as amended by
Laws 2009, chapter 173, article 2, section 1, subdivision 8, and Laws 2010, First Special
Session chapter 1, article 15, section 5, and article 25, section 16, is amended to read:

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

(a) Aging and Adult Services Grants

13,499,000

15,805,000

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
$260,000 for fiscal year 2010; $284,000 in
fiscal year 2011; $43,000 in fiscal year 2012;
and $43,000 in fiscal year 2013. Base level
funding shall be restored in fiscal year 2014.

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.

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.

367,444,000

419,749,000

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

853,567,000

1,039,517,000

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.

deleted text begin 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.
deleted text end

(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 placements beginning during fiscal years
2010 and 2011, county-negotiated rates and
provider claims to the consolidated chemical
dependency fund must not exceed the lesser
of:

(1) rates charged for these services on
January 1, 2009; or

(2) 160 percent of the average rate on January
1, 2009, for each group of vendors with
similar attributes.

Rates for fiscal years 2010 and 2011 must
not exceed 160 percent of the average rate on
January 1, 2009, for each group of vendors
with similar attributes.

Effective July 1, 2010, rates that were above
the average rate on January 1, 2009, are
reduced by five percent from the rates in
effect on June 1, 2010. Rates below the
average rate on January 1, 2009, are reduced
by 1.8 percent from the rates in effect on
June 1, 2010. Services provided under
this section by state-operated services are
exempt from the rate reduction. For services
provided in fiscal years 2012 and 2013, the
statewide aggregate payment under the new
rate methodology to be developed under
Minnesota Statutes, section 254B.12, must
not exceed the projected aggregate payment
under the rates in effect for fiscal year 2011
excluding the rate reduction for rates that
were below the average on January 1, 2009,
plus a state share increase of $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 October 1, 2008,
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. This provision is effective the day
following final enactment.

(h) Chemical Dependency Nonentitlement
Grants

1,729,000

(i) Other Continuing Care Grants

19,201,000

17,528,000

Base Adjustment. The general fund base is
increased by $2,639,000 in fiscal year 2012
and increased by $3,854,000 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.

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

new text begin By January 1, 2012, the commissioner shall establish rates to begin paying for
in-home services and personal supports under all of the home and community-based
waiver services programs consistent with the standards in Minnesota Statutes, section
256B.4912, subdivision 2.
new text end

new text begin By July 1, 2012, the commissioner shall establish the rate to be paid for case
management services under Minnesota Statutes, sections 256B.0621, subdivision 2, clause
(4), 256B.092, and 256B.49, consistent with the standards in Minnesota Statutes, section
256B.4912, subdivision 2.
new text end

new text begin By February 1, 2012, the commissioner of human services shall develop a legislative
report with specific recommendations and language for proposed legislation to be effective
July 1, 2012, for the following:
new text end

new text begin (1) definitions of service and consolidation of standards and rates to the extent
appropriate for all types of medical assistance case management services, including
targeted case management under Minnesota Statutes, sections 256B.0621; 256B.0625,
subdivision 20; and 256B.0924; mental health case management services for children
and adults, all types of home and community-based waiver case management, and case
management under Minnesota Rules, parts 9525.0004 to 9525.0036. This work shall be
completed in collaboration with efforts under Minnesota Statutes, section 256B.4912;
new text end

new text begin (2) recommendations on county of financial responsibility requirements and quality
assurance measures for case management;
new text end

new text begin (3) identification of county administrative functions that may remain entwined in
case management service delivery models; and
new text end

new text begin (4) implementation of a methodology to fully fund county case management
administrative functions.
new text end

new text begin The My Life, My Choices Task Force is established
to create a system of supports and services for people with disabilities governed by the
following principles:
new text end

new text begin (1) freedom to act as a consumer of services in the marketplace;
new text end

new text begin (2) freedom to choose to take as much risk as any other citizen;
new text end

new text begin (3) more choices in levels of service that may vary throughout life;
new text end

new text begin (4) opportunity to work with a trusted advocate and fiscal support entity to manage a
personal budget and to be accountable for reporting spending and personal outcomes;
new text end

new text begin (5) opportunity to live with minimal constraints instead of minimal freedoms; and
new text end

new text begin (6) ability to consolidate funding streams into an individualized budget.
new text end

new text begin The My Life, My Choices Task Force shall consist of:
new text end

new text begin (1) the lieutenant governor;
new text end

new text begin (2) the commissioner of human services, or the commissioner's designee;
new text end

new text begin (3) a representative of the Minnesota Chamber of Commerce;
new text end

new text begin (4) a county representative appointed by the Association of Minnesota Counties;
new text end

new text begin (5) seven members appointed by the governor as follows: one administrative law
judge, one labor representative, two family members of people with disabilities, and three
individual members with different disabilities;
new text end

new text begin (6) two members appointed by the speaker of the house as follows: a representative
of a disability advocacy organization, and a representative of a disability legal services
advocacy organization; and
new text end

new text begin (7) three members appointed by the majority leader of the senate, including two
representatives from nonprofit organizations, one of which serves all 87 counties and
one that serves persons with disabilities and employs fewer than 50 people, and a
representative of a philanthropic organization.
new text end

new text begin Appointed nongovernmental members of the task force shall serve as staff for the
task force and take on responsibilities of coordinating meetings, reporting on committee
recommendations, and providing other staff support as needed to meet the responsibilities
of the task force as described in subdivision 3. The chairs and ranking minority members
of the legislative committees with jurisdiction over health and human services policy and
finance shall serve as ex officio members.
new text end

new text begin The task force shall make recommendations, including proposed
legislation, and report to the legislative committees with jurisdiction over health and
human services policy and finance by November 15, 2011, on creating a system of
supports and services for people with disabilities by July 1, 2012, as governed by the
principles under subdivision 1. In making recommendations and proposed legislation, the
council shall work in conjunction with the Consumer-Directed Community Supports Task
Force and shall include self-directed planning, individual budgeting, choice of trusted
partner, self-directed purchasing of services and supports, reporting of outcomes, ability to
share in any savings, and any additional rules or laws that may need to be waived.
new text end

new text begin The members of the task force shall not be
reimbursed by the state for expenses related to the duties of the task force. The task force
shall be independently staffed and coordinated by nongovernmental appointees who
serve on the task force, and no state dollars shall be appropriated for expenses related to
the task force under this section.
new text end

new text begin The task force expires on July 1, 2013.
new text end

new text begin This section is effective the day following final enactment.
new text end

new text begin The Office of Ombudsman for Long-Term Care shall develop a work group to
address issues about, but not limited to: housing with services fees, staffing, and quality
assurance. The work group shall include, but not be limited to: consumers, relatives of
consumers, advocates, and providers. The Office of Ombudsman for Long-Term Care
shall present a report with recommendations related to housing with services fees, staffing,
and quality assurance to the legislative committees with jurisdiction over health and
human services policy and finance by January 15, 2012.
new text end

new text begin Counties must inform individuals who have had a level of service reduction of
their right to request an informal review conference with their case worker and any other
relevant county staff.
new text end

new text begin The commissioner of human services, in consultation with
the commissioner of health, stakeholders, and experts, shall provide to the legislature
recommendations by November 15, 2011, on how to develop a project to demonstrate a
new approach to caring for certain individuals in nursing facilities.
new text end

new text begin The recommendations shall address the:
new text end

new text begin (1) nature of the demonstration in terms of timing, size, qualifications to participate,
participation selection criteria and postdemonstration options for the demonstration and
for participating facilities;
new text end

new text begin (2) nature of needed new form of licensure;
new text end

new text begin (3) characteristics of the individuals the new model is intended to serve and
comparison of these characteristics with those individuals served by existing models of
care;
new text end

new text begin (4) quality standards for licensure addressing management, types and amounts of
staffing, safety, infection control, care processes, quality improvement, and resident rights;
new text end

new text begin (5) characteristics of inspection process;
new text end

new text begin (6) funding for inspection process;
new text end

new text begin (7) enforcement authorities;
new text end

new text begin (8) role of Medicare;
new text end

new text begin (9) participation in the elderly waiver program, including rate setting;
new text end

new text begin (10) nature of any federal approval or waiver requirements and the method and
timing of obtaining them;
new text end

new text begin (11) consumer rights; and
new text end

new text begin (12) methods and resources needed to evaluate the effectiveness of the model with
regards to cost and quality.
new text end

Minnesota Statutes 2010, section 246B.10, is amended to read:

The civilly committed sex offender's county shall pay to the state a portion of the
cost of care provided in the Minnesota sex offender program to a civilly committed sex
offender who has legally settled in that county. A county's payment must be made from
the county's own sources of revenue and payments must equal deleted text begin tendeleted text end new text begin 25new text end percent of the cost of
care, as determined by the commissioner, for each day or portion of a day, that the civilly
committed sex offender spends at the facility. If payments received by the state under this
chapter exceed deleted text begin 90deleted text end new text begin 75new text end percent of the cost of care, the county is responsible for paying the
state the remaining amount. The county is not entitled to reimbursement from the civilly
committed sex offender, the civilly committed sex offender's estate, or from the civilly
committed sex offender's relatives, except as provided in section 246B.07.

new text begin This section is effective for all individuals who are civilly
committed to the Minnesota sex offender program on or after August 1, 2011.
new text end

Minnesota Statutes 2010, section 252.025, subdivision 7, is amended to read:

The commissioner shall develop
by July 1, 1997, the Minnesota extended treatment options to serve Minnesotans who
have developmental disabilities and exhibit severe behaviors which present a risk to
public safety. This program is statewide and must provide specialized residential services
in Cambridge and an array of community-based services with sufficient levels of care
and a sufficient number of specialists to ensure that individuals referred to the program
receive the appropriate care. The individuals working in the community-based services
under this section are state employees supervised by the commissioner of human services.
No new text begin midcontract new text end layoffs shall occur as a result of restructuring under this sectionnew text begin , but
layoffs may occur as a normal consequence of a low census or closure of the facility
due to decreased censusnew text end .

Minnesota Statutes 2010, section 253B.212, is amended to read:

The commissioner of human services may contract with
and receive payment from the Indian Health Service of the United States Department of
Health and Human Services for the care and treatment of those members of the Red
Lake Band of Chippewa Indians who have been committed by tribal court order to the
Indian Health Service for care and treatment of mental illness, developmental disability, or
chemical dependency. The contract shall provide that the Indian Health Service may not
transfer any person for admission to a regional center unless the commitment procedure
utilized by the tribal court provided due process protections similar to those afforded
by sections 253B.05 to 253B.10.

new text begin The commissioner of human services may contract with and receive
payment from the Indian Health Service of the United States Department of Health and
Human Services for the care and treatment of those members of the White Earth Band
of Ojibwe Indians who have been committed by tribal court order to the Indian Health
Service for care and treatment of mental illness, developmental disability, or chemical
dependency. The tribe may also contract directly with the commissioner for treatment
of those members of the White Earth Band who have been committed by tribal court
order to the White Earth Department of Health for care and treatment of mental illness,
developmental disability, or chemical dependency. The contract shall provide that the
Indian Health Service and the White Earth Band shall not transfer any person for admission
to a regional center unless the commitment procedure utilized by the tribal court provided
due process protections similar to those afforded by sections 253B.05 to 253B.10.
new text end

When, under an agreement
entered into pursuant to deleted text begin subdivision 1deleted text end new text begin subdivisions 1 or 1anew text end , the Indian Health Service
applies to a regional center for admission of a person committed to the jurisdiction of the
health service by the tribal court as a person who is mentally ill, developmentally disabled,
or chemically dependent, the commissioner may treat the patient with the consent of
the Indian Health Service.

A person admitted to a regional center pursuant to this section has all the rights
accorded by section 253B.03. In addition, treatment reports, prepared in accordance with
the requirements of section 253B.12, subdivision 1, shall be filed with the Indian Health
Service within 60 days of commencement of the patient's stay at the facility. A subsequent
treatment report shall be filed with the Indian Health Service within six months of the
patient's admission to the facility or prior to discharge, whichever comes first. Provisional
discharge or transfer of the patient may be authorized by the head of the treatment facility
only with the consent of the Indian Health Service. Discharge from the facility to the
Indian Health Service may be authorized by the head of the treatment facility after notice
to and consultation with the Indian Health Service.

Minnesota Statutes 2010, section 254B.03, subdivision 1, is amended to read:

(a) Every local agency shall provide chemical
dependency services to persons residing within its jurisdiction who meet criteria
established by the commissioner for placement in a chemical dependency residential
or nonresidential treatment servicenew text begin subject to the limitations on residential chemical
dependency treatment in section 254B.04, subdivision 1new text end . Chemical dependency money
must be administered by the local agencies according to law and rules adopted by the
commissioner under sections 14.001 to 14.69.

(b) In order to contain costs, the commissioner of human services shall select eligible
vendors of chemical dependency services who can provide economical and appropriate
treatment. Unless the local agency is a social services department directly administered by
a county or human services board, the local agency shall not be an eligible vendor under
section 254B.05. The commissioner may approve proposals from county boards to provide
services in an economical manner or to control utilization, with safeguards to ensure that
necessary services are provided. If a county implements a demonstration or experimental
medical services funding plan, the commissioner shall transfer the money as appropriate.

(c) A culturally specific vendor that provides assessments under a variance under
Minnesota Rules, part 9530.6610, shall be allowed to provide assessment services to
persons not covered by the variance.

Minnesota Statutes 2010, section 254B.03, subdivision 4, is amended to read:

Except for services provided by a county under
section 254B.09, subdivision 1, or services provided under section 256B.69 or 256D.03,
subdivision 4, paragraph (b), the county shall, out of local money, pay the state for
deleted text begin 16.14deleted text end new text begin 22.95new text end percent of the cost of chemical dependency services, including those services
provided to persons eligible for medical assistance under chapter 256B and general
assistance medical care under chapter 256D. Counties may use the indigent hospitalization
levy for treatment and hospital payments made under this section. deleted text begin 16.14deleted text end new text begin 22.95new text end percent
of any state collections from private or third-party pay, less 15 percent for the cost of
payment and collections, must be distributed to the county that paid for a portion of the
treatment under this section.

new text begin This section is effective for claims processed beginning
July 1, 2011.
new text end

Minnesota Statutes 2010, section 254B.04, subdivision 1, is amended to read:

(a) Persons eligible for benefits under Code of Federal
Regulations, title 25, part 20, persons eligible for medical assistance benefits under
sections 256B.055, 256B.056, and 256B.057, subdivisions 1, 2, 5, and 6, or who meet
the income standards of section 256B.056, subdivision 4, and persons eligible for general
assistance medical care under section 256D.03, subdivision 3, are entitled to chemical
dependency fund servicesnew text begin subject to the following limitations: (1) no more than three
residential chemical dependency treatment episodes for the same person in a four-year
period of time unless the person meets the criteria established by the commissioner of
human services; and (2) no more than four residential chemical dependency treatment
episodes in a lifetime unless the person meets the criteria established by the commissioner
of human services. For purposes of this section, "episode" means a span of treatment
without interruption of 30 days or morenew text end . State money appropriated for this paragraph must
be placed in a separate account established for this purpose.

