1.1 	A bill for an act
1.2 	relating to state government; establishing the governor's budget for health and 
1.3 	human services; amending provisions related to continuing care, child care, 
1.4 	Minnesota family investment program, adult supports, program integrity, child 
1.5 	support, licensing, health care programs including MinnesotaCare, medical 
1.6 	assistance and general assistance medical care, state-operated services, the 
1.7 	Department of Health, chemical and mental health, health-related fees, and 
1.8 	correctional state employees retirement plans; establishing the Protecting 
1.9 	Children and Strengthening Families Act; establishing Northstar Care for 
1.10 	Children; establishing and increasing fees; creating work groups; requiring 
1.11 	reports; appropriating money;amending Minnesota Statutes 2008, sections 
1.12 	16A.725, subdivision 3; 62J.692, subdivision 7; 103I.208, subdivision 2; 
1.13 	119B.02, subdivision 5; 119B.09, subdivision 7; 119B.12, subdivision 1; 
1.14 	119B.13, subdivisions 1, 6; 125A.744, subdivision 3; 144.0724, subdivisions 
1.15 	2, 4, 8, by adding subdivisions; 144.121, subdivisions 1a, 1b; 144.122; 
1.16 	144.1222, subdivision 1a; 144.1501, subdivisions 2, 5; 144.226, subdivision 
1.17 	4; 144.72, subdivisions 1, 3; 144.9501, subdivisions 22b, 26a, by adding 
1.18 	subdivisions; 144.9505, subdivisions 1g, 4; 144.9508, subdivisions 2, 3, 4; 
1.19 	144.97, subdivisions 2, 4, 6, by adding subdivisions; 144.98, subdivisions 1, 
1.20 	2, 3, by adding subdivisions; 144.99, subdivision 1; 144A.46, subdivision 
1.21 	1; 145.986, subdivision 5; 148.108; 148.6445, by adding a subdivision; 
1.22 	148D.180, subdivisions 1, 2, 3, 5; 148E.180, subdivisions 1, 2, 3, 5; 153A.17; 
1.23 	156.015; 157.15, by adding a subdivision; 157.16; 157.22; 176.011, subdivision 
1.24 	9; 245.4885, subdivision 1; 245A.03, by adding a subdivision; 245A.10, 
1.25 	subdivisions 2, 3, 4, 5, by adding subdivisions; 245A.11, by adding a subdivision; 
1.26 	245C.03, subdivision 2; 245C.04, subdivision 3; 245C.10, subdivision 3, by 
1.27 	adding a subdivision; 246.50, subdivision 5, by adding subdivisions; 246.51, by 
1.28 	adding subdivisions; 246.511; 246.52; 246B.01, by adding subdivisions; 252.43; 
1.29 	252.46, by adding a subdivision; 254A.02, by adding a subdivision; 254A.16, by 
1.30 	adding a subdivision; 254B.03, subdivision 3; 256.01, subdivision 2b, by adding 
1.31 	a subdivision; 256.045, subdivision 3; 256.969, subdivisions 2b, 3a; 256.975, 
1.32 	subdivision 7; 256.991; 256B.04, subdivisions 14, 16; 256B.055, subdivision 
1.33 	12; 256B.056, subdivisions 3b, 3c, 3d, 10; 256B.057, subdivisions 3, 9; 
1.34 	256B.0575; 256B.0595, subdivisions 1, 2; 256B.0621, subdivision 2; 256B.0625, 
1.35 	subdivisions 6a, 7, 8, 8a, 8b, 9, 13e, 17, 19a, 19c, 26, 41, 47, by adding 
1.36 	subdivisions; 256B.0651; 256B.0652; 256B.0653; 256B.0654; 256B.0655, 
1.37 	subdivision 4; 256B.0657, subdivisions 2, 6, 8; 256B.0911, subdivisions 1, 1a, 3, 
1.38 	3a, 4a, 5, 6, 7, by adding subdivisions; 256B.0913, subdivision 4; 256B.0915, 
1.39 	subdivisions 3e, 3h, 5, by adding a subdivision; 256B.0917, by adding a 
2.1 	subdivision; 256B.092, subdivision 8a, by adding a subdivision; 256B.0944, by 
2.2 	adding a subdivision; 256B.0945, subdivision 4; 256B.0947, subdivision 1; 
2.3 	256B.15, subdivisions 1a, 1h, 2, by adding subdivisions; 256B.199; 256B.37, 
2.4 	subdivisions 1, 5; 256B.437, subdivision 6; 256B.441, by adding subdivisions; 
2.5 	256B.49, subdivisions 12, 13, 14, 17, by adding a subdivision; 256B.501, 
2.6 	subdivision 4a; 256B.5012, by adding a subdivision; 256B.69, subdivisions 
2.7 	5a, 5c, 5f; 256B.761; 256D.03, subdivisions 3, 4; 256D.06, subdivision 2; 
2.8 	256D.09, subdivision 6; 256D.46; 256D.49, subdivision 3; 256G.02, subdivision 
2.9 	6; 256I.03, subdivision 7; 256I.05, subdivision 1a; 256J.20, subdivision 3; 
2.10 	256J.21, subdivision 2; 256J.24, subdivisions 3, 4, 5a, 10; 256J.37, subdivision 
2.11 	3a, by adding a subdivision; 256J.38, subdivision 1; 256J.45, subdivision 3; 
2.12 	256J.53, subdivision 2; 256J.575, subdivision 3; 256J.621; 256J.626, subdivision 
2.13 	6; 256J.751, by adding a subdivision; 256J.95, subdivision 12; 256L.01, 
2.14 	subdivisions 1a, 3a, 4, 5, by adding a subdivision; 256L.02, subdivisions 1, 
2.15 	3; 256L.03, subdivisions 1, 1a, 1b, 3, 5; 256L.04, subdivisions 1, 1a, 2, 8, 10, 
2.16 	13; 256L.05, subdivisions 3, 3a, 3b, 3c, 5; 256L.06, subdivision 3; 256L.07, 
2.17 	subdivisions 2, 3, 5, 7, by adding subdivisions; 256L.09, subdivision 2; 256L.11, 
2.18 	subdivisions 1, 2a, 6; 256L.12, subdivisions 6, 9; 256L.15, subdivision 1, by 
2.19 	adding subdivisions; 256L.17, by adding a subdivision; 257.85, subdivisions 2, 5, 
2.20 	6; 259.67, by adding subdivisions; 260B.441; 270A.09, by adding a subdivision; 
2.21 	295.58; 297I.05, subdivision 5; 327.14, by adding a subdivision; 327.15; 327.16; 
2.22 	327.20, subdivision 1, by adding a subdivision; 352.72, subdivision 1; 352.90; 
2.23 	352.91, subdivisions 1, 3h; 352.93, subdivisions 1, 2a, 4, by adding a subdivision; 
2.24 	356.30, subdivision 1; 393.07, subdivision 10; 501B.89, by adding a subdivision; 
2.25 	518A.53, subdivisions 1, 4, 10; 518A.60; 519.05; 604A.33, subdivision 1; 
2.26 	609.232, subdivision 11; 626.5572, subdivisions 6, 21; Laws 2003, First Special 
2.27 	Session chapter 14, article 13C, section 2, subdivision 1, as amended; Laws 2005, 
2.28 	First Special Session chapter 4, article 8, section 66; Laws 2008, chapter 358, 
2.29 	article 3, section 8; proposing coding for new law in Minnesota Statutes, chapters 
2.30 	156; 246B; 254A; 254B; 256; 256B; proposing coding for new law as Minnesota 
2.31 	Statutes, chapters 256N; 256O; repealing Minnesota Statutes 2008, sections 
2.32 	16A.724; 62U.08; 62U.10, subdivision 4; 103I.112; 144.9501, subdivision 17b; 
2.33 	148D.180, subdivision 8; 246.51, subdivision 1; 246.53, subdivision 3; 256.82, 
2.34 	subdivisions 2, 3, 4, 5; 256.962, subdivisions 1, 2, 5, 7; 256.969, subdivisions 26, 
2.35 	27; 256.983; 256B.057, subdivision 2c; 256B.0655, subdivisions 1, 1a, 1b, 1c, 
2.36 	1d, 1e, 1f, 1g, 1h, 1i, 2, 3, 5, 6, 7, 8, 9, 10, 11, 12, 13; 256B.071, subdivisions 1, 2, 
2.37 	3, 4; 256B.0951; 256B.19, subdivision 1d; 256B.431, subdivision 23; 256B.76, 
2.38 	subdivision 4; 256I.06, subdivision 9; 256J.626, subdivision 7; 256L.02, 
2.39 	subdivision 3; 256L.04, subdivisions 7, 9; 256L.05, subdivision 1b; 256L.07, 
2.40 	subdivisions 1, 6, 7; 256L.09, subdivisions 2, 4, 5, 6; 256L.11, subdivision 7; 
2.41 	256L.15, subdivisions 2, 3, 4; 257.85; 259.67, subdivisions 1, 2, 3, 3a, 4, 5, 6, 
2.42 	7, 8, 9, 10; 295.581; 327.14, subdivisions 5, 6; 352.91, subdivisions 2, 2a, 3c, 
2.43 	3d, 3e, 3f, 3g, 3i, 4a, 4b, 5; Laws 1988, chapter 689, section 251; Laws 2005, 
2.44 	chapter 10, article 1, sections 56; 57; Laws 2005, First Special Session chapter 4, 
2.45 	article 8, sections 61; 67; 69; 74; 75; Laws 2007, chapter 147, article 5, sections 
2.46 	28; 32; 33; article 13, section 2; Laws 2008, chapter 358, article 3, sections 8; 9; 
2.47 	10; 11; 14; Minnesota Rules, parts 4626.2015, subpart 9; 9100.0400, subparts 1, 
2.48 	3; 9100.0500; 9100.0600; 9500.1243, subpart 3; 9500.1261, subparts 3, 4, 5, 6; 
2.49 	9560.0071; 9560.0081; 9560.0082; 9560.0083; 9560.0091; 9560.0093, subparts 
2.50 	1, 3, 4; 9560.0101; 9560.0102; 9560.0521, subparts 7, 10; 9560.0650, subparts 
2.51 	1, 3, 6; 9560.0651; 9560.0652; 9560.0653; 9560.0654; 9560.0655; 9560.0656; 
2.52 	9560.0657; 9560.0665, subparts 2, 3, 4, 5, 6, 7, 8, 9.
2.53 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

3.1 	ARTICLE 1
3.2 	CONTINUING CARE

3.3 	Section 1. Minnesota Statutes 2008, section 144.0724, subdivision 2, is amended to 
3.4 	read:
3.5 		Subd. 2.Definitions. For purposes of this section, the following terms have the 
3.6 	meanings given.
3.7 	(a) "Assessment reference date" means the last day of the minimum data set 
3.8 	observation period. The date sets the designated endpoint of the common observation 
3.9 	period, and all minimum data set items refer back in time from that point.
3.10 	(b) "Case mix index" means the weighting factors assigned to the RUG-III 
3.11 	classifications.
3.12 	(c) "Index maximization" means classifying a resident who could be assigned to 
3.13 	more than one category, to the category with the highest case mix index.
3.14 	(d) "Minimum data set" means the assessment instrument specified by the Centers for 
3.15 	Medicare and Medicaid Services and designated by the Minnesota Department of Health.
3.16 	(e) "Representative" means a person who is the resident's guardian or conservator, 
3.17 	the person authorized to pay the nursing home expenses of the resident, a representative 
3.18 	of the nursing home ombudsman's office whose assistance has been requested, or any 
3.19 	other individual designated by the resident.
3.20 	(f) "Resource utilization groups" or "RUG" means the system for grouping a nursing 
3.21 	facility's residents according to their clinical and functional status identified in data 
3.22 	supplied by the facility's minimum data set.
3.23 	(g) "Activities of daily living" means grooming, dressing, bathing, transferring, 
3.24 	mobility, positioning, eating, and toileting.
3.25 	(h) "Nursing facility level of care determination" means the assessment process 
3.26 	that results in a determination of a resident's or prospective resident's need for nursing 
3.27 	facility level of care as established in subdivision 11 for purposes of medical assistance 
3.28 	payment of long-term care services for:
3.29 	(1) nursing facility services under section 256B.434 or 256B.441;
3.30 	(2) elderly waiver services under section 256B.0915;
3.31 	(3) CADI and TBI waiver services under section 256B.49; and
3.32 	(4) state payment of alternative care services under section 256B.0913.

3.33 	Sec. 2. Minnesota Statutes 2008, section 144.0724, subdivision 4, is amended to read:
4.1 		Subd. 4.Resident assessment schedule. (a) A facility must conduct and 
4.2 	electronically submit to the commissioner of health case mix assessments that conform 
4.3 	with the assessment schedule defined by Code of Federal Regulations, title 42, section 
4.4 	483.20, and published by the United States Department of Health and Human Services, 
4.5 	Centers for Medicare and Medicaid Services, in the Long Term Care Assessment 
4.6 	Instrument User's Manual, version 2.0, October 1995, and subsequent clarifications made 
4.7 	in the Long-Term Care Assessment Instrument Questions and Answers, version 2.0, 
4.8 	August 1996. The commissioner of health may substitute successor manuals or question 
4.9 	and answer documents published by the United States Department of Health and Human 
4.10 	Services, Centers for Medicare and Medicaid Services, to replace or supplement the 
4.11 	current version of the manual or document.
4.12 	(b) The assessments used to determine a case mix classification for reimbursement 
4.13 	include the following:
4.14 	(1) a new admission assessment must be completed by day 14 following admission;
4.15 	(2) an annual assessment must be completed within 366 days of the last 
4.16 	comprehensive assessment;
4.17 	(3) a significant change assessment must be completed within 14 days of the 
4.18 	identification of a significant change; and
4.19 	(4) the second quarterly assessment following either a new admission assessment, 
4.20 	an annual assessment, or a significant change assessment, and all quarterly assessments 
4.21 	beginning October 1, 2006. Each quarterly assessment must be completed within 92 
4.22 	days of the previous assessment.
4.23 	(c) In addition to the assessments listed in paragraph (b), the assessments used to 
4.24 	determine nursing facility level of care include the following:
4.25 	(1) preadmission screening completed under section 256B.0911, subdivision 4a, 
4.26 	by a county, tribe, or managed care organization under contract with the Department 
4.27 	of Human Services; and
4.28 	(2) a face-to-face long-term care consultation assessment completed under section 
4.29 	256B.0911, subdivision 3a, 3b, or 4d, by a county, tribe, or managed care organization 
4.30 	under contract with the Department of Human Services.

4.31 	Sec. 3. Minnesota Statutes 2008, section 144.0724, subdivision 8, is amended to read:
4.32 		Subd. 8.Request for reconsideration of resident classifications. (a) The resident, 
4.33 	or resident's representative, or the nursing facility or boarding care home may request that 
4.34 	the commissioner of health reconsider the assigned reimbursement classification. The 
4.35 	request for reconsideration must be submitted in writing to the commissioner within 
5.1 	30 days of the day the resident or the resident's representative receives the resident 
5.2 	classification notice. The request for reconsideration must include the name of the 
5.3 	resident, the name and address of the facility in which the resident resides, the reasons for 
5.4 	the reconsideration, the requested classification changes, and documentation supporting 
5.5 	the requested classification. The documentation accompanying the reconsideration request 
5.6 	is limited to documentation which establishes that the needs of the resident at the time of 
5.7 	the assessment justify a classification which is different than the classification established 
5.8 	by the commissioner of health.
5.9 	(b) Upon request, the nursing facility must give the resident or the resident's 
5.10 	representative a copy of the assessment form and the other documentation that was given 
5.11 	to the commissioner of health to support the assessment findings. The nursing facility 
5.12 	shall also provide access to and a copy of other information from the resident's record that 
5.13 	has been requested by or on behalf of the resident to support a resident's reconsideration 
5.14 	request. A copy of any requested material must be provided within three working days of 
5.15 	receipt of a written request for the information. If a facility fails to provide the material 
5.16 	within this time, it is subject to the issuance of a correction order and penalty assessment 
5.17 	under sections 144.653 and 144A.10. Notwithstanding those sections, any correction order 
5.18 	issued under this subdivision must require that the nursing facility immediately comply 
5.19 	with the request for information and that as of the date of the issuance of the correction 
5.20 	order, the facility shall forfeit to the state a $100 fine for the first day of noncompliance, and 
5.21 	an increase in the $100 fine by $50 increments for each day the noncompliance continues. 
5.22 	(c) In addition to the information required under paragraphs (a) and (b), a 
5.23 	reconsideration request from a nursing facility must contain the following information: (i) 
5.24 	the date the reimbursement classification notices were received by the facility; (ii) the date 
5.25 	the classification notices were distributed to the resident or the resident's representative; 
5.26 	and (iii) a copy of a notice sent to the resident or to the resident's representative. This 
5.27 	notice must inform the resident or the resident's representative that a reconsideration of the 
5.28 	resident's classification is being requested, the reason for the request, that the resident's 
5.29 	rate will change if the request is approved by the commissioner, the extent of the change, 
5.30 	that copies of the facility's request and supporting documentation are available for review, 
5.31 	and that the resident also has the right to request a reconsideration. If the facility fails to 
5.32 	provide the required information with the reconsideration request, the request must be 
5.33 	denied, and the facility may not make further reconsideration requests on that specific 
5.34 	reimbursement classification.
5.35 	(d) Reconsideration by the commissioner must be made by individuals not involved 
5.36 	in reviewing the assessment, audit, or reconsideration that established the disputed 
6.1 	classification. The reconsideration must be based upon the initial assessment and upon the 
6.2 	information provided to the commissioner under paragraphs (a) and (b). If necessary for 
6.3 	evaluating the reconsideration request, the commissioner may conduct on-site reviews. 
6.4 	Within 15 working days of receiving the request for reconsideration, the commissioner 
6.5 	shall affirm or modify the original resident classification. The original classification 
6.6 	must be modified if the commissioner determines that the assessment resulting in the 
6.7 	classification did not accurately reflect the needs or assessment characteristics of the 
6.8 	resident at the time of the assessment. The resident and the nursing facility or boarding 
6.9 	care home shall be notified within five working days after the decision is made. A decision 
6.10 	by the commissioner under this subdivision is the final administrative decision of the 
6.11 	agency for the party requesting reconsideration.
6.12 	(e) The resident classification established by the commissioner shall be the 
6.13 	classification that applies to the resident while the request for reconsideration is pending.
6.14 	If a request for reconsideration applies to an assessment used to determine nursing facility 
6.15 	level of care under subdivision 4, paragraph (c), the resident shall continue to be eligible 
6.16 	for nursing facility level of care while the request for reconsideration is pending.
6.17 	(f) The commissioner may request additional documentation regarding a 
6.18 	reconsideration necessary to make an accurate reconsideration determination.

6.19 	Sec. 4. Minnesota Statutes 2008, section 144.0724, is amended by adding a subdivision 
6.20 	to read:
6.21 		Subd. 11.Nursing facility level of care. (a) For purposes of medical assistance 
6.22 	payment of long-term care services, a recipient must be determined, using assessments 
6.23 	defined in subdivision 4, to meet one of the following nursing facility level of care criteria:
6.24 	(1) the person needs the assistance of another person or constant supervision to 
6.25 	begin and complete at least four activities of daily living;
6.26 	(2) the person needs the assistance of another person or constant supervision to begin 
6.27 	and complete toileting, transferring, or positioning and the assistance cannot be scheduled;
6.28 	(3) the person has significant difficulty with memory, using information, daily 
6.29 	decision making, or behavioral needs that require intervention;
6.30 	(4) the person has had a previous qualifying nursing facility stay of at least 90 
6.31 	days; or
6.32 	(5) the person is determined to be at risk for nursing facility admission or 
6.33 	readmission through a face-to-face long-term care consultation assessment as specified 
6.34 	in section 256B.0911, subdivision 3a, 3b, or 4d, by a county, tribe, or managed care 
6.35 	organization under contract with the Department of Human Services. The person is 
7.1 	considered at risk under this clause if the person currently lives alone or will live alone 
7.2 	upon discharge and also meets one of the following criteria:
7.3 	(i) the person has experienced a fall resulting in a fracture;
7.4 	(ii) the person has been determined to be at risk of maltreatment or neglect, 
7.5 	including self-neglect; or
7.6 	(iii) the person has a sensory impairment that substantially impacts functional ability 
7.7 	and maintenance of a community residence.
7.8 	(b) The assessment used to establish medical assistance payment for nursing facility 
7.9 	services must be the most recent assessment performed under subdivision 4, paragraph 
7.10 	(b), that occurred no more than 90 calendar days before the effective date of medical 
7.11 	assistance financial eligibility determination. In no case shall medical assistance payment 
7.12 	for long-term care services occur prior to the date of the determination of nursing facility 
7.13 	level of care.
7.14 	(c) The assessment used to establish medical assistance payment for services 
7.15 	provided under sections 256B.0915 and 256B.49 and alternative care payment for services 
7.16 	provided under section 256B.0913 must be the most recent face-to-face assessment 
7.17 	performed under subdivision 4, paragraph (c), clause (2), that occurred no more than 60 
7.18 	calendar days before the effective date of financial eligibility determination.

7.19 	Sec. 5. Minnesota Statutes 2008, section 144.0724, is amended by adding a subdivision 
7.20 	to read:
7.21 		Subd. 12.Appeal of nursing facility level of care determination. A resident or 
7.22 	prospective resident whose level of care determination results in a denial of long-term care 
7.23 	services can appeal the determination as outlined in section 256B.0911, subdivision 3a, 
7.24 	paragraph (h), clause (7).

7.25 	Sec. 6. Minnesota Statutes 2008, section 245A.03, is amended by adding a subdivision 
7.26 	to read:
7.27 		Subd. 7.Licensing moratorium. (a) The commissioner shall not issue an 
7.28 	initial license for child foster care licensed under Minnesota Rules, parts 2960.3000 to 
7.29 	2960.3340, or adult foster care licensed under Minnesota Rules, parts 9555.5105 to 
7.30 	9555.6265, under this chapter for a physical location that will not be the primary residence 
7.31 	of the license holder for the entire period of licensure. If a license is issued during this 
7.32 	moratorium, and the license holder changes the license holder's primary residence away 
7.33 	from the physical location of the foster care license, the commissioner shall revoke the 
7.34 	license according to section 245A.07. Exceptions to the moratorium include:
8.1 	(1) foster care settings that are required to be registered under chapter 144D;
8.2 	(2) foster care licenses replacing foster care licenses in existence on the effective 
8.3 	date of this section and determined to be needed by the commissioner under paragraph (b);
8.4 	(3) new foster care licenses determined to be needed by the commissioner under 
8.5 	paragraph (b) for the closure of a nursing facility, ICF/MR, or regional treatment center;
8.6 	(4) new foster care licenses determined to be needed by the commissioner under 
8.7 	paragraph (b) for persons requiring hospital level of care; or
8.8 	(5) new foster care licenses determined to be needed by the commissioner for the 
8.9 	transition of people from personal care assistance to the home and community-based 
8.10 	services.
8.11 	(b) The commissioner shall determine the need for newly licensed foster care homes 
8.12 	as defined under this subdivision. As part of the determination, the commissioner shall 
8.13 	consider the availability of foster care capacity in the area which the licensee seeks to 
8.14 	operate, and the recommendation of the local county board. The determination by the 
8.15 	commissioner must be final. A determination of need is not required for a change in 
8.16 	ownership at the same address.
8.17 	(c) The commissioner shall study the effects of the license moratorium under this 
8.18 	subdivision and shall report back to the legislature by January 15, 2011.

8.19 	EFFECTIVE DATE. This section is effective the day following final enactment.

8.20 	Sec. 7. Minnesota Statutes 2008, section 245A.11, is amended by adding a subdivision 
8.21 	to read:
8.22 		Subd. 8.Community residential setting license. (a) The commissioner shall 
8.23 	establish provider standards for residential support services that integrate service standards 
8.24 	and the residential setting under one license. The commissioner shall propose statutory 
8.25 	language and an implementation plan for licensing requirements for residential support 
8.26 	services to the legislature by January 15, 2011.
8.27 	(b) Providers licensed under chapter 245B, and providing, contracting, or arranging 
8.28 	for services in settings licensed as adult foster care under Minnesota Rules, parts 
8.29 	9555.5105 to 9555.6265, or child foster care under Minnesota Rules, parts 2960.3000 to 
8.30 	2960.3340; and meeting the provisions of section 256B.092, subdivision 11, paragraph 
8.31 	(b), must be required to obtain a community residential setting license.

8.32 	Sec. 8. Minnesota Statutes 2008, section 252.43, is amended to read:
8.33 	252.43 COMMISSIONER'S DUTIES.
9.1 	The commissioner shall supervise county boards' provision of day training and 
9.2 	habilitation services to adults with developmental disabilities. The commissioner shall:
9.3 	(1) determine the need for day training and habilitation services under section 252.28;
9.4 	(2) approve payment rates established by a county under section 252.46, subdivision 
9.5 	1;
9.6 	(3) adopt rules for the administration and provision of day training and habilitation 
9.7 	services under sections 252.40 to 252.46 and sections 245A.01 to 245A.16 and 252.28, 
9.8 	subdivision 2;
9.9 	(4) (3) enter into interagency agreements necessary to ensure effective coordination 
9.10 	and provision of day training and habilitation services;
9.11 	(5) (4) monitor and evaluate the costs and effectiveness of day training and 
9.12 	habilitation services; and
9.13 	(6) (5) provide information and technical help to county boards and vendors in their 
9.14 	administration and provision of day training and habilitation services.

9.15 	Sec. 9. Minnesota Statutes 2008, section 252.46, is amended by adding a subdivision 
9.16 	to read:
9.17 		Subd. 1a.Day training and habilitation rates. The commissioner shall establish 
9.18 	a statewide rate-setting methodology for all day training and habilitation services. The 
9.19 	rate-setting methodology must abide by the principles of transparency and equitability 
9.20 	across the state. The methodology must involve a uniform process of structuring rates for 
9.21 	each service and must promote quality and participant choice.

9.22 	Sec. 10. [256.0281] INTERAGENCY DATA EXCHANGE.
9.23 	The Department of Human Services, the Department of Health, and the Office of the 
9.24 	Ombudsman for Mental Health and Developmental Disabilities may establish interagency 
9.25 	agreements governing the electronic exchange of data on providers and individuals 
9.26 	collected, maintained, or used by each agency when such exchange is outlined by each 
9.27 	agency in an interagency agreement to accomplish the purposes in clauses (1) to (4):
9.28 	(1) to improve provider enrollment processes for home and community-based 
9.29 	services and state plan home care services;
9.30 	(2) to improve quality management of providers between state agencies;
9.31 	(3) to establish and maintain provider eligibility to participate as providers under 
9.32 	Minnesota health care programs; and
10.1 	(4) to meet the quality assurance reporting requirements under federal law under 
10.2 	section 1915(c) of the Social Security Act related to home and community-based waiver 
10.3 	programs.
10.4 	Each interagency agreement must include provisions to ensure anonymity of individuals, 
10.5 	including mandated reporters, and must outline the specific uses of and access to shared 
10.6 	data within each agency. Electronic interfaces between source data systems developed 
10.7 	under these interagency agreements must incorporate these provisions as well as other 
10.8 	HIPPA provisions related to individual data.

10.9 	Sec. 11. Minnesota Statutes 2008, section 256.975, subdivision 7, is amended to read:
10.10 		Subd. 7.Consumer information and assistance; senior linkage. (a) The 
10.11 	Minnesota Board on Aging shall operate a statewide information and assistance service 
10.12 	to aid older Minnesotans and their families in making informed choices about long-term 
10.13 	care options and health care benefits. Language services to persons with limited English 
10.14 	language skills may be made available. The service, known as Senior LinkAge Line, must 
10.15 	be available during business hours through a statewide toll-free number and must also 
10.16 	be available through the Internet.
10.17 	(b) The service must assist provide long-term care options counseling by assisting
10.18 	older adults, caregivers, and providers in accessing information about choices in long-term 
10.19 	care services that are purchased through private providers or available through public 
10.20 	options. The service must:
10.21 	(1) develop a comprehensive database that includes detailed listings in both 
10.22 	consumer- and provider-oriented formats;
10.23 	(2) make the database accessible on the Internet and through other telecommunication 
10.24 	and media-related tools;
10.25 	(3) link callers to interactive long-term care screening tools and make these tools 
10.26 	available through the Internet by integrating the tools with the database;
10.27 	(4) develop community education materials with a focus on planning for long-term 
10.28 	care and evaluating independent living, housing, and service options;
10.29 	(5) conduct an outreach campaign to assist older adults and their caregivers in 
10.30 	finding information on the Internet and through other means of communication;
10.31 	(6) implement a messaging system for overflow callers and respond to these callers 
10.32 	by the next business day;
10.33 	(7) link callers with county human services and other providers to receive more 
10.34 	in-depth assistance and consultation related to long-term care options;
11.1 	(8) link callers with quality profiles for nursing facilities and other providers 
11.2 	developed by the commissioner of health; and
11.3 	(9) incorporate information about housing with services and consumer rights 
11.4 	within the MinnesotaHelp.info network long-term care database to facilitate consumer 
11.5 	comparison of services and costs among housing with services establishments and with 
11.6 	other in-home services and to support financial self-sufficiency as long as possible. 
11.7 	Housing with services establishments and their arranged home care providers shall provide 
11.8 	information to the commissioner of human services that is consistent with information 
11.9 	required by the commissioner of health under section 144G.06, the Uniform Consumer 
11.10 	Information Guide price and other information requested by the commissioner of human 
11.11 	services regarding rents and services. The commissioners of human services and health 
11.12 	shall align the data elements required by this section, and section 144G.06, the Uniform 
11.13 	Consumer Information Guide, to provide consumers standardized information and ease 
11.14 	of comparison of long-term care options. The commissioner of human services shall 
11.15 	provide the data to the Minnesota Board on Aging for inclusion in the MinnesotaHelp.info 
11.16 	network long-term care database.
11.17 	(c) The Minnesota Board on Aging shall conduct an evaluation of the effectiveness 
11.18 	of the statewide information and assistance, and submit this evaluation to the legislature 
11.19 	by December 1, 2002. The evaluation must include an analysis of funding adequacy, gaps 
11.20 	in service delivery, continuity in information between the service and identified linkages, 
11.21 	and potential use of private funding to enhance the service.