Persons with dependent children who are determined to be in need of chemical
dependency treatment pursuant to an assessment under section 626.556, subdivision 10, or
a case plan under section 260C.201, subdivision 6, or 260C.212, shall be assisted by the
local agency to access needed treatment services. Treatment services must be appropriate
for the individual or family, which may include long-term care treatment or treatment in a
facility that allows the dependent children to stay in the treatment facility. The county
shall pay for out-of-home placement costs, if applicable.

(b) A person not entitled to services under paragraph (a), but with family income
that is less than 215 percent of the federal poverty guidelines for the applicable family
size, shall be eligible to receive chemical dependency fund services within the limit
of funds appropriated for this group for the fiscal year. If notified by the state agency
of limited funds, a county must give preferential treatment to persons with dependent
children who are in need of chemical dependency treatment pursuant to an assessment
under section 626.556, subdivision 10, or a case plan under section 260C.201, subdivision
6, or 260C.212. A county may spend money from its own sources to serve persons under
this paragraph. State money appropriated for this paragraph must be placed in a separate
account established for this purpose.

(c) Persons whose income is between 215 percent and 412 percent of the federal
poverty guidelines for the applicable family size shall be eligible for chemical dependency
services on a sliding fee basis, within the limit of funds appropriated for this group for the
fiscal year. Persons eligible under this paragraph must contribute to the cost of services
according to the sliding fee scale established under subdivision 3. A county may spend
money from its own sources to provide services to persons under this paragraph. State
money appropriated for this paragraph must be placed in a separate account established
for this purpose.

new text begin This section is effective for all chemical dependency
residential treatment beginning on or after July 1, 2011.
new text end

Minnesota Statutes 2010, section 254B.04, is amended by adding a subdivision
to read:

new text begin Notwithstanding
provisions of Minnesota Rules, part 9530.6622, subparts 5 and 6, related to an assessor's
discretion in making placements to residential treatment settings, a person eligible for
services under this section must score at level 4 on assessment dimensions related to
relapse, continued use, and recovery environment in order to be assigned to services with
a room and board component reimbursed under this section.
new text end

Minnesota Statutes 2010, section 254B.06, subdivision 2, is amended to read:

The commissioner shall allocate all federal
financial participation collections to a special revenue account. The commissioner shall
allocate deleted text begin 83.86deleted text end new text begin 77.05new text end percent of patient payments and third-party payments to the special
revenue account and deleted text begin 16.14deleted text end new text begin 22.95new text end percent to the county financially responsible for the
patient.

new text begin This section is effective for claims processed beginning
July 1, 2011.
new text end

Minnesota Statutes 2010, section 256B.0625, subdivision 41, is amended to
read:

Medical assistance covers rehabilitative services in accordance with section 256B.0945
that are provided by a countynew text begin or an American Indian tribenew text end through a residential facility,
for children who have been diagnosed with severe emotional disturbance and have been
determined to require the level of care provided in a residential facility.

new text begin This section is effective October 1, 2011.
new text end

Minnesota Statutes 2010, section 256B.0945, subdivision 4, is amended to
read:

(a) Notwithstanding sections 256B.19 and 256B.041,
payments to counties for residential services provided by a residential facility shall only
be made of federal earnings for services provided under this section, and the nonfederal
share of costs for services provided under this section shall be paid by the county from
sources other than federal funds or funds used to match other federal funds. Payment to
counties for services provided according to this section shall be a proportion of the per
day contract rate that relates to rehabilitative mental health services and shall not include
payment for costs or services that are billed to the IV-E program as room and board.

(b) Per diem rates paid to providers under this section by prepaid plans shall be
the proportion of the per-day contract rate that relates to rehabilitative mental health
services and shall not include payment for group foster care costs or services that are
billed to the county of financial responsibility. Services provided in facilities located in
bordering states are eligible for reimbursement on a fee-for-service basis only as described
in paragraph (a) and are not covered under prepaid health plans.

(c) new text begin Payment for mental health rehabilitative services provided under this section by
or under contract with an American Indian tribe or tribal organization or by agencies
operated by or under contract with an American Indian tribe or tribal organization must
be made according to section 256B.0625, subdivision 34, or other relevant federally
approved rate-setting methodology.
new text end

new text begin (d) new text end The commissioner shall set aside a portion not to exceed five percent of the
federal funds earned for county expenditures under this section to cover the state costs of
administering this section. Any unexpended funds from the set-aside shall be distributed
to the counties in proportion to their earnings under this section.

new text begin This section is effective October 1, 2011.
new text end

new text begin The commissioner shall issue a written report to the chairs and ranking minority
members of the house and senate committees with jurisdiction of health and human
services by December 31, 2011, on how the community behavioral health hospital
facilities will be fully utilized to meet the mental health needs of regions in which the
hospitals are located. The commissioner must consult with the regional planning work
groups for adult mental health and must include the recommendations of the work groups
in the legislative report. The report must address future use of community behavioral
health hospitals that are not certified as Medicaid eligible by CMS or have a less than 65
percent licensed bed occupancy rate, and using the facilities for another purpose that will
meet the mental health needs of residents of the region. The regional planning work
groups shall work with the commissioner to prioritize the needs of their regions. These
priorities, by region, must be included in the commissioner's report to the legislature.
new text end

new text begin (a) The commissioner shall require individuals who perform chemical dependency
assessments or mental health diagnostic assessments to use screening tools approved
by the commissioner in order to identify whether an individual who is the subject of
the assessment screens positive for co-occurring mental health or chemical dependency
disorders. Screening for co-occurring disorders must begin no later than December 31,
2011.
new text end

new text begin (b) The commissioner shall adopt rules as necessary to implement this section. The
commissioner shall ensure that the rules are effective on July 1, 2013, thereby establishing
a certification process for integrated dual disorder treatment providers and a system
through which individuals receive integrated dual diagnosis treatment if assessed as having
both a substance use disorder and either a serious mental illness or emotional disturbance.
new text end

new text begin (c) The commissioner shall apply for any federal waivers necessary to secure, to the
extent allowed by law, federal financial participation for the provision of integrated dual
diagnosis treatment to persons with co-occurring disorders.
new text end

new text begin The commissioner shall issue a report to the legislative committees with jurisdiction
over health and human services finance no later than December 31, 2011, which provides
the number of employees in management positions at the Anoka-Metro Regional
Treatment Center and the Minnesota Security Hospital at St. Peter and the ratio of
management to direct-care staff for each facility.
new text end

new text begin The commissioner shall develop specific criteria to approve treatment for individuals
who require residential chemical dependency treatment in excess of the maximum allowed
in section 254B.04, subdivision 1, due to co-occurring disorders, including disorders
related to cognition, traumatic brain injury, or documented disability. Criteria shall be
developed for use no later than October 1, 2011.
new text end

new text begin Laws 2009, chapter 79, article 3, section 18, as amended by Laws 2010, First Special
Session chapter 1, article 19, section 19, new text end new text begin is repealed.
new text end

Minnesota Statutes 2010, section 256.01, subdivision 14, is amended to read:

The commissioner of human services
shall encourage local reforms in the delivery of child welfare servicesnew text begin , within available
appropriations,new text end and is authorized to approve local pilot programs which focus on reforming
the child protection and child welfare systems in Minnesota. Authority to approve pilots
includes authority to waive existing state rules as needed to accomplish reform efforts.
Notwithstanding section 626.556, subdivision 10, 10b, or 10d, the commissioner may
authorize programs to use alternative methods of investigating and assessing reports of
child maltreatment, provided that the programs comply with the provisions of section
626.556 dealing with the rights of individuals who are subjects of reports or investigations,
including notice and appeal rights and data practices requirements. Pilot programs must
be required to address responsibility for safety and protection of children, be time limited,
and include evaluation of the pilot program.

Minnesota Statutes 2010, section 256.01, subdivision 14b, is amended to read:

(a) The commissioner of
human services may authorize projects to test tribal delivery of child welfare services to
American Indian children and their parents and custodians living on the reservation.
The commissioner has authority to solicit and determine which tribes may participate
in a project. Grants may be issued to Minnesota Indian tribes to support the projects.
The commissioner may waive existing state rules as needed to accomplish the projects.
Notwithstanding section 626.556, the commissioner may authorize projects to use
alternative methods of investigating and assessing reports of child maltreatment, provided
that the projects comply with the provisions of section 626.556 dealing with the rights
of individuals who are subjects of reports or investigations, including notice and appeal
rights and data practices requirements. The commissioner may seek any federal approvals
necessary to carry out the projects as well as seek and use any funds available to the
commissioner, including use of federal funds, foundation funds, existing grant funds,
and other funds. The commissioner is authorized to advance state funds as necessary to
operate the projects. Federal reimbursement applicable to the projects is appropriated
to the commissioner for the purposes of the projects. The projects must be required to
address responsibility for safety, permanency, and well-being of children.

(b) For the purposes of this section, "American Indian child" means a person under
18 years of age who is a tribal member or eligible for membership in one of the tribes
chosen for a project under this subdivision and who is residing on the reservation of
that tribe.

(1) be one of the existing tribes with reservation land in Minnesota;

(2) have a tribal court with jurisdiction over child custody proceedings;

(3) have a substantial number of children for whom determinations of maltreatment
have occurred;

(4) have capacity to respond to reports of abuse and neglect under section 626.556;

(5) provide a wide range of services to families in need of child welfare services; and

(6) have a tribal-state title IV-E agreement in effect.

(d) Grants awarded under this section may be used for the nonfederal costs of
providing child welfare services to American Indian children on the tribe's reservation,
including costs associated with:

(1) assessment and prevention of child abuse and neglect;

(2) family preservation;

(3) facilitative, supportive, and reunification services;

(4) out-of-home placement for children removed from the home for child protective
purposes; and

(5) other activities and services approved by the commissioner that further the goals
of providing safety, permanency, and well-being of American Indian children.

(e) When a tribe has initiated a project and has been approved by the commissioner
to assume child welfare responsibilities for American Indian children of that tribe under
this section, the affected county social service agency is relieved of responsibility for
responding to reports of abuse and neglect under section 626.556 for those children
during the time within which the tribal project is in effect and funded. The commissioner
shall work with tribes and affected counties to develop procedures for data collection,
evaluation, and clarification of ongoing role and financial responsibilities of the county
and tribe for child welfare services prior to initiation of the project. Children who have not
been identified by the tribe as participating in the project shall remain the responsibility
of the county. Nothing in this section shall alter responsibilities of the county for law
enforcement or court services.

(f) Participating tribes may conduct children's mental health screenings under section
245.4874, subdivision 1, paragraph (a), clause (14), for children who are eligible for the
initiative and living on the reservation and who meet one of the following criteria:

(1) the child must be receiving child protective services;

(2) the child must be in foster care; or

(3) the child's parents must have had parental rights suspended or terminated.

Tribes may access reimbursement from available state funds for conducting the screenings.
Nothing in this section shall alter responsibilities of the county for providing services
under section 245.487.

(g) Participating tribes may establish a local child mortality review panel. In
establishing a local child mortality review panel, the tribe agrees to conduct local child
mortality reviews for child deaths or near-fatalities occurring on the reservation under
subdivision 12. Tribes with established child mortality review panels shall have access
to nonpublic data and shall protect nonpublic data under subdivision 12, paragraphs (c)
to (e). The tribe shall provide written notice to the commissioner and affected counties
when a local child mortality review panel has been established and shall provide data upon
request of the commissioner for purposes of sharing nonpublic data with members of the
state child mortality review panel in connection to an individual case.

(h) The commissioner shall collect information on outcomes relating to child safety,
permanency, and well-being of American Indian children who are served in the projects.
Participating tribes must provide information to the state in a format and completeness
deemed acceptable by the state to meet state and federal reporting requirements.

new text begin (i) In consultation with the White Earth Band, the commissioner shall develop
and submit to the chairs and ranking minority members of the legislative committees
with jurisdiction over health and human services a plan to transfer legal responsibility
for providing child protective services to White Earth Band member children residing in
Hennepin County to the White Earth Band. The plan shall include a financing proposal,
definitions of key terms, statutory amendments required, and other provisions required to
implement the plan. The commissioner shall submit the plan by January 15, 2012.
new text end

Minnesota Statutes 2010, section 256B.69, is amended by adding a subdivision
to read:

new text begin (a) For the
purposes of this subdivision, "alternative format" means a medium other than paper and
"prepaid health plan" means managed care plans and county-based purchasing plans.
new text end

new text begin (b) A prepaid health plan may provide in an alternative format a provider directory
and certificate of coverage, or materials otherwise required to be available in writing
under Code of Federal Regulations, title 42, section 438.10, or under the commissioner's
contract with the prepaid health plan, if the following conditions are met:
new text end

new text begin (1) the prepaid health plan, local agency, or commissioner, as applicable, informs the
enrollee that:
new text end

new text begin (i) an alternative format is available and the enrollee affirmatively requests of
the prepaid health plan that the provider directory, certificate of coverage, or materials
otherwise required under Code of Federal Regulations, title 42, section 438.10, or under
the commissioner's contract with the prepaid health plan be provided in an alternative
format; and
new text end

new text begin (ii) a record of the enrollee request is retained by the prepaid health plan in the
form of written direction from the enrollee or a documented telephone call followed by a
confirmation letter to the enrollee from the prepaid health plan that explains that the
enrollee may change the request at any time;
new text end

new text begin (2) the materials are sent to a secure electronic mailbox and are made available at a
password-protected secure electronic Web site or on a data storage device if the materials
contain enrollee data that is individually identifiable;
new text end

new text begin (3) the enrollee is provided a customer service number on the enrollee's membership
card that may be called to request a paper version of the materials provided in an
alternative format; and
new text end

new text begin (4) the materials provided in an alternative format meets all other requirements of
the commissioner regarding content, size of the typeface, and any required time frames
for distribution. "Required time frames for distribution" must permit sufficient time for
prepaid health plans to distribute materials in alternative formats upon receipt of enrollees'
requests for the materials.
new text end

new text begin (c) A prepaid health plan may provide in an alternative format its primary care
network list to the commissioner and to local agencies within its service area. The
commissioner or local agency, as applicable, shall inform a potential enrollee of the
availability of a prepaid health plan's primary care network list in an alternative format. If
the potential enrollee requests an alternative format of the prepaid health plan's primary
care network list, a record of that request shall be retained by the commissioner or local
agency. The potential enrollee is permitted to withdraw the request at any time.
new text end

new text begin The prepaid health plan shall submit sufficient paper versions of the primary
care network list to the commissioner and to local agencies within its service area to
accommodate potential enrollee requests for paper versions of the primary care network
list.
new text end

new text begin (d) A prepaid health plan may provide in an alternative format materials otherwise
required to be available in writing under Code of Federal Regulations, title 42, section
438.10, or under the commissioner's contract with the prepaid health plan, if the conditions
of paragraphs (b), (c), and (e), are met for persons who are eligible for enrollment in
managed care.
new text end

new text begin (e) The commissioner shall seek any federal Medicaid waivers within 90 days after
the effective date of this subdivision that are necessary to provide alternative formats of
required material to enrollees of prepaid health plans as authorized under this subdivision.
new text end

new text begin (f) The commissioner shall consult with managed care plans, county-based
purchasing plans, counties, and other interested parties to determine how materials
required to be made available to enrollees under Code of Federal Regulations, title 42,
section 438.10, or under the commissioner's contract with a prepaid health plan may
be provided in an alternative format on the basis that the enrollee has not opted in to
receive the alternative format. The commissioner shall consult with managed care
plans, county-based purchasing plans, counties, and other interested parties to develop
recommendations relating to the conditions that must be met for an opt-out process
to be granted.
new text end

Minnesota Statutes 2010, section 256D.09, subdivision 6, is amended to read:

(a) If an amount of general assistance or
family general assistance is paid to a recipient in excess of the payment due, it shall be
recoverable by the county agency. The agency shall give written notice to the recipient of
its intention to recover the overpayment.

(b) new text begin Except as provided for interim assistance in section 256D.06, subdivision
5, new text end when an overpayment occurs, the county agency shall recover the overpayment
from a current recipient by reducing the amount of aid payable to the assistance unit of
which the recipient is a member, for one or more monthly assistance payments, until
the overpayment is repaid. All county agencies in the state shall reduce the assistance
payment by three percent of the assistance unit's standard of need in nonfraud cases and
ten percent where fraud has occurred, or the amount of the monthly payment, whichever is
less, for all overpayments.

(c) In cases when there is both an overpayment and underpayment, the county
agency shall offset one against the other in correcting the payment.

(d) Overpayments may also be voluntarily repaid, in part or in full, by the individual,
in addition to the aid reductions provided in this subdivision, to include further voluntary
reductions in the grant level agreed to in writing by the individual, until the total amount
of the overpayment is repaid.

(e) The county agency shall make reasonable efforts to recover overpayments to
persons no longer on assistance under standards adopted in rule by the commissioner
of human services. The county agency need not attempt to recover overpayments of
less than $35 paid to an individual no longer on assistance if the individual does not
receive assistance again within three years, unless the individual has been convicted of
violating section 256.98.

new text begin (f) Establishment of an overpayment is limited to 12 months prior to the month of
discovery due to agency error and six years prior to the month of discovery due to client
error or an intentional program violation determined under section 256.046.
new text end

Minnesota Statutes 2010, section 256D.49, subdivision 3, is amended to read:

new text begin (a) new text end When
the county agency determines that an overpayment of the recipient's monthly payment
of Minnesota supplemental aid has occurred, it shall issue a notice of overpayment
to the recipient. If the person is no longer receiving Minnesota supplemental aid, the
county agency may request voluntary repayment or pursue civil recovery. If the person is
receiving Minnesota supplemental aid, the county agency shall recover the overpayment
by withholding an amount equal to three percent of the standard of assistance for the
recipient or the total amount of the monthly grant, whichever is less.

new text begin (b) Establishment of an overpayment is limited to 12 months from the date of
discovery due to agency error. Establishment of an overpayment is limited to six years
prior to the month of discovery due to client error or an intentional program violation
determined under section 256.046.
new text end

new text begin (c) new text end For recipients receiving benefits via electronic benefit transfer, if the overpayment
is a result of an automated teller machine (ATM) dispensing funds in error to the recipient,
the agency may recover the ATM error by immediately withdrawing funds from the
recipient's electronic benefit transfer account, up to the amount of the error.

new text begin (d) new text end Residents of deleted text begin nursing homes, regional treatment centers, anddeleted text end new text begin licensed residential
new text end facilities deleted text begin with negotiated ratesdeleted text end shall not have overpayments recovered from their personal
needs allowance.

Minnesota Statutes 2010, section 256J.38, subdivision 1, is amended to read:

new text begin (a) new text end When a participant or former participant
receives an overpayment due to agency, client, or ATM error, or due to assistance received
while an appeal is pending and the participant or former participant is determined
ineligible for assistance or for less assistance than was received, the county agency must
recoup or recover the overpayment using the following methods:

(1) reconstruct each affected budget month and corresponding payment month;

(2) use the policies and procedures that were in effect for the payment month; and

(3) do not allow employment disregards in section 256J.21, subdivision 3 or 4, in the
calculation of the overpayment when the unit has not reported within two calendar months
following the end of the month in which the income was received.

new text begin (b) Establishment of an overpayment is limited to 12 months prior to the month of
discovery due to agency error. Establishment of an overpayment is limited to six years
prior to the month of discovery due to client error or an intentional program violation
determined under section 256.046.
new text end

Minnesota Statutes 2010, section 393.07, subdivision 10, is amended to read:

(a) The local
social services agency shall establish and administer the food stamp program according
to rules of the commissioner of human services, the supervision of the commissioner as
specified in section 256.01, and all federal laws and regulations. The commissioner of
human services shall monitor food stamp program delivery on an ongoing basis to ensure
that each county complies with federal laws and regulations. Program requirements to be
monitored include, but are not limited to, number of applications, number of approvals,
number of cases pending, length of time required to process each application and deliver
benefits, number of applicants eligible for expedited issuance, length of time required
to process and deliver expedited issuance, number of terminations and reasons for
terminations, client profiles by age, household composition and income level and sources,
and the use of phone certification and home visits. The commissioner shall determine the
county-by-county and statewide participation rate.

(b) On July 1 of each year, the commissioner of human services shall determine a
statewide and county-by-county food stamp program participation rate. The commissioner
may designate a different agency to administer the food stamp program in a county if the
agency administering the program fails to increase the food stamp program participation
rate among families or eligible individuals, or comply with all federal laws and regulations
governing the food stamp program. The commissioner shall review agency performance
annually to determine compliance with this paragraph.

(c) A person who commits any of the following acts has violated section 256.98 or
609.821, or both, and is subject to both the criminal and civil penalties provided under
those sections:

(1) obtains or attempts to obtain, or aids or abets any person to obtain by means of a
willful statement or misrepresentation, or intentional concealment of a material fact, food
stamps or vouchers issued according to sections 145.891 to 145.897 to which the person
is not entitled or in an amount greater than that to which that person is entitled or which
specify nutritional supplements to which that person is not entitled; or

(2) presents or causes to be presented, coupons or vouchers issued according to
sections 145.891 to 145.897 for payment or redemption knowing them to have been
received, transferred or used in a manner contrary to existing state or federal law; or

(3) willfully uses, possesses, or transfers food stamp coupons, authorization to
purchase cards or vouchers issued according to sections 145.891 to 145.897 in any manner
contrary to existing state or federal law, rules, or regulations; or

(4) buys or sells food stamp coupons, authorization to purchase cards, other
assistance transaction devices, vouchers issued according to sections 145.891 to 145.897,
or any food obtained through the redemption of vouchers issued according to sections
145.891 to 145.897 for cash or consideration other than eligible food.

(d) A peace officer or welfare fraud investigator may confiscate food stamps,
authorization to purchase cards, or other assistance transaction devices found in the
possession of any person who is neither a recipient of the food stamp program nor
otherwise authorized to possess and use such materials. Confiscated property shall be
disposed of as the commissioner may direct and consistent with state and federal food
stamp law. The confiscated property must be retained for a period of not less than 30 days
to allow any affected person to appeal the confiscation under section 256.045.

(e) deleted text begin Food stamp overpayment claims which are due in whole or in part to client error
shall be established by the county agency for a period of six years from the date of any
resultant overpaymentdeleted text end new text begin Establishment of an overpayment is limited to 12 months prior to
the month of discovery due to agency error. Establishment of an overpayment is limited
to six years prior to the month of discovery due to client error or an intentional program
violation determined under section 256.046new text end .

(f) With regard to the federal tax revenue offset program only, recovery incentives
authorized by the federal food and consumer service shall be retained at the rate of 50
percent by the state agency and 50 percent by the certifying county agency.

(g) A peace officer, welfare fraud investigator, federal law enforcement official,
or the commissioner of health may confiscate vouchers found in the possession of any
person who is neither issued vouchers under sections 145.891 to 145.897, nor otherwise
authorized to possess and use such vouchers. Confiscated property shall be disposed of
as the commissioner of health may direct and consistent with state and federal law. The
confiscated property must be retained for a period of not less than 30 days.

(h) The commissioner of human services may seek a waiver from the United States
Department of Agriculture to allow the state to specify foods that may and may not be
purchased in Minnesota with benefits funded by the federal Food Stamp Program. The
commissioner shall consult with the members of the house of representatives and senate
policy committees having jurisdiction over food support issues in developing the waiver.
The commissioner, in consultation with the commissioners of health and education, shall
develop a broad public health policy related to improved nutrition and health status. The
commissioner must seek legislative approval prior to implementing the waiver.

Minnesota Statutes 2010, section 402A.10, subdivision 4, is amended to read:

"Essential human
services" or "essential services" means assistance and services to recipients or potential
recipients of public welfare and other services delivered by counties new text begin or tribes new text end that are
mandated in federal and state law that are to be available in all counties of the state.

Minnesota Statutes 2010, section 402A.10, subdivision 5, is amended to read:

"Service delivery authority" means a single
county, or deleted text begin groupdeleted text end new text begin consortiumnew text end of counties operating by execution of a joint powers
agreement under section 471.59 or other contractual agreement, that has voluntarily
chosen by resolution of the county board of commissioners to participate in the redesign
under this chapternew text begin or has been assigned by the commissioner pursuant to section 402A.18.
A service delivery authority includes an Indian tribe or group of tribes that have voluntarily
chosen by resolution of tribal government to participate in redesign under this chapternew text end .

Minnesota Statutes 2010, section 402A.15, is amended to read:

(a) The Steering Committee on Performance and Outcome
Reforms shall develop a uniform process to establish and review performance and outcome
standards for all essential human services based on the current level of resources available,
and deleted text begin todeleted text end new text begin shallnew text end develop appropriate reporting measures and a uniform accountability process
for responding to a county's or deleted text begin humandeleted text end service new text begin delivery new text end authority's failure to make adequate
progress on achieving performance measures. The accountability process shall focus on
the performance measures rather than inflexible implementation requirements.

(b) The steering committee shall:

(1) by November 1, 2009, establish an agreed-upon list of essential services;

(2) by February 15, 2010, develop and recommend to the legislature a uniform,
graduated process, in addition to the remedies identified in section 402A.18, for responding
to a county's failure to make adequate progress on achieving performance measures; and

(3) by December 15, 2012, for each essential servicenew text begin ,new text end make recommendations
to the legislature regarding deleted text begin (1)deleted text end new text begin (i)new text end performance measures and goals based on those
measures for each essential service, deleted text begin (2)deleted text end new text begin and (ii)new text end a system for reporting on the performance
measures and goalsdeleted text begin , and (3) appropriate resources, including funding, needed to achieve
those performance measures and goals. The resource recommendations shall take into
consideration program demand and the unique differences of local areas in geography and
the populations served. Priority shall be given to services with the greatest variation in
availability and greatest administrative demandsdeleted text end . By January 15 of each year starting
January 15, 2011, the steering committee shall report its recommendations to the governor
and legislative committees with jurisdiction over health and human services. As part of its
report, the steering committee shall, as appropriate, recommend statutory provisions, rules
and requirements, and reports that should be repealed or eliminated.

(c) As far as possible, the performance measures, reporting system, and funding
shall be consistent across program areas. The development of performance measures shall
consider the manner in which data will be collected and performance will be reported.
The steering committee shall consider state and local administrative costs related to
collecting data and reporting outcomes when developing performance measures. deleted text begin The
steering committee shall correlate the performance measures and goals to available levels
of resources, including state and local funding.deleted text end new text begin The steering committee shall also identify
and incorporate federal performance measures in its recommendations for those program
areas where federal funding is contingent on meeting federal performance standards.new text end The
steering committee shall take into consideration that the goal of implementing changes
to program monitoring and reporting the progress toward achieving outcomes is to
significantly minimize the cost of administrative requirements and to allow funds freed
by reduced administrative expenditures to be used to provide additional services, allow
flexibility in service design and management, and focus energies on achieving program
and client outcomes.

(d) In making its recommendations, the steering committee shall consider input from
the council established in section 402A.20. deleted text begin The steering committee shall review the
measurable goals established in a memorandum of understanding entered into under
section 402A.30, subdivision 2, paragraph (b), and consider whether they may be applied
as statewide performance outcomes.
deleted text end

(e) The steering committee shall form work groups that include persons who provide
or receive essential services and representatives of organizations who advocate on behalf
of those persons.

(f) By December 15, 2009, the steering committee shall establish a three-year
schedule for completion of its work. The schedule shall be published on the Department of
Human Services Web site and reported to the legislative committees with jurisdiction over
health and human services. In addition, the commissioner shall post quarterly updates on
the progress of the steering committee on the Department of Human Services Web site.

(a) The steering committee shall include:

(1) the commissioner of human services, or designee, and two additional
representatives of the department;

(2) two county commissioners, representative of rural and urban counties, selected
by the Association of Minnesota Counties;

(3) two county directors of human services, representative of rural and urban
counties, selected by the Minnesota Association of County Social Service Administrators;
and

(4) three clients or client advocates representing different populations receiving
services from the Department of Human Services, who are appointed by the commissioner.

(b) The commissioner, or designee, and a county commissioner shall serve as
cochairs of the committee. The committee shall be convened within 60 days of May
15, 2009.