11.22 	Sec. 12. Minnesota Statutes 2008, section 256B.0625, subdivision 6a, is amended to 
11.23 	read:
11.24 		Subd. 6a.Home health services. Home health services are those services specified 
11.25 	in Minnesota Rules, part 9505.0295 sections 256B.0651 and 256B.0653. Medical 
11.26 	assistance covers home health services at a recipient's home residence. Medical assistance 
11.27 	does not cover home health services for residents of a hospital, nursing facility, or 
11.28 	intermediate care facility, unless the commissioner of human services has prior authorized 
11.29 	skilled nurse visits for less than 90 days for a resident at an intermediate care facility for 
11.30 	persons with developmental disabilities, to prevent an admission to a hospital or nursing 
11.31 	facility or unless a resident who is otherwise eligible is on leave from the facility and the 
11.32 	facility either pays for the home health services or forgoes the facility per diem for the 
11.33 	leave days that home health services are used. Home health services must be provided by 
11.34 	a Medicare certified home health agency. All nursing and home health aide services must 
11.35 	be provided according to sections 256B.0651 to 256B.0656256B.0653.

12.1 	Sec. 13. Minnesota Statutes 2008, section 256B.0625, subdivision 7, is amended to 
12.2 	read:
12.3 		Subd. 7.Private duty nursing. Medical assistance covers private duty nursing 
12.4 	services in a recipient's home. Recipients who are authorized to receive private duty 
12.5 	nursing services in their home may use approved hours outside of the home during hours 
12.6 	when normal life activities take them outside of their home. To use private duty nursing 
12.7 	services at school, the recipient or responsible party must provide written authorization in 
12.8 	the care plan identifying the chosen provider and the daily amount of services to be used at 
12.9 	school. Medical assistance does not cover private duty nursing services for residents of a 
12.10 	hospital, nursing facility, intermediate care facility, or a health care facility licensed by the 
12.11 	commissioner of health, except as authorized in section 256B.64 for ventilator-dependent 
12.12 	recipients in hospitals or unless a resident who is otherwise eligible is on leave from the 
12.13 	facility and the facility either pays for the private duty nursing services or forgoes the 
12.14 	facility per diem for the leave days that private duty nursing services are used. Total hours 
12.15 	of service and payment allowed for services outside the home cannot exceed that which is 
12.16 	otherwise allowed in an in-home setting according to sections 256B.0651 and 256B.0653
12.17 	256B.0654 to 256B.0656. All private duty nursing services must be provided according to 
12.18 	the limits established under sections 256B.0651 and 256B.0653 to 256B.0656. Private 
12.19 	duty nursing services may not be reimbursed if the nurse is the foster care provider of 
12.20 	a recipient who is under age 18.

12.21 	Sec. 14. Minnesota Statutes 2008, section 256B.0625, subdivision 8, is amended to 
12.22 	read:
12.23 		Subd. 8.Physical therapy. Medical assistance covers physical therapy, as 
12.24 	described in section 148.65, and related services, including specialized maintenance 
12.25 	therapy. Services provided by a physical therapy assistant shall be reimbursed at the 
12.26 	same rate as services performed by a physical therapist when the services of the physical 
12.27 	therapy assistant are provided under the direction of a physical therapist who is on the 
12.28 	premises. Services provided by a physical therapy assistant that are provided under the 
12.29 	direction of a physical therapist who is not on the premises shall be reimbursed at 65 
12.30 	percent of the physical therapist rate.

12.31 	Sec. 15. Minnesota Statutes 2008, section 256B.0625, subdivision 8a, is amended to 
12.32 	read:
12.33 		Subd. 8a.Occupational therapy. Medical assistance covers occupational therapy, 
12.34 	as described in section 148.6404, and related services, including specialized maintenance 
13.1 	therapy. Services provided by an occupational therapy assistant shall be reimbursed at 
13.2 	the same rate as services performed by an occupational therapist when the services of 
13.3 	the occupational therapy assistant are provided under the direction of the occupational 
13.4 	therapist who is on the premises. Services provided by an occupational therapy assistant 
13.5 	that are provided under the direction of an occupational therapist who is not on the 
13.6 	premises shall be reimbursed at 65 percent of the occupational therapist rate.

13.7 	Sec. 16. Minnesota Statutes 2008, section 256B.0625, subdivision 19a, is amended to 
13.8 	read:
13.9 		Subd. 19a.Personal care assistant services. Medical assistance covers personal 
13.10 	care assistant services in a recipient's home. To qualify for personal care assistant services, 
13.11 	a recipient must require assistance and be determined dependent in two activities of daily 
13.12 	living as defined in section 256B.0659. Recipients or responsible parties must be able 
13.13 	to identify the recipient's needs, direct and evaluate task accomplishment, and provide 
13.14 	for health and safety. Approved hours may be used outside the home when normal life 
13.15 	activities take them outside the home. To use personal care assistant services at school, 
13.16 	the recipient or responsible party must provide written authorization in the care plan 
13.17 	identifying the chosen provider and the daily amount of services to be used at school. 
13.18 	Total hours for services, whether actually performed inside or outside the recipient's 
13.19 	home, cannot exceed that which is otherwise allowed for personal care assistant services 
13.20 	in an in-home setting according to sections 256B.0651and 256B.0653 to 256B.0656. 
13.21 	Medical assistance does not cover personal care assistant services for residents of a 
13.22 	hospital, nursing facility, intermediate care facility, health care facility licensed by the 
13.23 	commissioner of health, or unless a resident who is otherwise eligible is on leave from 
13.24 	the facility and the facility either pays for the personal care assistant services or forgoes 
13.25 	the facility per diem for the leave days that personal care assistant services are used. 
13.26 	All personal care assistant services must be provided according to sections 256B.0651
13.27 	and 256B.0653 to 256B.0656. Personal care assistant services may not be reimbursed if 
13.28 	the personal care assistant is the spouse or legalpaid guardian of the recipient or the 
13.29 	parent of a recipient under age 18, or the responsible party or the foster care provider 
13.30 	of a recipient who cannot direct the recipient's own care unless, in the case of a foster 
13.31 	care provider, a county or state case manager visits the recipient as needed, but not less 
13.32 	than every six months, to monitor the health and safety of the recipient and to ensure the 
13.33 	goals of the care plan are met. Parents of adult recipients, adult children of the recipient 
13.34 	or adult siblings of the recipient may be reimbursed for personal care assistant services, 
13.35 	if they are granted a waiver under sections 256B.0651 and 256B.0653 to 256B.0656. 
14.1 	Notwithstanding the provisions of section 256B.0655, subdivision 2, paragraph (b), clause 
14.2 	(4) 256B.0659, the noncorporate legal unpaid guardian or conservator of an adult, who 
14.3 	is not the responsible party and not the personal care provider organization, may be 
14.4 	granted a hardship waiver under sections 256B.0651 and 256B.0653 to 256B.0656, to be
14.5 	reimbursed to provide personal care assistant services to the recipient if the guardian or 
14.6 	conservator meet all criteria for a personal care assistant according to section 256B.0659, 
14.7 	and shall not be considered to have a service provider interest for purposes of participation 
14.8 	on the screening team under section 256B.092, subdivision 7.

14.9 	Sec. 17. Minnesota Statutes 2008, section 256B.0625, subdivision 19c, is amended to 
14.10 	read:
14.11 		Subd. 19c.Personal care. Medical assistance covers personal care assistant services 
14.12 	provided by an individual who is qualified to provide the services according to subdivision 
14.13 	19a and sections 256B.0651and 256B.0653 to 256B.0656, where the services have a 
14.14 	statement of need by a physician, provided in accordance with a plan, and are supervised 
14.15 	by the recipient or a qualified professional. The physician's statement of need for personal 
14.16 	care assistant services shall be documented on a form approved by the commissioner and 
14.17 	include the diagnosis or condition of the person that results in a need for personal care 
14.18 	assistant services and be updated when the person's medical condition requires a change, 
14.19 	but at least annually if the need for personal care assistant services is ongoing.
14.20 	"Qualified professional" means a mental health professional as defined in section 245.462, 
14.21 	subdivision 18, or 245.4871, subdivision 27; or a registered nurse as defined in sections 
14.22 	148.171 to 148.285, or a licensed social worker as defined in section 148B.21. As part 
14.23 	of the assessment, the county public health nurse will assist the recipient or responsible 
14.24 	party to identify the most appropriate person to provide supervision of the personal 
14.25 	care assistant. The qualified professional shall perform the duties describedrequired in 
14.26 	Minnesota Rules, part 9505.0335, subpart 4 section 256B.0659.

14.27 	Sec. 18. Minnesota Statutes 2008, section 256B.0651, is amended to read:
14.28 	256B.0651 HOME CARE SERVICES.
14.29 		Subdivision 1.Definitions. (a) "Activities of daily living" includes eating, toileting, 
14.30 	grooming, dressing, bathing, transferring, mobility, and positioning For the purposes of 
14.31 	sections 256B.0651 to 256B.0656 and 256B.0659, the terms in paragraphs (b) to (g) 
14.32 	have the meanings given.
14.33 	(b) "Activities of daily living" has the meaning given in section 256B.0659, 
14.34 	subdivision 1, paragraph (b).
15.1 	(b) (c) "Assessment" means a review and evaluation of a recipient's need for home 
15.2 	care services conducted in person as required in section 256B.0911. Assessments for home 
15.3 	health agency services shall be conducted by a home health agency nurse. Assessments 
15.4 	for medical assistance home care services for developmental disability and alternative care 
15.5 	services for developmentally disabled home and community-based waivered recipients 
15.6 	may be conducted by the county public health nurse to ensure coordination and avoid 
15.7 	duplication. Assessments must be completed on forms provided by the commissioner 
15.8 	within 30 days of a request for home care services by a recipient or responsible party.
15.9 	(c) (d) "Home care services" means a health service, determined by the commissioner 
15.10 	as medically necessary, that is ordered by a physician and documented in a service plan 
15.11 	that is reviewed by the physician at least once every 60 days for the provision of home 
15.12 	health services, or private duty nursing, or at least once every 365 days for personal care. 
15.13 	Home care services are provided to the recipient at the recipient's residence that is a 
15.14 	place other than a hospital or long-term care facility or as specified in section 256B.0625
15.15 	means medical assistance covered services that are home health agency services, including 
15.16 	skilled nurse visits; home health aide visits; physical therapy, occupational therapy, 
15.17 	respiratory therapy, and language-speech pathology therapy; private duty nursing; and 
15.18 	personal care assistance.
15.19 	(e) "Home residence" means a residence owned or rented by the recipient either 
15.20 	alone, with roommates of the recipient's choosing, or with an unpaid responsible party 
15.21 	or legal representative; or a family foster home where the license holder lives with the 
15.22 	recipient and is not paid to provide home care services for the recipient.
15.23 	(d) (f) "Medically necessary" has the meaning given in Minnesota Rules, parts 
15.24 	9505.0170 to 9505.0475.
15.25 	(e) "Telehomecare" means the use of telecommunications technology by a home 
15.26 	health care professional to deliver home health care services, within the professional's 
15.27 	scope of practice, to a patient located at a site other than the site where the practitioner 
15.28 	is located.
15.29 	(g) "Ventilator-dependent" means an individual who receives mechanical ventilation 
15.30 	for life support at least six hours per day and is expected to be or has been dependent on a 
15.31 	ventilator for at least 30 consecutive days.
15.32 		Subd. 2.Services covered. Home care services covered under this section and 
15.33 	sections 256B.0653 256B.0652  to 256B.0656 and 256B.0659 include:
15.34 	(1) nursing services under section sections256B.0625, subdivision 6a, and 
15.35 	256B.0653;
16.1 	(2) private duty nursing services under section sections256B.0625, subdivision 
16.2 	7, and 256B.0654;
16.3 	(3) home health services under section sections256B.0625, subdivision 6a, and 
16.4 	256B.0653;
16.5 	(4) personal care assistant services under section sections256B.0625, subdivision 
16.6 	19a, and 256B.0659;
16.7 	(5) supervision of personal care assistant services provided by a qualified 
16.8 	professional under section sections256B.0625, subdivision 19a, and 256B.0659;
16.9 	(6) qualified professional of personal care assistant services under the fiscal 
16.10 	intermediary option as specified in section 256B.0655, subdivision 7;
16.11 	(7) (6) face-to-face assessments by county public health nurses for services under 
16.12 	section sections256B.0625, subdivision 19a, and 256B.0659; and
16.13 	(8) (7) service updates and review of temporary increases for personal care assistant 
16.14 	services by the county public health nurse for services under section sections256B.0625, 
16.15 	subdivision 19a, and 256B.0659.
16.16 		Subd. 3.Noncovered home care services. The following home care services are 
16.17 	not eligible for payment under medical assistance:
16.18 	(1) skilled nurse visits for the sole purpose of supervision of the home health aide;
16.19 	(2) a skilled nursing visit:
16.20 	(i) only for the purpose of monitoring medication compliance with an established 
16.21 	medication program for a recipient; or
16.22 	(ii) to administer or assist with medication administration, including injections, 
16.23 	prefilling syringes for injections, or oral medication set-up of an adult recipient, when as 
16.24 	determined and documented by the registered nurse, the need can be met by an available 
16.25 	pharmacy or the recipient is physically and mentally able to self-administer or prefill 
16.26 	a medication;
16.27 	(3) home care services to a recipient who is eligible for covered services under the 
16.28 	Medicare program or any other insurance held by the recipient;
16.29 	(4) services to other members of the recipient's household;
16.30 	(5) a visit made by a skilled nurse solely to train other home health agency workers;
16.31 	(6) any home care service included in the daily rate of the community-based 
16.32 	residential facility where the recipient is residing;
16.33 	(7) nursing and rehabilitation therapy services that are reasonably accessible to a 
16.34 	recipient outside the recipient's place of residence, excluding the assessment, counseling 
16.35 	and education, and personal assistant care;
17.1 	(8) any home health agency service, excluding personal care assistant services and 
17.2 	private duty nursing services, which are performed in a place other than the recipient's 
17.3 	residence; and
17.4 	(9) Medicare evaluation or administrative nursing visits on dual-eligible recipients 
17.5 	that do not qualify for Medicare visit billing.
17.6 	(1) services provided in a nursing facility, hospital, or intermediate care facility with 
17.7 	exceptions in section 256B.0653;
17.8 	(2) services for the sole purpose of monitoring medication compliance with an 
17.9 	established medication program for a recipient;
17.10 	(3) home care services for covered services under the Medicare program or any other 
17.11 	insurance held by the recipient;
17.12 	(4) services to other members of the recipient's household;
17.13 	(5) any home care service included in the daily rate of the community-based 
17.14 	residential facility where the recipient is residing;
17.15 	(6) nursing and rehabilitation therapy services that are reasonably accessible to a 
17.16 	recipient outside the recipient's place of residence, excluding the assessment, counseling 
17.17 	and education, and personal assistance care; or
17.18 	(7) Medicare evaluation or administrative nursing visits on dual-eligible recipients 
17.19 	that do not qualify for Medicare visit billing.
17.20 		Subd. 4.Prior Authorization; exceptions. All home care services above the limits 
17.21 	in subdivision 11 must receive the commissioner's prior authorization before services 
17.22 	begin, except when:
17.23 	(1) the home care services were required to treat an emergency medical condition 
17.24 	that if not immediately treated could cause a recipient serious physical or mental disability, 
17.25 	continuation of severe pain, or death. The provider must request retroactive authorization 
17.26 	no later than five working days after giving the initial service. The provider must be able 
17.27 	to substantiate the emergency by documentation such as reports, notes, and admission or 
17.28 	discharge histories;
17.29 	(2) the home care services were provided on or after the date on which the recipient's 
17.30 	eligibility began, but before the date on which the recipient was notified that the case was 
17.31 	opened. Authorization will be considered if the request is submitted by the provider 
17.32 	within 20 working days of the date the recipient was notified that the case was opened;
17.33 	a recipient's eligibility lapse from medical assistance has been retroactively reinstated 
17.34 	and an authorization for home care services is completed based on the date of a current 
17.35 	assessment, eligibility, and request for authorization;
18.1 	(3) a third-party payor for home care services has denied or adjusted a payment. 
18.2 	Authorization requests must be submitted by the provider within 20 working days of the 
18.3 	notice of denial or adjustment. A copy of the notice must be included with the request;
18.4 	(4) the commissioner has determined that a county or state human services agency 
18.5 	has made an error; or
18.6 	(5) the professional nurse determines an immediate need for up to 40 skilled nursing 
18.7 	or home health aide visits per calendar year and submits a request for authorization within 
18.8 	20 working days of the initial service date, and medical assistance is determined to be 
18.9 	the appropriate payer. if a recipient enrolled in managed care experiences a temporary 
18.10 	disenrollment from a health plan, the commissioner shall accept the current health plan 
18.11 	authorization for personal care assistance services for up to 60 days. The request must 
18.12 	be received within the first 30 days of the disenrollment. If the recipient's reenrollment 
18.13 	in managed care is after the 60 days and before 90 days, the provider shall request an 
18.14 	additional 30-day extension of the current health plan authorization, for a total limit of 
18.15 	90 days from the time of disenrollment.
18.16 		Subd. 5.Retroactive authorization. A request for retroactive authorization will be 
18.17 	evaluated according to the same criteria applied to prior authorization requests.
18.18 		Subd. 6.Prior Authorization. (a) The commissioner, or the commissioner's 
18.19 	designee, shall review the assessment, service update, request for temporary services, 
18.20 	request for flexible use option, service plan, and any additional information that is 
18.21 	submitted. The commissioner shall, within 30 days after receiving a complete request, 
18.22 	assessment, and service plan, authorize home care services as follows: provided in this 
18.23 	section.
18.24 	(a) Home health services.(b) All Home health services provided by a home health 
18.25 	aide including skilled nurse visits and home health aide visits must be prior authorized 
18.26 	by the commissioner or the commissioner's designee. Prior Authorization must be based 
18.27 	on medical necessity and cost-effectiveness when compared with other care options. 
18.28 	The commissioner must receive the request for authorization of skilled nurse visits and 
18.29 	home health aide visits within 20 working days of the start of service. When home health 
18.30 	services are used in combination with personal care and private duty nursing, the cost of 
18.31 	all home care services shall be considered for cost-effectiveness. The commissioner shall 
18.32 	limit home health aide visits to no more than one visit each per day. The commissioner, or 
18.33 	the commissioner's designee, may authorize up to two skilled nurse visits per day.
18.34 	(b) Ventilator-dependent recipients.(c) If the recipient is ventilator-dependent, the 
18.35 	monthly medical assistance authorization for home care services shall not exceed what the 
18.36 	commissioner would pay for care at the highest cost hospital designated as a long-term 
19.1 	hospital under the Medicare program. For purposes of this paragraph, home care services 
19.2 	means all direct care services provided in the home that would be included in the payment 
19.3 	for care at the long-term hospital. "Ventilator-dependent" means an individual who 
19.4 	receives mechanical ventilation for life support at least six hours per day and is expected 
19.5 	to be or has been dependent for at least 30 consecutive days. Recipients who meet the 
19.6 	definition of ventilator dependent and the EN home care rating and utilize a combination 
19.7 	of home care services are limited up to a total of 24 hours of home care services per day. 
19.8 	Additional hours may be authorized when a recipient's assessment indicates a need for two 
19.9 	staff to perform activities. Additional time is limited to four hours per day.
19.10 		Subd. 7.Prior Authorization; time limits. (a) The commissioner or the 
19.11 	commissioner's designee shall determine the time period for which a prior an authorization 
19.12 	shall be effective and, if flexible use has been requested, whether to allow the flexible use 
19.13 	option. If the recipient continues to require home care services beyond the duration of 
19.14 	the prior authorization, the home care provider must request a new prior authorization. 
19.15 	A personal care provider agency must request a new personal care assistant services 
19.16 	assessment, or service update if allowed, at least 60 days prior to the end of the current 
19.17 	prior authorization time period. The request for the assessment must be made on a form 
19.18 	approved by the commissioner. Under no circumstances, other than the exceptions 
19.19 	in subdivision 4, shall a prior An authorization must be valid prior to the date the 
19.20 	commissioner receives the request or for no more than 12 months.
19.21 	(b) A recipient who appeals a reduction in previously authorized home care 
19.22 	services may continue previously authorized services, other than temporary services 
19.23 	under subdivision 8, pending an appeal under section 256.045. The commissioner must 
19.24 	provide a detailed explanation of why the authorized services are reduced in amount from 
19.25 	those requested by the home care provider.
19.26 		Subd. 8.Prior Authorization requests; temporary services. The agency nurse, 
19.27 	the independently enrolled private duty nurse, or county public health nurse may request 
19.28 	a temporary authorization for home care services by telephone. The commissioner may 
19.29 	approve a temporary level of home care services based on the assessment, and service 
19.30 	or care plan information, and primary payer coverage determination information as 
19.31 	required. Authorization for a temporary level of home care services including nurse 
19.32 	supervision is limited to the time specified by the commissioner, but shall not exceed 
19.33 	45 days, unless extended because the county public health nurse has not completed the 
19.34 	required assessment and service plan, or the commissioner's determination has not been 
19.35 	made. The level of services authorized under this provision shall have no bearing on a 
19.36 	future prior authorization.
20.1 		Subd. 9.Prior Authorization for foster care setting. (a) Home care services 
20.2 	provided in an adult or child foster care setting must receive prior authorization by the 
20.3 	department commissioner according to the limits established in subdivision 11.
20.4 	(b) The commissioner may not authorize:
20.5 	(1) home care services that are the responsibility of the foster care provider under 
20.6 	the terms of the foster care placement agreement and administrative rules;
20.7 	(2) personal care assistant services when the foster care license holder is also 
20.8 	the personal care provider or personal care assistant unless the recipient can direct the 
20.9 	recipient's own care, or case management is provided as required in section 256B.0625, 
20.10 	subdivision 19a; or
20.11 	(3) personal care assistant services when the responsible party is an employee of, or 
20.12 	under contract with, or has any direct or indirect financial relationship with the personal 
20.13 	care provider or personal care assistant, unless case management is provided as required 
20.14 	in section 256B.0625, subdivision 19a; or
20.15 	(4) (3) personal care assistant and private duty nursing services when the number
20.16 	of foster care residents licensed capacity is greater than four unless the county responsible 
20.17 	for the recipient's foster placement made the placement prior to April 1, 1992, requests 
20.18 	that personal care assistant and private duty nursing services be provided, and case 
20.19 	management is provided as required in section 256B.0625, subdivision 19a.
20.20 		Subd. 10.Limitation on payments. Medical assistance payments for home care 
20.21 	services shall be limited according to subdivisions 4 to 12 and sections 256B.0654, 
20.22 	subdivision 2, and 256B.0655, subdivisions 3 and 4.
20.23 		Subd. 11.Limits on services without prior authorization. A recipient may receive 
20.24 	the following home care services during a calendar year:
20.25 	(1) up to two face-to-face assessments to determine a recipient's need for personal 
20.26 	care assistant services;
20.27 	(2) one service update done to determine a recipient's need for personal care assistant 
20.28 	services; and
20.29 	(3) up to nine face-to-face skilled nurse visits.
20.30 		Subd. 12.Approval of home care services. The commissioner or the 
20.31 	commissioner's designee shall determine the medical necessity of home care services, the 
20.32 	level of caregiver according to subdivision 2, and the institutional comparison according to 
20.33 	subdivisions 4 to 12 and sections 256B.0654, subdivision 2, and 256B.0655, subdivisions 
20.34 	3 and 4 256B.0659, the cost-effectiveness of services, and the amount, scope, and duration 
20.35 	of home care services reimbursable by medical assistance, based on the assessment, 
20.36 	primary payer coverage determination information as required, the service plan, the 
21.1 	recipient's age, the cost of services, the recipient's medical condition, and diagnosis or 
21.2 	disability. The commissioner may publish additional criteria for determining medical 
21.3 	necessity according to section 256B.04.
21.4 		Subd. 13.Recovery of excessive payments. The commissioner shall seek 
21.5 	monetary recovery from providers of payments made for services which exceed the limits 
21.6 	established in this section and sections 256B.0653 to 256B.0656. This subdivision does 
21.7 	not apply to services provided to a recipient at the previously authorized level pending an 
21.8 	appeal under section 256.045, subdivision 10.
21.9 		Subd. 14.Referrals to Medicare providers required. Home care providers that 
21.10 	do not participate in or accept Medicare assignment must refer and document the referral 
21.11 	of dual-eligible recipients to Medicare providers when Medicare is determined to be the 
21.12 	appropriate payer for services and supplies and equipment. Providers must be terminated 
21.13 	from participation in the medical assistance program for failure to make these referrals.
21.14 		Subd. 15.Quality assurance for program integrity. The commissioner shall 
21.15 	maintain processes for monitoring ongoing program integrity including provider standards 
21.16 	and training, consumer surveys, and random reviews of documentation.
21.17 		Subd. 16.Oversight of enrolled providers. The commissioner shall establish 
21.18 	an ongoing quality assurance process for home care services. The commissioner has 
21.19 	the authority to request proof of documentation of meeting provider standards, quality 
21.20 	standards of care, correct billing practices, and other information. Failure to provide access 
21.21 	and information to demonstrate compliance with laws, rules, or policies must result in 
21.22 	suspension, denial, or termination of the provider agency's enrollment with the department.

21.23 	Sec. 19. Minnesota Statutes 2008, section 256B.0652, is amended to read:
21.24 	256B.0652 PRIOR AUTHORIZATION AND REVIEW OF HOME CARE 
21.25 	SERVICES.
21.26 		Subdivision 1.State coordination. The commissioner shall supervise the 
21.27 	coordination of the prior authorization and review of home care services that are 
21.28 	reimbursed by medical assistance.
21.29 		Subd. 2.Duties. (a) The commissioner may contract with or employ qualified 
21.30 	registered nurses and necessary support staff, or contract with qualified agencies, to 
21.31 	provide home care prior authorization and review services for medical assistance 
21.32 	recipients who are receiving home care services.
21.33 	(b) Reimbursement for the prior authorization function shall be made through the 
21.34 	medical assistance administrative authority. The state shall pay the nonfederal share. 
21.35 	The functions will be to:
22.1 	(1) assess the recipient's individual need for services required to be cared for safely 
22.2 	in the community;
22.3 	(2) ensure that a service care plan that meets the recipient's needs is developed 
22.4 	by the appropriate agency or individual;
22.5 	(3) ensure cost-effectiveness and nonduplication of medical assistance home care 
22.6 	services;
22.7 	(4) recommend the approval or denial of the use of medical assistance funds to pay 
22.8 	for home care services;
22.9 	(5) reassess the recipient's need for and level of home care services at a frequency 
22.10 	determined by the commissioner; and
22.11 	(6) conduct on-site assessments when determined necessary by the commissioner 
22.12 	and recommend changes to care plans that will provide more efficient and appropriate 
22.13 	home care.
22.14 	(c) In addition, the commissioner or the commissioner's designee may:
22.15 	(1) review care service plans and reimbursement data for utilization of services that 
22.16 	exceed community-based standards for home care, inappropriate home care services, 
22.17 	medical necessity, home care services that do not meet quality of care standards, or 
22.18 	unauthorized services and make appropriate referrals within the department or to other 
22.19 	appropriate entities based on the findings;
22.20 	(2) assist the recipient in obtaining services necessary to allow the recipient to 
22.21 	remain safely in or return to the community;
22.22 	(3) coordinate home care services with other medical assistance services under 
22.23 	section 256B.0625;
22.24 	(4) assist the recipient with problems related to the provision of home care services;
22.25 	(5) assure the quality of home care services; and
22.26 	(6) assure that all liable third-party payers including, but not limited to, Medicare 
22.27 	have been used prior to medical assistance for home care services, including but not 
22.28 	limited to, home health agency, elected hospice benefit, waivered services, alternative care 
22.29 	program services, and personal care services.
22.30 	(d) For the purposes of this section, "home care services" means medical assistance 
22.31 	services defined under section 256B.0625, subdivisions 6a, 7, and 19a.
22.32 		Subd. 3.Assessment and prior authorization process for persons receiving 
22.33 	personal care assistance and developmental disabilities services. Effective January 1, 
22.34 	1996, For purposes of providing informed choice, coordinating of local planning decisions, 
22.35 	and streamlining administrative requirements, the assessment and prior authorization 
22.36 	process for persons receiving both home care and home and community-based waivered 
23.1 	services for persons with developmental disabilities shall meet the requirements of 
23.2 	sections 256B.0651 and 256B.0653 to 256B.0656 with the following exceptions:
23.3 	(a) Upon request for home care services and subsequent assessment by the public 
23.4 	health nurse under sections 256B.0651 and 256B.0653 to 256B.0656, the public health 
23.5 	nurse shall participate in the screening process, as appropriate, and, if home care 
23.6 	services are determined to be necessary, participate in the development of a service plan 
23.7 	coordinating the need for home care and home and community-based waivered services 
23.8 	with the assigned county case manager, the recipient of services, and the recipient's legal 
23.9 	representative, if any.
23.10 	(b) The public health nurse shall give prior authorization for home care services 
23.11 	to the extent that home care services are:
23.12 	(1) medically necessary;
23.13 	(2) chosen by the recipient and their legal representative, if any, from the array of 
23.14 	home care and home and community-based waivered services available;
23.15 	(3) coordinated with other services to be received by the recipient as described 
23.16 	in the service plan; and
23.17 	(4) provided within the county's reimbursement limits for home care and home and 
23.18 	community-based waivered services for persons with developmental disabilities.
23.19 	(c) If the public health agency is or may be the provider of home care services to the 
23.20 	recipient, the public health agency shall provide the commissioner of human services with 
23.21 	a written plan that specifies how the assessment and prior authorization process will be 
23.22 	held separate and distinct from the provision of services.

23.23 	Sec. 20. Minnesota Statutes 2008, section 256B.0653, is amended to read:
23.24 	256B.0653 HOME HEALTH AGENCY COVERED SERVICES.
23.25 		Subdivision 1.Homecare; skilled nurse visits Scope.  "Skilled nurse visits" are 
23.26 	provided in a recipient's residence under a plan of care or service plan that specifies a level 
23.27 	of care which the nurse is qualified to provide. These services are:
23.28 	(1) nursing services according to the written plan of care or service plan and accepted 
23.29 	standards of medical and nursing practice in accordance with chapter 148;
23.30 	(2) services which due to the recipient's medical condition may only be safely and 
23.31 	effectively provided by a registered nurse or a licensed practical nurse;
23.32 	(3) assessments performed only by a registered nurse; and
23.33 	(4) teaching and training the recipient, the recipient's family, or other caregivers 
23.34 	requiring the skills of a registered nurse or licensed practical nurse. This section applies to 
24.1 	home health agency services including, home health aide, skilled nursing visits, physical 
24.2 	therapy, occupational therapy, respiratory therapy, and speech language pathology therapy.
24.3 		Subd. 2.Telehomecare; skilled nurse visits Definitions.  Medical assistance 
24.4 	covers skilled nurse visits according to section 256B.0625, subdivision 6a, provided via 
24.5 	telehomecare, for services which do not require hands-on care between the home care 
24.6 	nurse and recipient. The provision of telehomecare must be made via live, two-way 
24.7 	interactive audiovisual technology and may be augmented by utilizing store-and-forward 
24.8 	technologies. Store-and-forward technology includes telehomecare services that do not 
24.9 	occur in real time via synchronous transmissions, and that do not require a face-to-face 
24.10 	encounter with the recipient for all or any part of any such telehomecare visit. Individually 
24.11 	identifiable patient data obtained through real-time or store-and-forward technology must 
24.12 	be maintained as health records according to sections 144.291 to 144.298. If the video 
24.13 	is used for research, training, or other purposes unrelated to the care of the patient, the 
24.14 	identity of the patient must be concealed. A communication between the home care nurse 
24.15 	and recipient that consists solely of a telephone conversation, facsimile, electronic mail, or 
24.16 	a consultation between two health care practitioners, is not to be considered a telehomecare 
24.17 	visit. Multiple daily skilled nurse visits provided via telehomecare are allowed. Coverage 
24.18 	of telehomecare is limited to two visits per day. All skilled nurse visits provided via 
24.19 	telehomecare must be prior authorized by the commissioner or the commissioner's 
24.20 	designee and will be covered at the same allowable rate as skilled nurse visits provided 
24.21 	in-person. For the purposes of this section, the following terms have the meanings given.
24.22 	(a) "Assessment" means an evaluation of the recipient's medical need for home 
24.23 	health agency services by a registered nurse or appropriate therapist that is conducted 
24.24 	within 30 days of a request and as specified Code of Federal Regulations, title 42, section 
24.25 	484.1 to 494.55.
24.26 	(b) "Home care therapies" means occupational, physical, and respiratory therapy 
24.27 	and speech-language pathology services provided in the home by a Medicare certified 
24.28 	home health agency.
24.29 	(c) "Home health agency services" means services delivered in the recipient's home 
24.30 	residence, except as specified in section 256B.0625, by a home health agency to a recipient 
24.31 	with medical needs due to illness, disability, or physical conditions.
24.32 	(d) "Home health aide" means an employee of a home health agency who meets 
24.33 	the requirements of Code of Federal Regulations, title 42, sections 484.1 to 494.55, and 
24.34 	completes medically oriented tasks written in the plan of care for a recipient.
25.1 	(e) "Home health agency" means a home care provider agency who is 
25.2 	Medicare-certified satisfying the requirements of Code of Federal Regulations, title 42, 
25.3 	sections 484.1 to 494.55.
25.4 	(f) "Occupational therapy services" mean the services defined in section 148.6402.
25.5 	(g) "Physical therapy services" mean the services defined in section 148.65.
25.6 	(h) "Respiratory therapy services" mean the services defined in chapter 147C and 
25.7 	Minnesota Rules, part 4668.0003, subpart 37.
25.8 	(i) "Speech-language pathology services" mean the services defined in section 
25.9 	148.512.
25.10 	(j) "Skilled nurse visit" means a professional nursing visit to complete nursing tasks 
25.11 	required due to a recipient's medical condition that can only be safely provided by a 
25.12 	professional nurse to restore and maintain optimal health.
25.13 	(k) "Store-and-forward technology" means telehomecare services that do not occur 
25.14 	in real time via synchronous transmissions such as diabetic and vital sign monitoring.
25.15 	(l) "Telehomecare" means the use of telecommunications technology via 
25.16 	live, two-way interactive audiovisual technology which may be augmented by 
25.17 	store-and-forward technology.
25.18 	(m) "Telehomecare skilled nurse visit" means a visit by a professional nurse to 
25.19 	deliver a skilled nurse visit to a recipient located at a site other than the site where the 
25.20 	nurse is located and is used in combination with face-to-face skilled nurse visits to 
25.21 	adequately meet the recipient's needs.
25.22 		Subd. 3.Therapies through home health agencies Home health aide visits.
 25.23 	(a) Medical assistance covers physical therapy and related services, including specialized 
25.24 	maintenance therapy. Services provided by a physical therapy assistant shall be 
25.25 	reimbursed at the same rate as services performed by a physical therapist when the 
25.26 	services of the physical therapy assistant are provided under the direction of a physical 
25.27 	therapist who is on the premises. Services provided by a physical therapy assistant that are 
25.28 	provided under the direction of a physical therapist who is not on the premises shall be 
25.29 	reimbursed at 65 percent of the physical therapist rate. Direction of the physical therapy 
25.30 	assistant must be provided by the physical therapist as described in Minnesota Rules, part 
25.31 	9505.0390, subpart 1, item B. The physical therapist and physical therapist assistant may 
25.32 	not both bill for services provided to a recipient on the same day.
25.33 	(b) Medical assistance covers occupational therapy and related services, including 
25.34 	specialized maintenance therapy. Services provided by an occupational therapy assistant 
25.35 	shall be reimbursed at the same rate as services performed by an occupational therapist 
25.36 	when the services of the occupational therapy assistant are provided under the direction of 
26.1 	the occupational therapist who is on the premises. Services provided by an occupational 
26.2 	therapy assistant under the direction of an occupational therapist who is not on the 
26.3 	premises shall be reimbursed at 65 percent of the occupational therapist rate. Direction 
26.4 	of the occupational therapy assistant must be provided by the occupational therapist as 
26.5 	described in Minnesota Rules, part 9505.0390, subpart 1, item B. The occupational 
26.6 	therapist and occupational therapist assistant may not both bill for services provided 
26.7 	to a recipient on the same day.
26.8 	(a) Home health aide visits must be provided by a certified home health aide 
26.9 	using a written plan of care that is updated in compliance with Medicare regulations. 
26.10 	A home health aide shall provide hands-on personal care, perform simple procedures 
26.11 	as an extension of therapy or nursing services, and assist in instrumental activities of 
26.12 	daily living as defined in section 256B.0659. Home health aide visits must be provided 
26.13 	in the recipient's home.
26.14 	(b) All home health aide visits must have authorization under section 256B.0652. 
26.15 	The commissioner shall limit home health aide visits to no more than one visit per day 
26.16 	per recipient.
26.17 	(c) Home health aides must be supervised by a registered nurse or an appropriate 
26.18 	therapist when providing services that are an extension of therapy.
26.19 		Subd. 4.Skilled nurse visit services. (a) Skilled nurse visit services must be 
26.20 	provided by a registered nurse or a licensed practical nurse under the supervision of a 
26.21 	registered nurse, according to the written plan of care and accepted standards of medical 
26.22 	and nursing practice according to chapter 148. Skilled nurse visit services must be ordered 
26.23 	by a physician and documented in a plan of care that is reviewed and approved by the 
26.24 	ordering physician at least once every 60 days. All skilled nurse visits must be medically 
26.25 	necessary and provided in the recipient's home residence except as allowed under section 
26.26 	256B.0625, subdivision 6a.
26.27 	(b) Skilled nurse visits include face-to-face and telehomecare visits with a limit of 
26.28 	up to two visits per day per recipient. All visits must be based on assessed needs.
26.29 	(c) Telehomecare skilled nurse visits are allowed when the recipient's health status 
26.30 	can be accurately measured and assessed without a need for a face-to-face, hands-on 
26.31 	encounter. All telehomecare skilled nurse visits must have authorization and are paid at 
26.32 	the same allowable rates as face-to-face skilled nurse visits.
26.33 	(d) The provision of telehomecare must be made via live, two-way interactive 
26.34 	audiovisual technology and may be augmented by utilizing store-and-forward 
26.35 	technologies. Individually identifiable patient data obtained through real-time or 
26.36 	store-and-forward technology must be maintained as health records according to sections 
27.1 	144.291 to 144.298. If the video is used for research, training, or other purposes unrelated 
27.2 	to the care of the patient, the identity of the patient must be concealed.
27.3 	(e) Authorization for skilled nurse visits must be completed under section 
27.4 	256B.0652. A total of nine face-to-face skilled nurses visits per calendar year do not 
27.5 	require authorization. All telehomecare skilled nurse visits require authorization.
27.6 		Subd. 5.Home care therapies. (a) Home care therapies include the following: 
27.7 	physical therapy, occupational therapy, respiratory therapy, and speech and language 
27.8 	pathology therapy services.
27.9 	(b) Home care therapies must be:
27.10 	(1) provided in the recipient's residence after it has been determined the recipient is 
27.11 	unable to access outpatient therapy;
27.12 	(2) prescribed, ordered, or referred by a physician and documented in a plan of care 
27.13 	and reviewed, according to Minnesota Rules, part 9505.0390;
27.14 	(3) assessed by an appropriate therapist; and
27.15 	(4) provided by a Medicare-certified home health agency enrolled as a Medicaid 
27.16 	provider agency.
27.17 	(c) Restorative and specialized maintenance therapies must be provided according to 
27.18 	Minnesota Rules, part 9505.0390. Physical and occupational therapy assistants may be 
27.19 	used as allowed under Minnesota Rules, part 9505.0390, subpart 1, item B.
27.20 	(d) For both physical and occupational therapies, the therapist and the therapist's 
27.21 	assistant may not both bill for services provided to a recipient on the same day.
27.22 		Subd. 6.Noncovered home health agency services. The following are not eligible 
27.23 	for payment under medical assistance as a home health agency service:
27.24 	(1) telehomecare skilled nurses services that is communication between the home 
27.25 	care nurse and recipient that consists solely of a telephone conversation, facsimile, 
27.26 	electronic mail, or a consultation between two health care practitioners;
27.27 	(2) the following skilled nurse visits:
27.28 	(i) for the purpose of monitoring medication compliance with an established 
27.29 	medication program for a recipient;
27.30 	(ii) administering or assisting with medication administration, including injections, 
27.31 	prefilling syringes for injections, or oral medication setup of an adult recipient, when, 
27.32 	as determined and documented by the registered nurse, the need can be met by an 
27.33 	available pharmacy or the recipient or a family member is physically and mentally able 
27.34 	to self-administer or prefill a medication;
27.35 	(iii) services done for the sole purpose of supervision of the home health aide or 
27.36 	personal care assistant;
28.1 	(iv) services done for the sole purpose to train other home health agency workers;
28.2 	(v) services done for the sole purpose of blood samples or lab draw or Synagis 
28.3 	injections when the recipient is able to access these services outside the home; and
28.4 	(vi) Medicare evaluation or administrative nursing visits required by Medicare;
28.5 	(3) home health aide visits when the following activities are the sole purpose for the 
28.6 	visit: companionship, socialization, household tasks, transportation, and education; and
28.7 	(4) home care therapies provided in other settings such as a clinic, day program, or as 
28.8 	an inpatient or when the recipient can access therapy outside of the recipient's residence.

28.9 	Sec. 21. Minnesota Statutes 2008, section 256B.0654, is amended to read:
28.10 	256B.0654 PRIVATE DUTY NURSING.
28.11 		Subdivision 1.Definitions. (a) "Assessment" means a review and evaluation of a 
28.12 	recipient's need for home care services conducted in person. Assessments for private duty 
28.13 	nursing shall be conducted by a registered private duty nurse. Assessments for medical 
28.14 	assistance home care services for developmental disabilities and alternative care services 
28.15 	for developmentally disabled home and community-based waivered recipients may be 
28.16 	conducted by the county public health nurse to ensure coordination and avoid duplication.
28.17 	(b) (a) "Complex and regular private duty nursing care" means:
28.18 	(1) complex care is private duty nursing services provided to recipients who are 
28.19 	ventilator dependent or for whom a physician has certified that were it not for private 
28.20 	duty nursing the recipient would meet meets the criteria for inpatient hospital intensive 
28.21 	care unit (ICU) level of care; and
28.22 	(2) regular care is private duty nursing provided to all other recipients.
28.23 	(b) "Private duty nursing" means ongoing professional nursing services by a 
28.24 	registered or licensed practical nurse including assessment, professional nursing tasks, and 
28.25 	education, based on an assessment and physician orders to maintain or restore optimal 
28.26 	health of the recipient.
28.27 	(c) "Private duty nursing agency" means a medical assistance enrolled provider 
28.28 	licensed under chapter 144A to provide private duty nursing services.
28.29 	(d) "Regular private duty nursing" means nursing services provided to a recipient 
28.30 	who is considered stable and not at an inpatient hospital intensive care unit level of care, 
28.31 	but may have episodes of instability that are not life threatening.
28.32 	(e) "Shared private duty nursing" means the provision of nursing services by a 
28.33 	private duty nurse to two recipients at the same time and in the same setting.
28.34 		Subd. 2.Authorization; private duty nursing services. (a) All private duty 
28.35 	nursing services shall be prior authorized by the commissioner or the commissioner's 
29.1 	designee. Prior Authorization for private duty nursing services shall be based on 
29.2 	medical necessity and cost-effectiveness when compared with alternative care options. 
29.3 	The commissioner may authorize medically necessary private duty nursing services in 
29.4 	quarter-hour units when:
29.5 	(1) the recipient requires more individual and continuous care than can be provided 
29.6 	during a skilled nurse visit; or
29.7 	(2) the cares are outside of the scope of services that can be provided by a home 
29.8 	health aide or personal care assistant.
29.9 	(b) The commissioner may authorize:
29.10 	(1) up to two times the average amount of direct care hours provided in nursing 
29.11 	facilities statewide for case mix classification "K" as established by the annual cost report 
29.12 	submitted to the department by nursing facilities in May 1992;
29.13 	(2) private duty nursing in combination with other home care services up to the total 
29.14 	cost allowed under section 256B.0655, subdivision 4;
29.15 	(3) up to 16 hours per day if the recipient requires more nursing than the maximum 
29.16 	number of direct care hours as established in clause (1) and the recipient meets the hospital 
29.17 	admission criteria established under Minnesota Rules, parts 9505.0501 to 9505.0540.
29.18 	(c) The commissioner may authorize up to 16 hours per day of medically necessary 
29.19 	private duty nursing services or up to 24 hours per day of medically necessary private duty 
29.20 	nursing services until such time as the commissioner is able to make a determination of 
29.21 	eligibility for recipients who are cooperatively applying for home care services under 
29.22 	the community alternative care program developed under section 256B.49, or until it is 
29.23 	determined by the appropriate regulatory agency that a health benefit plan is or is not 
29.24 	required to pay for appropriate medically necessary health care services. Recipients 
29.25 	or their representatives must cooperatively assist the commissioner in obtaining this 
29.26 	determination. Recipients who are eligible for the community alternative care program 
29.27 	may not receive more hours of nursing under this section and sections 256B.0651, 
29.28 	256B.0653, 256B.0655, and256B.0656, and 256B.0659 than would otherwise be 
29.29 	authorized under section 256B.49.
29.30 		Subd. 2a.Private duty nursing services. (a) Private duty nursing services must 
29.31 	be used:
29.32 	(1) in the recipient's home or outside the home when normal life activities require;
29.33 	(2) when the recipient requires more individual and continuous care than can be 
29.34 	provided during a skilled nurse visit; and
29.35 	(3) when the care required is outside of the scope of services that can be provided by 
29.36 	a home health aide or personal care assistant.
30.1 	(b) Private duty nursing services must be:
30.2 	(1) assessed by a registered nurse on a form approved by the commissioner;
30.3 	(2) ordered by a physician and documented in a plan of care that is reviewed by the 
30.4 	physician at least once every 60 days; and
30.5 	(3) authorized by the commissioner under section 256B.0652.
30.6 		Subd. 2b.Noncovered private duty nursing services. Private duty nursing 
30.7 	services do not cover the following:
30.8 	(1) nursing services by a nurse who is the foster care provider of a person who 
30.9 	has not reached 18 years of age;
30.10 	(2) nursing services to more than two persons receiving shared private duty nursing 
30.11 	services from a private duty nurse in a single setting; and
30.12 	(3) nursing services provided by a registered nurse or licensed practical nurse who is 
30.13 	the recipient's legal guardian or related to the recipient as spouse, parent, or child whether 
30.14 	by blood, marriage, or adoption except as specified in section 256B.0652, subdivision 4.
30.15 		Subd. 3.Shared private duty nursing care option. (a) Medical assistance 
30.16 	payments for shared private duty nursing services by a private duty nurse shall be limited 
30.17 	according to this subdivision. For the purposes of this section and sections 256B.0651, 
30.18 	256B.0653, 256B.0655, and 256B.0656, "private duty nursing agency" means an agency 
30.19 	licensed under chapter 144A to provide private duty nursing services. Unless otherwise 
30.20 	provided in this subdivision, all other statutory and regulatory provisions relating to 
30.21 	private duty nursing services apply to shared private duty nursing services. Nothing in 
30.22 	this subdivision shall be construed to reduce the total number of private duty nursing 
30.23 	hours authorized for an individual recipient.
30.24 	(b) Recipients of private duty nursing services may share nursing staff and the 
30.25 	commissioner shall provide a rate methodology for shared private duty nursing. For two 
30.26 	persons sharing nursing care, the rate paid to a provider shall not exceed 1.5 times the 
30.27 	regular private duty nursing rates paid for serving a single individual by a registered nurse 
30.28 	or licensed practical nurse. These rates apply only to situations in which both recipients 
30.29 	are present and receive shared private duty nursing care on the date for which the service 
30.30 	is billed. No more than two persons may receive shared private duty nursing services 
30.31 	from a private duty nurse in a single setting.
30.32 	(c) (b) Shared private duty nursing care is the provision of nursing services by a 
30.33 	private duty nurse to two medical assistance eligible recipients at the same time and in 
30.34 	the same setting. This subdivision does not apply when a private duty nurse is caring for 
30.35 	multiple recipients in more than one setting.
30.36 	(c) For the purposes of this subdivision, "setting" means:
31.1 	(1) the home residence or foster care home of one of the individual recipients as 
31.2 	defined in section 256B.0651; or
31.3 	(2) a child care program licensed under chapter 245A or operated by a local school 
31.4 	district or private school; or
31.5 	(3) an adult day care service licensed under chapter 245A; or
31.6 	(4) outside the home residence or foster care home of one of the recipients when 
31.7 	normal life activities take the recipients outside the home.
31.8 	This subdivision does not apply when a private duty nurse is caring for multiple 
31.9 	recipients in more than one setting.
31.10 	(d) The private duty nursing agency must offer the recipient the option of shared or 
31.11 	one-on-one private duty nursing services. The recipient may withdraw from participating 
31.12 	in a shared service arrangement at any time.
31.13 	(d) (e) The recipient or the recipient's legal representative, and the recipient's 
31.14 	physician, in conjunction with the home health care private duty nursing agency, shall 
31.15 	determine:
31.16 	(1) whether shared private duty nursing care is an appropriate option based on the 
31.17 	individual needs and preferences of the recipient; and
31.18 	(2) the amount of shared private duty nursing services authorized as part of the 
31.19 	overall authorization of nursing services.
31.20 	(e) (f) The recipient or the recipient's legal representative, in conjunction with the 
31.21 	private duty nursing agency, shall approve the setting, grouping, and arrangement of 
31.22 	shared private duty nursing care based on the individual needs and preferences of the 
31.23 	recipients. Decisions on the selection of recipients to share services must be based on the 
31.24 	ages of the recipients, compatibility, and coordination of their care needs.
31.25 	(f) (g) The following items must be considered by the recipient or the recipient's 
31.26 	legal representative and the private duty nursing agency, and documented in the recipient's 
31.27 	health service record:
31.28 	(1) the additional training needed by the private duty nurse to provide care to 
31.29 	two recipients in the same setting and to ensure that the needs of the recipients are met 
31.30 	appropriately and safely;
31.31 	(2) the setting in which the shared private duty nursing care will be provided;
31.32 	(3) the ongoing monitoring and evaluation of the effectiveness and appropriateness 
31.33 	of the service and process used to make changes in service or setting;
31.34 	(4) a contingency plan which accounts for absence of the recipient in a shared private 
31.35 	duty nursing setting due to illness or other circumstances;
31.36 	(5) staffing backup contingencies in the event of employee illness or absence; and
32.1 	(6) arrangements for additional assistance to respond to urgent or emergency care 
32.2 	needs of the recipients.
32.3 	(g) The provider must offer the recipient or responsible party the option of shared or 
32.4 	one-on-one private duty nursing services. The recipient or responsible party can withdraw 
32.5 	from participating in a shared service arrangement at any time.
32.6 	(h) The private duty nursing agency must document the following in the 
32.7 	health service record for each individual recipient sharing private duty nursing care
32.8 	The documentation for shared private duty nursing must be on a form approved by 
32.9 	the commissioner for each individual recipient sharing private duty nursing. The 
32.10 	documentation must be part of the recipient's health service record and include:
32.11 	(1) permission by the recipient or the recipient's legal representative for the 
32.12 	maximum number of shared nursing care hours per week chosen by the recipient and 
32.13 	permission for shared private duty nursing services provided in and outside the recipient's 
32.14 	home residence;
32.15 	(2) permission by the recipient or the recipient's legal representative for shared 
32.16 	private duty nursing services provided outside the recipient's residence;
32.17 	(3) permission by the recipient or the recipient's legal representative for others to 
32.18 	receive shared private duty nursing services in the recipient's residence;
32.19 	(4) (2) revocation by the recipient or the recipient's legal representative of for the 
32.20 	shared private duty nursing care authorization, or the shared care to be provided to others in 
32.21 	the recipient's residence, or the shared private duty nursing services to be provided outside
32.22 	permission, or services provided to others in and outside the recipient's residence; and
32.23 	(5) (3) daily documentation of the shared private duty nursing services provided by 
32.24 	each identified private duty nurse, including:
32.25 	(i) the names of each recipient receiving shared private duty nursing services 
32.26 	together;
32.27 	(ii) the setting for the shared services, including the starting and ending times that 
32.28 	the recipient received shared private duty nursing care; and
32.29 	(iii) notes by the private duty nurse regarding changes in the recipient's condition, 
32.30 	problems that may arise from the sharing of private duty nursing services, and scheduling 
32.31 	and care issues.
32.32 	(i) Unless otherwise provided in this subdivision, all other statutory and regulatory 
32.33 	provisions relating to private duty nursing services apply to shared private duty nursing 
32.34 	services.
32.35 	Nothing in this subdivision shall be construed to reduce the total number of private 
32.36 	duty nursing hours authorized for an individual recipient under subdivision 2.
33.1 	(i) The commissioner shall provide a rate methodology for shared private duty 
33.2 	nursing. For two persons sharing nursing care, the rate paid to a provider must not exceed 
33.3 	1.5 times the regular private duty nursing rates paid for serving a single individual by a 
33.4 	registered nurse or licensed practical nurse. These rates apply only to situations in which 
33.5 	both recipients are present and receive shared private duty nursing care on the date for 
33.6 	which the service is billed.
33.7 		Subd. 4.Hardship criteria; private duty nursing. (a) Payment is allowed for 
33.8 	extraordinary services that require specialized nursing skills and are provided by parents 
33.9 	of minor children, spouses, and legal guardians who are providing private duty nursing 
33.10 	care under the following conditions:
33.11 	(1) the provision of these services is not legally required of the parents, spouses, 
33.12 	or legal guardians;
33.13 	(2) the services are necessary to prevent hospitalization of the recipient; and
33.14 	(3) the recipient is eligible for state plan home care or a home and community-based 
33.15 	waiver and one of the following hardship criteria are met:
33.16 	(i) the parent, spouse, or legal guardian resigns from a part-time or full-time job to 
33.17 	provide nursing care for the recipient; or
33.18 	(ii) the parent, spouse, or legal guardian goes from a full-time to a part-time job with 
33.19 	less compensation to provide nursing care for the recipient; or
33.20 	(iii) the parent, spouse, or legal guardian takes a leave of absence without pay to 
33.21 	provide nursing care for the recipient; or
33.22 	(iv) because of labor conditions, special language needs, or intermittent hours of 
33.23 	care needed, the parent, spouse, or legal guardian is needed in order to provide adequate 
33.24 	private duty nursing services to meet the medical needs of the recipient.
33.25 	(b) Private duty nursing may be provided by a parent, spouse, or legal guardian who 
33.26 	is a nurse licensed in Minnesota. Private duty nursing services provided by a parent, 
33.27 	spouse, or legal guardian cannot be used in lieu of nursing services covered and available 
33.28 	under liable third-party payors, including Medicare. The private duty nursing provided 
33.29 	by a parent, spouse, or legal guardian must be included in the service plan. Authorized 
33.30 	skilled nursing services for a single recipient or recipients with the same residence and
33.31 	provided by the parent, spouse, or legal guardian may not exceed 50 percent of the total 
33.32 	approved nursing hours, or eight hours per day, whichever is less, up to a maximum of 
33.33 	40 hours per week. A parent or parents, spouse, or legal guardian shall not provide more 
33.34 	than 40 hours of services in a seven-day period. For parents and legal guardians, 40 hours 
33.35 	is the total amount allowed regardless of the number of children or adults who receive 
33.36 	services. Nothing in this subdivision precludes the parent's, spouse's, or legal guardian's 
34.1 	obligation of assuming the nonreimbursed family responsibilities of emergency backup 
34.2 	caregiver and primary caregiver.
34.3 	(c) A parent or a spouse may not be paid to provide private duty nursing care if:
34.4 	(1) the parent or spouse fails to pass a criminal background check according to 
34.5 	chapter 245C, or if;
34.6 	(2) it has been determined by the home health care agency, the case manager, or 
34.7 	the physician that the private duty nursing care provided by the parent, spouse, or legal 
34.8 	guardian is unsafe; or
34.9 	(3) the parent, spouse, or legal guardian do not follow physician orders.
34.10 	(d) For purposes of this section, "assessment" means a review and evaluation of a 
34.11 	recipient's need for home care services conducted in person. Assessments for private duty 
34.12 	nursing must be conducted by a registered nurse.