(c) State agency staff shall serve as informational resources and staff to the steering
committee. Statewide county associations may assemble county program data as required.

deleted text begin (d) To promote information sharing and coordination between the steering committee
and council, one of the county representatives from paragraph (a), clause (2), and one of the
county representatives from paragraph (a), clause (3), must also serve as a representative
on the council under section 402A.20, subdivision 1, paragraph (b), clause (5) or (6).
deleted text end

Minnesota Statutes 2010, section 402A.18, is amended to read:

If the commissioner
determines that a county or service delivery authority is deficient in achieving minimum
performance outcomes for a specific essential service, the commissioner may impose the
following remediesnew text begin and adjust state and federal program allocations accordinglynew text end :

(1) voluntary incorporation of the administration and operation of the specific
essential service with an existing service delivery authority or another county. A
service delivery authority or county incorporating an underperforming county shall
not be financially liable for the costs associated with remedying performance outcome
deficiencies;

(2) mandatory incorporation of the administration and operation of the specific
essential service with an existing service delivery authority or another county. A
service delivery authority or county incorporating an underperforming county shall
not be financially liable for the costs associated with remedying performance outcome
deficiencies; or

(3) transfer of authority for program administration and operation of the specific
essential service to the commissioner.

If
the commissioner determines that a county or service delivery authority is deficient in
achieving minimum performance outcomes for more than one-half of the defined essential
deleted text begin servicedeleted text end new text begin servicesnew text end , the commissioner may impose the following remedies:

(1) voluntary incorporation of the administration and operation of deleted text begin the specificdeleted text end
essential deleted text begin servicedeleted text end new text begin servicesnew text end with an existing service delivery authority or another county.
A service delivery authority or county incorporating an underperforming county shall
not be financially liable for the costs associated with remedying performance outcome
deficiencies;

(2) mandatory incorporation of the administration and operation of deleted text begin the specificdeleted text end
essential deleted text begin servicedeleted text end new text begin servicesnew text end with an existing service delivery authority or another county.
A service delivery authority or county incorporating an underperforming county shall
not be financially liable for the costs associated with remedying performance outcome
deficiencies; or

(3) transfer of authority for program administration and operation of deleted text begin the specificdeleted text end
essential deleted text begin servicedeleted text end new text begin servicesnew text end to the commissioner.

new text begin A county subject
to remedies under subdivision 1 or 2 shall provide to the entity assuming administration of
the essential service or essential services the amount of nonfederal and nonstate funding
needed to remedy performance outcome deficiencies.
new text end

Before the commissioner may
impose the remedies authorized under this section, the following conditions must be met:

(1) the county or service delivery authority determined by the commissioner
to be deficient in achieving minimum performance outcomes has the opportunity, in
coordination with the council, to develop a program outcome improvement plan. The
program outcome improvement plan must be developed no later than six months from the
date of the deficiency determination; and

(2) the council has conducted an assessment of the program outcome improvement
plan to determine if the county or service delivery authority has made satisfactory
progress toward performance outcomes and has made a recommendation about remedies
to the commissioner. The deleted text begin reviewdeleted text end new text begin assessmentnew text end and recommendation must be made to the
commissioner within 12 months from the date of the deficiency determination.

Minnesota Statutes 2010, section 402A.20, is amended to read:

(a) The State-County Results, Accountability, and Service
Delivery Redesign Council is established. Appointed council members must be appointed
by their respective agencies, associations, or governmental units by November 1, 2009.
The council shall be cochaired by the commissioner of human services, or designee, and a
county representative from paragraph (b), clause (4) or (5), appointed by the Association
of Minnesota Counties. Recommendations of the council must be approved by a majority
of the new text begin voting new text end council members. The provisions of section 15.059 do not apply to this
council, and this council does not expire.

(b) The council must consist of the following members:

(1) two legislators appointed by the speaker of the house, one from the minority
and one from the majority;

(2) two legislators appointed by the Senate Rules Committee, one from the majority
and one from the minority;

(3) the commissioner of human services, or designee, and three employees from
the department;

(4) two county commissioners appointed by the Association of Minnesota Counties;

(5) two county representatives appointed by the Minnesota Association of County
Social Service Administrators;

(6) one representative appointed by AFSCME as a nonvoting member; and

(7) one representative appointed by the Teamsters as a nonvoting member.

(d) Member agencies and associations are responsible for initial and subsequent
appointments to the council.

The council shall:

(1) provide review of the new text begin service delivery new text end redesign processnew text begin , including proposed
memoranda of understanding to establish a service delivery authority to conduct and
administer experimental projects to test new methods and procedures of delivering
servicesnew text end ;

deleted text begin (2) certify, in accordance with section 402A.30, subdivision 4, the formation of
a service delivery authority, including the memorandum of understanding in section
402A.30, subdivision 2, paragraph (b);
deleted text end

deleted text begin (3) ensure the consistency of the memorandum of understanding entered into
under section 402A.30, subdivision 2, paragraph (b), with the performance standards
recommended by the steering committee and enacted by the legislature;
deleted text end

deleted text begin (4)deleted text end new text begin (2)new text end ensure the consistency of the memorandum of understanding, to the extent
appropriate, deleted text begin ordeleted text end new text begin withnew text end other memorandum of understanding entered into by other service
delivery authorities;

new text begin (3) review and make recommendations on applications from a service delivery
authority for waivers of statutory or rule program requirements that are needed for
flexibility to determine the most cost-effective means of achieving specified measurable
goals in a redesign of human services delivery;
new text end

deleted text begin (5)deleted text end new text begin (4)new text end establish a process to take public input on the deleted text begin service delivery framework
specified in the memorandum of understanding in section 402A.30, subdivision 2,
paragraph (b)deleted text end new text begin scope of essential services over which a service delivery authority has
jurisdictionnew text end ;

deleted text begin (6)deleted text end new text begin (5)new text end form work groups as necessary to carry out the duties of the council under the
redesign;

deleted text begin (7)deleted text end new text begin (6)new text end serve as a forum for resolving conflicts among participating counties new text begin and
tribes new text end or between participating counties new text begin or tribes new text end and the commissioner of human services,
provided nothing in this section is intended to create a formal binding legal process;

deleted text begin (8)deleted text end new text begin (7)new text end engage in the program improvement process established in section 402A.18,
subdivision 3; and

deleted text begin (9)deleted text end new text begin (8)new text end identify and recommend incentives for counties new text begin and tribes new text end to participate in
deleted text begin human servicesdeleted text end new text begin service deliverynew text end authorities.

new text begin By December 15, 2014, the council shall request
consideration by the legislative auditor for a reevaluation under section 3.971, subdivision
7, of those aspects of the program evaluation of human services administration reported
in January 2007 affected by this chapter.
new text end

new text begin (a) A county, tribe, or consortium of counties is eligible to establish a service delivery
authority if:
new text end

new text begin (1) the county, tribe, or consortium of counties is:
new text end

new text begin (i) a single county with a population of 55,000 or more;
new text end

new text begin (ii) a consortium of counties with a total combined population of 55,000 or more;
new text end

new text begin (iii) a consortium of four or more counties in reasonable geographic proximity
without regard to population; or
new text end

new text begin (iv) one or more tribes with a total combined population of 25,000 or more.
new text end

new text begin The council may recommend that the commissioner of human services exempt a
single county, tribe, or consortium of counties from the minimum population standard if
the county, tribe, or consortium of counties can demonstrate that it can otherwise meet
the requirements of this chapter.
new text end

new text begin (b) A service delivery authority shall:
new text end

new text begin (1) comply with current state and federal law, including any existing federal or state
performance measures and performance measures under section 402A.15 when they are
enacted into law, except where waivers are approved by the commissioner. Nothing
in this subdivision requires the establishment of performance measures under section
402A.15 prior to a service delivery authority participating in the service delivery redesign
under this chapter;
new text end

new text begin (2) define the scope of essential services over which the service delivery authority
has jurisdiction;
new text end

new text begin (3) designate a single administrative structure to oversee the delivery of those
services included in a proposal for a redesigned service or services and identify a single
administrative agent for purposes of contact and communication with the department;
new text end

new text begin (4) identify the waivers from statutory or rule program requirements that are needed
to ensure greater local control and flexibility to determine the most cost-effective means of
achieving specified measurable goals that the participating service delivery authority is
expected to achieve;
new text end

new text begin (5) set forth a reasonable level of targeted reductions in overhead and administrative
costs for each service delivery authority participating in the service delivery redesign;
new text end

new text begin (6) set forth the terms under which a county, tribe, or consortium of counties
may withdraw from participation. In the case of withdrawal of any or all parties or
the dissolution of the service delivery authority, the employees shall continue to be
represented by the same exclusive representative or representatives and continue to be
covered by the same collective bargaining union agreement until a new agreement is
negotiated or the collective bargaining agreement term ends; and
new text end

new text begin (7) set forth a structure for managing the terms and conditions of employment of the
employees as provided in section 402A.40.
new text end

new text begin (c) Once a county, tribe, or consortium of counties establishes a service delivery
authority, no county, tribe, or consortium of counties that is a member of the service
delivery authority may participate as a member of any other service delivery authority.
The service delivery authority may allow an additional county, a tribe, or a consortium of
counties to join the service delivery authority subject to the approval of the council and
the commissioner.
new text end

new text begin (d) Nothing in this chapter precludes local governments from using sections 465.81
and 465.82 to establish procedures for local governments to merge, with the consent
of the voters. Nothing in this chapter limits the authority of a county board or tribal
council to enter into contractual agreements for services not covered by the provisions
of a memorandum of understanding establishing a service delivery authority with other
agencies or with other units of government.
new text end

new text begin (a) Unless otherwise identified in
the memorandum of understanding, any county, tribe, or consortium of counties forming a
service delivery authority is exempt from the provisions of sections 245.465; 245.4835;
245.4874; 245.492, subdivision 2; 245.4932; 256F.13; 256J.626, subdivision 2, paragraph
(b); and 256M.30.
new text end

new text begin (b) This subdivision does not preclude any county, tribe, or consortium of counties
forming a service delivery authority from requesting additional waivers from statutory and
rule requirements to ensure greater local control and flexibility.
new text end

new text begin The service delivery authority shall:
new text end

new text begin (1) within the scope of essential services set forth in the memorandum of
understanding establishing the authority, carry out the responsibilities required of local
agencies under chapter 393 and human services boards under chapter 402;
new text end

new text begin (2) manage the public resources devoted to human services and other public services
delivered or purchased by the counties or tribes that are subsidized or regulated by the
Department of Human Services under chapters 245 to 261;
new text end

new text begin (3) employ staff to assist in carrying out its duties;
new text end

new text begin (4) develop and maintain a continuity of operations plan to ensure the continued
operation or resumption of essential human services functions in the event of any business
interruption according to local, state, and federal emergency planning requirements;
new text end

new text begin (5) receive and expend funds received for the redesign process under the
memorandum of understanding;
new text end

new text begin (6) plan and deliver services directly or through contract with other governmental,
tribal, or nongovernmental providers;
new text end

new text begin (7) rent, purchase, sell, and otherwise dispose of real and personal property as
necessary to carry out the redesign; and
new text end

new text begin (8) carry out any other service designated as a responsibility of a county.
new text end

new text begin (a) The county,
tribe, or consortium of counties meeting the requirements of section 402A.30 and
proposing to establish a service delivery authority shall present to the council:
new text end

new text begin (1) in conjunction with the commissioner, a proposed memorandum of understanding
meeting the requirements of subdivision 1, paragraph (b), and outlining:
new text end

new text begin (i) the details of the proposal;
new text end

new text begin (ii) the state, tribal, and local resources, which may include, but are not limited to,
funding, administrative and technology support, and other requirements necessary for
the service delivery authority; and
new text end

new text begin (iii) the relief available to the service delivery authority if the resource commitments
identified in item (ii) are not met; and
new text end

new text begin (2) a board resolution from the board of commissioners of each participating county
stating the county's intent to participate, or in the case of a tribe, a resolution from tribal
government, stating the tribe's intent to participate.
new text end

new text begin (b) After the council has considered and recommended approval of a proposed
memorandum of understanding, the commissioner may finalize and execute the
memorandum of understanding.
new text end

new text begin The commissioner may use the
authority under section 256.01, subdivision 2, paragraph (l), to grant waivers identified as
part of a proposed service delivery authority under subdivision 1, paragraph (b), clause
(4), except that waivers granted under this section must be approved by the council under
section 402A.20 rather than the Legislative Advisory Committee.
new text end

new text begin Notwithstanding the provisions of section
179A.12 or any other law, this section governs, where contrary to other law, the initial
certification and decertification, if any, of exclusive representatives for service delivery
authorities. Employees of a service delivery authority are public employees under section
179A.03, subdivision 14. Service delivery authorities are public employers under section
179A.03, subdivision 15.
new text end

new text begin The commissioner of the Minnesota Bureau of
Mediation Services shall certify an employee organization for employees of a service
delivery authority as exclusive representative for an appropriate unit upon a petition
filed with the commissioner by the organization demonstrating that the petitioner is
certified pursuant to section 179A.12 as the exclusive representative of a majority of the
employees included within the unit as of that date. Two or more employee organizations
that represent the employees in a unit may petition jointly under this subdivision, provided
that any organization may withdraw from a joint certification in favor of the remaining
organizations on 30 days' notice to the remaining organizations, the employer, and the
commissioner, without affecting the rights and obligations of the remaining organizations
or the employer. The commissioner shall make a determination on a timely petition within
45 days of its receipt.
new text end

new text begin (a) If no exclusive representative is certified under
subdivision 2, the commissioner shall certify an employee organization as exclusive
representative for an appropriate unit established upon a petition filed by the organization
within the time period provided in subdivision 2 demonstrating that the petitioner is
certified under section 179A.12 as the exclusive representative of fewer than a majority
of the employees included within the unit if no other employee organization so certified
has filed a petition within the time period provided in subdivision 2 and a majority of the
employees in the unit are represented by employee organizations under section 179A.12
on the date of the petition. Two or more employee organizations, each of which represents
employees included in the unit may petition jointly under this paragraph, provided that
any organization may withdraw from a joint certification in favor of the remaining
organizations on 30 days' notice to the remaining organizations, the employer, and the
commissioner without affecting the rights and obligations of the remaining organizations
or the employer. The commissioner shall make a determination on a timely petition within
45 days of its receipt.
new text end

new text begin (b) If no exclusive representative is certified under paragraph (a) or subdivision 2,
and an employee organization petitions the commissioner within 90 days of the creation of
the service delivery authority demonstrating that a majority of the employees included
within an appropriate unit wish to be represented by the petitioner, where this majority
is evidenced by current dues deduction rights, signed statements from employees in
counties within the service delivery authority that are not currently represented by any
employee organization plainly indicating that the signatories wish to be represented for
collective bargaining purposes by the petitioner rather than by any other organization,
or a combination of those, the commissioner shall certify the petitioner as exclusive
representative of the employees in the unit. The commissioner shall make a determination
on a timely petition within 45 days of its receipt.
new text end