34.13 	Sec. 22. Minnesota Statutes 2008, section 256B.0655, subdivision 4, is amended to 
34.14 	read:
34.15 		Subd. 4.Prior Authorization; personal care assistance and qualified 
34.16 	professional. The commissioner, or the commissioner's designee, shall review the 
34.17 	assessment, service update, request for temporary services, request for flexible use option, 
34.18 	service plan, and any additional information that is submitted. The commissioner shall, 
34.19 	within 30 days after receiving a complete request, assessment, and service plan, authorize 
34.20 	home care services as follows:
34.21 	(1) (a) All personal care assistant services and, supervision by a qualified 
34.22 	professional, if requested by the recipient, and additional services beyond the limits 
34.23 	established in section 256B.0652, subdivision 11, must be prior authorized by the 
34.24 	commissioner or the commissioner's designee before services begin except for the 
34.25 	assessments established in section sections256B.0651, subdivision 11, and 256B.0911.
34.26 	The authorization for personal care assistance and qualified professional services under 
34.27 	section 256B.0659 must be completed within 30 days after receiving a complete request.
34.28 	(b) The amount of personal care assistant services authorized must be based on 
34.29 	the recipient's home care rating. The home care rating shall be determined by the 
34.30 	commissioner or the commissioner's designee based on information submitted to the 
34.31 	commissioner identifying the following:
34.32 	(1) total number of dependencies of activities of daily living as defined in section 
34.33 	256B.0659;
34.34 	(2) number of complex health-related functions as defined in section 256B.0659; and
34.35 	(3) number of behavior descriptions as defined in section 256B.0659.
35.1 	(c) The methodology to determine total time for personal care assistance services for 
35.2 	each home care rating is based on fiscal year 2007 data from the personal care assistance 
35.3 	program. Each home care rating has a base level of hours assigned. Additional time is 
35.4 	added through the assessment and identification of the following:
35.5 	(1) 30 additional minutes for a dependency in each critical activity of daily living 
35.6 	as defined in section 256B.0659;
35.7 	(2) 30 additional minutes for each complex health-related function as defined in 
35.8 	section 256B.0659; and
35.9 	(3) 30 additional minutes for each behavior issue as defined in section 256B.0659.
35.10 	(d) A limit of 96 units of qualified professional supervision may be authorized for 
35.11 	each recipient receiving personal care assistance services. A request to the commissioner 
35.12 	to exceed this total in a calendar year must be requested by the personal care provider 
35.13 	agency on a form approved by the commissioner.
35.14 	A child may not be found to be dependent in an activity of daily living if because 
35.15 	of the child's age an adult would either perform the activity for the child or assist the 
35.16 	child with the activity and the amount of assistance needed is similar to the assistance 
35.17 	appropriate for a typical child of the same age. Based on medical necessity, the 
35.18 	commissioner may authorize:
35.19 	(A) up to two times the average number of direct care hours provided in nursing 
35.20 	facilities for the recipient's comparable case mix level; or
35.21 	(B) up to three times the average number of direct care hours provided in nursing 
35.22 	facilities for recipients who have complex medical needs or are dependent in at least seven 
35.23 	activities of daily living and need physical assistance with eating or have a neurological 
35.24 	diagnosis; or
35.25 	(C) up to 60 percent of the average reimbursement rate, as of July 1, 1991, for care 
35.26 	provided in a regional treatment center for recipients who have Level I behavior, plus any 
35.27 	inflation adjustment as provided by the legislature for personal care service; or
35.28 	(D) up to the amount the commissioner would pay, as of July 1, 1991, plus any 
35.29 	inflation adjustment provided for home care services, for care provided in a regional 
35.30 	treatment center for recipients referred to the commissioner by a regional treatment center 
35.31 	preadmission evaluation team. For purposes of this clause, home care services means 
35.32 	all services provided in the home or community that would be included in the payment 
35.33 	to a regional treatment center; or
35.34 	(E) up to the amount medical assistance would reimburse for facility care for 
35.35 	recipients referred to the commissioner by a preadmission screening team established 
35.36 	under section 256B.0911 or 256B.092; and
36.1 	(F) a reasonable amount of time for the provision of supervision by a qualified 
36.2 	professional of personal care assistant services, if a qualified professional is requested by 
36.3 	the recipient or responsible party.
36.4 	(2) The number of direct care hours shall be determined according to the annual cost 
36.5 	report submitted to the department by nursing facilities. The average number of direct care 
36.6 	hours, as established by May 1, 1992, shall be calculated and incorporated into the home 
36.7 	care limits on July 1, 1992. These limits shall be calculated to the nearest quarter hour.
36.8 	(3) The home care rating shall be determined by the commissioner or the 
36.9 	commissioner's designee based on information submitted to the commissioner by the 
36.10 	county public health nurse on forms specified by the commissioner. The home care rating 
36.11 	shall be a combination of current assessment tools developed under sections 256B.0911
36.12 	and 256B.501 with an addition for seizure activity that will assess the frequency and 
36.13 	severity of seizure activity and with adjustments, additions, and clarifications that are 
36.14 	necessary to reflect the needs and conditions of recipients who need home care including 
36.15 	children and adults under 65 years of age. The commissioner shall establish these forms 
36.16 	and protocols under this section and sections 256B.0651, 256B.0653, 256B.0654, and 
36.17 	256B.0656 and shall use an advisory group, including representatives of recipients, 
36.18 	providers, and counties, for consultation in establishing and revising the forms and 
36.19 	protocols.
36.20 	(4) A recipient shall qualify as having complex medical needs if the care required is 
36.21 	difficult to perform and because of recipient's medical condition requires more time than 
36.22 	community-based standards allow or requires more skill than would ordinarily be required 
36.23 	and the recipient needs or has one or more of the following:
36.24 	(A) daily tube feedings;
36.25 	(B) daily parenteral therapy;
36.26 	(C) wound or decubiti care;
36.27 	(D) postural drainage, percussion, nebulizer treatments, suctioning, tracheotomy 
36.28 	care, oxygen, mechanical ventilation;
36.29 	(E) catheterization;
36.30 	(F) ostomy care;
36.31 	(G) quadriplegia; or
36.32 	(H) other comparable medical conditions or treatments the commissioner determines 
36.33 	would otherwise require institutional care.
36.34 	(5) A recipient shall qualify as having Level I behavior if there is reasonable 
36.35 	supporting evidence that the recipient exhibits, or that without supervision, observation, or 
37.1 	redirection would exhibit, one or more of the following behaviors that cause, or have the 
37.2 	potential to cause:
37.3 	(A) injury to the recipient's own body;
37.4 	(B) physical injury to other people; or
37.5 	(C) destruction of property.
37.6 	(6) Time authorized for personal care relating to Level I behavior in paragraph 
37.7 	(5), clauses (A) to (C), shall be based on the predictability, frequency, and amount of 
37.8 	intervention required.
37.9 	(7) A recipient shall qualify as having Level II behavior if the recipient exhibits on a 
37.10 	daily basis one or more of the following behaviors that interfere with the completion of 
37.11 	personal care assistant services under subdivision 2, paragraph (a):
37.12 	(A) unusual or repetitive habits;
37.13 	(B) withdrawn behavior; or
37.14 	(C) offensive behavior.
37.15 	(8) A recipient with a home care rating of Level II behavior in paragraph (7), clauses 
37.16 	(A) to (C), shall be rated as comparable to a recipient with complex medical needs under 
37.17 	paragraph (4). If a recipient has both complex medical needs and Level II behavior, the 
37.18 	home care rating shall be the next complex category up to the maximum rating under 
37.19 	paragraph (1), clause (B).

37.20 	Sec. 23. [256B.0659] PERSONAL CARE ASSISTANCE PROGRAM.
37.21 		Subdivision 1.Definitions. (a) For the purposes of this section, the terms defined in 
37.22 	paragraphs (b) to (p) have the meanings given unless otherwise provided in text.
37.23 	(b) "Activities of daily living" means grooming, dressing, bathing, transferring, 
37.24 	mobility, positioning, eating, and toileting.
37.25 	(c) "Behavior" means a category to determine the home care rating and is based on 
37.26 	the criteria found in this section.
37.27 	(d) "Complex health-related functions" means a category to determine the home care 
37.28 	rating and is based on the criteria found in this section.
37.29 	(e) "Critical activities of daily living" means transferring, mobility, eating, and 
37.30 	toileting.
37.31 	(f) "Dependency in activities of daily living" means a person requires assistance to 
37.32 	begin and complete one or more of the activities of daily living.
37.33 	(g) "Health-related functions" means functions that can be delegated or assigned 
37.34 	by a licensed health care professional under state law to be performed by a personal 
37.35 	care assistant.
38.1 	(h) "Instrumental activities of daily living" means activities to include meal planning 
38.2 	and preparation; basic assistance with paying bills; shopping for food, clothing, and 
38.3 	other essential items; performing household tasks integral to the personal care assistance 
38.4 	services; communication by telephone and other media; and traveling and participating 
38.5 	in the community.
38.6 	(i) "Managerial official" has the same definition as Code of Federal Regulations, 
38.7 	title 42, section 455.
38.8 	(j) "Qualified professional" means a professional providing supervision of personal 
38.9 	care assistance services and staff as defined in section 256B.0625, subdivision 19c.
38.10 	(k) "Personal care assistance provider agency" means a medical assistance enrolled 
38.11 	provider that provides or assists with providing personal care assistance services and 
38.12 	includes personal care assistance provider organizations, personal care assistance choice 
38.13 	agency, class A licensed nursing agency, and Medicare-certified home health agency.
38.14 	(l) "Personal care assistant" or "PCA" means an individual employed by a personal 
38.15 	care assistance agency who provides personal care assistance services.
38.16 	(m) "Personal care assistance care plan" means a written description of personal 
38.17 	care assistance services developed by the personal care assistance provider according 
38.18 	to the service plan.
38.19 	(n) "Responsible party" means an individual who lives with and is capable of 
38.20 	providing the support necessary to assist the recipient to live in the community.
38.21 	(o) "Self-administered medication" means medication taken orally, by injection or 
38.22 	insertion, or applied topically without the need for assistance.
38.23 	(p) "Service plan" means a written summary of the assessment and description of the 
38.24 	services needed by the recipient.
38.25 		Subd. 2.Personal care assistance services; covered services. (a) The personal 
38.26 	care assistance services eligible for payment include services and supports furnished 
38.27 	to an individual, as needed, to assist in:
38.28 	(1) activities of daily living;
38.29 	(2) health-related functions;
38.30 	(3) assistance with behavior needs; and
38.31 	(4) instrumental activities of daily living.
38.32 	(b) Activities of daily living include the following covered services:
38.33 	(1) dressing, including assistance with choosing, application, and changing of 
38.34 	clothing and application of special appliances, wraps, or clothing;
39.1 	(2) grooming, including assistance with basic hair care, oral care, shaving, applying 
39.2 	cosmetics and deodorant, and care of eyeglasses and hearing aids. Nail care is included, 
39.3 	except for recipients who are diabetic or have poor circulation;
39.4 	(3) bathing, including assistance with basic personal hygiene and skin care;
39.5 	(4) eating, including assistance with hand washing and application of orthotics 
39.6 	required for eating, transfers, and feeding;
39.7 	(5) transfers, including assistance with transferring the recipient from one seating or 
39.8 	reclining area to another;
39.9 	(6) mobility, including assistance with ambulation, including use of a wheelchair. 
39.10 	Mobility does not include providing transportation for a recipient;
39.11 	(7) positioning, including assistance with positioning or turning a recipient for 
39.12 	necessary care and comfort; and
39.13 	(8) toileting, including assistance with helping recipient with bowel or bladder 
39.14 	elimination and care including transfers, mobility, positioning, feminine hygiene, use of 
39.15 	toileting equipment or supplies, cleansing the perineal area, inspection of the skin, and 
39.16 	adjusting clothing.
39.17 	(c) Health-related functions include the following covered services:
39.18 	(1) range of motion and passive exercise to maintain a recipient's strength and 
39.19 	muscle functioning;
39.20 	(2) assistance with self-administered medication as defined by this section, including 
39.21 	reminders to take medication, bringing medication to the recipient, and assistance with 
39.22 	opening medication under the direction of the recipient or responsible party;
39.23 	(3) interventions for seizure disorders, including monitoring and observation; and
39.24 	(4) other activities considered within the scope of the personal care service and 
39.25 	meeting the definition of health-related functions under this section.
39.26 	(d) A personal care assistant may provide health-related functions associated with 
39.27 	the complex health-related function needs of a recipient if the tasks meet the definition 
39.28 	of health-related functions under this section and the personal care assistant is trained 
39.29 	by a qualified professional and demonstrates competency to safely complete the task. 
39.30 	Delegation of health-related functions and all training must be documented in the personal 
39.31 	care assistance care plan and the recipient's and personal care assistant's files.
39.32 	(e) For a personal care assistant to provide the health-related functions of 
39.33 	tracheostomy suctioning and services to recipients on ventilator support there must be:
39.34 	(1) delegation and training by a registered nurse, certified or licensed respiratory 
39.35 	therapist, or a physician;
39.36 	(2) utilization of clean rather than sterile procedure;
40.1 	(3) specialized training about the health-related functions and equipment, including 
40.2 	ventilator operation and maintenance;
40.3 	(4) individualized training regarding the needs of the recipient; and
40.4 	(5) supervision by a qualified professional who is a registered nurse.
40.5 	(f) A personal care assistant may observe and redirect the recipient for episodes 
40.6 	where there is a need for redirection due to behaviors. Training of the personal care 
40.7 	assistant must occur based on the needs of the recipient, the personal care assistance care 
40.8 	plan, and any other support services provided.
40.9 	(g) Instrumental activities of daily living under subdivision 1, paragraph (h), include 
40.10 	accompanying a recipient to obtain medical diagnosis or treatment when assistance is 
40.11 	required by the recipient during the appointment.
40.12 		Subd. 3.Noncovered personal care assistance services. (a) Personal care 
40.13 	assistance services are not eligible for medical assistance payment under this section 
40.14 	when provided:
40.15 	(1) by the recipient's spouse, parent of a recipient under the age of 18, paid legal 
40.16 	guardian, licensed foster provider, or responsible party;
40.17 	(2) in lieu of other staffing options in a residential or child care setting;
40.18 	(3) solely as a child care or babysitting service; or
40.19 	(4) without authorization by the commissioner or the commissioner's designee.
40.20 	(b) The following personal care services are not eligible for medical assistance 
40.21 	payment under this section when provided in residential settings:
40.22 	(1) when the provider of home care services who is not related by blood, marriage, 
40.23 	or adoption owns or otherwise controls the living arrangement, including licensed or 
40.24 	unlicensed services; or
40.25 	(2) when personal care assistance services are the responsibility of a residential or 
40.26 	program license holder under the terms of a service agreement and administrative rules.
40.27 	(c) Other specific tasks not covered under paragraph (a) or (b) that are not eligible 
40.28 	for medical assistance reimbursement for personal care assistance services under this 
40.29 	section include:
40.30 	(1) sterile procedures;
40.31 	(2) injections of fluids and medications into veins, muscles, or skin;
40.32 	(3) instrumental activities of daily living without a dependency in at least two 
40.33 	activities of daily living;
40.34 	(4) home maintenance or chore services;
40.35 	(5) homemaker services not an integral part of assessed personal care assistance 
40.36 	services needed by a recipient;
41.1 	(6) application of restraints or implementation of procedures under section 245.825;
41.2 	(7) instrumental activities of daily living for children under the age of 18; and
41.3 	(8) assessments for personal care assistance services by personal care assistance 
41.4 	provider agencies or by independently enrolled registered nurses.
41.5 		Subd. 4.Assessment for personal care assistance services. (a) An assessment as 
41.6 	defined in section 256B.0911 must be completed for personal care assistance services.
41.7 	(b) The following limitations apply to the assessment:
41.8 	(1) a person must be assessed as dependent in an activity of daily living based 
41.9 	on the person's need, on a daily basis, for:
41.10 	(i) cueing and constant supervision to complete the task; or
41.11 	(ii) hands-on assistance to complete the task.
41.12 	(2) an adult may not be found to be dependent in an activity of daily living because 
41.13 	of individual choices; and
41.14 	(3) a child may not be found to be dependent in an activity of daily living if because 
41.15 	of the child's age an adult would either perform the activity for the child or assist the child 
41.16 	with the activity. Assistance needed is the assistance appropriate for a typical child of 
41.17 	the same age.
41.18 	(c) Assessment for complex health-related functions must meet the criteria in 
41.19 	this paragraph. During the assessment process, a recipient qualifies as having complex 
41.20 	health-related functions if the recipient has one or more of the interventions that are 
41.21 	ordered by a physician, specified in a personal care assistance care plan, and found in 
41.22 	the following:
41.23 	(1) tube feedings requiring:
41.24 	(i) a gastro/jejunostomy tube; or
41.25 	(ii) continuous tube feeding lasting longer than 12 hours per day;
41.26 	(2) wounds described as:
41.27 	(i) stage III or stage IV;
41.28 	(ii) multiple wounds;
41.29 	(iii) requiring sterile or clean dressing changes or a wound vac; or
41.30 	(iv) open lesions such as burns, fistulas, tube sites, or ostomy sites that require 
41.31 	specialized care;
41.32 	(3) parenteral therapy described as:
41.33 	(i) IV therapy more than two times per week lasting longer than four hours for 
41.34 	each treatment; or
41.35 	(ii) total parenteral nutrition (TPN) daily;
41.36 	(4) respiratory interventions including:
42.1 	(i) oxygen required more than eight hours per day;
42.2 	(ii) respiratory vest more than one time per day;
42.3 	(iii) bronchial drainage treatments more than two times per day;
42.4 	(iv) sterile or clean suctioning more than six times per day;
42.5 	(v) dependence on another to apply respiratory ventilation augmentation devises 
42.6 	such as BiPAP and CPAP; and
42.7 	(vi) ventilator dependence under section 256B.0652;
42.8 	(5) insertion and maintenance of catheter including:
42.9 	(i) sterile catheter changes more than one time per month;
42.10 	(ii) clean self-catheterization more than six times per day; or
42.11 	(iii) bladder irrigations;
42.12 	(6) bowel program more than two times per week requiring more than 30 minutes to 
42.13 	perform each time;
42.14 	(7) neurological intervention including:
42.15 	(i) seizures more than two times per week and requiring significant physical 
42.16 	assistance to maintain safety; or
42.17 	(ii) swallowing disorders diagnosed by a physician and requiring specialized 
42.18 	assistance from another on a daily basis; and
42.19 	(8) other congenital or acquired diseases creating a need for significantly increased 
42.20 	direct hands-on assistance and interventions in six to eight activities of daily living.
42.21 	(d) An assessment of behaviors must meet the criteria in this paragraph. A recipient 
42.22 	qualifies as having a need for assistance due to behaviors if the recipient's behavior requires 
42.23 	assistance at least four times per week and shows one or more of the following behaviors:
42.24 	(1) physical aggression towards self, others, or property that requires immediate 
42.25 	response of another;
42.26 	(2) increased vulnerability due to cognitive deficits or socially inappropriate 
42.27 	behavior; or
42.28 	(3) verbally aggressive and resistive to care.
42.29 		Subd. 5.Service and support planning. (a) The assessor, with the recipient or 
42.30 	responsible party, shall review the assessment information and determine referrals for 
42.31 	other payers, services, and community supports as appropriate.
42.32 	(b) The recipient must be referred for evaluation, services, or supports that are 
42.33 	appropriate to help meet the recipient's needs including, but not limited to, the following 
42.34 	circumstances:
42.35 	(1) when there is another payer who is responsible to provide the service to meet 
42.36 	the recipient's needs;
43.1 	(2) when the recipient qualifies for assistance with behaviors under this section, 
43.2 	a referral into the mental health system for a mental health diagnostic and functional 
43.3 	assessment must be completed;
43.4 	(3) when the recipient is eligible for medical assistance and meets medical assistance 
43.5 	eligibility for a home health aide or skilled nurse visit;
43.6 	(4) when the recipient would benefit from an evaluation for another service; and
43.7 	(5) when there is a more appropriate service to meet the assessed needs.
43.8 	(c) The reimbursement rates for public health nurse visits that relate to the provision 
43.9 	of personal care assistance services under this section and section 256B.0625, subdivision 
43.10 	19a, are:
43.11 	(1) $210.50 for a face-to-face assessment visit;
43.12 	(2) $105.25 for each service update; and
43.13 	(3) $105.25 for each request for a temporary service increase.
43.14 	(d) The rates specified in paragraph (c) must be adjusted to reflect provider rate 
43.15 	increases for personal care assistance services that are approved by the legislature for the 
43.16 	fiscal year ending June 30, 2000, and subsequent fiscal years. Any requirements applied 
43.17 	by the legislature to provider rate increases for personal care assistance services also 
43.18 	apply to adjustments under this paragraph.
43.19 	(e) Effective July 1, 2008, the payment rate for an assessment under this section and 
43.20 	section 256B.0651 shall be reduced by 25 percent when the assessment is not completed 
43.21 	on time and the service agreement documentation is not submitted in time to continue 
43.22 	services. The commissioner shall reduce the amount of the claim for those assessments 
43.23 	that are not submitted on time.
43.24 		Subd. 6.Service plan. The service plan must be completed by the assessor with the 
43.25 	recipient and responsible party on a form determined by the commissioner and include 
43.26 	a summary of the assessment with a description of the need, authorized amount, and 
43.27 	expected outcomes and goals of personal care assistance services. The recipient and 
43.28 	the provider chosen by the recipient or responsible party must be given a copy of the 
43.29 	completed service plan. The recipient or responsible party must be given information by 
43.30 	the assessor about the options in the personal care assistance program to allow for review 
43.31 	and decision making.
43.32 		Subd. 7.Personal care assistance care plan. (a) Each recipient must have a current 
43.33 	personal care assistance care plan based on the service plan in subdivision 21 that is 
43.34 	developed by the qualified professional with the recipient and responsible party. A copy of 
43.35 	the most current personal care assistance care plan is required to be in the recipient's home 
43.36 	and in the recipient's file at the provider agency.
44.1 	(b) The personal care assistance care plan must have the following components:
44.2 	(1) start and end date of the care plan;
44.3 	(2) recipient demographic information, including name and telephone number;
44.4 	(3) emergency numbers and procedures, including a backup plan;
44.5 	(4) name of responsible party and instructions for contact;
44.6 	(5) description of the recipient's individualized needs for assistance with activities of 
44.7 	daily living, instrumental activities of daily living, health-related tasks, and behaviors; and
44.8 	(6) dated signatures of recipient or responsible party and qualified professional.
44.9 	(c) The personal care assistance care plan must have instructions and comments 
44.10 	about the recipient's needs for assistance and any special instructions or procedures 
44.11 	required. The month-to-month plan for the use of personal care assistance services is part 
44.12 	of the personal care assistance care plan. The personal care assistance care plan must 
44.13 	be completed within the first week after start of services with a personal care provider 
44.14 	agency and must be updated as needed when there is a change in need for personal care 
44.15 	assistance services. A new personal care assistance care plan is required annually at the 
44.16 	time of the reassessment.
44.17 		Subd. 8.Communication with recipient's physician. The personal care assistance 
44.18 	program requires communication with the recipient's physician about a recipient's assessed 
44.19 	needs for personal care assistance services. The commissioner shall work with the state 
44.20 	medical director to develop options for communication with the recipient's physician.
44.21 		Subd. 9.Responsible party; generally. (a) "Responsible party" means an 
44.22 	individual who lives with and is capable of providing the support necessary to assist the 
44.23 	recipient to live in the community.
44.24 	(b) A responsible party must be 18 years of age, actively participate in planning and 
44.25 	directing of personal care assistance services, and attend all assessments for the recipient.
44.26 	(c) A responsible party must not have a direct or indirect financial interest in care 
44.27 	provided to the recipient and must not be the:
44.28 	(1) personal care assistant;
44.29 	(2) home care provider agency staff; or
44.30 	(3) county staff acting as part of employment.
44.31 	(d) A licensed family foster parent who lives with the recipient may be the 
44.32 	responsible party as long as the foster parent does not also have a direct or indirect 
44.33 	financial interest in the provision of personal care assistant services.
44.34 	(e) A responsible party is required when:
44.35 	(1) the person is a minor according to section 524.5-102, subdivision 10;
45.1 	(2) the person is an incapacitated adult according to section 524.5-102, subdivision 
45.2 	6, resulting in a court-appointed guardian; or
45.3 	(3) the assessment according to section 256B.0911 determines that the recipient is in 
45.4 	need of a responsible party to direct the recipient's care.
45.5 	(f) There may be two persons designated as the responsible party for reasons such as 
45.6 	divided households and court-ordered custodies. Each person named as responsible party 
45.7 	must meet the program criteria and responsibilities including living with the recipient at 
45.8 	the time they are serving as the responsible party.
45.9 	(g) The recipient or the recipient's legal representative shall appoint a responsible 
45.10 	party if necessary to direct and supervise the care provided to the recipient. The 
45.11 	responsible party must be identified at the time of assessment and listed on the recipient's 
45.12 	service agreement and personal care assistance care plan.
45.13 		Subd. 10.Responsible party; duties; delegation. (a) A responsible party with a 
45.14 	personal care assistance provider agency shall enter into a written agreement, on a form 
45.15 	determined by the commissioner, to perform the following duties:
45.16 	(1) live with the individual who is receiving personal care assistance services;
45.17 	(2) be available while care is provided in a method agreed upon by the individual 
45.18 	or the individual's legal representative and documented in the recipient's personal care 
45.19 	assistance care plan;
45.20 	(3) monitor personal care assistance services to ensure the recipient's personal care 
45.21 	assistance care plan is being followed; and
45.22 	(4) review and sign personal care assistance time sheets after services are provided 
45.23 	to provide verification of the personal care assistance services.
45.24 	Failure to provide the support required by the recipient must result in a referral to the 
45.25 	county common entry point.
45.26 	(b) Responsible parties who are parents of minors or guardians of minors or 
45.27 	incapacitated persons may delegate the responsibility to another adult who is not the 
45.28 	personal care assistant during a temporary absence of at least 24 hours but not more 
45.29 	than six months. The person delegated as a responsible party must be able to meet the 
45.30 	definition of the responsible party, except that the delegated responsible party is required 
45.31 	to reside with the recipient only while serving as the responsible party. The responsible 
45.32 	party must ensure that the delegate performs the functions of the responsible party, is 
45.33 	identified at the time of the assessment, and is listed on the personal care assistance 
45.34 	care plan. The responsible party must communicate to the personal care assistance 
45.35 	provider agency about the need for a delegate responsible party, including the name of the 
46.1 	delegated responsible party, dates the delegated responsible party will be living with the 
46.2 	recipient, and contact numbers.
46.3 		Subd. 11.Personal care assistant; requirements. (a) A personal care assistant 
46.4 	must meet the following requirements:
46.5 	(1) be at least 18 years of age with the exception of persons who are 16 or 17 years 
46.6 	of age with these additional requirements:
46.7 	(i) supervision by a qualified professional every 60 days; and
46.8 	(ii) employment by only one personal care assistance provider agency responsible 
46.9 	for compliance with current labor laws;
46.10 	(2) be employed by a personal care assistance provider agency;
46.11 	(3) enroll with the department as a non-pay-to provider after clearing a background 
46.12 	study. Before a personal care assistant provides services, the personal care assistance 
46.13 	provider agency must initiate a background study on the personal care assistant under 
46.14 	chapter 245C, and the personal care assistance provider agency must have received a 
46.15 	notice from the commissioner that the personal care assistant is:
46.16 	(i) not disqualified under section 245C.14; or
46.17 	(ii) is disqualified, but the personal care assistant has received a set aside of the 
46.18 	disqualification under section 245C.22;
46.19 	(4) be able to effectively communicate with the recipient and personal care 
46.20 	assistance provider agency;
46.21 	(5) be able to provide covered personal care assistance services according to the 
46.22 	recipient's personal care assistance care plan, respond appropriately to recipient needs, 
46.23 	and report changes in the recipient's condition to the supervising qualified professional 
46.24 	or physician;
46.25 	(6) not be a consumer of personal care assistance services;
46.26 	(7) maintain daily written records including, but not limited to, time sheets under 
46.27 	subdivision 12;
46.28 	(8) complete standardized training as determined by the commissioner before 
46.29 	completing enrollment. Personal care assistant training must include successful completion 
46.30 	of the following training components: basic first aid, vulnerable adult, child maltreatment, 
46.31 	OSHA universal precautions, basic roles and responsibilities of personal care assistants 
46.32 	including information about assistance with lifting and transfers for recipients, emergency 
46.33 	preparedness, fraud issues, and completion of time sheets. Included with the basic training 
46.34 	is a need for the personal care assistant to demonstrate competency of ability to understand 
46.35 	and provide assistance. Personal care assistant training and orientation must be completed 
47.1 	within the first seven days after the services begin and be directed to the needs of the 
47.2 	recipient and the recipient's personal care assistance care plan; and
47.3 	(9) be limited to providing and being paid for up to an amount of hours per month of 
47.4 	personal care assistance services that is determined by the commissioner regardless of 
47.5 	the number of recipients being served or the number of personal care assistance provider 
47.6 	agencies enrolled with.
47.7 	(b) A legal guardian may be a personal care assistant if the guardian is not being paid 
47.8 	for the guardian services and meets the criteria for personal care assistants in paragraph (a).
47.9 	(c) Persons who do not qualify as a personal care assistant include parents and 
47.10 	stepparents of minors, spouses, paid legal guardians, foster care providers, staff of a 
47.11 	residential setting, or anyone who has a direct or indirect financial interest in the service 
47.12 	delivery.
47.13 		Subd. 12.Documentation of personal care assistance services provided. (a) 
47.14 	Personal care assistance services for a recipient must be documented daily, on a form 
47.15 	approved by the commissioner by each personal care assistant, and kept in the recipient's 
47.16 	home for the current month of service. The completed form must be submitted on a 
47.17 	monthly basis to the provider and kept in the recipient's health record.
47.18 	(b) The activity documentation must correspond to the personal care assistance care 
47.19 	plan and be reviewed by the qualified professional.
47.20 	(c) The personal care assistant time sheet must be on a form approved by the 
47.21 	commissioner documenting time the personal care assistant provides services in the home. 
47.22 	The following criteria must be included in the time sheet:
47.23 	(1) full name of personal care assistant and individual provider number;
47.24 	(2) provider name and telephone numbers;
47.25 	(3) full name of recipient;
47.26 	(4) consecutive dates, including month, day, and year, and arrival and departure 
47.27 	time with a.m. or p.m. notations;
47.28 	(5) signatures of recipient or the responsible party;
47.29 	(6) personal signature of the personal care assistant;
47.30 	(7) any shared care provided, if applicable;
47.31 	(8) a statement that it is a federal crime to provide false information on personal 
47.32 	care service billings for medical assistance payments; and
47.33 	(9) dates and location of recipient stays in a hospital, care facility, or incarceration.
47.34 		Subd. 13.Qualified professional; qualifications. (a) The qualified professional 
47.35 	must be employed by a personal care assistance provider agency and meet the definition 
47.36 	under section 256B.0625, subdivision 19c. Before a qualified professional provides 
48.1 	services, the personal care assistance provider agency must initiate a background study on 
48.2 	the qualified professional under chapter 245C, and the personal care assistance provider 
48.3 	agency must have received a notice from the commissioner that the qualified professional:
48.4 	(1) is not disqualified under section 245C.14; or
48.5 	(2) is disqualified, but the qualified professional has received a set aside of the 
48.6 	disqualification under section 245C.22.
48.7 	(b) The qualified professional shall perform the duties of training, supervision, and 
48.8 	evaluation of the personal care assistance staff and evaluation of the effectiveness of 
48.9 	personal care assistance services. The qualified professional shall:
48.10 	(1) develop and monitor with the recipient a personal care assistance care plan based 
48.11 	on the service plan and individualized needs of the recipient;
48.12 	(2) develop and monitor with the recipient a monthly plan for the use of personal 
48.13 	care assistance services;
48.14 	(3) review documentation of personal care assistance services provided;
48.15 	(4) provide training and ensure competency for the personal care assistant in the 
48.16 	individual needs of the recipient; and
48.17 	(5) document all training, communication, evaluations, and needed actions to 
48.18 	improve performance of the personal care assistants.
48.19 	(c) The qualified professional shall complete the provider training with basic 
48.20 	information about the personal care assistance program approved by the commissioner 
48.21 	within six months of the date hired by a personal care assistance provider agency. 
48.22 	Qualified professionals who have completed the required trainings as an employee with a 
48.23 	personal care assistance provider agency do not need to repeat the required trainings if they 
48.24 	are hired by another agency, if they have completed the training within the last three years.
48.25 		Subd. 14.Qualified professional; duties. (a) All personal care assistants must 
48.26 	be supervised by a qualified professional or in a joint supervision relationship with the 
48.27 	recipient or the responsible party.
48.28 	(b) Through direct training, observation, return demonstrations, and consultation 
48.29 	with the staff and the recipient, the qualified professional must ensure and document 
48.30 	that the personal care assistant is:
48.31 	(1) capable of providing the required personal care assistance services;
48.32 	(2) knowledgeable about the plan of personal care assistance services before services 
48.33 	are performed; and
48.34 	(3) able to identify conditions that should be immediately brought to the attention of 
48.35 	the qualified professional.
49.1 	(c) The qualified professional shall evaluate the personal care assistant within the 
49.2 	first 14 days of starting to provide services for a recipient. The qualified professional shall 
49.3 	evaluate the personal care assistance services for a recipient through direct observation of 
49.4 	a personal care assistant's work:
49.5 	(1) at least every 90 days thereafter for the first year of services; and
49.6 	(2) every 120 days after the first year of service, or whenever needed for response to 
49.7 	a recipient's request for increased supervision of the personal care assistance staff.
49.8 	(d) Communication with the recipient is a part of the evaluation process of the 
49.9 	personal care assistance staff.
49.10 	(e) At each supervisory visit, the qualified professional shall evaluate personal care 
49.11 	assistance services including the following information:
49.12 	(1) satisfaction level of the recipient with personal care assistance services;
49.13 	(2) review of the month-to-month plan for use of personal care assistance services;
49.14 	(3) review of documentation of personal care assistance services provided;
49.15 	(4) whether the personal care assistance services are meeting the goals of the service 
49.16 	as stated in the personal care assistance care plan and service plan;
49.17 	(5) a written record of the results of the evaluation and actions taken to correct any 
49.18 	deficiencies in the work of a personal care assistant; and
49.19 	(6) revision of the personal care assistance care plan as necessary in consultation 
49.20 	with the recipient or responsible party, to meet the needs of the recipient.
49.21 	(f) The qualified professional shall complete the required documentation in the 
49.22 	agency recipient and employee files and the recipient's home, including the following 
49.23 	documentation:
49.24 	(1) the personal care assistance care plan based on the service plan and individualized 
49.25 	needs of the recipient;
49.26 	(2) a month-to-month plan for use of personal care assistance services;
49.27 	(3) changes in need of the recipient requiring a change to the level of service and the 
49.28 	personal care assistance care plan;
49.29 	(4) evaluation results of supervision visits and identified issues with personal care 
49.30 	assistance staff with actions taken;
49.31 	(5) all communication with the recipient and personal care assistance staff; and
49.32 	(6) hands-on training or individualized training for the care of the recipient.
49.33 	(g) The documentation in paragraph (f) must be done on agency forms.
49.34 	(h) The services that are not eligible for payment as qualified professional services 
49.35 	include:
50.1 	(1) direct professional nursing tasks that could be assessed and authorized as skilled 
50.2 	nursing tasks;
50.3 	(2) supervision of personal care assistance completed by telephone;
50.4 	(3) agency administrative activities;
50.5 	(4) training other than the individualized training required to provide care for a 
50.6 	recipient; and
50.7 	(5) any other activity that is not described in this section.
50.8 		Subd. 15.Flexible use. (a) "Flexible use" means the scheduled use of authorized 
50.9 	hours of personal care assistance services, which vary within a service authorization 
50.10 	period covering no more than six months, in order to more effectively meet the needs and 
50.11 	schedule of the recipient. Each 12-month service agreement is divided into two six-month 
50.12 	authorization date spans. No more than 75 percent of the total authorized units for a 
50.13 	12-month service agreement may be used in a six-month date span.
50.14 	(b) Authorization of flexible use occurs during the authorization process under 
50.15 	section 256B.0652. The flexible use of authorized hours does not increase the total 
50.16 	amount of authorized hours available to a recipient. The commissioner shall not authorize 
50.17 	additional personal care assistance services to supplement a service authorization that 
50.18 	is exhausted before the end date under a flexible service use plan, unless the assessor 
50.19 	determines a change in condition and a need for increased services is established. 
50.20 	Authorized hours not used within the six-month period must not be carried over to another 
50.21 	time period.
50.22 	(c) A recipient who has terminated personal care assistance services before the end 
50.23 	of the 12-month authorization period must not receive additional hours upon reapplying 
50.24 	during the same 12-month authorization period, except if a change in condition is 
50.25 	documented. Services must be prorated for the remainder of the 12-month authorization 
50.26 	period based on the first six-month assessment.
50.27 	(d) The recipient, responsible party, and qualified professional must develop a 
50.28 	written month-to-month plan of the projected use of personal care assistance services that 
50.29 	is part of the personal care assistance care plan and ensures:
50.30 	(1) that the health and safety needs of the recipient are met throughout both date 
50.31 	spans of the authorization period; and
50.32 	(2) that the total authorized amount of personal care assistance services for each date 
50.33 	span must not be used before the end of each date span in the authorization period.
50.34 	(e) The personal care assistance provider agency shall monitor the use of personal 
50.35 	care assistance services to ensure health and safety needs of the recipient are met 
50.36 	throughout both date spans of the authorization period. The commissioner or the 
51.1 	commissioner's designee shall provide written notice to the provider and the recipient or 
51.2 	responsible party when a recipient is at risk of exceeding the personal care assistance 
51.3 	services prior to the end of the six-month period.
51.4 	(f) Misuse and abuse of the flexible use of personal care assistance services resulting 
51.5 	in the overuse of units in a manner where the recipient will not have enough units to meet 
51.6 	their needs for assistance and ensure health and safety for the entire six-month date span 
51.7 	may lead to an action by the commissioner. The commissioner may take action including, 
51.8 	but not limited to: (1) restricting recipients to service authorizations of no more than one 
51.9 	month in duration; (2) requiring the recipient to have a responsible party; and (3) requiring 
51.10 	a qualified professional to monitor and report services on a monthly basis.
51.11 		Subd. 16.Shared services. (a) Medical assistance payments for shared personal 
51.12 	care assistance services are limited according to this subdivision.
51.13 	(b) Shared service is the provision of personal care assistance services by a personal 
51.14 	care assistant to two or three recipients, eligible for medical assistance, who voluntarily 
51.15 	enter into an agreement to receive services at the same time and in the same setting.
51.16 	(c) For the purposes of this subdivision, "setting" means:
51.17 	(1) the home residence or family foster care home of one or more of the individual 
51.18 	recipients; or
51.19 	(2) a child care program licensed under chapter 245A or operated by a local school 
51.20 	district or private school.
51.21 	(d) Shared personal care assistance services follow the same criteria for covered 
51.22 	services as subdivision 2.
51.23 	(e) Noncovered shared personal care assistance services include the following:
51.24 	(1) services for more than three recipients by one personal care assistant at one time;
51.25 	(2) staff requirements for child care programs under chapter 245C;
51.26 	(3) caring for multiple recipients in more than one setting;
51.27 	(4) additional units of personal care assistance based on the selection of the option; 
51.28 	and
51.29 	(5) use of more than one personal care assistance provider agency for the shared 
51.30 	care services.
51.31 	(f) The option of shared personal care assistance is elected by the recipient or the 
51.32 	responsible party with the assistance of the assessor. The option must be determined 
51.33 	appropriate based on the ages of the recipients, compatibility, and coordination of their 
51.34 	assessed care needs. The recipient or the responsible party, in conjunction with the 
51.35 	qualified professional, shall arrange the setting and grouping of shared services based 
51.36 	on the individual needs and preferences of the recipients. The personal care assistance 
52.1 	provider agency shall offer the recipient or the responsible party the option of shared or 
52.2 	one-on-one personal care assistance services or a combination of both. The recipient or 
52.3 	the responsible party may withdraw from participating in a shared services arrangement at 
52.4 	any time.
52.5 	(g) Authorization for the shared service option must be determined by the 
52.6 	commissioner based on the criteria that the shared service is appropriate to meet all of the 
52.7 	recipients' needs and their health and safety is maintained. The authorization of shared 
52.8 	services is part of the overall authorization of personal care assistance services. Nothing 
52.9 	in this subdivision must be construed to reduce the total number of hours authorized for 
52.10 	an individual recipient.
52.11 	(h) A personal care assistant providing shared personal care assistance services must:
52.12 	(1) receive training specific for each recipient served; and
52.13 	(2) follow all required documentation requirements for time and services provided.
52.14 	(i) A qualified professional shall:
52.15 	(1) evaluate the ability of the personal care assistant to provide services for all of 
52.16 	the recipients in a shared setting;
52.17 	(2) visit the shared setting as services are being provided at least once every six 
52.18 	months or whenever needed for response to a recipient's request for increased supervision 
52.19 	of the personal care assistance staff;
52.20 	(3) provide ongoing monitoring and evaluation of the effectiveness and 
52.21 	appropriateness of the shared services;
52.22 	(4) develop a contingency plan with each of the recipients which accounts for 
52.23 	absence of the recipient in a share services setting due to illness or other circumstances;
52.24 	(5) obtain permission from each of the recipients who are sharing a personal care 
52.25 	assistant for number of shared hours for services provided inside and outside the home 
52.26 	residence; and
52.27 	(6) document the training completed by the personal care assistants specific to the 
52.28 	shared setting and recipients sharing services.
52.29 		Subd. 17.Shared services; rates. The commissioner shall provide a rate system for 
52.30 	shared personal care assistance services. For two persons sharing services, the rate paid 
52.31 	to a provider must not exceed one and one-half times the rate paid for serving a single 
52.32 	individual, and for three persons sharing services, the rate paid to a provider must not 
52.33 	exceed twice the rate paid for serving a single individual. These rates apply only when all 
52.34 	of the criteria for the shared care personal care assistance service have been met.
52.35 		Subd. 18.Personal care assistance choice option; generally. (a) The 
52.36 	commissioner may allow a recipient of personal care assistance services to use a fiscal 
53.1 	intermediary to assist the recipient in paying and account for medically necessary covered 
53.2 	personal care assistance services. Unless otherwise provided in this section, all other 
53.3 	statutory and regulatory provisions relating to personal care assistance services apply to a 
53.4 	recipient using the personal care assistance choice option.
53.5 	(b) Personal care assistance choice is an option of the personal care assistance 
53.6 	program that allows the recipient who receives personal care assistance services to be 
53.7 	responsible for the hiring, training, and firing of personal care assistants. This program 
53.8 	offers greater control and choice for the recipient in who provides the personal care 
53.9 	assistance service and when the service is scheduled. The recipient or the recipient's 
53.10 	responsible party must choose a personal care assistance choice provider agency as 
53.11 	a fiscal intermediary. This personal care assistance choice provider agency manages 
53.12 	payroll, invoices the state, is responsible for all payroll related taxes and insurance, and is 
53.13 	responsible for providing the consumer training and support in managing the recipient's 
53.14 	personal care assistance services.
53.15 		Subd. 19.Personal care assistance choice option; qualifications; duties. (a) 
53.16 	Under personal care assistance choice, the recipient or responsible party shall:
53.17 	(1) recruit, hire, and terminate personal care assistants and a qualified professional;
53.18 	(2) develop a personal care assistance care plan based on the assessed needs 
53.19 	and addressing the health and safety of the recipient with the assistance of a qualified 
53.20 	professional as needed;
53.21 	(3) orient and train the personal care assistant with assistance as needed from the 
53.22 	qualified professional;
53.23 	(4) supervise and evaluate the personal care assistant with the qualified professional;
53.24 	(5) monitor and verify in writing and report to the personal care assistance choice 
53.25 	agency the number of hours worked by the personal care assistant and the qualified 
53.26 	professional;
53.27 	(6) engage in an annual face-to-face reassessment to determine continuing eligibility 
53.28 	and service authorization; and
53.29 	(7) use the same personal care assistance choice provider agency if shared personal 
53.30 	assistance care is being used.
53.31 	(b) The personal care assistance choice provider agency shall:
53.32 	(1) meet all personal care assistance provider agency standards;
53.33 	(2) enter into a written agreement with the recipient, responsible party, and personal 
53.34 	care assistants;
53.35 	(3) not be related to the recipient, qualified professional, or the personal care 
53.36 	assistant; and
54.1 	(4) ensure arm's-length transactions with the recipient and personal care assistant.
54.2 	(c) The duties of the personal care assistance choice provider agency are to:
54.3 	(1) be the employer of the personal care assistant and the qualified professional for 
54.4 	employment law and related regulations including but not limited to purchasing and 
54.5 	maintaining workers' compensation, unemployment insurance, surety and fidelity bonds, 
54.6 	and liability insurance, and submit any or all necessary documentation including, but not 
54.7 	limited to, workers' compensation and unemployment insurance;
54.8 	(2) bill the medical assistance program for personal care assistance services and 
54.9 	qualified professional services;
54.10 	(3) request and complete background studies that comply with the requirements for 
54.11 	personal care assistants and qualified professionals;
54.12 	(4) pay the personal care assistant and qualified professional based on actual hours 
54.13 	of services provided;
54.14 	(5) withhold and pay all applicable federal and state taxes;
54.15 	(6) verify and keep records of hours worked by the personal care assistant and 
54.16 	qualified professional;
54.17 	(7) make the arrangements and pay taxes and other benefits, if any; and comply with 
54.18 	any legal requirements for a Minnesota employer;
54.19 	(8) enroll in the medical assistance program as a personal care assistance choice 
54.20 	agency; and
54.21 	(9) enter into a written agreement as specified in subdivision 20 before services 
54.22 	are provided.
54.23 		Subd. 20.Personal care assistance choice option; administration. (a) Before 
54.24 	services commence under the personal care assistance choice option, and annually 
54.25 	thereafter, the personal care assistance choice provider agency, recipient, or responsible 
54.26 	party, each personal care assistant, and the qualified professional shall enter into a written 
54.27 	agreement. The agreement must include at a minimum:
54.28 	(1) duties of the recipient, qualified professional, personal care assistant, and 
54.29 	personal care assistance choice provider agency;
54.30 	(2) salary and benefits for the personal care assistant and the qualified professional;
54.31 	(3) administrative fee of the personal care assistance choice provider agency and 
54.32 	services paid for with that fee, including background study fees;
54.33 	(4) grievance procedures to respond to complaints;
54.34 	(5) procedures for hiring and terminating the personal care assistant; and
54.35 	(6) documentation requirements including, but not limited to, time sheets, activity 
54.36 	records, and the personal care assistance care plan.
55.1 	(b) Except for the administrative fee of the personal care assistance choice provider 
55.2 	agency as reported on the written agreement, the remainder of the rates paid to the personal 
55.3 	care assistance choice provider agency must be used to pay for the salary and benefits for 
55.4 	the personal care assistant or the qualified professional.
55.5 	(c) The commissioner shall deny, revoke, or suspend the authorization to use the 
55.6 	personal care assistance choice option if:
55.7 	(1) it has been determined by the qualified professional or public health nurse that 
55.8 	the use of this option jeopardizes the recipient's health and safety;
55.9 	(2) the parties have failed to comply with the written agreement specified in 
55.10 	subdivision 20;
55.11 	(3) the use of the option has led to abusive or fraudulent billing for personal care 
55.12 	assistance services; or
55.13 	(4) the department terminates the personal care assistance choice option.
55.14 	(d) The recipient or responsible party may appeal the commissioner's decision in 
55.15 	paragraph (c) according to section 256.045. The denial, revocation, or suspension to 
55.16 	use the personal care assistance choice option must not affect the recipient's authorized 
55.17 	level of personal care assistance services.
55.18 		Subd. 21.Requirements for initial enrollment of personal care assistance 
55.19 	provider agencies. (a) All personal care assistance provider agencies must provide, at the 
55.20 	time of enrollment as a personal care assistance provider agency in a format determined 
55.21 	by the commissioner, information and documentation that includes, but is not limited to, 
55.22 	the following:
55.23 	(1) the personal care assistance provider agency's current contact information 
55.24 	including address, telephone number, and e-mail address;
55.25 	(2) proof of surety bond coverage in the amount of $50,000 or ten percent of the 
55.26 	provider's payments from Medicaid in the previous year, whichever is less;
55.27 	(3) proof of fidelity bond coverage in the amount of $20,000;
55.28 	(4) proof of workers' compensation insurance coverage;
55.29 	(5) a description of the personal care assistance provider agency's organization 
55.30 	identifying the names of all owners, managerial officials, staff, board of directors, and the 
55.31 	affiliations of the directors, owners, or staff to other service providers;
55.32 	(6) a copy of the personal care assistance provider agency's written policies and 
55.33 	procedures including: hiring of employees; training requirements; service delivery; 
55.34 	and employee and consumer safety including process for notification and resolution 
55.35 	of consumer grievances, identification and prevention of communicable diseases, and 
55.36 	employee misconduct;
56.1 	(7) copies of all other forms the personal care assistance provider agency uses in 
56.2 	the course of daily business including, but not limited to:
56.3 	(i) a copy of the personal care assistance provider agency's time sheet if the time 
56.4 	sheet varies from the standard time sheet for personal care assistance services approved 
56.5 	by the commissioner, and a letter requesting approval of the personal care assistance 
56.6 	provider agency's nonstandard time sheet;
56.7 	(ii) the personal care assistance provider agency's template for the personal care 
56.8 	assistance care plan; and
56.9 	(iii) the personal care assistance provider agency's template and the written 
56.10 	agreement in subdivision 20 for recipients using the personal care assistance choice 
56.11 	option, if applicable;
56.12 	(8) a list of all trainings and classes that the personal care assistance provider agency 
56.13 	requires of its staff providing personal care assistance services;
56.14 	(9) documentation that the personal care assistance provider agency and staff have 
56.15 	successfully completed all the training required by this section; and
56.16 	(10) disclosure of ownership, leasing, or management of all residential properties 
56.17 	that is used or could be used for providing home care services.
56.18 	(b) Personal care assistance provider agencies shall provide the information specified 
56.19 	in paragraph (a) to the commissioner at the time the personal care assistance provider 
56.20 	agency enrolls as a vendor or upon request from the commissioner. The commissioner 
56.21 	shall collect the information specified in paragraph (a) from all personal care assistance 
56.22 	providers beginning upon enactment of this section.
56.23 	(c) All personal care assistance provider agencies shall complete mandatory training 
56.24 	as determined by the commissioner before enrollment as a provider. Personal care 
56.25 	assistance provider agencies are required to send all owners, qualified professionals 
56.26 	employed by the agency, and all other managerial officials to the initial and subsequent 
56.27 	trainings. Personal care assistance provider agency billing staff shall complete training 
56.28 	about personal care assistance program financial management. This training is effective 
56.29 	upon enactment of this section. Any personal care assistance provider agency enrolled 
56.30 	before that date shall, if it has not already, complete the provider training within 18 months 
56.31 	of the effective date of this section. Any new owners, new qualified professionals, and new 
56.32 	managerial officials are required to complete mandatory training as a requisite of hiring.
56.33 		Subd. 22.Annual review for personal care providers. (a) All personal care 
56.34 	assistance provider agencies shall resubmit, on an annual basis, the information specified 
56.35 	in subdivision 21, in a format determined by the commissioner, and provide a copy of the 
56.36 	personal care assistance provider agency's most current version of its grievance policies 
57.1 	and procedures along with a written record of grievances and resolutions of the grievances 
57.2 	that the personal care assistance provider agency has received in the previous year and any 
57.3 	other information requested by the commissioner.
57.4 	(b) The commissioner shall send annual review notification to personal care 
57.5 	assistance provider agencies 30 days prior to renewal. The notification must:
57.6 	(1) list the materials and information the personal care assistance provider agency is 
57.7 	required to submit;
57.8 	(2) provide instructions on submitting information to the commissioner; and
57.9 	(3) provide a due date by which the commissioner must receive the requested 
57.10 	information.
57.11 	Personal care assistance provider agencies shall submit required documentation for 
57.12 	annual review within 30 days of notification from the commissioner. If no documentation 
57.13 	is submitted, the personal care assistance provider agency enrollment number must be 
57.14 	terminated or suspended.
57.15 	(c) Personal care assistance provider agencies also currently licensed under 
57.16 	Minnesota Rules, part 4668.0012, as a class A provider or currently certified for 
57.17 	participation in Medicare as a home health agency under Code of Federal Regulations, 
57.18 	title 42, part 484, are deemed in compliance with the personal care assistance requirements 
57.19 	for enrollment, annual review process, and documentation.
57.20 		Subd. 23.Enrollment requirements following termination. (a) A terminated 
57.21 	personal care assistance provider agency, including all named individuals on the current 
57.22 	enrollment disclosure form and known or discovered affiliates of the personal care 
57.23 	assistance provider agency, is not eligible to enroll as a personal care assistance provider 
57.24 	agency for two years following the termination.
57.25 	(b) After the two-year period in paragraph (a), if the provider seeks to reenroll 
57.26 	as a personal care assistance provider agency, the personal care assistance provider 
57.27 	agency must be placed on a one-year probation period, beginning after completion of 
57.28 	the following:
57.29 	(1) the department's provider trainings under this section; and
57.30 	(2) initial enrollment requirements under subdivision 21.
57.31 	(c) During the probationary period the commissioner shall complete site visits and 
57.32 	request submission of documentation to review compliance with program policy.
57.33 		Subd. 24.Personal care assistance provider agency; general duties. A personal 
57.34 	care assistance provider agency shall:
57.35 	(1) enroll as a Medicaid provider meeting all provider standards, including 
57.36 	completion of the required provider training;
58.1 	(2) comply with general medical assistance coverage requirements;
58.2 	(3) demonstrate compliance with law and policies of the personal care assistance 
58.3 	program to be determined by the commissioner;
58.4 	(4) comply with background study requirements;
58.5 	(5) verify and keep records of hours worked by the personal care assistant and 
58.6 	qualified professional;
58.7 	(6) pay the personal care assistant and qualified professional based on actual hours 
58.8 	of services provided;
58.9 	(7) withhold and pay all applicable federal and state taxes;
58.10 	(8) make the arrangements and pay unemployment insurance, taxes, workers' 
58.11 	compensation, liability insurance, and other benefits, if any;
58.12 	(9) enter into a written agreement under subdivision 21 before services are provided;
58.13 	(10) report suspected neglect and abuse to the common entry point according to 
58.14 	section 256B.0651; and
58.15 	(11) provide the recipient with a copy of the home care bill of rights at start of service.
58.16 		Subd. 25.Personal care assistance provider agency; background studies.
 58.17 	Personal care assistance provider agencies enrolled to provide personal care assistance 
58.18 	services under the medical assistance program shall comply with the following:
58.19 	(1) owners who have a five percent interest or more and all managerial officials are 
58.20 	subject to a background study as provided in chapter 245C. This applies to currently 
58.21 	enrolled personal care assistance provider agencies and those agencies seeking enrollment 
58.22 	as a personal care assistance provider agency. Managerial official has the same meaning 
58.23 	as Code of Federal Regulations, title 42, section 455. An organization is barred from 
58.24 	enrollment if:
58.25 	(i) the organization has not initiated background studies on owners and managerial 
58.26 	officials; or
58.27 	(ii) the organization has initiated background studies on owners and managerial 
58.28 	officials, but the commissioner has sent the organization a notice that an owner or 
58.29 	managerial official of the organization has been disqualified under section 245C.14, 
58.30 	and the owner or managerial official has not received a set aside of the disqualification 
58.31 	under section 245C.22;
58.32 	(2) a background study must be initiated and completed for all qualified 
58.33 	professionals; and
58.34 	(3) a background study must be initiated and completed for all personal care 
58.35 	assistants.
59.1 		Subd. 26.Personal care assistance provider agency; communicable disease 
59.2 	prevention. A personal care assistance provider agency shall establish and implement 
59.3 	policies and procedures for prevention, control, and investigation of infections and 
59.4 	communicable diseases according to current nationally recognized infection control 
59.5 	practices or guidelines established by the United States Centers for Disease Control and 
59.6 	Prevention, as well as applicable regulations of other federal or state agencies.
59.7 		Subd. 27.Personal care assistance provider agency; ventilator training. The 
59.8 	personal care assistance provider agency is required to provide training for the personal 
59.9 	care assistant responsible for working with a recipient who is ventilator dependent. All 
59.10 	training must be administered by a respiratory therapist, nurse, or physician. Qualified 
59.11 	professional supervision by a nurse must be completed and documented on file in the 
59.12 	personal care assistant's employment record and the recipient's health record. If offering 
59.13 	personal care services to a ventilator-dependent recipient, the personal care assistance 
59.14 	provider agency shall demonstrate the ability to:
59.15 	(1) train the personal care assistant;
59.16 	(2) supervise the personal care assistant in ventilator operation and maintenance; and
59.17 	(3) supervise the recipient and responsible party in ventilator operation and 
59.18 	maintenance.
59.19 		Subd. 28.Personal care assistance provider agency; required documentation.
 59.20 	Required documentation must be completed and kept in the personal care assistance 
59.21 	provider agency file or the recipient's home residence. The required documentation 
59.22 	consists of:
59.23 	(1) employee files, including:
59.24 	(i) applications for employment;
59.25 	(ii) background study requests and results;
59.26 	(iii) orientation records about the agency policies;
59.27 	(iv) trainings completed with demonstration of competence;
59.28 	(v) supervisory visits;
59.29 	(vi) evaluations of employment; and
59.30 	(vii) signature on fraud statement;
59.31 	(2) recipient files, including:
59.32 	(i) demographics;
59.33 	(ii) emergency contact information and emergency backup plan;
59.34 	(iii) medical assistance service plan;
59.35 	(iv) personal care assistance care plan;
59.36 	(v) month-to-month service use plan;
60.1 	(vi) all communication records;
60.2 	(vii) start of service information, including the written agreement with recipient; and
60.3 	(viii) date the home care bill of rights was given to the recipient;
60.4 	(3) agency policy manual, including:
60.5 	(i) policies for employment and termination;
60.6 	(ii) grievance policies with resolution of consumer grievances;
60.7 	(iii) staff and consumer safety;
60.8 	(iv) staff misconduct; and
60.9 	(v) staff hiring, service delivery, staff and consumer safety, staff misconduct, and 
60.10 	resolution of consumer grievances; and
60.11 	(4) time sheets for each personal care assistant along with completed activity sheets 
60.12 	for each recipient served.
60.13 		Subd. 29.Transitional assistance. Notwithstanding any contrary provision in 
60.14 	this section, the commissioner, counties, and personal care assistance providers shall 
60.15 	work together to provide transitional assistance for recipients and families to come into 
60.16 	compliance with the new live-in responsible party requirements of this section, and 
60.17 	ensure that services are prohibited from being provided by the housing provider. The 
60.18 	commissioner and counties shall provide this assistance until July 1, 2010.

60.19 	Sec. 24. Minnesota Statutes 2008, section 256B.0911, subdivision 1, is amended to 
60.20 	read:
60.21 		Subdivision 1.Purpose and goal. (a) The purpose of long-term care consultation 
60.22 	services is to assist persons with long-term or chronic care needs in making long-term 
60.23 	care decisions and selecting options that meet their needs and reflect their preferences. 
60.24 	The availability of, and access to, information and other types of assistance, including 
60.25 	assessment and support planning, is also intended to prevent or delay certified nursing 
60.26 	facility placements and to provide transition assistance after admission. Further, the goal 
60.27 	of these services is to contain costs associated with unnecessary certified nursing facility 
60.28 	admissions. Long-term consultation services must be available to any person regardless 
60.29 	of public program eligibility. The commissionerscommissioner of human services and 
60.30 	health shall seek to maximize use of available federal and state funds and establish the 
60.31 	broadest program possible within the funding available.
60.32 	(b) These services must be coordinated with serviceslong-term care options 
60.33 	counseling provided under section 256.975, subdivision 7, and with services provided by 
60.34 	other public and private agencies in the communitysection 256.01, subdivision 24, for 
60.35 	telephone assistance and follow up and to offer a variety of cost-effective alternatives 
61.1 	to persons with disabilities and elderly persons. The county or tribal agency providing 
61.2 	long-term care consultation services shall encourage the use of volunteers from families, 
61.3 	religious organizations, social clubs, and similar civic and service organizations to provide 
61.4 	community-based services.

61.5 	Sec. 25. Minnesota Statutes 2008, section 256B.0911, subdivision 1a, is amended to 
61.6 	read:
61.7 		Subd. 1a.Definitions. For purposes of this section, the following definitions apply:
61.8 	(a) "Long-term care consultation services" means:
61.9 	(1) providing information and education to the general public regarding availability 
61.10 	of the services authorized under this section;
61.11 	(2) an intake process that provides access to the services described in this section;
61.12 	(3) assessment of the health, psychological, and social needs of referred individuals;
61.13 	(4)(1) assistance in identifying services needed to maintain an individual in the 
61.14 	least restrictivemost inclusive environment;
61.15 	(5)(2) providing recommendations on cost-effective community services that are 
61.16 	available to the individual;
61.17 	(6)(3) development of an individual's person-centered community support plan;
61.18 	(7)(4) providing information regarding eligibility for Minnesota health care 
61.19 	programs;
61.20 	(5) face-to-face long-term care consultation assessments, which may be completed 
61.21 	in a hospital, nursing facility, intermediate care facility for persons with developmental 
61.22 	disabilities (ICF/DDs), regional treatment centers, or the person's current or planned 
61.23 	residence;
61.24 	(8) preadmission(6) federally mandated screening to determine the need for 
61.25 	a nursing facilityinstitutional level of care under section 256B.0911, subdivision 4, 
61.26 	paragraph (a);
61.27 	(9) preliminary(7) determination of Minnesota health care programshome and 
61.28 	community-based waiver service eligibility including level of care determination for 
61.29 	individuals who need a nursing facilityan institutional level of care as defined under 
61.30 	section 144.0724, subdivision 11, or 256B.092, service eligibility including state plan 
61.31 	home care services identified in section 256B.0625, subdivisions 6, 7, and 19, paragraphs 
61.32 	(a) and (c), based on assessment and support plan development with appropriate referrals 
61.33 	for final determination;
61.34 	(10)(8) providing recommendations for nursing facility placement when there are 
61.35 	no cost-effective community services available; and
62.1 	(11)(9) assistance to transition people back to community settings after facility 
62.2 	admission.
62.3 	(b) "Long-term options counseling" means the services provided by the linkage 
62.4 	lines as mandated by sections 256.01 and 256.975, subdivision 7, and also includes 
62.5 	telephone assistance and follow up once a long-term care consultation assessment has 
62.6 	been completed. Long-term care options counselors shall:
62.7 	(1) for individuals not eligible for case management under a public program or 
62.8 	public funding source, provide interactive decision support whereby consumers, family 
62.9 	members, or other helpers are supported in their deliberations to determine appropriate 
62.10 	long-term care choices in the context of the consumer's needs, preferences, values, and 
62.11 	individual circumstances including implementing a community support plan:
62.12 	(2) provide Web-based educational information and collateral written materials to 
62.13 	familiarize consumers, family members, or other helpers with the long-term care basics, 
62.14 	issues to be considered, and the range of options available in the community;
62.15 	(3) provide long-term care futures planning defined as providing assistance to 
62.16 	individuals who anticipate having long-term care needs to develop a plan for the more 
62.17 	distant future; and
62.18 	(4) provide expertise in benefits and financing options for long-term care including 
62.19 	Medicare, long-term care insurance, tax or employer-based incentives, reverse mortgages, 
62.20 	private pay options, and ways to access low or no-cost services or benefits through 
62.21 	volunteer-based or charitable programs.
62.22 	(b) (c) "Minnesota health care programs" means the medical assistance program 
62.23 	under chapter 256B and the alternative care program under section 256B.0913.
62.24 	(d) "Lead agencies" means counties or a collaboration of counties, tribes, and health 
62.25 	plans administering long-term care consultation assessment and support planning services.