new text begin (c) If no exclusive representative is certified under paragraph (a) or (b) or subdivision
2, and an employee organization petitions the commissioner subsequent to the creation
of the service delivery authority demonstrating that at least 30 percent of the employees
included within an appropriate unit wish to be represented by the petitioner, where this 30
percent is evidenced by current dues deduction rights, signed statements from employees
in counties within the service delivery authority that are not currently represented by any
employee organization plainly indicating that the signatories wish to be represented for
collective bargaining purposes by the petitioner rather than by any other organization, or a
combination of those, the commissioner shall conduct a secret ballot election to determine
the wishes of the majority. The election must be conducted within 45 days of receipt or
final decision on any petitions filed pursuant to subdivision 2, whichever is later. The
election is governed by section 179A.12, where not inconsistent with other provisions
of this section.
new text end

new text begin The commissioner may not consider a petition for
decertification of an exclusive representative certified under this section for one year after
certification, unless section 179A.20, subdivision 6, applies.
new text end

new text begin (a) The terms and conditions of collective
bargaining agreements covering the employees of service delivery authorities remain in
effect until a successor agreement becomes effective or, if no employee organization
petitions to represent the employees of the service delivery authority, until six months
after the establishment of the service delivery authority.
new text end

new text begin (b) Any accrued leave, including but not limited to sick leave, vacation time,
compensatory leave or paid time off, or severance pay benefits accumulated under policies
of the previously employing county or a collective bargaining agreement between the
previously employing county and an exclusive representative shall continue to apply in the
newly created service delivery authority for the employees of the previously employing
county. An employee who was eligible for the benefits of the Family and Medical Leave
Act at the previously employing county shall continue to be eligible at the newly created
service delivery authority.
new text end

new text begin (c) If it is necessary, prior to the negotiation of a new collective bargaining
agreement, to lay off an employee of a service delivery authority and if two or more
employees previously performed the work, seniority based on continuous length of
service with a service delivery authority member county shall be the determining factor
in determining which qualified employee shall be offered the job by the service delivery
authority. An employee whose work is being transferred to the service delivery authority
shall have the option of being laid off.
new text end

new text begin (a) The exclusive
representatives of units of employees certified prior to the creation of the service delivery
authority remain responsible for administration of their contracts and for other contractual
duties and have the right to dues and fair share fee deduction and other contractual
privileges and rights until a contract is agreed upon with the service delivery authority.
Exclusive representatives of service delivery authority employees certified after the
creation of the service delivery authority are immediately upon certification responsible
for bargaining on behalf of employees within the unit. They are also responsible for
administering grievances arising under previous contracts covering employees included
within the unit that remain unresolved upon agreement with the service delivery authority
on a contract. Where the employer does not object, these responsibilities may be varied by
agreement between the outgoing and incoming exclusive representatives. All other rights
and duties of representation begin upon the creation of a service delivery authority, except
that exclusive representatives certified upon or after the creation of the service delivery
authority shall immediately, upon certification, have the right to all employer information
and all forms of access to employees within the bargaining unit which would be permitted
to the current contract holder, including the rights in section 179A.07, subdivision 6. This
section does not affect an existing collective bargaining contract. Incoming exclusive
representatives are immediately, upon certification, responsible for bargaining on behalf of
all previously unrepresented employees assigned to their units.
new text end

new text begin (b) Nothing in this section prevents an exclusive representative certified after
the effective dates of these provisions from assessing fair share or dues deductions
immediately upon certification if the employees were unrepresented for collective
bargaining purposes before that certification.
new text end

new text begin The commissioner of human services shall define which public assistance program
requirements may be electronically verified for the purposes of determining eligibility,
and shall also define procedures for electronic verification. The commissioner of human
services shall report back to the chairs and ranking minority members of the legislative
committees with jurisdiction over these issues by January 15, 2012, with draft legislation
to implement the procedures if legislation is necessary for purposes of implementation.
new text end

new text begin The commissioner of human services, in consultation with counties and other key
stakeholders, shall analyze and develop recommendations to align program policy and
procedures across all public assistance programs to simplify and streamline program
eligibility and access. The commissioner shall report back to the chairs and ranking
minority members of the legislative committees with jurisdiction over these issues by
January 15, 2013, with draft legislation to implement the recommendations.
new text end

new text begin The commissioner of human services shall develop and implement by January 15,
2012, a simplified process to redetermine eligibility for recipient populations in the medical
assistance, Minnesota supplemental aid, food support, and group residential housing
programs who are eligible based upon disability, age, or chronic medical conditions, and
who are expected to experience minimal change in income or assets from month to month.
The commissioner shall apply for any federal waivers needed to implement this section.
new text end

new text begin (a) The commissioner of human services shall issue a request for information for an
integrated service delivery system for health care programs, food support, cash assistance,
and child care. The commissioner shall determine, in consultation with partners in
paragraph (c), if the products meet departments' and counties' functions. The request for
information may incorporate a performance-based vendor financing option in which the
vendor shares the risk of the project's success. The health care system must be developed
in phases with the capacity to integrate food support, cash assistance, and child care
programs as funds are available. The request for information must require that the system:
new text end

new text begin (1) streamline eligibility determinations and case processing to support statewide
eligibility processing;
new text end

new text begin (2) enable interested persons to determine eligibility for each program, and to apply
for programs online in a manner that the applicant will be asked only those questions
relevant to the programs for which the person is applying;
new text end

new text begin (3) leverage technology that has been operational in other state environments with
similar requirements; and
new text end

new text begin (4) include Web-based application, worker application processing support, and the
opportunity for expansion.
new text end

new text begin (b) The commissioner shall issue a final report, including the implementation plan,
to the chairs and ranking minority members of the legislative committees with jurisdiction
over health and human services no later than October 31, 2011.
new text end

new text begin (c) The commissioner shall partner with counties, a service delivery authority
established under Minnesota Statutes, chapter 402A, the Office of Enterprise Technology,
other state agencies, and service partners to develop an integrated service delivery
framework, which will simplify and streamline human services eligibility and enrollment
processes. The primary objectives for the simplification effort include significantly
improved eligibility processing productivity resulting in reduced time for eligibility
determination and enrollment, increased customer service for applicants and recipients of
services, increased program integrity, and greater administrative flexibility.
new text end

new text begin (d) The commissioner, along with a county representative appointed by the
Association of Minnesota Counties, shall report specific implementation progress to the
legislature annually beginning May 15, 2012.
new text end

new text begin (e) The commissioner shall work with the Minnesota Association of County Social
Service Administrators and the Office of Enterprise Technology to develop collaborative
task forces, as necessary, to support implementation of the service delivery components
under this paragraph. The commissioner must evaluate, develop, and include as part
of the integrated eligibility and enrollment service delivery framework, the following
minimum components:
new text end

new text begin (1) screening tools for applicants to determine potential eligibility as part of an
online application process;
new text end

new text begin (2) the capacity to use databases to electronically verify application and renewal
data as required by law;
new text end

new text begin (3) online accounts accessible by applicants and enrollees;
new text end

new text begin (4) an interactive voice response system, available statewide, that provides case
information for applicants, enrollees, and authorized third parties;
new text end

new text begin (5) an electronic document management system that provides electronic transfer of
all documents required for eligibility and enrollment processes; and
new text end

new text begin (6) a centralized customer contact center that applicants, enrollees, and authorized
third parties can use statewide to receive program information, application assistance,
and case information, report changes, make cost-sharing payments, and conduct other
eligibility and enrollment transactions.
new text end

new text begin (f) Subject to a legislative appropriation, the commissioner of human services shall
issue a request for proposal for the appropriate phase of an integrated service delivery
system for health care programs, food support, cash assistance, and child care.
new text end

new text begin This section is effective the day following final enactment.
new text end

new text begin (a) The commissioner of human services, in consultation with the White Earth Band
of Ojibwe, shall transfer legal responsibility to the tribe for providing human services to
tribal members and their families who reside on or off the reservation in Mahnomen
County. The transfer shall include:
new text end

new text begin (1) financing, including federal and state funds, grants, and foundation funds; and
new text end

new text begin (2) services to eligible tribal members and families defined as it applies to state
programs being transferred to the tribe.
new text end

new text begin (b) The determination as to which programs will be transferred to the tribe and
the timing of the transfer of the programs shall be made by a consensus decision of the
governing body of the tribe and the commissioner. The commissioner shall waive existing
rules and seek all federal approvals and waivers as needed to carry out the transfer.
new text end

new text begin (c) When the commissioner approves transfer of programs and the tribe assumes
responsibility under this section, Mahnomen County is relieved of responsibility for
providing program services to tribal members and their families who live on or off the
reservation while the tribal project is in effect and funded, except that a family member
who is not a White Earth member may choose to receive services through the tribe or the
county. The commissioner shall have authority to redirect funds provided to Mahnomen
County for these services, including administrative expenses, to the White Earth Band
of Ojibwe Indians.
new text end

new text begin (d) Upon the successful transfer of legal responsibility for providing human services
for tribal members and their families who reside on and off the reservation in Mahnomen
County, the commissioner and the White Earth Band of Ojibwe shall develop a plan to
transfer legal responsibility for providing human services for tribal members and their
families who reside on or off reservation in Clearwater and Becker Counties.
new text end

new text begin (e) No later than January 15, 2012, the commissioner shall submit a written
report detailing the transfer progress to the chairs and ranking minority members of the
legislative committees with jurisdiction over health and human services. If legislation is
needed to fully complete the transfer of legal responsibility for providing human services,
the commissioner shall submit proposed legislation along with the written report.
new text end

new text begin (a) new text end new text begin Minnesota Statutes 2010, sections 402A.30; and 402A.45, new text end new text begin are repealed.
new text end

new text begin (b) new text end new text begin Minnesota Rules, part 9500.1243, subpart 3, new text end new text begin is repealed.
new text end

new text begin The sums shown are added to, or if shown in parentheses, are subtracted from the
appropriations in Laws 2009, chapter 79, article 13, as amended by Laws 2009, chapter
173, article 2; Laws 2010, First Special Session chapter 1, articles 15, 23, and 25; and
Laws 2010, Second Special Session chapter 1, article 3, to the commissioner of human
services and for the purposes specified in this article. The appropriations are from the
general fund or another named fund and are available for the fiscal year indicated for
each purpose. The figure "2011" used in this article means that the appropriation or
appropriations listed are available for the fiscal year ending June 30, 2011.
new text end

new text begin $
new text end

new text begin (235,463,000)
new text end

new text begin Appropriations by Fund new text end
		new text begin 2011 new text end
new text begin General new text end		new text begin (381,869,000) new text end
new text begin Health Care Access new text end		new text begin 169,514,000 new text end
new text begin Federal TANF new text end		new text begin (23,108,000) new text end

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

new text begin 732,000
new text end

new text begin This appropriation is from the federal TANF
fund.
new text end

new text begin Appropriations by Fund new text end
new text begin General new text end		new text begin (7,098,000) new text end
new text begin Federal TANF new text end		new text begin (23,840,000) new text end

(a) MFIP/DWP Grants

new text begin Appropriations by Fund new text end
new text begin General new text end		new text begin 18,715,000 new text end
new text begin Federal TANF new text end		new text begin (23,840,000) new text end

(b) MFIP Child Care Assistance Grants

(24,394,000)

(664,000)

(d) Minnesota Supplemental Aid Grants

793,000

(e) Group Residential Housing Grants

(1,548,000)

new text begin Appropriations by Fund new text end
new text begin General new text end		new text begin (335,050,000) new text end
new text begin Health Care Access new text end		new text begin 169,514,000 new text end

(a) MinnesotaCare Grants

169,514,000

new text begin This appropriation is from the health care
access fund.
new text end

(b) Medical Assistance Basic Health Care -
Families and Children

(49,368,000)

(43,258,000)

(d) Medical Assistance Basic Health Care -
Adults without Children

(242,424,000)

(39,721,000)

(a) Medical Assistance Long-Term Care
Facilities

(14,627,000)

(b) Medical Assistance Long-Term Care
Waivers

(44,718,000)

19,624,000

Laws 2010, First Special Session chapter 1, article 25, section 3, subdivision 6,
is amended to read:

(a) MinnesotaCare Grants

998,000

(13,376,000)

This appropriation is from the health care
access fund.

Health Care Access Fund Transfer to
General Fund. The commissioner of
management and budget shall transfer the
following amounts in the following years
from the health care access fund to the
general fund: deleted text begin $998,000deleted text end new text begin $0new text end in fiscal year
2010; deleted text begin $176,704,000deleted text end new text begin $59,901,000new text end in fiscal
year 2011; $141,041,000 in fiscal year 2012;
and $286,150,000 in fiscal year 2013. If at
any time the governor issues an executive
order not to participate in early medical
assistance expansion, no funds shall be
transferred from the health care access
fund to the general fund until early medical
assistance expansion takes effect. This
paragraph is effective the day following final
enactment.

MinnesotaCare Ratable Reduction.
Effective for services rendered on or after
July 1, 2010, to December 31, 2013,
MinnesotaCare payments to managed care
plans under Minnesota Statutes, section
256L.12, for single adults and households
without children whose income is greater
than 75 percent of federal poverty guidelines
shall be reduced by 15 percent. Effective
for services provided from July 1, 2010, to
June 30, 2011, this reduction shall apply to
all services. Effective for services provided
from July 1, 2011, to December 31, 2013, this
reduction shall apply to all services except
inpatient hospital services. Notwithstanding
any contrary provision of this article, this
paragraph shall expire on December 31,
2013.

(b) Medical Assistance Basic Health Care
Grants - Families and Children

-0-

295,512,000

Critical Access Dental. Of the general
fund appropriation, $731,000 in fiscal year
2011 is to the commissioner for critical
access dental provider reimbursement
payments under Minnesota Statutes, section
256B.76 subdivision 4. This is a onetime
appropriation.

Nonadministrative Rate Reduction. For
services rendered on or after July 1, 2010,
to December 31, 2013, the commissioner
shall reduce contract rates paid to managed
care plans under Minnesota Statutes,
sections 256B.69 and 256L.12, and to
county-based purchasing plans under
Minnesota Statutes, section 256B.692, by
three percent of the contract rate attributable
to nonadministrative services in effect on
June 30, 2010. Notwithstanding any contrary
provision in this article, this rider expires on
December 31, 2013.

-0-

(30,265,000)

(d) General Assistance Medical Care Grants

-0-

(75,389,000)
(59,583,000)

new text begin The reduction to general assistance medical
care grants is contingent upon the effective
date in Laws 2010, First Special Session
chapter 1, article 16, section 48. The
reduction shall be reestimated based upon
the actual effective date of the law. The
commissioner of management and budget
shall make adjustments in fiscal year
2011 to general assistance medical care
appropriations to conform to the total
expected expenditure reductions specified in
this section.
new text end

(e) Other Health Care Grants

-0-

(7,000,000)

Cobra Carryforward. Unexpended funds
appropriated in fiscal year 2010 for COBRA
grants under Laws 2009, chapter 79, article
5, section 78, do not cancel and are available
to the commissioner for fiscal year 2011
COBRA grant expenditures. Up to $111,000
of the fiscal year 2011 appropriation for
COBRA grants provided in Laws 2009,
chapter 79, article 13, section 3, subdivision
6, may be used by the commissioner for costs
related to administration of the COBRA
grants.

new text begin This article is effective the day following final enactment.
new text end

new text begin The amounts shown in this section summarize direct appropriations, by fund, made
in this article.
new text end

		new text begin 2012 new text end		new text begin 2013 new text end		new text begin Total new text end
new text begin General new text end	new text begin $ new text end	new text begin 5,564,457,000 new text end	new text begin $ new text end	new text begin 5,407,093,000 new text end	new text begin $ new text end	new text begin 10,971,550,000 new text end
new text begin State Government Special Revenue new text end		new text begin 63,700,000 new text end		new text begin 63,475,000 new text end		new text begin 127,175,000 new text end
new text begin Health Care Access new text end		new text begin 317,467,000 new text end		new text begin 306,733,000 new text end		new text begin 624,200,000 new text end
new text begin Federal TANF new text end		new text begin 286,744,000 new text end		new text begin 258,466,000 new text end		new text begin 545,210,000 new text end
new text begin Lottery Prize Fund new text end		new text begin 1,665,000 new text end		new text begin 1,665,000 new text end		new text begin 3,330,000 new text end
new text begin Total new text end	new text begin $ new text end	new text begin 6,234,032,000 new text end	new text begin $ new text end	new text begin 6,037,432,000 new text end	new text begin $ new text end	new text begin 12,271,464,000 new text end

new text begin The sums shown in the columns marked "Appropriations" are appropriated to the
agencies and for the purposes specified in this article. The appropriations are from the
general fund, or another named fund, and are available for the fiscal years indicated
for each purpose. The figures "2012" and "2013" used in this article mean that the
appropriations listed under them are available for the fiscal year ending June 30, 2012, or
June 30, 2013, respectively. "The first year" is fiscal year 2012. "The second year" is fiscal
year 2013. "The biennium" is fiscal years 2012 and 2013.
new text end

new text begin $
new text end

new text begin 6,078,510,000
new text end

new text begin $
new text end

new text begin 5,891,475,000
new text end

new text begin Appropriations by Fund new text end
	new text begin 2012 new text end	new text begin 2013 new text end
new text begin General new text end	new text begin 5,489,816,000 new text end	new text begin 5,337,566,000 new text end
new text begin State Government Special Revenue new text end	new text begin 565,000 new text end	new text begin 565,000 new text end
new text begin Health Care Access new text end	new text begin 306,086,000 new text end	new text begin 299,578,000 new text end
new text begin Federal TANF new text end	new text begin 280,378,000 new text end	new text begin 252,101,000 new text end
new text begin Lottery Prize Fund new text end	new text begin 1,665,000 new text end	new text begin 1,665,000 new text end

new text begin new text begin Receipts for Systems Projects.
new text end Appropriations and federal receipts for
information systems projects for MAXIS,
PRISM, MMIS, and SSIS must be deposited
in the state systems 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 management and budget, may be
transferred from one project to another
and from development to operations as the
commissioner of human services considers
necessary. Any unexpended balance in
the appropriation for these projects does
not cancel but is available for ongoing
development and operations.
new text end

new text begin 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.
new text end

new text begin TANF Maintenance of Effort.
new text end

new text begin (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:
new text end

new text begin (1) MFIP cash, diversionary work program,
and food assistance benefits under Minnesota
Statutes, chapter 256J;
new text end

new text begin (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;
new text end

new text begin (3) state and county MFIP administrative
costs under Minnesota Statutes, chapters
256J and 256K;
new text end

new text begin (4) state, county, and tribal MFIP
employment services under Minnesota
Statutes, chapters 256J and 256K;
new text end

new text begin (5) qualifying working family credit
expenditures under Minnesota Statutes,
section 290.0671; and
new text end

new text begin (6) qualifying Minnesota education credit
expenditures under Minnesota Statutes,
section 290.0674.
new text end

new text begin (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.
new text end

new text begin (c) For fiscal years beginning with state fiscal
year 2003, the commissioner shall assure
that the maintenance of effort used by the
commissioner of management and budget
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.
new text end

new text begin (d) Minnesota Statutes, section 256.011,
subdivision 3, which requires that federal
grants or aids secured or obtained under that
subdivision be used to reduce any direct
appropriations provided by law, do not apply
if the grants or aids are federal TANF funds.
new text end

new text begin (e) 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:
new text end

new text begin (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;
new text end

new text begin (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
new text end

new text begin (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).
new text end

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

new text begin (f) Notwithstanding any contrary provision
in this article, paragraphs (a) to (e) expire
June 30, 2015.
new text end

new text begin Working Family Credit Expenditures
as TANF/MOE. The commissioner may
claim as TANF maintenance of effort up to
$6,707,000 per year of working family credit
expenditures for fiscal years 2012 and 2013.
new text end

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

new text begin (1) fiscal year 2012, $37,517,000;
new text end

new text begin (2) fiscal year 2013, $28,171,000;
new text end

new text begin (3) fiscal year 2014, $34,097,000; and
new text end

new text begin (4) fiscal year 2015, $34,100,000.
new text end

new text begin Notwithstanding any contrary provision in
this article, this rider expires June 30, 2015.
new text end

new text begin TANF Transfer to Federal Child Care
and Development Fund. (a) The following
TANF fund amounts are appropriated
to the commissioner for purposes of
MFIP/Transition Year Child Care Assistance
under Minnesota Statutes, section 119B.05:
new text end

new text begin (1) fiscal year 2012, $25,020,000;
new text end

new text begin (2) fiscal year 2013, $12,020,000;
new text end

new text begin (3) fiscal year 2014, $15,818,000; and
new text end

new text begin (4) fiscal year 2015, $15,818,000.
new text end

new text begin (b) 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

new text begin Food Stamps Employment and Training
Funds. (a) Notwithstanding Minnesota
Statutes, sections 256D.051, subdivisions 1a,
6b, and 6c, and 256J.626, federal food stamps
employment and training funds received
as reimbursement for child care assistance
program expenditures must be deposited in
the general fund. The amount of funds must
be limited to $500,000 per year in fiscal
years 2012 through 2015, contingent upon
approval by the federal Food and Nutrition
Service.
new text end

new text begin (b) 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, 2015.
new text end

new text begin new text begin ARRA Food Support Benefit Increases.
new text end 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.
new text end

new text begin new text begin Supplemental Security Interim Assistance
Reimbursement Funds. new text end $2,800,000 of
uncommitted revenue available to the
commissioner of human services for SSI
advocacy and outreach services must be
transferred to and deposited into the general
fund by October 1, 2011.
new text end

new text begin new text begin Transfer. new text end By June 30, 2012, the
commissioner of management and budget
must transfer $49,694,000 from the health
care access fund to the general fund. By June
30, 2013, the commissioner of management
and budget must transfer $5,000,000 from the
health care access fund to the general fund.
new text end

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

(a) Operations

new text begin Appropriations by Fund new text end
new text begin General new text end	new text begin 72,547,000 new text end	new text begin 71,077,000 new text end
new text begin Health Care Access new text end	new text begin 11,508,000 new text end	new text begin 11,508,000 new text end
new text begin State Government Special Revenue new text end	new text begin 440,000 new text end	new text begin 440,000 new text end
new text begin Federal TANF new text end	new text begin 222,000 new text end	new text begin 222,000 new text end

new text begin new text begin DHS Receipt Center Accounting. new text end The
commissioner is authorized to transfer
appropriations to, and account for DHS
receipt center operations in, the special
revenue fund.
new text end

new text begin new text begin Administrative Recovery; Set-Aside.new text end The
commissioner may invoice local entities
through the SWIFT accounting system as an
alternative means to recover the actual cost
of administering the following provisions:
new text end

new text begin (1) Minnesota Statutes, section 125A.744,
subdivision 3;
new text end

new text begin (2) Minnesota Statutes, section 245.495,
paragraph (b);
new text end

new text begin (3) Minnesota Statutes, section 256B.0625,
subdivision 20, paragraph (k);
new text end

new text begin (4) Minnesota Statutes, section 256B.0924,
subdivision 6, paragraph (g);
new text end

new text begin (5) Minnesota Statutes, section 256B.0945,
subdivision 4, paragraph (d); and
new text end

new text begin (6) Minnesota Statutes, section 256F.10,
subdivision 6, paragraph (b).
new text end

new text begin new text begin Payments for Cost Settlements. new text end The
commissioner is authorized to use amounts
repaid to the general assistance medical care
program under Minnesota Statutes 2009
Supplement, section 256D.03, subdivision
3, to pay cost settlements for claims for
services provided prior to June 1, 2010.
Notwithstanding any contrary provision in
this article, this provision does not expire.
new text end

new text begin Base Adjustment. The general fund base
for fiscal year 2014 shall be increased by
$68,000 and decreased by $11,000 in fiscal
year 2015.
new text end

(b) Children and Families

new text begin Appropriations by Fund new text end
new text begin General new text end	new text begin 9,457,000 new text end	new text begin 9,337,000 new text end
new text begin Federal TANF new text end	new text begin 2,160,000 new text end	new text begin 2,160,000 new text end

new text begin new text begin Financial Institution Data Match and
Payment of Fees. new text end The commissioner is
authorized to allocate up to $310,000 each
year in fiscal years 2012 and 2013 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.
new text end

new text begin new text begin Base Adjustment. new text end The general fund base
is decreased by $47,000 in fiscal years 2014
and 2015.
new text end

new text begin Appropriations by Fund new text end
new text begin General new text end	new text begin 16,376,000 new text end	new text begin 16,278,000 new text end
new text begin Health Care Access new text end	new text begin 22,623,000 new text end	new text begin 26,926,000 new text end

new text begin new text begin Minnesota Senior Health Options
Reimbursement. new text end Federal administrative
reimbursement resulting from the Minnesota
senior health options project is appropriated
to the commissioner for this activity.
new text end

new text begin new text begin Utilization Review. new text end Federal administrative
reimbursement resulting from prior
authorization and inpatient admission
certification by a professional review
organization shall be dedicated to the
commissioner for these purposes. A portion
of these funds must be used for activities to
decrease unnecessary pharmaceutical costs
in medical assistance.
new text end

new text begin Base Adjustment. The general fund base
shall be decreased by $2,000 in fiscal year
2014 and $114,000 in fiscal year 2015.
new text end

new text begin The health care access fund base is decreased
by $411,000 in fiscal year 2014 and $880,000
in fiscal year 2015.
new text end

(d) Continuing Care

new text begin Appropriations by Fund new text end
new text begin General new text end	new text begin 18,078,000 new text end	new text begin 17,864,000 new text end
new text begin State Government Special Revenue new text end	new text begin 125,000 new text end	new text begin 125,000 new text end

new text begin Region 10 Administrative Expenses.
$100,000 is appropriated each fiscal
year, beginning in fiscal year 2012, for
the administration of the State Quality
Improvement and Licensing System under
Minnesota Statutes, section 256B.0961.
new text end

new text begin new text begin Base Adjustment. new text end The general fund base is
decreased by $662,000 in fiscal year 2014
and $762,000 in fiscal year 2015.
new text end

(e) Chemical and Mental Health

new text begin Appropriations by Fund new text end
new text begin General new text end	new text begin 4,194,000 new text end	new text begin 4,194,000 new text end
new text begin Lottery Prize new text end	new text begin 157,000 new text end	new text begin 157,000 new text end

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

(a) MFIP/DWP Grants

new text begin Appropriations by Fund new text end
new text begin General new text end	new text begin 83,986,000 new text end	new text begin 88,187,000 new text end
new text begin Federal TANF new text end	new text begin 84,425,000 new text end	new text begin 75,417,000 new text end

(b) MFIP Child Care Assistance Grants

39,012,000

44,805,000

48,774,000

44,003,000

new text begin 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. This paragraph expires
September 30, 2012.
new text end

new text begin Emergency General Assistance. The
amount appropriated for emergency general
assistance funds is limited to no more
than $7,089,812 in fiscal year 2012 and
$1,682,453 in fiscal year 2013. Funds
to counties shall be allocated by the
commissioner using the allocation method
specified in Minnesota Statutes, section
256D.06. This paragraph expires September
30, 2012.
new text end

new text begin Base Adjustment. The general fund base
for adult assistance is $44,512,000 in fiscal
years 2014 and 2015.
new text end

(d) Minnesota Supplemental Aid Grants

34,460,000

33,532,000

new text begin new text begin Emergency Minnesota Supplemental
Aid Funds. new text end The amount appropriated for
emergency Minnesota supplemental aid
funds is limited to no more than $367,000
in fiscal year 2012. Funds to counties shall
be allocated by the commissioner using the
allocation method specified in Minnesota
Statutes, section 256D.46. This paragraph
expires September 30, 2012.
new text end

(e) Group Residential Housing Grants

121,080,000

129,238,000

(f) MinnesotaCare Grants

271,430,000

260,619,000

new text begin This appropriation is from the health care
access fund.
new text end

(g) GAMC Grants

174,150,000

232,200,000

new text begin General Assistance Medical Care
Payments. For general assistance medical
care payments under Minnesota Statutes,
section 256D.031:
new text end

new text begin $120,150,000 in fiscal year 2012 and
$160,200,000 in fiscal year 2013 are for
payments to coordinated care delivery
systems under Minnesota Statutes, section
256D.031, subdivision 7; and
new text end

new text begin $54,000,000 in fiscal year 2012 and
$72,000,000 in fiscal year 2013 are for
payments for prescription drugs under
Minnesota Statutes, section 256D.031,
subdivision 9.
new text end

new text begin Any amount under paragraph (g) that is not
spent in the first year does not cancel and is
available for payments in the second year.
new text end

new text begin The commissioner may transfer any
unexpended amount under Minnesota
Statutes, section 256D.031, subdivision 9,
after the final allocation in fiscal year 2011 to
make payments under Minnesota Statutes,
section 256D.031, subdivision 7.
new text end