62.26 	Sec. 26. Minnesota Statutes 2008, section 256B.0911, is amended by adding a 
62.27 	subdivision to read:
62.28 		Subd. 2b.Certified assessors. (a) Beginning January 1, 2011, each lead agency 
62.29 	shall have certified assessors who have completed training and certification process 
62.30 	determined by the commissioner in subdivision 2c. Certified assessors shall demonstrate 
62.31 	best practices in assessment and support planning including person-centered planning 
62.32 	principals and have a common set of skills that must ensure consistency and equitable 
62.33 	access to services statewide.
62.34 	(b) Certified assessors are persons with a minimum of a bachelor's degree in social 
62.35 	work, nursing with a public health nursing certificate, or other closely related field with at 
63.1 	least one year of home and community-based experience or a two-year registered nursing 
63.2 	degree with at least three years of home and community-based experience that have 
63.3 	received training and certification specific to assessment and consultation for long-term 
63.4 	care services in the state.

63.5 	Sec. 27. Minnesota Statutes 2008, section 256B.0911, is amended by adding a 
63.6 	subdivision to read:
63.7 		Subd. 2c.Assessor training and certification. The commissioner shall develop 
63.8 	curriculum and a certification process to begin no later than January 1, 2010. All existing 
63.9 	lead agency staff designated to provide the services defined in subdivision 1a must be 
63.10 	certified by December 30, 2010. Each lead agency is required to ensure that they have 
63.11 	sufficient numbers of certified assessors to provide long-term consultation assessment and 
63.12 	support planning within the timelines and parameters of the service by January 1, 2011. 
63.13 	Certified assessors are required to be recertified every three years.

63.14 	Sec. 28. Minnesota Statutes 2008, section 256B.0911, subdivision 3, is amended to 
63.15 	read:
63.16 		Subd. 3.Long-term care consultation team. (a) Until January 1, 2011, a long-term 
63.17 	care consultation team shall be established by the county board of commissioners. Each 
63.18 	local consultation team shall consist of at least one social worker and at least one public 
63.19 	health nurse from their respective county agencies. The board may designate public 
63.20 	health or social services as the lead agency for long-term care consultation services. If a 
63.21 	county does not have a public health nurse available, it may request approval from the 
63.22 	commissioner to assign a county registered nurse with at least one year experience in 
63.23 	home care to participate on the team. Two or more counties may collaborate to establish 
63.24 	a joint local consultation team or teams.
63.25 	(b) The team is responsible for providing long-term care consultation services to 
63.26 	all persons located in the county who request the services, regardless of eligibility for 
63.27 	Minnesota health care programs.
63.28 	(c) The commissioner shall allow arrangements and make recommendations that 
63.29 	encourage counties to collaborate to establish joint local long-term care consultation 
63.30 	teams to ensure that long-term care consultations are done within the timelines and 
63.31 	parameters of the service. This includes integrated service models as required in section 
63.32 	256B.0911, subdivision 1, paragraph (b).

64.1 	Sec. 29. Minnesota Statutes 2008, section 256B.0911, subdivision 3a, is amended to 
64.2 	read:
64.3 		Subd. 3a.Assessment and support planning. (a) Persons requesting assessment, 
64.4 	services planning, or other assistance intended to support community-based living, 
64.5 	including persons who need assessment in order to determine personal care assistance 
64.6 	services, private duty nursing services, home health agency services, waiver or alternative 
64.7 	care program eligibility, must be visited by a long-term care consultation team on or after 
64.8 	January 1, 2011, a certified assessor within ten working15 calendar days after the date on 
64.9 	which an assessment was requested or recommended. Face-to-face assessments must be 
64.10 	conducted according to paragraphs (b) to (i) (k).
64.11 	(b) The county may utilize a team of either the social worker or public health nurse, 
64.12 	or both, after January 1, 2011, lead agencies shall use a certified assessor to conduct the 
64.13 	assessment in a face-to-face interview. The consultation team members must confer 
64.14 	regarding the most appropriate care for each individual screened or assessed.
64.15 	(c) The long-term care consultation team must assess the health and social needs of 
64.16 	the person assessment must be comprehensive and include a person-centered assessment 
64.17 	of the health, psychological, functional, environmental, and social needs of referred 
64.18 	individuals and provide information necessary to develop a support plan that meets the 
64.19 	consumers needs, using an assessment form provided by the commissioner.
64.20 	(d) The team must conduct the assessment must be conducted in a face-to-face 
64.21 	interview with the person being assessed and the person's legal representative, if applicable
64.22 	as required by legally executed documents, and other individuals as requested by the 
64.23 	person, who can provide information on the needs, strengths, and preferences of the 
64.24 	person necessary to develop a support plan that ensures the person's health and safety, but 
64.25 	who is not a provider of service or has any financial interest in the provision of services.
64.26 	(e) The team must provide the person, or the person's legal representative, must 
64.27 	be provided with written recommendations for facility- or community-based services. 
64.28 	The team must documentor institutional care that include documentation that the most 
64.29 	cost-effective alternatives available were offered to the individual. For purposes of 
64.30 	this requirement, "cost-effective alternatives" means community services and living 
64.31 	arrangements that cost the same as or less than nursing facility institutional care.
64.32 	(f) If the person chooses to use community-based services, the team must provide 
64.33 	the person or the person's legal representative must be provided with a written community 
64.34 	support plan, regardless of whether the individual is eligible for Minnesota health care 
64.35 	programs. TheA person may request assistance in developing a community support plan 
64.36 	 identifying community supports without participating in a complete assessment. Upon 
65.1 	a request for assistance identifying community support, the person must be transferred 
65.2 	or referred to the services available under sections 256.975, subdivision 7, and 256.01, 
65.3 	subdivision 24, for telephone assistance and follow up.
65.4 	(g) The person has the right to make the final decision between nursing 
65.5 	facility institutional placement and community placement after the screening team's 
65.6 	recommendation recommendations have been provided, except as provided in subdivision 
65.7 	4a, paragraph (c).
65.8 	(h) The team must give the person receiving assessment or support planning, or 
65.9 	the person's legal representative, materials, and forms supplied by the commissioner 
65.10 	containing the following information:
65.11 	(1) the need for and purpose of preadmission screening if the person selects nursing 
65.12 	facility placement;
65.13 	(2) the role of the long-term care consultation assessment and support planning in 
65.14 	waiver and alternative care program eligibility determination;
65.15 	(3) information about Minnesota health care programs;
65.16 	(4) the person's freedom to accept or reject the recommendations of the team;
65.17 	(5) the person's right to confidentiality under the Minnesota Government Data 
65.18 	Practices Act, chapter 13;
65.19 	(6) the long-term care consultant's decision regarding the person's need for nursing 
65.20 	facility institutional level of care as determined under criteria established in section 
65.21 	144.0724, subdivision 11, or 256B.092; and
65.22 	(7) the person's right to appeal the decision regarding the need for nursing facility 
65.23 	level of care or the county's final decisions regarding public programs eligibility according 
65.24 	to section 256.045, subdivision 3.
65.25 	(i) Face-to-face assessment completed as part of eligibility determination for 
65.26 	the alternative care, elderly waiver, community alternatives for disabled individuals, 
65.27 	community alternative care, and traumatic brain injury waiver programs under sections 
65.28 	256B.0915, 256B.0917, and 256B.49 is valid to establish service eligibility for no more 
65.29 	than 60 calendar days after the date of assessment. The effective eligibility start date 
65.30 	for these programs can never be prior to the date of assessment. If an assessment was 
65.31 	completed more than 60 days before the effective waiver or alternative care program 
65.32 	eligibility start date, assessment and support plan information must be updated in a 
65.33 	face-to-face visit and documented in the department's Medicaid Management Information 
65.34 	System (MMIS). The effective date of program eligibility in this case cannot be prior to 
65.35 	the date the updated assessment is completed.

66.1 	Sec. 30. Minnesota Statutes 2008, section 256B.0911, subdivision 4a, is amended to 
66.2 	read:
66.3 		Subd. 4a.Preadmission screening activities related to nursing facility 
66.4 	admissions. (a) All applicants to Medicaid certified nursing facilities, including certified 
66.5 	boarding care facilities, must be screened prior to admission regardless of income, assets, 
66.6 	or funding sources for nursing facility care, except as described in subdivision 4b. The 
66.7 	purpose of the screening is to determine the need for nursing facility level of care as 
66.8 	described in paragraph (d) and to complete activities required under federal law related to 
66.9 	mental illness and developmental disability as outlined in paragraph (b).
66.10 	(b) A person who has a diagnosis or possible diagnosis of mental illness or 
66.11 	developmental disability must receive a preadmission screening before admission 
66.12 	regardless of the exemptions outlined in subdivision 4b, paragraph (b), to identify the need 
66.13 	for further evaluation and specialized services, unless the admission prior to screening is 
66.14 	authorized by the local mental health authority or the local developmental disabilities case 
66.15 	manager, or unless authorized by the county agency according to Public Law 101-508.
66.16 	The following criteria apply to the preadmission screening:
66.17 	(1) the county must use forms and criteria developed by the commissioner to identify 
66.18 	persons who require referral for further evaluation and determination of the need for 
66.19 	specialized services; and
66.20 	(2) the evaluation and determination of the need for specialized services must be 
66.21 	done by:
66.22 	(i) a qualified independent mental health professional, for persons with a primary or 
66.23 	secondary diagnosis of a serious mental illness; or
66.24 	(ii) a qualified developmental disability professional, for persons with a primary or 
66.25 	secondary diagnosis of developmental disability. For purposes of this requirement, a 
66.26 	qualified developmental disability professional must meet the standards for a qualified 
66.27 	developmental disability professional under Code of Federal Regulations, title 42, section 
66.28 	483.430.
66.29 	(c) The local county mental health authority or the state developmental disability 
66.30 	authority under Public Law Numbers 100-203 and 101-508 may prohibit admission to a 
66.31 	nursing facility if the individual does not meet the nursing facility level of care criteria or 
66.32 	needs specialized services as defined in Public Law Numbers 100-203 and 101-508. For 
66.33 	purposes of this section, "specialized services" for a person with developmental disability 
66.34 	means active treatment as that term is defined under Code of Federal Regulations, title 
66.35 	42, section 483.440 (a)(1).
67.1 	(d) The determination of the need for nursing facility level of care must be made 
67.2 	according to criteria established in section 144.0724, subdivision 11, and 256B.092, 
67.3 	using forms developed by the commissioner. In assessing a person's needs, consultation 
67.4 	team members shall have a physician available for consultation and shall consider the 
67.5 	assessment of the individual's attending physician, if any. The individual's physician must 
67.6 	be included if the physician chooses to participate. Other personnel may be included on 
67.7 	the team as deemed appropriate by the county.

67.8 	Sec. 31. Minnesota Statutes 2008, section 256B.0911, subdivision 5, is amended to 
67.9 	read:
67.10 		Subd. 5.Administrative activity. The commissioner shall minimize the number 
67.11 	of forms required in the provision of long-term care consultation services and shall 
67.12 	limit the screening document to items necessary for community support plan approval, 
67.13 	reimbursement, program planning, evaluation, and policy development business processes 
67.14 	required to provide the services in this section and shall implement integrated solutions 
67.15 	to automate the business processes to the extent necessary for community support plan 
67.16 	approval, reimbursement, program planning, evaluation, and policy development.

67.17 	Sec. 32. Minnesota Statutes 2008, section 256B.0911, subdivision 6, is amended to 
67.18 	read:
67.19 		Subd. 6.Payment for long-term care consultation services. (a) The total payment 
67.20 	for each county must be paid monthly by certified nursing facilities in the county. The 
67.21 	monthly amount to be paid by each nursing facility for each fiscal year must be determined 
67.22 	by dividing the county's annual allocation for long-term care consultation services by 12 
67.23 	to determine the monthly payment and allocating the monthly payment to each nursing 
67.24 	facility based on the number of licensed beds in the nursing facility. Payments to counties 
67.25 	in which there is no certified nursing facility must be made by increasing the payment 
67.26 	rate of the two facilities located nearest to the county seat.
67.27 	(b) The commissioner shall include the total annual payment determined under 
67.28 	paragraph (a) for each nursing facility reimbursed under section 256B.431 or 256B.434
67.29 	according to section 256B.431, subdivision 2b, paragraph (g).
67.30 	(c) In the event of the layaway, delicensure and decertification, or removal from 
67.31 	layaway of 25 percent or more of the beds in a facility, the commissioner may adjust 
67.32 	the per diem payment amount in paragraph (b) and may adjust the monthly payment 
67.33 	amount in paragraph (a). The effective date of an adjustment made under this paragraph 
68.1 	shall be on or after the first day of the month following the effective date of the layaway, 
68.2 	delicensure and decertification, or removal from layaway.
68.3 	(d) Payments for long-term care consultation services are available to the county 
68.4 	or counties to cover staff salaries and expenses to provide the services described in 
68.5 	subdivision 1a. The county shall employ, or contract with other agencies to employ, within 
68.6 	the limits of available funding, sufficient personnel to provide long-term care consultation 
68.7 	services while meeting the state's long-term care outcomes and objectives as defined in 
68.8 	section 256B.0917, subdivision 1. The county shall be accountable for meeting local 
68.9 	objectives as approved by the commissioner in the biennial home and community-based 
68.10 	services quality assurance plan on a form provided by the commissioner.
68.11 	(e) Notwithstanding section 256B.0641, overpayments attributable to payment of the 
68.12 	screening costs under the medical assistance program may not be recovered from a facility.
68.13 	(f) The commissioner of human services shall amend the Minnesota medical 
68.14 	assistance plan to include reimbursement for the local consultation teams.
68.15 	(g) The county may bill, as case management services, assessments, support 
68.16 	planning, and follow-along provided to persons determined to be eligible for case 
68.17 	management under Minnesota health care programs. No individual or family member 
68.18 	shall be charged for an initial assessment or initial support plan development provided 
68.19 	under subdivision 3a or 3b.
68.20 	(h) The commissioner shall develop an alternative payment methodology for 
68.21 	long-term care consultation services that includes the funding available under this 
68.22 	subdivision, and sections 256B.092 and 256B.0659. In developing the new payment 
68.23 	methodology, the commissioner shall consider the maximization of federal funding for 
68.24 	this activity.

68.25 	Sec. 33. Minnesota Statutes 2008, section 256B.0911, subdivision 7, is amended to 
68.26 	read:
68.27 		Subd. 7.Reimbursement for certified nursing facilities. (a) Medical assistance 
68.28 	reimbursement for nursing facilities shall be authorized for a medical assistance recipient 
68.29 	only if a preadmission screening has been conducted prior to admission or the county has 
68.30 	authorized an exemption. Medical assistance reimbursement for nursing facilities shall 
68.31 	not be provided for any recipient who the local screener has determined does not meet the 
68.32 	level of care criteria for nursing facility placement in section 144.0724, subdivision 11, or, 
68.33 	if indicated, has not had a level II OBRA evaluation as required under the federal Omnibus 
68.34 	Budget Reconciliation Act of 1987 completed unless an admission for a recipient with 
68.35 	mental illness is approved by the local mental health authority or an admission for a 
69.1 	recipient with developmental disability is approved by the state developmental disability 
69.2 	authority.
69.3 	(b) The nursing facility must not bill a person who is not a medical assistance 
69.4 	recipient for resident days that preceded the date of completion of screening activities as 
69.5 	required under subdivisions 4a, 4b, and 4c. The nursing facility must include unreimbursed 
69.6 	resident days in the nursing facility resident day totals reported to the commissioner.

69.7 	Sec. 34. Minnesota Statutes 2008, section 256B.0913, subdivision 4, is amended to 
69.8 	read:
69.9 		Subd. 4.Eligibility for funding for services for nonmedical assistance recipients.
 69.10 	(a) Funding for services under the alternative care program is available to persons who 
69.11 	meet the following criteria:
69.12 	(1) the person has been determined by a community assessment under section 
69.13 	256B.0911 to be a person who would require the level of care provided in a nursing 
69.14 	facility according to the criteria established in section 144.0724, subdivision 11, but for 
69.15 	the provision of services under the alternative care program;
69.16 	(2) the person is age 65 or older;
69.17 	(3) the person would be eligible for medical assistance within 135 days of admission 
69.18 	to a nursing facility;
69.19 	(4) the person is not ineligible for the payment of long-term care services by the 
69.20 	medical assistance program due to an asset transfer penalty under section 256B.0595 or 
69.21 	equity interest in the home exceeding $500,000 as stated in section 256B.056;
69.22 	(5) the person needs long-term care services that are not funded through other state 
69.23 	or federal funding;
69.24 	(6) the monthly cost of the alternative care services funded by the program for 
69.25 	this person does not exceed 75 percent of the monthly limit described under section 
69.26 	256B.0915, subdivision 3a. This monthly limit does not prohibit the alternative care 
69.27 	client from payment for additional services, but in no case may the cost of additional 
69.28 	services purchased under this section exceed the difference between the client's monthly 
69.29 	service limit defined under section 256B.0915, subdivision 3, and the alternative care 
69.30 	program monthly service limit defined in this paragraph. If care-related supplies and 
69.31 	equipment or environmental modifications and adaptations are or will be purchased for 
69.32 	an alternative care services recipient, the costs may be prorated on a monthly basis for 
69.33 	up to 12 consecutive months beginning with the month of purchase. If the monthly cost 
69.34 	of a recipient's other alternative care services exceeds the monthly limit established in 
69.35 	this paragraph, the annual cost of the alternative care services shall be determined. In this 
70.1 	event, the annual cost of alternative care services shall not exceed 12 times the monthly 
70.2 	limit described in this paragraph; and
70.3 	(7) the person is making timely payments of the assessed monthly fee.
70.4 	A person is ineligible if payment of the fee is over 60 days past due, unless the person 
70.5 	agrees to:
70.6 	(i) the appointment of a representative payee;
70.7 	(ii) automatic payment from a financial account;
70.8 	(iii) the establishment of greater family involvement in the financial management of 
70.9 	payments; or
70.10 	(iv) another method acceptable to the lead agency to ensure prompt fee payments.
70.11 	The lead agency may extend the client's eligibility as necessary while making 
70.12 	arrangements to facilitate payment of past-due amounts and future premium payments. 
70.13 	Following disenrollment due to nonpayment of a monthly fee, eligibility shall not be 
70.14 	reinstated for a period of 30 days.
70.15 	(b) Alternative care funding under this subdivision is not available for a person 
70.16 	who is a medical assistance recipient or who would be eligible for medical assistance 
70.17 	without a spenddown or waiver obligation. A person whose initial application for medical 
70.18 	assistance and the elderly waiver program is being processed may be served under the 
70.19 	alternative care program for a period up to 60 days. If the individual is found to be eligible 
70.20 	for medical assistance, medical assistance must be billed for services payable under the 
70.21 	federally approved elderly waiver plan and delivered from the date the individual was 
70.22 	found eligible for the federally approved elderly waiver plan. Notwithstanding this 
70.23 	provision, alternative care funds may not be used to pay for any service the cost of which: 
70.24 	(i) is payable by medical assistance; (ii) is used by a recipient to meet a waiver obligation; 
70.25 	or (iii) is used to pay a medical assistance income spenddown for a person who is eligible 
70.26 	to participate in the federally approved elderly waiver program under the special income 
70.27 	standard provision.
70.28 	(c) Alternative care funding is not available for a person who resides in a licensed 
70.29 	nursing home, certified boarding care home, hospital, or intermediate care facility, except 
70.30 	for case management services which are provided in support of the discharge planning 
70.31 	process for a nursing home resident or certified boarding care home resident to assist with 
70.32 	a relocation process to a community-based setting.
70.33 	(d) Alternative care funding is not available for a person whose income is greater 
70.34 	than the maintenance needs allowance under section 256B.0915, subdivision 1d, but equal 
70.35 	to or less than 120 percent of the federal poverty guideline effective July 1 in the fiscal 
71.1 	year for which alternative care eligibility is determined, who would be eligible for the 
71.2 	elderly waiver with a waiver obligation.

71.3 	Sec. 35. Minnesota Statutes 2008, section 256B.0915, subdivision 3e, is amended to 
71.4 	read:
71.5 		Subd. 3e.Customized living service rate. (a) Payment for customized living 
71.6 	services shall be a monthly rate negotiated and authorized by the lead agency within the 
71.7 	parameters established by the commissioner. The payment agreement must delineate the 
71.8 	services that have been customized for each recipient and specify the amount of each 
71.9 	component service included in the recipient's customized living service to be provided
71.10 	plan. The lead agency shall ensure that there is a documented need for allwithin the 
71.11 	parameters established by the commissioner for all component customized living services 
71.12 	authorized. Customized living services must not include rent or raw food costs.
71.13 	(b) The negotiated payment rate must be based on the amount of component services 
71.14 	to be provided utilizing component rates established by the commissioner. Counties and 
71.15 	tribes shall use tools issued by the commissioner to develop and document customized 
71.16 	living service plans and rates.
71.17 	Negotiated (c) Component service rates must not exceed payment rates for 
71.18 	comparable elderly waiver or medical assistance services and must reflect economies of 
71.19 	scale. Customized living services must not include rent or raw food costs.
71.20 	(b)(d) The individualized monthly negotiated authorized payment for the 
71.21 	customized living services service plan shall not exceed the nonfederal share, in effect 
71.22 	on July 1 of the state fiscal year for which the rate limit is being calculated, 50 percent
71.23 	of the greater of either the statewide or any of the geographic groups' weighted average 
71.24 	monthly nursing facility rate of the case mix resident class to which the elderly waiver 
71.25 	eligible client would be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, 
71.26 	less the maintenance needs allowance as described in subdivision 1d, paragraph (a), until 
71.27 	the July 1 of the state fiscal year in which the resident assessment system as described 
71.28 	in section 256B.438 for nursing home rate determination is implemented. Effective on 
71.29 	July 1 of the state fiscal year in which the resident assessment system as described in 
71.30 	section 256B.438 for nursing home rate determination is implemented and July 1 of each 
71.31 	subsequent state fiscal year, the individualized monthly negotiated authorized payment 
71.32 	for the services described in this clause shall not exceed the limit described in this clause
71.33 	which was in effect on June 30 of the previous state fiscal year and which has been 
71.34 	adjusted by the greater of any legislatively adopted home and community-based services 
71.35 	cost-of-living percentage increase or any legislatively adopted statewide percent rate 
72.1 	increase for nursing facilities updated annually based on legislatively adopted changes to 
72.2 	all service rate maximums for home and community-based service providers.
72.3 	(c)(e) Customized living services are delivered by a provider licensed by the 
72.4 	Department of Health as a class A or class F home care provider and provided in a 
72.5 	building that is registered as a housing with services establishment under chapter 144D.

72.6 	Sec. 36. Minnesota Statutes 2008, section 256B.0915, subdivision 3h, is amended to 
72.7 	read:
72.8 		Subd. 3h.Service rate limits; 24-hour customized living services. (a) The 
72.9 	payment rates for 24-hour customized living services isare a monthly rate negotiated and
72.10 	authorized by the lead agency within the parameters established by the commissioner 
72.11 	of human services. The payment agreement must delineate the services that have been 
72.12 	customized for each recipient and specify the amount of each component service included 
72.13 	in each recipient's customized living service to be provided plan. The lead agency 
72.14 	shall ensure that there is a documented need within the parameters established by the 
72.15 	commissioner for all component customized living services authorized. The lead agency 
72.16 	shall not authorize 24-hour customized living services unless there is a documented need 
72.17 	for 24-hour supervision.
72.18 	(b) For purposes of this section, "24-hour supervision" means that the recipient 
72.19 	requires assistance due to needs related to one or more of the following:
72.20 	(1) intermittent assistance with toileting or transferring;
72.21 	(2) cognitive or behavioral issues;
72.22 	(3) a medical condition that requires clinical monitoring; or
72.23 	(4) other conditions or needs as defined by the commissioner of human services. 
72.24 	The lead agency shall ensure that the frequency and mode of supervision of the recipient 
72.25 	and the qualifications of staff providing supervision are described and meet the needs of 
72.26 	the recipient. Customized living services must not include rent or raw food costs.
72.27 	(c) The negotiated payment rate for 24-hour customized living services must be 
72.28 	based on the amount of component services to be provided utilizing component rates 
72.29 	established by the commissioner. Counties and tribes will use tools issued by the 
72.30 	commissioner to develop and document customized living plans and authorize rates.
72.31 	Negotiated (d) Component service rates must not exceed payment rates for 
72.32 	comparable elderly waiver or medical assistance services and must reflect economies 
72.33 	of scale.
72.34 	(e) The individually negotiated authorized 24-hour customized living payments, 
72.35 	in combination with the payment for other elderly waiver services, including case 
73.1 	management, must not exceed the recipient's community budget cap specified in 
73.2 	subdivision 3a. Customized living services must not include rent or raw food costs.
73.3 	(f) The individually authorized 24-hour customized living payment rates shall not 
73.4 	exceed the 95 percentile of statewide monthly authorizations for 24-hour customized 
73.5 	living services in effect and in the Medicaid management information systems on March 
73.6 	31, 2009, for each case mix resident class under Minnesota Rules, parts 9549.0050 
73.7 	to 9549.0059, to which elderly waiver service clients are assigned. When there are 
73.8 	fewer than 50 authorizations in effect in the case mix resident class, the commissioner 
73.9 	shall multiply the calculated service payment rate maximum for the A classification by 
73.10 	the standard weight for that classification under Minnesota Rules, parts 9549.0050 to 
73.11 	9549.0059, to determine the applicable payment rate maximum. Service payment rate 
73.12 	maximums shall be updated annually based on legislatively adopted changes to all service 
73.13 	rates for home and community-based service providers.
73.14 	(g) Notwithstanding the requirements of paragraphs (d) and (f), the commissioner 
73.15 	may establish an alternative payment rate system for 24-hour customized living services 
73.16 	by applying a single hourly rate for direct services provided in establishments, which 
73.17 	meet the following criteria:
73.18 	(1) 24-hour customized living services must be provided in a shared living unit; and
73.19 	(2) the unit is licensed as an adult foster care for no more than five residents or 
73.20 	licensed as a board and lodge facility with no more than ten residents.

73.21 	Sec. 37. Minnesota Statutes 2008, section 256B.0915, subdivision 5, is amended to 
73.22 	read:
73.23 		Subd. 5.Assessments and reassessments for waiver clients. (a) Each client 
73.24 	shall receive an initial assessment of strengths, informal supports, and need for services 
73.25 	in accordance with section 256B.0911, subdivisions 3, 3a, and 3b. A reassessment of a 
73.26 	client served under the elderly waiver must be conducted at least every 12 months and at 
73.27 	other times when the case manager determines that there has been significant change in 
73.28 	the client's functioning. This may include instances where the client is discharged from 
73.29 	the hospital. There must be a determination that the client requires nursing facility level of 
73.30 	care as defined in section 144.0724, subdivision 11, at initial and subsequent assessments 
73.31 	to initiate and maintain participation in the waiver program.
73.32 	(b) Regardless of other assessments identified in section 144.0724, subdivision 
73.33 	4, as appropriate to determine nursing facility level of care for purposes of medical 
73.34 	assistance payment for nursing facility services, only face-to-face assessments conducted 
73.35 	according to section 256B.0911, subdivisions 3a and 3b, that result in a nursing facility 
74.1 	level of care determination will be accepted for purposes of initial and ongoing access to 
74.2 	waiver service payment.

74.3 	Sec. 38. Minnesota Statutes 2008, section 256B.0915, is amended by adding a 
74.4 	subdivision to read:
74.5 		Subd. 10.Waiver payment rates; managed care organizations. The 
74.6 	commissioner shall adjust the elderly waiver capitation payment rates for managed care 
74.7 	organizations paid under section 256B.69, subdivisions 6a and 23, to reflect the maximum 
74.8 	service rate limits for customized living services and 24-hour customized living services 
74.9 	under subdivisions 3e and 3h for the contract period beginning January 1, 2010. Medical 
74.10 	assistance rates paid to customized living providers by managed care organizations 
74.11 	under this section shall not exceed the maximum service rate limits determined by the 
74.12 	commissioner under subdivisions 3e and 3h.

74.13 	Sec. 39. Minnesota Statutes 2008, section 256B.0917, is amended by adding a 
74.14 	subdivision to read:
74.15 		Subd. 14.Essential community supports grants. (a) The purpose of the essential 
74.16 	community supports grant program is to provide targeted services to persons 65 years and 
74.17 	older who need essential community support, but whose needs do not meet the level of 
74.18 	care required for nursing facility placement under section 144.0724, subdivision 11.
74.19 	(b) Within the limits of the appropriation and not to exceed $400 per person per 
74.20 	month, funding must be available to a person who:
74.21 	(1) is age 65 or older;
74.22 	(2) is not eligible for medical assistance;
74.23 	(3) would otherwise be financially eligible for the alternative care program under 
74.24 	section 256B.0913, subdivision 4;
74.25 	(4) has received a community assessment under section 256B.0911, subdivision 3a 
74.26 	or 3b, and does not require the level of care provided in a nursing facility;
74.27 	(5) has a community support plan; and
74.28 	(6) has been determined by a community assessment under section 256B.0911, 
74.29 	subdivision 3a or 3b, to be a person who would require provision of at least one of the 
74.30 	following services, as defined in the approved elderly waiver plan, in order to maintain 
74.31 	their community residence:
74.32 	(i) caregiver support;
74.33 	(ii) homemaker;
74.34 	(iii) chore; or
75.1 	(iv) a personal emergency response device or system.
75.2 	(c) The person receiving any of the essential community supports in this subdivision 
75.3 	must also receive service coordination as part of their community support plan.
75.4 	(d) A person who has been determined to be eligible for an essential community 
75.5 	support grant must be reassessed at least annually and continue to meet the criteria in 
75.6 	paragraph (b) to remain eligible for an essential community support grant.
75.7 	(e) The commissioner shall allocate grants to counties and tribes under contract with 
75.8 	the department based upon the historic use of the medical assistance elderly waiver and 
75.9 	alternative care grant programs and other criteria as determined by the commissioner.