(h) Medical Assistance Grants

4,175,592,000

3,938,873,000

new text begin new text begin Managed Care Incentive Payments. new text end The
commissioner shall not make managed care
incentive payments for expanding preventive
services. This provision does not expire.
new text end

new text begin Capitation Payment Delay. The
commissioner shall delay 71 percent of the
medical assistance capitation payment for
families with children to managed care plans
and county-based purchasing plans due in
May of 2013 until July of 2013.
new text end

new text begin Reduction of Rates for Congregate
Living for Individuals with Lower Needs.
Beginning October 1, 2011, lead agencies
must reduce rates in effect on January 1,
2011, by ten percent for individuals with
lower needs living in foster care settings
where the license holder does not share the
residence with recipients on the CADI, DD,
and TBI waivers and customized living
settings for CADI and TBI. Lead agencies
must adjust contracts within 60 days of the
effective date.
new text end

new text begin Reduction of Lead Agency Waiver
Allocations to Implement Rate Reductions
for Congregate Living for Individuals
with Lower Needs. Beginning October 1,
2011, the commissioner shall reduce lead
agency waiver allocations to implement the
reduction of rates for individuals with lower
needs living in foster care settings where the
license holder does not share the residence
with recipients on the CADI, DD, and TBI
waivers and customized living settings for
CADI and TBI.
new text end

new text begin Manage Elderly Waiver Growth.
Beginning July 1, 2011, and ending on June
30, 2013, the commissioner shall manage
the elderly waiver so that the number of
people does not exceed the number on June
30, 2011.
new text end

new text begin Reduce customized living and 24-hour
customized living component rates.
Effective July 1, 2011, the commissioner
shall reduce elderly waiver customized living
and 24-hour customized living component
service spending by ten percent through
reductions in component rates and service
rate limits. The commissioner shall adjust
the elderly waiver capitation payment
rates for managed care organizations paid
under Minnesota Statutes, section 256B.69,
subdivisions 6a and 23, to reflect reductions
in component spending for customized living
services and 24-hour customized living
services under Minnesota Statutes, section
256B.0915, subdivisions 3e and 3h, for the
contract period beginning January 1, 2012.
To implement the reduction specified in
this provision, capitation rates paid by the
commissioner to managed care organizations
under Minnesota Statutes, section 256B.69,
shall reflect a 20 percent reduction for the
specified services for the period January 1,
2012, to June 30, 2012, and a ten percent
reduction for those services on or after July
1, 2012.
new text end

new text begin Limit Growth in the Developmental
Disability Waiver. For the biennium
beginning July 1, 2011, the commissioner
shall limit the developmental disability
waiver to the number of recipients served
in March 2010. If necessary to achieve
this level, the commissioner shall not
refill waiver openings until the number of
waiver recipients reaches the March 2010
level. Once the March 2010 enrollment
level is reached, the commissioner shall
refill vacated openings to maintain the
March 2010 enrollment level. To the
extent possible, waiver allocations shall
be available to individuals who meet the
priorities for accessing waiver services
described in Minnesota Statutes, section
256B.092, subdivision 12. The limits do not
include conversions from intermediate care
facilities for persons with developmental
disabilities. When implementing the waiver
enrollment limits under this provision, it
is an absolute defense to an appeal under
Minnesota Statutes, section 256.045, if
the commissioner or lead agency proves
that it followed the established written
procedures and criteria and determined that
home and community-based services could
not be provided to the person within the
appropriations or lead agency's allocation of
home and community-based services money.
new text end

new text begin Limit Growth in the Community
Alternatives for Disabled Individuals
Waiver. For the biennium beginning
July 1, 2011, the commissioner shall limit
the community alternatives for disabled
individuals waiver to the number of
recipients served in March 2010. If necessary
to achieve this level, the commissioner shall
not refill waiver openings until the number
of waiver recipients reaches the March 2010
level. Once the March 2010 enrollment
level is reached, the commissioner shall
refill vacated openings to maintain the
March 2010 enrollment level. To the
extent possible, waiver allocations shall
be available to individuals who meet the
priorities for accessing waiver services
described in Minnesota Statutes, section
256B.49, subdivision 11a. The limits include
conversions and diversions, unless the
commissioner has approved a plan to convert
funding due to the closure or downsizing
of a residential facility or nursing facility
to serve directly affected individuals on
the community alternatives for disabled
individuals waiver. When implementing
the waiver enrollment limits under this
provision, it is an absolute defense to an
appeal under Minnesota Statutes, section
256.045, if the commissioner or lead agency
proves that it followed the established written
procedures and criteria and determined that
home and community-based services could
not be provided to the person within the
appropriations or lead agency's allocation of
home and community-based services money.
new text end

new text begin Limit Growth in the Waiver for
Individuals with Traumatic Brain Injury.
For the biennium beginning July 1, 2011, the
commissioner shall limit the traumatic brain
injury waiver to the number of recipients
served in March 2010. If necessary to
achieve this level, the commissioner shall
not refill waiver openings until the number
of waiver recipients reaches the March 2010
level. Once the March 2010 enrollment
level is reached, the commissioner shall
refill vacated openings to maintain the
March 2010 enrollment level. To the
extent possible, waiver allocations shall
be available to individuals who meet the
priorities for accessing waiver services
described in Minnesota Statutes, section
256B.49, subdivision 11a. The limits include
conversions and diversions, unless the
commissioner has approved a plan to convert
funding due to the closure or downsizing of a
residential facility or nursing facility to serve
directly affected individuals on the traumatic
brain injury waiver. When implementing
the waiver enrollment limits under this
provision, it is an absolute defense to an
appeal under Minnesota Statutes, section
256.045, if the commissioner or lead agency
proves that it followed the established written
procedures and criteria and determined that
home and community-based services could
not be provided to the person within the
appropriations or lead agency's allocation of
home and community-based services money.
new text end

new text begin Personal Care Assistance Relative
Care. The commissioner shall adjust the
capitation payment rates for managed care
organizations paid under Minnesota Statutes,
section 256B.69, to reflect the rate reductions
for personal care assistance provided by
a relative pursuant to Minnesota Statutes,
section 256B.0659, subdivision 11.
new text end

(i) Alternative Care Grants

45,727,000

47,877,000

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

(j) Chemical Dependency Entitlement Grants

108,568,000

123,095,000

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

(a) Support Services Grants

new text begin Appropriations by Fund new text end
new text begin General new text end	new text begin 8,715,000 new text end	new text begin 8,715,000 new text end
new text begin Federal TANF new text end	new text begin 100,525,000 new text end	new text begin 94,611,000 new text end

new text begin MFIP Consolidated Fund Grants. The
TANF fund base is reduced by $10,000,000
each year beginning in fiscal year 2012.
new text end

new text begin 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 year 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.
new text end

(b) Basic Sliding Fee Child Care Assistance
Grants

36,067,000

37,342,000

new text begin Base Adjustment. The general fund base is
decreased by $1,490,000 in fiscal year 2014
and $867,000 in fiscal year 2015.
new text end

new text begin new text begin Child Care and Development Fund
Unexpended Balance. new text end In addition to
the amount provided in this section, the
commissioner shall expend $5,000,000
in fiscal year 2012 from the federal child
care and 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.
new text end

232,000

new text begin Base Adjustment. The general fund base is
increased by $1,255,000 is fiscal years 2014
and 2015.
new text end

(d) Child Support Enforcement Grants

50,000

new text begin new text begin Federal Child Support Demonstration
Grants. new text end Federal administrative
reimbursement resulting from the federal
child support grant expenditures authorized
under section 1115a of the Social Security
Act is appropriated to the commissioner for
this activity.
new text end

(e) Children's Services Grants

new text begin Appropriations by Fund new text end
new text begin General new text end	new text begin 45,654,000 new text end	new text begin 45,654,000 new text end
new text begin Federal TANF new text end	new text begin 140,000 new text end	new text begin 140,000 new text end

new text begin Adoption Assistance and Relative Custody
Assistance Payments. $1,661,000 each
year is for continuation of current payments
for adoption assistance and relative custody
assistance.
new text end

new text begin Adoption Assistance and Relative Custody
Assistance Transfer. The commissioner
may transfer unencumbered appropriation
balances for adoption assistance and relative
custody assistance between fiscal years and
between programs.
new text end

new text begin new text begin Privatized Adoption Grants. new text end 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.
new text end

new text begin Adoption Assistance Incentive Grants.
Federal funds available during fiscal year
2012 and fiscal year 2013 for adoption
incentive grants are appropriated to the
commissioner for these purposes.
new text end

new text begin new text begin Base Adjustment.new text end The general fund base is
increased by $1,134,000 is fiscal years 2014
and 2015.
new text end

(f) Children and Community Services Grants

54,301,000

52,301,000

(g) Children and Economic Support Grants

new text begin Appropriations by Fund new text end
new text begin General new text end	new text begin 15,770,000 new text end	new text begin 15,772,000 new text end
new text begin Federal TANF new text end	new text begin 700,000 new text end	new text begin 0 new text end

new text begin new text begin Long-Term Homeless Services.new text end $700,000
is appropriated from the federal TANF
fund for the biennium beginning July
1, 2011, to the commissioner of human
services for long-term homeless services
for low-income homeless families under
Minnesota Statutes, section 256K.26. This
is a onetime appropriation and is not added
to the base.
new text end

new text begin Base Adjustment. The general fund base is
increased by $42,000 in fiscal year 2014 and
$43,000 in fiscal year 2015.
new text end

(h) Health Care Grants

150,000

new text begin This appropriation is from the health care
access fund.
new text end

new text begin new text begin Surplus Appropriation Canceled.new text end Of the
health care access fund appropriation in
Laws 2009, chapter 79, article 13, section 3,
subdivision 6, paragraph (e), for the COBRA
premium state subsidy program, $11,750,000
must be canceled in fiscal year 2011. This
provision is effective the day following final
enactment.
new text end

(i) Aging and Adult Services Grants

18,734,000

18,910,000

new text begin Aging Grants Reduction. Effective July
1, 2011, funding for grants made under
Minnesota Statutes, sections 256.9754 and
256B.0917, subdivision 13, is reduced by
$3,600,000 for each year of the biennium.
These reductions are onetime and do
not affect base funding for the 2014-2015
biennium. Grants made during the 2012-2013
biennium under Minnesota Statutes, section
256B.9754, must not be used for new
construction or building renovation.
new text end

new text begin new text begin Base Level Adjustment. new text end The general fund
base is increased by $3,600,000 in fiscal year
2014 and increased by $3,600,000 in fiscal
year 2015.
new text end

(j) Deaf and Hard-of-Hearing Grants

1,936,000

1,767,000

(k) Disabilities Grants

15,438,000

18,432,000

new text begin HIV Grants. The general fund appropriation
for the HIV drug and insurance grant
program shall be reduced by $2,425,000 in
fiscal year 2012 and increased by $2,425,000
in fiscal year 2014. These adjustments are
onetime and shall not be applied to the base.
Notwithstanding any contrary provision, this
provision expires June 30, 2014. Money
appropriated for the HIV drug and insurance
grant program in fiscal year 2014 may be
used in either year of the biennium.
new text end

new text begin Region 10. Any unspent allocation for
Region 10 Quality Assurance from the
biennium beginning on July 1, 2009, may be
carried over into the biennium beginning on
July 1, 2011.
new text end

new text begin Base Level Adjustment. The general fund
base is increased by $2,425,000 in fiscal year
2014 only.
new text end

new text begin Local Planning Grants for Creating
Alternatives to Congregate Living for
Individuals with Lower Needs. The
commissioner shall make available a total
of $250,000 per year in local planning
grants, beginning July 1, 2011, to assist
lead agencies and provider organizations in
developing alternatives to congregate living
within the available level of resources for the
home and community-based services waivers
for persons with disabilities.
new text end

(l) Adult Mental Health Grants

new text begin Appropriations by Fund new text end
new text begin General new text end	new text begin 69,957,000 new text end	new text begin 69,957,000 new text end
new text begin Health Care Access new text end	new text begin 375,000 new text end	new text begin 375,000 new text end
new text begin Lottery Prize Fund new text end	new text begin 1,508,000 new text end	new text begin 1,508,000 new text end

new text begin new text begin Funding Usage. new text end 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.
new text end

new text begin Base Adjustment. The general fund base is
increased by $813,000 in fiscal years 2014
and 2015. The health care access fund base
is increased by $375,000 in fiscal years 2014
and 2015.
new text end

(m) Children's Mental Health Grants

14,251,000

new text begin 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.
new text end

new text begin Base Adjustment. The general fund base is
increased by $2,431,000 in fiscal years 2014
and 2015.
new text end

(n) Chemical Dependency Nonentitlement
Grants

1,336,000

new text begin Transfer Authority Related to
State-Operated Services. Money
appropriated for state-operated services
may be transferred between fiscal years
of the biennium with the approval of the
commissioner of management and budget.
new text end

(a) State-Operated Services Mental Health

115,286,000

115,135,000

new text begin The commissioner shall close the Community
Behavioral Health Hospital-Willmar on or
before June 30, 2011. The commissioner
shall relocate the Child and Adolescent
Behavioral Health Hospital located in
the former Willmar Regional Treatment
Center to the facility previously housing
the Community Behavioral Health
Hospital-Willmar.
new text end

(b) Minnesota Security Hospital

69,582,000

70,416,000

67,570,000

new text begin new text begin Transfer Authority Related to Minnesota
Sex Offender Program. new text end Money
appropriated for the Minnesota sex offender
program may be transferred between fiscal
years of the biennium with the approval
of the commissioner of management and
budget.
new text end

new text begin new text begin Minnesota Sex Offender Program
Reduction. new text end The fiscal year 2011 general
fund appropriation for Minnesota sex
offender services under Laws 2009, chapter
79, article 13, section 3, subdivision 10,
paragraph (b), is reduced by $3,000,000.
This paragraph is effective the day following
final enactment.
new text end

92,206,000

79,551,000

new text begin This appropriation is from the federal TANF
fund.
new text end

new text begin new text begin Base Level Adjustment. new text end The TANF fund
base is increased by $4,155,000 in fiscal year
2014 and increased by $4,582,000 in fiscal
year 2015.
new text end

new text begin $
new text end

new text begin 132,589,000
new text end

new text begin $
new text end

new text begin 123,237,000
new text end

new text begin Appropriations by Fund new text end
	new text begin 2012 new text end	new text begin 2013 new text end
new text begin General new text end	new text begin 69,455,000 new text end	new text begin 64,341,000 new text end
new text begin State Government Special Revenue new text end	new text begin 45,387,000 new text end	new text begin 45,376,000 new text end
new text begin Health Care Access new text end	new text begin 11,381,000 new text end	new text begin 7,155,000 new text end
new text begin Federal TANF new text end	new text begin 6,366,000 new text end	new text begin 6,365,000 new text end

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

new text begin Appropriations by Fund new text end
new text begin General new text end	new text begin 43,539,000 new text end	new text begin 38,799,000 new text end
new text begin State Government Special Revenue new text end	new text begin 1,033,000 new text end	new text begin 1,033,000 new text end
new text begin Health Care Access new text end	new text begin 1,719,000 new text end	new text begin 1,719,000 new text end
new text begin Federal TANF new text end	new text begin 6,366,000 new text end	new text begin 6,365,000 new text end

new text begin TANF Appropriations. new text end new text begin (1) $578,000 of the
TANF funds is appropriated each year to the
commissioner for family planning grants
under Minnesota Statutes, section 145.925.
new text end

new text begin (2) $1,790,000 of the TANF funds is
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.
new text end

new text begin (3) $1,000,000 of the TANF funds is
appropriated each year to the commissioner
for decreasing infant mortality rates under
Minnesota Statutes, section 145.928,
subdivision 7.
new text end

new text begin (4) $2,998,000 of the TANF funds is
appropriated each year to the commissioner
for the family home visiting grant program
according to Minnesota Statutes, section
145A.17. $2,000,000 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.
new text end

new text begin (5) The commissioner may use up to 7.06
percent of the funds appropriated each fiscal
year to conduct the ongoing evaluations
required under Minnesota Statutes, section
145A.17, subdivision 7, and training and
technical assistance as required under
Minnesota Statutes, section 145A.17,
subdivisions 4 and 5.
new text end

new text begin TANF Carryforward. new text end new text begin Any unexpended
balance of the TANF appropriation in the
first year of the biennium does not cancel but
is available for the second year.
new text end

new text begin new text begin Base Level Adjustment.new text end The general fund
base is decreased by $5,000 in fiscal years
2014 and 2015.
new text end

new text begin Appropriations by Fund new text end
new text begin General new text end	new text begin 10,395,000 new text end	new text begin 10,023,000 new text end
new text begin State Government Special Revenue new text end	new text begin 14,026,000 new text end	new text begin 14,083,000 new text end
new text begin Health Care Access new text end	new text begin 9,662,000 new text end	new text begin 5,436,000 new text end

new text begin new text begin Medical Education and Research
Costs (MERC) Fund Transfers.new text end The
commissioner of management and budget
shall transfer $9,800,000 from the MERC
fund to the general fund by October 1, 2011.
new text end

new text begin White Earth Clinic. Of the general fund
appropriation, $500,000 in the first year and
$200,000 in the second year is for a grant
to the White Earth Band of Ojibwe Indians.
If the White Earth Band of Ojibwe Indians
accepts this grant, funds must be used for
the White Earth Clinic under Minnesota
Statutes, section 145.9271. The base for this
program is $200,000 for each of fiscal years
2014 and 2015.
new text end

new text begin Comprehensive Advanced Life Support.
Of the general fund appropriation, $31,000
each year is added to the base of the
comprehensive advanced life support
(CALS) program under Minnesota Statutes,
section 144.6062.
new text end

new text begin Unused Federal Match Funds. new text end new text begin Of the
funds appropriated in Laws 2009, chapter
79, article 13, section 4, subdivision 3, for
state matching funds for the federal Health
Information Technology for Economic and
Clinical Health Act, $2,800,000 is transferred
to the health care access fund by October 1,
2011.
new text end

new text begin new text begin Loan Forgiveness.new text end $1,014,000 is
appropriated from the health care access
fund in fiscal year 2012 for the department to
fulfill existing obligations of loan forgiveness
agreements. This funding is available
through fiscal year 2014. In addition, prior
year funds appropriated for loan forgiveness
and required to fulfill existing obligations do
not expire and are available until expended.
new text end

new text begin Administrative Reports. new text end new text begin Of the general
fund appropriation, $82,000 in fiscal year
2012 and $10,000 in fiscal year 2013
are for transfer to the commissioner of
management and budget for the reduction of
the administrative report study.
new text end

new text begin Base Level Adjustment. new text end new text begin The state
government special revenue fund base shall
be reduced by $141,000 in fiscal years 2014
and 2015. The health care access base shall
be increased by $600,000 in fiscal year 2014.
new text end

new text begin Appropriations by Fund new text end
new text begin General new text end	new text begin 9,370,000 new text end	new text begin 9,370,000 new text end
new text begin State Government Special Revenue new text end	new text begin 30,328,000 new text end	new text begin 30,260,000 new text end

6,151,000

6,149,000

new text begin $
new text end

new text begin 524,000
new text end

new text begin $
new text end

new text begin 524,000
new text end

new text begin $
new text end

new text begin 1,655,000
new text end

new text begin $
new text end

new text begin 1,655,000
new text end

new text begin Funds appropriated for fiscal year 2011 are
available until expended.
new text end

new text begin $
new text end

new text begin 265,000
new text end

new text begin $
new text end

new text begin 265,000
new text end

new text begin $
new text end

new text begin 17,748,000
new text end

new text begin $
new text end

new text begin 17,534,000
new text end

new text begin This appropriation is from the state
government special revenue fund. The
amounts that may be spent for each purpose
are specified in the following subdivisions.
new text end

469,000

1,829,000

1,814,000

new text begin new text begin Health Professional Services Program.new text end Of
this appropriation, $704,000 in fiscal year
2012 and $704,000 in fiscal year 2013 from
the state government special revenue fund are
for the health professional services program.
new text end

110,000

192,000

167,000

new text begin Rulemaking. Of this appropriation, $25,000
in fiscal year 2012 is for rulemaking. This is
a onetime appropriation.
new text end

3,866,000

3,694,000

3,551,000

2,153,000

2,145,000

new text begin Rulemaking. Of this appropriation, $44,000
in fiscal year 2012 is for rulemaking. This is
a onetime appropriation.
new text end

new text begin Electronic Licensing System Adaptors.
Of this appropriation, $761,000 in fiscal
year 2013 from the state government special
revenue fund is to the administrative services
unit to cover the costs to connect to the
e-licensing system. Minnesota Statutes,
section 16E.22. Base level funding for this
activity in fiscal year 2014 shall be $100,000.
Base level funding for this activity in fiscal
year 2015 shall be $50,000.
new text end

new text begin Development and Implementation of a
Disciplinary, Regulatory, Licensing and
Information Management System. Of this
appropriation, $800,000 in fiscal year 2012
and $300,000 in fiscal year 2013 are for the
development of a shared system. Base level
funding for this activity in fiscal year 2014
shall be $50,000.
new text end

new text begin Administrative Services Unit - Operating
Costs. Of this appropriation, $526,000
in fiscal year 2012 and $526,000 in
fiscal year 2013 are for operating costs
of the administrative services unit. The
administrative services unit may receive
and expend reimbursements for services
performed by other agencies.
new text end

new text begin Administrative Services Unit - Retirement
Costs. Of this appropriation in fiscal year
2012, $225,000 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.
new text end

new text begin Administrative Services Unit - Volunteer
Health Care Provider Program. Of this
appropriation, $150,000 in fiscal year 2012
and $150,000 in fiscal year 2013 are to pay
for medical professional liability coverage
required under Minnesota Statutes, section
214.40.
new text end

new text begin new text begin Administrative Services Unit - Contested
Cases and Other Legal Proceedings.new text end Of
this appropriation, $200,000 in fiscal year
2012 and $200,000 in fiscal year 2013 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 management and
budget. This appropriation does not cancel.
Any unencumbered and unspent balances
remain available for these expenditures in
subsequent fiscal years.
new text end

new text begin Base Adjustment. The State Government
Special Revenue Fund base is decreased by
$911,000 in fiscal year 2014 and $1,011,000
in fiscal year 2015.
new text end

106,000

2,341,000

2,344,000

new text begin Prescription Electronic Reporting. Of
this appropriation, $356,000 in fiscal year
2012 and $356,000 in fiscal year 2013 from
the state government special revenue fund
are to the board to operate the prescription
electronic reporting system in Minnesota
Statutes, section 152.126. Base level funding
for this activity in fiscal year 2014 shall be
$356,000.
new text end

389,000

345,000

new text begin Rulemaking. Of this appropriation, $44,000
in fiscal year 2012 is for rulemaking. This is
a onetime appropriation.
new text end

75,000

846,000

1,036,000

1,053,000

228,000

229,000

414,000

new text begin $
new text end

new text begin 2,742,000
new text end

new text begin $
new text end

new text begin 2,742,000
new text end

new text begin Regional Grants. $585,000 in fiscal year
2012 and $585,000 in fiscal year 2013 are
for regional emergency medical services
programs, to be distributed equally to the
eight emergency medical service regions.
Notwithstanding Minnesota Statutes, section
144E.50, 100 percent of the appropriation
shall be granted to the emergency medical
service regions.
new text end

new text begin Cooper/Sams Volunteer Ambulance
Program. $700,000 in fiscal year 2012 and
$700,000 in fiscal year 2013 are for the
Cooper/Sams volunteer ambulance program
under Minnesota Statutes, section 144E.40.
new text end

new text begin (a) Of this amount, $611,000 in fiscal year
2012 and $611,000 in fiscal year 2013
are for the ambulance service personnel
longevity award and incentive program,
under Minnesota Statutes, section 144E.40.
new text end

new text begin (b) Of this amount, $89,000 in fiscal year
2012 and $89,000 in fiscal year 2013 are
for the operations of the ambulance service
personnel longevity award and incentive
program, under Minnesota Statutes, section
144E.40.
new text end

new text begin Ambulance Training Grant. $361,000 in
fiscal year 2012 and $361,000 in fiscal year
2013 are for training grants.
new text end

new text begin EMSRB Board Operations. $1,096,000 in
fiscal year 2012 and $1,096,000 in fiscal year
2013 are for operations.
new text end

Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision
to read:

new text begin Federal
administrative reimbursement resulting from the following activities is appropriated to the
commissioner for the designated purposes:
new text end

new text begin (1) reimbursement for the Minnesota senior health options project; and
new text end

new text begin (2) reimbursement related to prior authorization and inpatient admission certification
by a professional review organization. A portion of these funds must be used for activities
to decrease unnecessary pharmaceutical costs in medical assistance.
new text end

Laws 2010, First Special Session chapter 1, article 15, section 3, subdivision
6, is amended to read:

(a) Aging and Adult Services Grants

(3,600,000)

Community Service/Service Development
Grants Reduction. Effective retroactively
from July 1, 2009, funding for grants made
under Minnesota Statutes, sections 256.9754
and 256B.0917, subdivision 13, is reduced by
deleted text begin $5,807,000deleted text end new text begin $3,600,000new text end for each year of the
biennium. Grants made during the biennium
under Minnesota Statutes, section 256.9754,
shall not be used for new construction or
building renovation.

Aging Grants Delay. Aging grants must be
reduced by $917,000 in fiscal year 2011 and
increased by $917,000 in fiscal year 2012.
These adjustments are onetime and must not
be applied to the base. This provision expires
June 30, 2012.

(b) Medical Assistance Long-Term Care
Facilities Grants

(3,827,000)

(2,745,000)

ICF/MR Variable Rates Suspension.
Effective retroactively from July 1, 2009,
to June 30, 2010, no new variable rates
shall be authorized for intermediate care
facilities for persons with developmental
disabilities under Minnesota Statutes, section
256B.5013, subdivision 1.

ICF/MR Occupancy Rate Adjustment
Suspension. Effective retroactively from
July 1, 2009, to June 30, 2011, approval
of new applications for occupancy rate
adjustments for unoccupied short-term
beds under Minnesota Statutes, section
256B.5013, subdivision 7, is suspended.

(2,318,000)

(5,807,000)

Developmental Disability Waiver Acuity
Factor. Effective retroactively from January
1, 2010, the January 1, 2010, one percent
growth factor in the developmental disability
waiver allocations under Minnesota Statutes,
section 256B.092, subdivisions 4 and 5,
that is attributable to changes in acuitydeleted text begin ,deleted text end
is deleted text begin suspended to June 30, 2011deleted text end new text begin eliminated.
Effective January 1, 2012, the one percent
growth factor in the developmental
disability waiver allocations is eliminated.
Notwithstanding any law to the contrary, this
provision does not expirenew text end .

(d) Adult Mental Health Grants

(5,000,000)

-0-

(e) Chemical Dependency Entitlement Grants

(3,622,000)

(f) Chemical Dependency Nonentitlement
Grants

(393,000)

(g) Other Continuing Care Grants

-0-

(2,500,000)
(1,414,000)

Other Continuing Care Grants Delay.
Other continuing care grants must be reduced
by $1,414,000 in fiscal year 2011 and
increased by $1,414,000 in fiscal year 2012.
These adjustments are onetime and must not
be applied to the base. This provision expires
June 30, 2012.

(h) Deaf and Hard-of-Hearing Grants

-0-

(169,000)

new text begin new text begin Deaf and Hard-of-Hearing Grants Delay.new text end
Effective retroactively from July 1, 2010,
deaf and hard-of-hearing grants must be
reduced by $169,000 in fiscal year 2011 and
increased by $169,000 in fiscal year 2012.
These adjustments are onetime and must not
be applied to the base. This provision expires
June 30, 2012.
new text end

new text begin The commissioner of human services, with the approval
of the commissioner of management and budget, and after notification of the chairs of
the senate health and human services budget and policy committee and the house of
representatives health and human services finance committee, may transfer unencumbered
appropriation balances for the biennium ending June 30, 2013, within fiscal years among
the MFIP; general assistance; general assistance medical care under Minnesota Statutes,
section 256D.03, subdivision 3; medical assistance; MFIP child care assistance under
Minnesota Statutes, section 119B.05; Minnesota supplemental aid; MinnesotaCare,
and group residential housing programs, and the entitlement portion of the chemical
dependency consolidated treatment fund, and between fiscal years of the biennium.
new text end

new text begin Positions, salary money, and nonsalary administrative
money may be transferred within the Departments of Health and Human Services as the
commissioners consider necessary, with the advance approval of the commissioner of
management and budget. The commissioner shall inform the chairs of the senate health
and human services budget and policy committee and the house of representatives health
and human services finance committee quarterly about transfers made under this provision.
new text end

new text begin The commissioners of health and human services shall not use indirect cost
allocations to pay for the operational costs of any program for which they are responsible.
new text end

new text begin All uncodified language contained in this article expires on June 30, 2013, unless a
different expiration date is explicit.
new text end

new text begin The provisions in this article are effective July 1, 2011, unless a different effective
date is specified.
new text end

new text begin APPROPRIATIONS
new text end

new text begin Available for the Year
new text end

new text begin Ending June 30
new text end

new text begin 2012
new text end

new text begin 2013
new text end