75.10 	Sec. 40. Minnesota Statutes 2008, section 256B.092, subdivision 8a, is amended to 
75.11 	read:
75.12 		Subd. 8a.County concurrence. (a) If the county of financial responsibility wishes 
75.13 	to place a person in another county for services, the county of financial responsibility shall 
75.14 	seek concurrence from the proposed county of service and the placement shall be made 
75.15 	cooperatively between the two counties. Arrangements shall be made between the two 
75.16 	counties for ongoing social service, including annual reviews of the person's individual 
75.17 	service plan. The county where services are provided may not make changes in the 
75.18 	person's service plan without approval by the county of financial responsibility.
75.19 	(b) When a person has been screened and authorized for services in an intermediate 
75.20 	care facility for persons with developmental disabilities or for home and community-based 
75.21 	services for persons with developmental disabilities, the case manager shall assist that 
75.22 	person in identifying a service provider who is able to meet the needs of the person 
75.23 	according to the person's individual service plan. If the identified service is to be provided 
75.24 	in a county other than the county of financial responsibility, the county of financial 
75.25 	responsibility shall request concurrence of the county where the person is requesting to 
75.26 	receive the identified services. The county of service may refuse to concur if:
75.27 	(1) it can demonstrate that the provider is unable to provide the services identified in 
75.28 	the person's individual service plan as services that are needed and are to be provided; or
75.29 	(2) in the case of an intermediate care facility for persons with developmental 
75.30 	disabilities, there has been no authorization for admission by the admission review team 
75.31 	as required in section 256B.0926; or.
75.32 	(3) in the case of home and community-based services for persons with 
75.33 	developmental disabilities, the county of service can demonstrate that the prospective 
75.34 	provider has failed to substantially comply with the terms of a past contract or has had a 
76.1 	prior contract terminated within the last 12 months for failure to provide adequate services, 
76.2 	or has received a notice of intent to terminate the contract.
76.3 	(c) The county of service shall notify the county of financial responsibility of 
76.4 	concurrence or refusal to concur no later than 20 working days following receipt of the 
76.5 	written request. Unless other mutually acceptable arrangements are made by the involved 
76.6 	county agencies, the county of financial responsibility is responsible for costs of social 
76.7 	services and the costs associated with the development and maintenance of the placement. 
76.8 	The county of service may request that the county of financial responsibility purchase 
76.9 	case management services from the county of service or from a contracted provider 
76.10 	of case management when the county of financial responsibility is not providing case 
76.11 	management as defined in this section and rules adopted under this section, unless other 
76.12 	mutually acceptable arrangements are made by the involved county agencies. Standards 
76.13 	for payment limits under this section may be established by the commissioner. Financial 
76.14 	disputes between counties shall be resolved as provided in section 256G.09.

76.15 	Sec. 41. Minnesota Statutes 2008, section 256B.092, is amended by adding a 
76.16 	subdivision to read:
76.17 		Subd. 11.Residential support services. (a) Upon federal approval, there is 
76.18 	established a new service called residential support that is available on the CAC, CADI, 
76.19 	DD, and TBI waivers. Existing waiver service descriptions must be modified to the extent 
76.20 	necessary to ensure there is no duplication between other services. Residential support 
76.21 	services must be provided by vendors licensed under category community residential 
76.22 	setting as defined in section 245A.11, subdivision 8.
76.23 	(b) Residential support services must meet the following criteria:
76.24 	(1) providers of residential support services must own or control the residential site;
76.25 	(2) the residential site must not be the primary residence of the license holder;
76.26 	(3) the residential site must have a designated program supervisor responsible for 
76.27 	program oversight, development, and implementation of policies and procedures;
76.28 	(4) the provider of residential support services must provide supervision, training, 
76.29 	and assistance as described in the person's community support plan; and
76.30 	(5) the provider of residential support services must meet the requirements of 
76.31 	licensure and additional requirements of the person's community support plan.
76.32 	(c) Providers of residential support services that meet the definition in paragraph (a) 
76.33 	must be registered using a process determined by the commissioner beginning July 1, 2009.

76.34 	Sec. 42. Minnesota Statutes 2008, section 256B.37, subdivision 1, is amended to read:
77.1 		Subdivision 1.Subrogation. Upon furnishing medical assistance or alternative 
77.2 	care services under section 256B.0913 to any person who has private accident or health 
77.3 	care coverage, or receives or has a right to receive health or medical care from any 
77.4 	type of organization or entity, or has a cause of action arising out of an occurrence that 
77.5 	necessitated the payment of medical assistance, the state agency or the state agency's agent 
77.6 	shall be subrogated, to the extent of the cost of medical care furnished, to any rights the 
77.7 	person may have under the terms of the coverage, or against the organization or entity 
77.8 	providing or liable to provide health or medical care, or under the cause of action.
77.9 	The right of subrogation created in this section includes all portions of the cause 
77.10 	of action, notwithstanding any settlement allocation or apportionment that purports to 
77.11 	dispose of portions of the cause of action not subject to subrogation.

77.12 	Sec. 43. Minnesota Statutes 2008, section 256B.37, subdivision 5, is amended to read:
77.13 		Subd. 5.Private benefits to be used first. Private accident and health care coverage 
77.14 	including Medicare for medical services is primary coverage and must be exhausted before 
77.15 	medical assistance is or alternative care services are  paid for medical services including 
77.16 	home health care, personal care assistant services, hospice, supplies and equipment, or 
77.17 	services covered under a Centers for Medicare and Medicaid Services waiver. When a 
77.18 	person who is otherwise eligible for medical assistance has private accident or health care 
77.19 	coverage, including Medicare or a prepaid health plan, the private health care benefits 
77.20 	available to the person must be used first and to the fullest extent.

77.21 	Sec. 44. Minnesota Statutes 2008, section 256B.437, subdivision 6, is amended to read:
77.22 		Subd. 6.Planned closure rate adjustment. (a) The commissioner of human 
77.23 	services shall calculate the amount of the planned closure rate adjustment available under 
77.24 	subdivision 3, paragraph (b), for up to 5,140 beds according to clauses (1) to (4):
77.25 	(1) the amount available is the net reduction of nursing facility beds multiplied 
77.26 	by $2,080;
77.27 	(2) the total number of beds in the nursing facility or facilities receiving the planned 
77.28 	closure rate adjustment must be identified;
77.29 	(3) capacity days are determined by multiplying the number determined under 
77.30 	clause (2) by 365; and
77.31 	(4) the planned closure rate adjustment is the amount available in clause (1), divided 
77.32 	by capacity days determined under clause (3).
78.1 	(b) A planned closure rate adjustment under this section is effective on the first day 
78.2 	of the month following completion of closure of the facility designated for closure in the 
78.3 	application and becomes part of the nursing facility's total operating payment rate.
78.4 	(c) Applicants may use the planned closure rate adjustment to allow for a property 
78.5 	payment for a new nursing facility or an addition to an existing nursing facility or as an 
78.6 	operating payment rate adjustment. Applications approved under this subdivision are 
78.7 	exempt from other requirements for moratorium exceptions under section 144A.073, 
78.8 	subdivisions 2 and 3.
78.9 	(d) Upon the request of a closing facility, the commissioner must allow the facility a 
78.10 	closure rate adjustment as provided under section 144A.161, subdivision 10.
78.11 	(e) A facility that has received a planned closure rate adjustment may reassign it 
78.12 	to another facility that is under the same ownership at any time within three years of its 
78.13 	effective date. The amount of the adjustment shall be computed according to paragraph (a).
78.14 	(f) If the per bed dollar amount specified in paragraph (a), clause (1), is increased, 
78.15 	the commissioner shall recalculate planned closure rate adjustments for facilities that 
78.16 	delicense beds under this section on or after July 1, 2001, to reflect the increase in the per 
78.17 	bed dollar amount. The recalculated planned closure rate adjustment shall be effective 
78.18 	from the date the per bed dollar amount is increased.
78.19 	(g) For planned closures approved after June 30, 2009, the commissioner of human 
78.20 	services shall calculate the amount of the planned closure rate adjustment available under 
78.21 	subdivision 3, paragraph (b), according to paragraph (a), clauses (1) to (4).

78.22 	Sec. 45. Minnesota Statutes 2008, section 256B.441, is amended by adding a 
78.23 	subdivision to read:
78.24 		Subd. 59.Single-bed payments for medical assistance recipients.
 78.25 	Notwithstanding Minnesota Rules, part 9549.0070, subpart 3, beginning on October 1, 
78.26 	2009, the commissioner shall allow a single-bed payment rate for any medical assistance 
78.27 	recipient residing in a single-bed room regardless of having physician's orders for a 
78.28 	single-bed room. The amount of the single-bed payment shall be 110 percent of the 
78.29 	payment rate for the individual recipient. This subdivision does not affect the use of the 
78.30 	single-bed election under Minnesota Rules, part 9549.0060, subpart 11.

78.31 	Sec. 46. Minnesota Statutes 2008, section 256B.441, is amended by adding a 
78.32 	subdivision to read:
78.33 		Subd. 60.Rebasing not to be implemented. Notwithstanding subdivisions 53 and 
78.34 	55, for rate years beginning on October 1, 2009, and after, no rate adjustments shall be 
79.1 	implemented under this section. For rate years beginning October 1, 2009, and after, 
79.2 	nursing facility rates shall be determined under section 256B.434.

79.3 	Sec. 47. Minnesota Statutes 2008, section 256B.49, subdivision 12, is amended to read:
79.4 		Subd. 12.Informed choice. Persons who are determined likely to require the 
79.5 	level of care provided in a nursing facility as determined under sections 256B.0911 and 
79.6 	144.0724, subdivision 11, or hospital shall be informed of the home and community-based 
79.7 	support alternatives to the provision of inpatient hospital services or nursing facility 
79.8 	services. Each person must be given the choice of either institutional or home and 
79.9 	community-based services using the provisions described in section 256B.77, subdivision 
79.10 	2, paragraph (p).

79.11 	Sec. 48. Minnesota Statutes 2008, section 256B.49, subdivision 13, is amended to read:
79.12 		Subd. 13.Case management. (a) Each recipient of a home and community-based 
79.13 	waiver shall be provided case management services by qualified vendors as described 
79.14 	in the federally approved waiver application. The case management service activities 
79.15 	provided will include:
79.16 	(1) assessing the needs of the individual within 20 working days of a recipient's 
79.17 	request;
79.18 	(2) developing the written individual service plan within ten working days after the 
79.19 	assessment is completed;
79.20 	(3) informing the recipient or the recipient's legal guardian or conservator of service 
79.21 	options;
79.22 	(4) assisting the recipient in the identification of potential service providers;
79.23 	(5) assisting the recipient to access services;
79.24 	(6) coordinating, evaluating, and monitoring of the services identified in the service 
79.25 	plan;
79.26 	(7) completing the annual reviews of the service plan; and
79.27 	(8) informing the recipient or legal representative of the right to have assessments 
79.28 	completed and service plans developed within specified time periods, and to appeal county 
79.29 	action or inaction under section 256.045, subdivision 3, including the determination of 
79.30 	nursing facility level of care.
79.31 	(b) The case manager may delegate certain aspects of the case management service 
79.32 	activities to another individual provided there is oversight by the case manager. The case 
79.33 	manager may not delegate those aspects which require professional judgment including 
79.34 	assessments, reassessments, and care plan development.

80.1 	Sec. 49. Minnesota Statutes 2008, section 256B.49, subdivision 14, is amended to read:
80.2 		Subd. 14.Assessment and reassessment. (a) Assessments of each recipient's 
80.3 	strengths, informal support systems, and need for services shall be completed within 
80.4 	20 working days of the recipient's request. Reassessment of each recipient's strengths, 
80.5 	support systems, and need for services shall be conducted at least every 12 months and at 
80.6 	other times when there has been a significant change in the recipient's functioning.
80.7 	(b) There must be a determination that the client requires a hospital level of care or a 
80.8 	nursing facility level of care as defined in section 144.0724, subdivision 11, at initial and 
80.9 	subsequent assessments to initiate and maintain participation in the waiver program.
80.10 	(c) Regardless of other assessments identified in section 144.0724, subdivision 4, as 
80.11 	appropriate to determine nursing facility level of care for purposes of medical assistance 
80.12 	payment for nursing facility services, only face-to-face assessments conducted according 
80.13 	to section 256B.0911, subdivisions 3a, 3b, and 4d, that result in a hospital level of care 
80.14 	determination or a nursing facility level of care determination must be accepted for 
80.15 	purposes of initial and ongoing access to waiver services payment.
80.16 	(d) Persons with developmental disabilities who apply for services under the nursing 
80.17 	facility level waiver programs shall be screened for the appropriate level of care according 
80.18 	to section 256B.092.
80.19 	(c)(e) Recipients who are found eligible for home and community-based services 
80.20 	under this section before their 65th birthday may remain eligible for these services after 
80.21 	their 65th birthday if they continue to meet all other eligibility factors.

80.22 	Sec. 50. Minnesota Statutes 2008, section 256B.49, is amended by adding a 
80.23 	subdivision to read:
80.24 		Subd. 22.Residential support services. For the purposes of this section, the 
80.25 	provisions of section 256B.092, subdivision 11, are controlling.

80.26 	Sec. 51. [256B.4912] HOME AND COMMUNITY-BASED WAIVERS; 
80.27 	PROVIDERS AND PAYMENT.
80.28 		Subdivision 1.Provider qualifications. For the home and community-based 
80.29 	waivers providing services to seniors and individuals with disabilities, the commissioner 
80.30 	shall establish:
80.31 	(1) agreements with enrolled waiver service providers to ensure providers meet 
80.32 	qualifications defined in the waiver plans;
80.33 	(2) regular reviews of provider qualifications; and
81.1 	(3) processes to gather the necessary information to determine provider 
81.2 	qualifications.
81.3 	By July 2010, staff that provide direct contact, as defined in section 245C.02, subdivision 
81.4 	11, that are employees of waiver service providers must meet the requirements of chapter 
81.5 	245C prior to providing waiver services and as part of ongoing enrollment. Upon federal 
81.6 	approval, this requirement must also apply to consumer-directed community supports.
81.7 		Subd. 2.Rate-setting methodologies. The commissioner shall establish 
81.8 	statewide rate-setting methodologies that meet federal waiver requirements for home 
81.9 	and community-based waiver services for individuals with disabilities. The rate-setting 
81.10 	methodologies must abide by the principles of transparency and equitability across the 
81.11 	state. The methodologies must involve a uniform process of structuring rates for each 
81.12 	service and must promote quality and participant choice.

81.13 	Sec. 52. Minnesota Statutes 2008, section 256B.5012, is amended by adding a 
81.14 	subdivision to read:
81.15 		Subd. 8.ICF/MR rate decreases effective July 1, 2009. The commissioner shall 
81.16 	decrease each facility reimbursed under this section operating payment adjustments 
81.17 	equal to 3.0 percent of the operating payment rates in effect on June 30, 2009. For each 
81.18 	facility, the commissioner shall implement the rate reduction, based on occupied beds, 
81.19 	using the percentage specified in this subdivision multiplied by the total payment rate, 
81.20 	including the variable rate but excluding the property-related payment rate, in effect on 
81.21 	the preceding date. The total rate reduction shall include the adjustment provided in 
81.22 	section 256B.502, subdivision 7.

81.23 	Sec. 53. COLA COMPENSATION REQUIREMENTS.
 81.24 	Effective July 1, 2009, providers who received rate increases under Laws 2007, 
81.25 	chapter 147, article 7, section 71, as amended by Laws 2008, chapter 363, article 15, 
81.26 	section 17, and Minnesota Statutes, section 256B.5012, subdivision 7, for state fiscal years 
81.27 	2008 and 2009 are no longer required to continue or retain employee compensation or 
81.28 	wage-related increases required by those sections.

81.29 	Sec. 54. AGING AND DISABILITY SERVICES FOR ADULTS.
 81.30 	(a) The commissioner of human services shall form a work group with counties, in 
81.31 	consultation with other stakeholders, to develop recommendations and priorities for the 
81.32 	portion of funding to be allocated to counties for aging and disability services for adults. 
81.33 	This funding must be transferred from the Children and Community Services Act (CCSA) 
82.1 	distribution beginning July 1, 2011, and the CCSA distribution of county social services 
82.2 	block grant funds beginning January 1, 2011.
82.3 	(b) Starting January 1, 2011, funding for aging and disability services for adults 
82.4 	must be governed under the CCSA under Minnesota Statutes, chapter 256M, pending final 
82.5 	enactment of the legislation in paragraph (d).
82.6 	(c) The work group's recommendations must include:
82.7 	(1) identification of the priorities and targeted activities for this funding; and
82.8 	(2) the funding allocation method to counties that must be effective January 1, 2011.
82.9 	(d) The commissioner shall draft legislation for the 2010 legislative session that is 
82.10 	necessary for the implementation of this funding allocation method. This allocation shall 
82.11 	thereafter be referred to as the "Protecting Adults Act."

82.12 	EFFECTIVE DATE. This section is effective July 1, 2009.

82.13 	Sec. 55. PROVIDER RATE AND GRANT REDUCTIONS.
 82.14 	(a) The commissioner of human services shall decrease grants, allocations, 
82.15 	reimbursement rates, or rate limits, as applicable, by 3.0 percent effective July 1, 2009, for 
82.16 	services rendered on or after that date. County or tribal contracts for services specified 
82.17 	in this section must be amended to pass through these rate reductions within 60 days of 
82.18 	the effective date of the decrease and must be retroactive from the effective date of the 
82.19 	rate decrease.
82.20 	(b) The annual rate decreases described in this section must be provided to:
82.21 	(1) home and community-based waivered services for persons with developmental 
82.22 	disabilities or related conditions, including consumer-directed community supports, under 
82.23 	Minnesota Statutes, section 256B.501;
82.24 	(2) home and community-based waivered services for the elderly, including 
82.25 	consumer-directed community supports, under Minnesota Statutes, section 256B.0915;
82.26 	(3) waivered services under community alternatives for disabled individuals, 
82.27 	including consumer-directed community supports, under Minnesota Statutes, section 
82.28 	256B.49;
82.29 	(4) community alternative care waivered services, including consumer-directed 
82.30 	community supports, under Minnesota Statutes, section 256B.49;
82.31 	(5) traumatic brain injury waivered services, including consumer-directed 
82.32 	community supports, under Minnesota Statutes, section 256B.49;
82.33 	(6) nursing services and home health services under Minnesota Statutes, section 
82.34 	256B.0625, subdivision 6a;
83.1 	(7) personal care services and qualified professional supervision of personal care 
83.2 	services under Minnesota Statutes, section 256B.0625, subdivisions 6a and 19a;
83.3 	(8) private duty nursing services under Minnesota Statutes, section 256B.0625, 
83.4 	subdivision 7;
83.5 	(9) day training and habilitation services for adults with developmental disabilities 
83.6 	or related conditions under Minnesota Statutes, sections 252.40 to 252.46, including the 
83.7 	additional cost of rate adjustments on day training and habilitation services, provided as a 
83.8 	social service under Minnesota Statutes, section 256M.60;
83.9 	(10) alternative care services under Minnesota Statutes, section 256B.0913;
83.10 	(11) the group residential housing supplementary service rate under Minnesota 
83.11 	Statutes, section 256I.05, subdivision 1a;
83.12 	(12) semi-independent living services (SILS) under Minnesota Statutes, section 
83.13 	252.275, including SILS funding under county social services grants formerly funded 
83.14 	under Minnesota Statutes, chapter 256I;
83.15 	(13) community support services for deaf and hard-of-hearing adults with mental 
83.16 	illness who use or wish to use sign language as their primary means of communication 
83.17 	under Minnesota Statutes, section 256.01, subdivision 2; and deaf and hard-of-hearing 
83.18 	grants under Minnesota Statutes, sections 256C.233 and 256C.25; Laws 1985, chapter 9; 
83.19 	and Laws 1997, First Special Session chapter 5, section 20;
83.20 	(14) physical therapy services under Minnesota Statutes, sections 256B.0625, 
83.21 	subdivision 8, and 256D.03, subdivision 4;
83.22 	(15) occupational therapy services under Minnesota Statutes, sections 256B.0625, 
83.23 	subdivision 8a, and 256D.03, subdivision 4;
83.24 	(16) speech-language therapy services under Minnesota Statutes, section 256D.03, 
83.25 	subdivision 4, and Minnesota Rules, part 9505.0390;
83.26 	(17) respiratory therapy services under Minnesota Statutes, section 256D.03, 
83.27 	subdivision 4, and Minnesota Rules, part 9505.0295;
83.28 	(18) consumer support grants under Minnesota Statutes, section 256.476;
83.29 	(19) family support grants under Minnesota Statutes, section 252.32;
83.30 	(20) aging grants under Minnesota Statutes, sections 256.975 to 256.977, 256B.0917, 
83.31 	and 256B.0928;
83.32 	(21) disability linkage line grants under Minnesota Statutes, section 256.01, 
83.33 	subdivision 24; and
83.34 	(22) housing access grants under Minnesota Statutes, section 256B.0658.
84.1 	(c) A managed care plan receiving state payments for the services in this section 
84.2 	must include these decreases in their payments to providers effective on January 1 
84.3 	following the effective date of the rate decrease.

84.4 	Sec. 56. REVISOR'S INSTRUCTION.
 84.5 		Subdivision 1.Renumbering of Minnesota Statutes, section 256B.0652, 
84.6 	authorization and review of home care services. (a) The revisor of statutes shall 
84.7 	renumber each section of Minnesota Statutes listed in column A with the number in 
84.8 	column B.

84.9	Column A
	Column B
	
84.10	256B.0652, subdivision 3
	256B.0652, subdivision 14
	
84.11	256B.0651, subdivision 6, paragraph (a)
	256B.0652, subdivision 3
	
84.12	256B.0651, subdivision 6, paragraph (b)
	256B.0652, subdivision 4
	
84.13	256B.0651, subdivision 6, paragraph (c)
	256B.0652, subdivision 7
	
84.14	256B.0651, subdivision 7, paragraph (a)
	256B.0652, subdivision 8
	
84.15	256B.0651, subdivision 7, paragraph (b)
	256B.0652, subdivision 14
	
84.16	256B.0651, subdivision 8
	256B.0652, subdivision 9
	
84.17	256B.0651, subdivision 9
	256B.0652, subdivision 10
	
84.18	256B.0651, subdivision 11
	256B.0652, subdivision 11
	
84.19	256B.0654, subdivision 2
	256B.0652, subdivision 5
	
84.20	256B.0655, subdivision 4
	256B.0652, subdivision 6
	
84.21 	(b) The revisor of statutes shall make necessary cross-reference changes in statutes 
84.22 	and rules consistent with the renumbering in paragraph (a). The Department of Human 
84.23 	Services shall assist the revisor with any cross-reference changes. The revisor may make 
84.24 	changes necessary to correct the punctuation, grammar, or structure of the remaining text 
84.25 	to conform with the intent of the renumbering in paragraph (a).
84.26 		Subd. 2.Renumbering personal care assistance services. The revisor of statutes 
84.27 	shall replace any reference to Minnesota Statutes, section 256B.0655 with section 
84.28 	256B.0659, wherever it appears in statutes or rules. The revisor shall correct any cross 
84.29 	reference changes that are necessary as a result of this section. The Department of Human 
84.30 	Services shall assist the revisor in making these changes, and if necessary, shall draft a 
84.31 	corrections bill with changes for introduction in the 2010 legislative session. The revisor 
84.32 	may make changes to punctuation, grammar, or sentence structure to preserve the integrity 
84.33 	of statutes and effectuate the intention of this section.

84.34 	Sec. 57.  REPEALER.
 84.35 	(a) Minnesota Statutes 2008, sections 256B.19, subdivision 1d; and 256B.431, 
84.36 	subdivision 23, are repealed effective May 1, 2009.
85.1 	(b) Laws 1988, chapter 689, section 251, is repealed effective July 1, 2009.
85.2 	(c) Minnesota Statutes 2008, section 256B.0951, is repealed effective July 1, 2009.
85.3 	(d) Minnesota Statutes 2008, sections 256B.0655, subdivisions 1, 1a, 1b, 1c, 1d, 
85.4 	1e, 1f, 1g, 1h, 1i, 2, 3, 5, 6, 7, 8, 9, 10, 11, 12, and 13; and 256B.071, subdivisions 1, 
85.5 	2, 3, and 4, are repealed.

85.6 	ARTICLE 2
85.7 	MFIP/CHILD CARE

85.8 	Section 1. Minnesota Statutes 2008, section 119B.09, subdivision 7, is amended to read:
85.9 		Subd. 7.Date of eligibility for assistance. (a) The date of eligibility for child 
85.10 	care assistance under this chapter is the later of the date the application was signed; the 
85.11 	beginning date of employment, education, or training; the date the infant is born for 
85.12 	applicants to the at-home infant care program; or the date a determination has been made 
85.13 	that the applicant is a participant in employment and training services under Minnesota 
85.14 	Rules, part 3400.0080, or chapter 256J.
85.15 	(b) Payment ceases for a family under the at-home infant child care program when a 
85.16 	family has used a total of 12 months of assistance as specified under section 119B.035. 
85.17 	Payment of child care assistance for employed persons on MFIP is effective the date of 
85.18 	employment or the date of MFIP eligibility, whichever is later. Payment of child care 
85.19 	assistance for MFIP or DWP participants in employment and training services is effective 
85.20 	the date of commencement of the services or the date of MFIP or DWP eligibility, 
85.21 	whichever is later. Payment of child care assistance for transition year child care must be 
85.22 	made retroactive to the date of eligibility for transition year child care. 
85.23 	(c) Notwithstanding paragraph (b), payment of child care assistance for participants 
85.24 	eligible under section 119B.05 may only be made retroactive for a maximum of six 
85.25 	months from the date of application for child care assistance.

85.26 	EFFECTIVE DATE. This section is effective October 1, 2009.

85.27 	Sec. 2. Minnesota Statutes 2008, section 119B.12, subdivision 1, is amended to read:
85.28 		Subdivision 1.Fee schedule. In setting the sliding fee schedule, the commissioner 
85.29 	shall exclude from the amount of income used to determine eligibility an amount for 
85.30 	federal and state income and Social Security taxes attributable to that income level 
85.31 	according to federal and state standardized tax tables. The commissioner shall base the 
85.32 	parent fee on the ability of the family to pay for child care. The fee schedule must be 
85.33 	designed to use any available tax credits.
86.1 	PARENT FEE SCHEDULE. The parent fee schedule is as follows, except as noted 
86.2 	in subdivision 2:

86.3
86.4
86.5	Income Range (as a percent of the state 
median income, except at the start of the 
first tier)
	Co-payment (as a percentage of adjusted 
gross income)
	
86.6	0-74.99% of federal poverty guidelines
	$0/month
	
86.7	75.00-99.99% of federal poverty guidelines
	$5/month
	
86.8
86.9	100.00% of federal poverty 
guidelines-27.72%
	2.61% 2.69%
	
86.10	27.73-29.04%
	2.61% 2.69%
	
86.11	29.05-30.36%
	2.61% 2.69%
	
86.12	30.37-31.68%
	2.61% 2.69%
	
86.13	31.69-33.00%
	2.91% 3.00%
	
86.14	33.01-34.32%
	2.91% 3.00%
	
86.15	34.33-35.65%
	2.91% 3.00%
	
86.16	35.66-36.96%
	2.91% 3.00%
	
86.17	36.97-38.29%
	3.21% 3.31%
	
86.18	38.30-39.61%
	3.21% 3.31%
	
86.19	39.62-40.93%
	3.21% 3.31%
	
86.20	40.94-42.25%
	3.84% 3.96%
	
86.21	42.26-43.57%
	3.84% 3.96%
	
86.22	43.58-44.89%
	4.46% 4.59%
	
86.23	44.90-46.21%
	4.76% 4.90%
	
86.24	46.22-47.53%
	5.05% 5.20%
	
86.25	47.54-48.85%
	5.65% 5.82%
	
86.26	48.86-50.17%
	5.95% 6.13%
	
86.27	50.18-51.49%
	6.24% 6.43%
	
86.28	51.50-52.81%
	6.84% 7.05%
	
86.29	52.82-54.13%
	7.58% 7.81%
	
86.30	54.14-55.45%
	8.33% 8.58%
	
86.31	55.46-56.77%
	9.20% 9.48%
	
86.32	56.78-58.09%
	10.07% 10.37%
	
86.33	58.10-59.41%
	10.94% 11.27%
	
86.34	59.42-60.73%
	11.55% 11.90%
	
86.35	60.74-62.06%
	12.16% 12.52%
	
86.36	62.07-63.38%
	12.77% 13.15%
	
86.37	63.39-64.70%
	13.38% 13.78%
	
86.38	64.71-66.99%
	14.00% 14.42%
	
86.39	67.00%
	ineligible
	
86.40 	A family's monthly co-payment fee is the fixed percentage established for the 
86.41 	income range multiplied by the highest possible income within that income range.

86.42 	Sec. 3. Minnesota Statutes 2008, section 119B.13, subdivision 1, is amended to read:
87.1 		Subdivision 1.Subsidy restrictions. (a) Beginning July 1, 2006 2009, the 
87.2 	maximum rate paid for child care assistance in any county or multicounty region under the 
87.3 	child care fund shall be the rate for like-care arrangements in the county effective January 
87.4 	1, 2006, increased July 1, 2008, decreased  by six three percent.
87.5 	(b) Rate changes shall be implemented for services provided in September 2006 
87.6 	unless a participant eligibility redetermination or a new provider agreement is completed 
87.7 	between July 1, 2006, and August 31, 2006.
87.8 	As necessary, appropriate notice of adverse action must be made according to 
87.9 	Minnesota Rules, part 3400.0185, subparts 3 and 4.
87.10 	New cases approved on or after July 1, 2006, shall have the maximum rates under 
87.11 	paragraph (a), implemented immediately.
87.12 	(c)(b) Every year, the commissioner shall survey rates charged by child care 
87.13 	providers in Minnesota to determine the 75th percentile for like-care arrangements in 
87.14 	counties. When the commissioner determines that, using the commissioner's established 
87.15 	protocol, the number of providers responding to the survey is too small to determine 
87.16 	the 75th percentile rate for like-care arrangements in a county or multicounty region, 
87.17 	the commissioner may establish the 75th percentile maximum rate based on like-care 
87.18 	arrangements in a county, region, or category that the commissioner deems to be similar.
87.19 	(d)(c) A rate which includes a special needs rate paid under subdivision 3 or under a 
87.20 	school readiness service agreement paid under section 119B.231, may be in excess of the 
87.21 	maximum rate allowed under this subdivision.
87.22 	(e)(d) The department shall monitor the effect of this paragraph on provider rates. 
87.23 	The county shall pay the provider's full charges for every child in care up to the maximum 
87.24 	established. The commissioner shall determine the maximum rate for each type of care on 
87.25 	an hourly, full-day, and weekly basis, including special needs and disability care.
87.26 	(f)(e) When the provider charge is greater than the maximum provider rate allowed, 
87.27 	the parent is responsible for payment of the difference in the rates in addition to any 
87.28 	family co-payment fee.
87.29 	(g)(f) All maximum provider rates changes shall be implemented on the Monday 
87.30 	following the effective date of the maximum provider rate.

87.31 	Sec. 4. Minnesota Statutes 2008, section 119B.13, subdivision 6, is amended to read:
87.32 		Subd. 6.Provider payments. (a) Counties or the state shall make vendor payments 
87.33 	to the child care provider or pay the parent directly for eligible child care expenses.
87.34 	(b) If payments for child care assistance are made to providers, the provider shall 
87.35 	bill the county for services provided within ten days of the end of the service period. If 
88.1 	bills are submitted within ten days of the end of the service period, a county or the state 
88.2 	shall issue payment to the provider of child care under the child care fund within 30 days 
88.3 	of receiving a bill from the provider. Counties or the state may establish policies that 
88.4 	make payments on a more frequent basis.
88.5 	(c) All billsIf a provider has received an authorization of care and been issued a 
88.6 	billing form for an eligible family, the bill must be submitted within 60 days of the last 
88.7 	date of service on the bill. A county may pay a bill submitted more than 60 days after 
88.8 	the last date of service if the provider shows good cause why the bill was not submitted 
88.9 	within 60 days. Good cause must be defined in the county's child care fund plan under 
88.10 	section 119B.08, subdivision 3, and the definition of good cause must include county 
88.11 	error. A county may not pay any bill submitted more than a year after the last date of 
88.12 	service on the bill. 
88.13 	(d) If a provider provided care for a time period without receiving an authorization 
88.14 	of care and a billing form for an eligible family, payment of child care assistance may only 
88.15 	be made retroactively for a maximum of six months from the date the provider is issued 
88.16 	an authorization of care and billing form.
88.17 	(d)(e) A county may stop payment issued to a provider or may refuse to pay a 
88.18 	bill submitted by a provider if:
88.19 	(1) the provider admits to intentionally giving the county materially false information 
88.20 	on the provider's billing forms; or
88.21 	(2) a county finds by a preponderance of the evidence that the provider intentionally 
88.22 	gave the county materially false information on the provider's billing forms.
88.23 	(e)(f) A county's payment policies must be included in the county's child care plan 
88.24 	under section 119B.08, subdivision 3. If payments are made by the state, in addition to 
88.25 	being in compliance with this subdivision, the payments must be made in compliance 
88.26 	with section 16A.124. 

88.27 	EFFECTIVE DATE. This section is effective October 1, 2009.

88.28 	Sec. 5. Minnesota Statutes 2008, section 256J.20, subdivision 3, is amended to read:
88.29 		Subd. 3.Other property limitations. To be eligible for MFIP, the equity value of 
88.30 	all nonexcluded real and personal property of the assistance unit must not exceed $2,000 
88.31 	for applicants and $5,000 for ongoing participants. The value of assets in clauses (1) to 
88.32 	(19) must be excluded when determining the equity value of real and personal property:
88.33 	(1) a licensed vehicle up to a loan value of less than or equal to $15,000 $7,500. If the 
88.34 	assistance unit owns more than one licensed vehicle, the county agency shall determine the 
88.35 	loan value of all additional vehicles and exclude the combined loan value of less than or 
89.1 	equal to $7,500. The county agency shall apply any excess loan value as if it were equity 
89.2 	value to the asset limit described in this section,. If the assistance unit owns more than 
89.3 	one licensed vehicle, the county agency shall determine the vehicle with the highest loan 
89.4 	value and count only the loan value over $7,500, excluding: (i) the value of one vehicle 
89.5 	per physically disabled person when the vehicle is needed to transport the disabled unit 
89.6 	member; this exclusion does not apply to mentally disabled people; (ii) the value of special 
89.7 	equipment for a disabled member of the assistance unit; and (iii) any vehicle used for 
89.8 	long-distance travel, other than daily commuting, for the employment of a unit member.
89.9 	The county agency shall count the loan value of all other vehicles and apply this 
89.10 	amount as if it were equity value to the asset limit described in this section. To establish the 
89.11 	loan value of vehicles, a county agency must use the N.A.D.A. Official Used Car Guide, 
89.12 	Midwest Edition, for newer model cars. When a vehicle is not listed in the guidebook, 
89.13 	or when the applicant or participant disputes the loan value listed in the guidebook as 
89.14 	unreasonable given the condition of the particular vehicle, the county agency may require 
89.15 	the applicant or participant document the loan value by securing a written statement from 
89.16 	a motor vehicle dealer licensed under section 168.27, stating the amount that the dealer 
89.17 	would pay to purchase the vehicle. The county agency shall reimburse the applicant or 
89.18 	participant for the cost of a written statement that documents a lower loan value; 
89.19 	(2) the value of life insurance policies for members of the assistance unit;
89.20 	(3) one burial plot per member of an assistance unit;
89.21 	(4) the value of personal property needed to produce earned income, including 
89.22 	tools, implements, farm animals, inventory, business loans, business checking and 
89.23 	savings accounts used at least annually and used exclusively for the operation of a 
89.24 	self-employment business, and any motor vehicles if at least 50 percent of the vehicle's use 
89.25 	is to produce income and if the vehicles are essential for the self-employment business;
89.26 	(5) the value of personal property not otherwise specified which is commonly 
89.27 	used by household members in day-to-day living such as clothing, necessary household 
89.28 	furniture, equipment, and other basic maintenance items essential for daily living;
89.29 	(6) the value of real and personal property owned by a recipient of Supplemental 
89.30 	Security Income or Minnesota supplemental aid;
89.31 	(7) the value of corrective payments, but only for the month in which the payment 
89.32 	is received and for the following month;
89.33 	(8) a mobile home or other vehicle used by an applicant or participant as the 
89.34 	applicant's or participant's home;
89.35 	(9) money in a separate escrow account that is needed to pay real estate taxes or 
89.36 	insurance and that is used for this purpose;
90.1 	(10) money held in escrow to cover employee FICA, employee tax withholding, 
90.2 	sales tax withholding, employee worker compensation, business insurance, property rental, 
90.3 	property taxes, and other costs that are paid at least annually, but less often than monthly;
90.4 	(11) monthly assistance payments for the current month's or short-term emergency 
90.5 	needs under section 256J.626, subdivision 2; 
90.6 	(12) the value of school loans, grants, or scholarships for the period they are 
90.7 	intended to cover;
90.8 	(13) payments listed in section 256J.21, subdivision 2, clause (9), which are held 
90.9 	in escrow for a period not to exceed three months to replace or repair personal or real 
90.10 	property; 
90.11 	(14) income received in a budget month through the end of the payment month;
90.12 	(15) savings from earned income of a minor child or a minor parent that are set aside 
90.13 	in a separate account designated specifically for future education or employment costs;
90.14 	(16) the federal earned income credit, Minnesota working family credit, state and 
90.15 	federal income tax refunds, state homeowners and renters credits under chapter 290A, 
90.16 	property tax rebates and other federal or state tax rebates in the month received and the 
90.17 	following month;
90.18 	(17) payments excluded under federal law as long as those payments are held in a 
90.19 	separate account from any nonexcluded funds;
90.20 	(18) the assets of children ineligible to receive MFIP benefits because foster care or 
90.21 	adoption assistance payments are made on their behalf; and
90.22 	(19) the assets of persons whose income is excluded under section 256J.21, 
90.23 	subdivision 2, clause (43). 

90.24 	EFFECTIVE DATE. This section is effective March 1, 2010.

90.25 	Sec. 6. Minnesota Statutes 2008, section 256J.24, subdivision 5a, is amended to read:
90.26 		Subd. 5a.Food portion of MFIP transitional standard. The commissioner 
90.27 	shall adjust the food portion of the MFIP transitional standard by October 1 each year 
90.28 	beginning October 1998 as needed to reflect the cost-of-living adjustments to the food 
90.29 	Stamp support program. The commissioner shall annually publish in the State Register
90.30 	the transitional standard for an assistance unit of sizes one to ten in the State Register 
90.31 	whenever an adjustment is made.

90.32 	Sec. 7. Minnesota Statutes 2008, section 256J.24, subdivision 10, is amended to read:
90.33 		Subd. 10.MFIP exit level. The commissioner shall adjust the MFIP earned income 
90.34 	disregard to ensure that most participants do not lose eligibility for MFIP until their 
91.1 	income reaches at least 115 110 percent of the federal poverty guidelines in effect in 
91.2 	October of each fiscal year at the time of the adjustment. The adjustment to the disregard 
91.3 	shall be based on a household size of three, and the resulting earned income disregard 
91.4 	percentage must be applied to all household sizes. The adjustment under this subdivision 
91.5 	must be implemented at the same time as the October food stamp or whenever there is a
91.6 	food support cost-of-living adjustment is reflected in the food portion of MFIP transitional 
91.7 	standard as required under subdivision 5a.

91.8 	Sec. 8. Minnesota Statutes 2008, section 256J.37, subdivision 3a, is amended to read:
91.9 		Subd. 3a.Rental subsidies; unearned income. (a) Effective July 1, 2003, The 
91.10 	county agency shall count $50$100 of the value of public and assisted rental subsidies 
91.11 	provided through the Department of Housing and Urban Development (HUD) as unearned 
91.12 	income to the cash portion of the MFIP grant. The full amount of the subsidy must be 
91.13 	counted as unearned income when the subsidy is less than $50 $100. The income from 
91.14 	this subsidy shall be budgeted according to section 256J.34. 
91.15 	(b) The provisions of this subdivision shall not apply to an MFIP assistance unit 
91.16 	which includes a participant who is:
91.17 	(1) age 60 or older;
91.18 	(2) a caregiver who is suffering from an illness, injury, or incapacity that has been 
91.19 	certified by a qualified professional when the illness, injury, or incapacity is expected 
91.20 	to continue for more than 30 days and prevents the person from obtaining or retaining 
91.21 	employment; or
91.22 	(3) a caregiver whose presence in the home is required due to the illness or 
91.23 	incapacity of another member in the assistance unit, a relative in the household, or a foster 
91.24 	child in the household when the illness or incapacity and the need for the participant's 
91.25 	presence in the home has been certified by a qualified professional and is expected to 
91.26 	continue for more than 30 days.
91.27 	(c) The provisions of this subdivision shall not apply to an MFIP assistance unit 
91.28 	where the parental caregiver is an SSI recipient.
91.29 	(d) Prior to implementing this provision, the commissioner must identify the MFIP 
91.30 	participants subject to this provision and provide written notice to these participants at 
91.31 	least 30 days before the first grant reduction. The notice must inform the participant of the 
91.32 	basis for the potential grant reduction, the exceptions to the provision, if any, and inform 
91.33 	the participant of the steps necessary to claim an exception. A person who is found not to 
91.34 	meet one of the exceptions to the provision must be notified and informed of the right to a 
91.35 	fair hearing under section 256J.40. The notice must also inform the participant that the 
92.1 	participant may be eligible for a rent reduction resulting from a reduction in the MFIP 
92.2 	grant and encourage the participant to contact the local housing authority. 

92.3 	EFFECTIVE DATE. This section is effective February 1, 2010.

92.4 	Sec. 9. Minnesota Statutes 2008, section 256J.37, is amended by adding a subdivision 
92.5 	to read:
92.6 		Subd. 11.Treatment of Supplemental Security Income. Effective March 1, 
92.7 	2010, the county shall reduce the cash portion of the MFIP grant by up to $125 for an 
92.8 	MFIP assistance unit that includes one or more Supplemental Security Income (SSI) 
92.9 	recipients who reside in the household, and who would otherwise be included in the MFIP 
92.10 	assistance unit under section 256J.24, subdivision 2, but are excluded solely due to the 
92.11 	SSI recipient status under section 256J.24, subdivision 3, paragraph (a), clause (1). If 
92.12 	the SSI recipient or recipients receive less than $125 of SSI, only the amount received 
92.13 	must be used in calculating the MFIP cash assistance payment. This provision does not 
92.14 	apply to relative caregivers who could elect to be included in the MFIP assistance unit 
92.15 	under section 256J.24, subdivision 4, unless the caregiver's children or stepchildren are 
92.16 	included in the MFIP assistance unit.

92.17 	EFFECTIVE DATE. This section is effective March 1, 2010.

92.18 	Sec. 10. Minnesota Statutes 2008, section 256J.53, subdivision 2, is amended to read:
92.19 		Subd. 2.Approval of postsecondary education or training. (a) In order for a 
92.20 	postsecondary education or training program to be an approved activity in an employment 
92.21 	plan, the plan must include additional work activities if the education and training 
92.22 	activities do not meet the minimum hours required to meet the federal work participation 
92.23 	rate under Code of Federal Regulations, title 45, sections 261.31 and 261.35 participant 
92.24 	must be working in unsubsidized employment at least 20 hours per week.
92.25 	(b) Participants seeking approval of a postsecondary education or training plan 
92.26 	must provide documentation that:
92.27 	(1) the employment goal can only be met with the additional education or training;
92.28 	(2) there are suitable employment opportunities that require the specific education or 
92.29 	training in the area in which the participant resides or is willing to reside;
92.30 	(3) the education or training will result in significantly higher wages for the 
92.31 	participant than the participant could earn without the education or training;
92.32 	(4) the participant can meet the requirements for admission into the program; and
93.1 	(5) there is a reasonable expectation that the participant will complete the training 
93.2 	program based on such factors as the participant's MFIP assessment, previous education, 
93.3 	training, and work history; current motivation; and changes in previous circumstances.
93.4 	(c) The hourly unsubsidized employment requirement may be reduced for intensive 
93.5 	education or training programs lasting 12 weeks or less when full-time attendance is 
93.6 	required.
93.7 	(d) Participants with an approved employment plan in place on July 1, 2009, which 
93.8 	includes more than 12 months of postsecondary education or training, must be allowed 
93.9 	to complete that plan provided that hourly requirements in section 256J.55, subdivision 
93.10 	1, are met.

93.11 	Sec. 11. Minnesota Statutes 2008, section 256J.575, subdivision 3, is amended to read:
93.12 		Subd. 3.Eligibility. (a) The following MFIP or diversionary work program (DWP)
93.13 	participants are eligible for the services under this section:
93.14 	(1) a participant who meets the requirements for or has been granted a hardship 
93.15 	extension under section 256J.425, subdivision 2 or 3, except that it is not necessary for 
93.16 	the participant to have reached or be approaching 60 months of eligibility for this section 
93.17 	to apply;
93.18 	(2) a participant who is applying for Supplemental Security Income or Social 
93.19 	Security disability insurance; and
93.20 	(3) a participant who is a noncitizen who has been in the United States for 12 or 
93.21 	fewer months.
93.22 	(b) Families must meet all other eligibility requirements for MFIP established in 
93.23 	this chapter. Families are eligible for financial assistance to the same extent as if they 
93.24 	were participating in MFIP.
93.25 	(c) A participant under paragraph (a), clause (3), must be provided with English as a 
93.26 	second language opportunities and skills training for up to 12 months. After 12 months, 
93.27 	the case manager and participant must determine whether the participant should continue 
93.28 	with English as a second language classes or skills training, or both, and continue to 
93.29 	receive family stabilization services.

93.30 	EFFECTIVE DATE. This section is effective March 1, 2010.

93.31 	Sec. 12. Minnesota Statutes 2008, section 256J.621, is amended to read:
93.32 	256J.621 WORK PARTICIPATION CASH BENEFITS.
94.1 	(a) Effective October 1, 2009, upon exiting the diversionary work program (DWP) 
94.2 	or upon terminating the Minnesota family investment program with earnings, a participant 
94.3 	who is employed may be eligible for work participation cash benefits of $75 $50 per 
94.4 	month to assist in meeting the family's basic needs as the participant continues to move 
94.5 	toward self-sufficiency.
94.6 	(b) To be eligible for work participation cash benefits, the participant shall not 
94.7 	receive MFIP or diversionary work program assistance during the month and the 
94.8 	participant or participants must meet the following work requirements:
94.9 	(1) if the participant is a single caregiver and has a child under six years of age, the 
94.10 	participant must be employed at least 87 hours per month;
94.11 	(2) if the participant is a single caregiver and does not have a child under six years of 
94.12 	age, the participant must be employed at least 130 hours per month; or
94.13 	(3) if the household is a two-parent family, at least one of the parents must be 
94.14 	employed an average of at least 130 hours per month.
94.15 	Whenever a participant exits the diversionary work program or is terminated from 
94.16 	MFIP and meets the other criteria in this section, work participation cash benefits are 
94.17 	available for up to 24 consecutive months.
94.18 	(c) Expenditures on the program are maintenance of effort state funds under 
94.19 	a separate state program for participants under paragraph (b), clauses (1) and (2). 
94.20 	Expenditures for participants under paragraph (b), clause (3), are nonmaintenance of effort 
94.21 	funds. Months in which a participant receives work participation cash benefits under this 
94.22 	section do not count toward the participant's MFIP 60-month time limit.

94.23 	Sec. 13. Minnesota Statutes 2008, section 256J.626, subdivision 6, is amended to read:
94.24 		Subd. 6.Base allocation to counties and tribes; definitions. (a) For purposes of 
94.25 	this section, the following terms have the meanings given.
94.26 	(1) "2002 historic spending base" means the commissioner's determination of 
94.27 	the sum of the reimbursement related to fiscal year 2002 of county or tribal agency 
94.28 	expenditures for the base programs listed in clause (6), items (i) through (iv), and earnings 
94.29 	related to calendar year 2002 in the base program listed in clause (6), item (v), and the 
94.30 	amount of spending in fiscal year 2002 in the base program listed in clause (6), item (vi), 
94.31 	issued to or on behalf of persons residing in the county or tribal service delivery area.
94.32 	(2) "Adjusted caseload factor" means a factor weighted:
94.33 	(i) 47 percent on the MFIP cases in each county at four points in time in the most 
94.34 	recent 12-month period for which data is available multiplied by the county's caseload 
94.35 	difficulty factor; and
95.1 	(ii) 53 percent on the count of adults on MFIP in each county and tribe at four points 
95.2 	in time in the most recent 12-month period for which data is available multiplied by the 
95.3 	county or tribe's caseload difficulty factor.
95.4 	(3) "Caseload difficulty factor" means a factor determined by the commissioner for 
95.5 	each county and tribe based upon the self-support index described in section 256J.751, 
95.6 	subdivision 2, clause (6).
95.7 	(4) "Initial allocation" means the amount potentially available to each county or tribe 
95.8 	based on the formula in paragraphs (b) through (d).
95.9 	(5)(4) "Final allocation" means the amount available to each county or tribe based 
95.10 	on the formula in paragraphs (b) through (d), after adjustment by subdivision 7 and (c).
95.11 	(6)(5) "Base programs" means the:
95.12 	(i) MFIP employment and training services under Minnesota Statutes 2002, section 
95.13 	256J.62, subdivision 1, in effect June 30, 2002;
95.14 	(ii) bilingual employment and training services to refugees under Minnesota Statutes 
95.15 	2002, section 256J.62, subdivision 6, in effect June 30, 2002;
95.16 	(iii) work literacy language programs under Minnesota Statutes 2002, section 
95.17 	256J.62, subdivision 7, in effect June 30, 2002;
95.18 	(iv) supported work program authorized in Laws 2001, First Special Session chapter 
95.19 	9, article 17, section 2, in effect June 30, 2002;
95.20 	(v) administrative aid program under section 256J.76 in effect December 31, 2002; 
95.21 	and
95.22 	(vi) emergency assistance program under Minnesota Statutes 2002, section 256J.48, 
95.23 	in effect June 30, 2002.
95.24 	(b) The commissioner shall:
95.25 	(1) beginning July 1, 2003, determine the initial allocation of funds available under 
95.26 	this section according to clause (2);
95.27 	(2) allocate all of the funds available for the period beginning July 1, 2003, and 
95.28 	ending December 31, 2004, to each county or tribe in proportion to the county's or tribe's 
95.29 	share of the statewide 2002 historic spending base;
95.30 	(3) determine for calendar year 2005 the initial allocation of funds to be made 
95.31 	available under this section in proportion to the county or tribe's initial allocation for the 
95.32 	period of July 1, 2003, to December 31, 2004;
95.33 	(4) determine for calendar year 2006 the initial allocation of funds to be made 
95.34 	available under this section based 90 percent on the proportion of the county or tribe's 
95.35 	share of the statewide 2002 historic spending base and ten percent on the proportion of 
95.36 	the county or tribe's share of the adjusted caseload factor;
96.1 	(5) determine for calendar year 2007 the initial allocation of funds to be made 
96.2 	available under this section based 70 percent on the proportion of the county or tribe's 
96.3 	share of the statewide 2002 historic spending base and 30 percent on the proportion of the 
96.4 	county or tribe's share of the adjusted caseload factor; and
96.5 	(6) determine for calendar year 2008 and subsequent years the initial allocation of
96.6 	allocate funds to be made available under this section based 50 percent on the proportion 
96.7 	of the county or tribe's share of the statewide 2002 historic spending base and 50 percent 
96.8 	on the proportion of the county or tribe's share of the adjusted caseload factor.
96.9 	(c) With the commencement of a new or expanded tribal TANF program or an 
96.10 	agreement under section 256.01, subdivision 2, paragraph (g), in which some or all of 
96.11 	the responsibilities of particular counties under this section are transferred to a tribe, 
96.12 	the commissioner shall:
96.13 	(1) in the case where all responsibilities under this section are transferred to a tribal 
96.14 	program, determine the percentage of the county's current caseload that is transferring to a 
96.15 	tribal program and adjust the affected county's allocation accordingly; and
96.16 	(2) in the case where a portion of the responsibilities under this section are 
96.17 	transferred to a tribal program, the commissioner shall consult with the affected county or 
96.18 	counties to determine an appropriate adjustment to the allocation.
96.19 	(d) Effective January 1, 2005, counties and tribes will have their final allocations 
96.20 	adjusted based on the performance provisions of subdivision 7.

96.21 	EFFECTIVE DATE. This section is effective January 1, 2010.

96.22 	Sec. 14. Minnesota Statutes 2008, section 256J.751, is amended by adding a 
96.23 	subdivision to read:
96.24 		Subd. 2a.County performance standards. (a) For the purpose of this section, the 
96.25 	following terms have the meanings given:
96.26 	(1) "Caseload reduction credit" (CRC) means the measure of how much the 
96.27 	Minnesota TANF caseload, including the separate state program caseload, has fallen 
96.28 	relative to the federal fiscal year 2005 caseload based on caseload data from October 
96.29 	1 to September 30.
96.30 	(2) "TANF participation rate target" means a 50 percent participation rate reduced by 
96.31 	the CRC as calculated by the Department of Human Services.
96.32 	(b) A county or tribe shall negotiate a multiyear improvement plan with the 
96.33 	commissioner if the county or tribe does not:
96.34 	(1) achieve the TANF participation rate target or a five percentage point improvement 
96.35 	over the county or tribe's previous year's TANF participation rate under subdivision 2, 
97.1 	clause (7), as averaged across 12 consecutive months for the most recent year for which 
97.2 	the measurements are available; or
97.3 	(2) perform within or above its range of expected performance on the annualized 
97.4 	three-year self-support index under subdivision 2, clause (6).
97.5 	(c) A county or tribe that has successfully negotiated an improvement plan must 
97.6 	provide a semiannual report indicating that the plan has been implemented, the impact of 
97.7 	the plan, and any anticipated changes to the plan.

97.8 	Sec. 15. Minnesota Statutes 2008, section 256J.95, subdivision 12, is amended to read:
97.9 		Subd. 12.Conversion or referral to MFIP. (a) If at any time during the DWP 
97.10 	application process or during the four-month DWP eligibility period, it is determined that 
97.11 	a participant is unlikely to benefit from the diversionary work program, the county shall 
97.12 	convert or refer the participant to MFIP as specified in paragraph (d). Participants who are 
97.13 	determined to be unlikely to benefit from the diversionary work program must develop 
97.14 	and sign an employment plan. Participants who meet any one of the criteria in paragraph 
97.15 	(b) shall be considered to be unlikely to benefit from DWP, provided the necessary 
97.16 	documentation is available to support the determination.
97.17 	(b) A participant who: meets the eligibility requirements under section 256J.575, 
97.18 	subdivision 3, must be considered to be unlikely to benefit from DWP, provided the 
97.19 	necessary documentation is available to support the determination.
97.20 	(1) has been determined by a qualified professional as being unable to obtain or retain 
97.21 	employment due to an illness, injury, or incapacity that is expected to last at least 60 days;
97.22 	(2) is required in the home as a caregiver because of the illness, injury, or incapacity, 
97.23 	of a family member, or a relative in the household, or a foster child, and the illness, injury, 
97.24 	or incapacity and the need for a person to provide assistance in the home has been certified 
97.25 	by a qualified professional and is expected to continue more than 60 days;
97.26 	(3) is determined by a qualified professional as being needed in the home to care for 
97.27 	a child or adult meeting the special medical criteria in section 256J.561, subdivision 2, 
97.28 	paragraph (d), clause (3); 
97.29 	(4) is pregnant and is determined by a qualified professional as being unable to 
97.30 	obtain or retain employment due to the pregnancy; or
97.31 	(5) has applied for SSI or SSDI.
97.32 	(c) In a two-parent family unit, both parents must be if one parent is determined 
97.33 	to be unlikely to benefit from the diversionary work program before, the family unit 
97.34 	can must be converted or referred to MFIP.
98.1 	(d) A participant who is determined to be unlikely to benefit from the diversionary 
98.2 	work program shall be converted to MFIP and, if the determination was made within 30 
98.3 	days of the initial application for benefits, no additional application form is required. 
98.4 	A participant who is determined to be unlikely to benefit from the diversionary work 
98.5 	program shall be referred to MFIP and, if the determination is made more than 30 
98.6 	days after the initial application, the participant must submit a program change request 
98.7 	form. The county agency shall process the program change request form by the first of 
98.8 	the following month to ensure that no gap in benefits is due to delayed action by the 
98.9 	county agency. In processing the program change request form, the county must follow 
98.10 	section 256J.32, subdivision 1, except that the county agency shall not require additional 
98.11 	verification of the information in the case file from the DWP application unless the 
98.12 	information in the case file is inaccurate, questionable, or no longer current. 
98.13 	(e) The county shall not request a combined application form for a participant who 
98.14 	has exhausted the four months of the diversionary work program, has continued need for 
98.15 	cash and food assistance, and has completed, signed, and submitted a program change 
98.16 	request form within 30 days of the fourth month of the diversionary work program. The 
98.17 	county must process the program change request according to section 256J.32, subdivision 
98.18 	1, except that the county agency shall not require additional verification of information 
98.19 	in the case file unless the information is inaccurate, questionable, or no longer current. 
98.20 	When a participant does not request MFIP within 30 days of the diversionary work 
98.21 	program benefits being exhausted, a new combined application form must be completed 
98.22 	for any subsequent request for MFIP. 

98.23 	EFFECTIVE DATE. This section is effective March 1, 2010.

98.24 	Sec. 16.  REPEALER.
 98.25 	Minnesota Statutes 2008, section 256J.626, subdivision 7, is repealed.

98.26 	ARTICLE 3
98.27 	ADULT SUPPORTS

98.28 	Section 1. Minnesota Statutes 2008, section 256D.06, subdivision 2, is amended to 
98.29 	read:
98.30 		Subd. 2.Emergency need. (a) Notwithstanding the provisions of subdivision 1, a 
98.31 	grant of emergency general assistance shall, to the extent funds are available, be made to 
98.32 	an eligible single adult, married couple, or family for an emergency need, as defined in 
98.33 	rules promulgated by the commissioner, where the recipient requests temporary assistance 
99.1 	not exceeding 30 days if an emergency situation appears to exist under criteria adopted by 
99.2 	the county agency and the individual or family is ineligible for MFIP or DWP or is not a 
99.3 	participant of MFIP or DWP and whose annual net income is no greater than 200 percent 
99.4 	of the federal poverty level for the previous calendar year. If an applicant or recipient 
99.5 	relates facts to the county agency which may be sufficient to constitute an emergency 
99.6 	situation, the county agency shall, to the extent funds are available, advise the person of the 
99.7 	procedure for applying for assistance according to this subdivision. An emergency general 
99.8 	assistance grant is available to a recipient not more than once in any 12-month period. 
99.9 	(b) Funding for an emergency general assistance program is limited to the 
99.10 	appropriation. Each fiscal year, the commissioner shall allocate to counties the money 
99.11 	appropriated for emergency general assistance grants based on each county agency's 
99.12 	average share of state's emergency general expenditures for the immediate past three fiscal 
99.13 	years as determined by the commissioner, and may reallocate any unspent amounts to 
99.14 	other counties.
99.15 	(c) No county shall be allocated less than $1,000 for the fiscal year.
99.16 	(d) Should an emergency be declared as provided in section 12.31, the commissioner 
99.17 	may immediately reallocate unspent funds without regard to the other provisions of this 
99.18 	section to meet the emergency needs. The emergency reallocation must be excluded from 
99.19 	calculations for subsequent allocations as provided in paragraphs (b) and (c).
99.20 	(e) Any emergency general assistance expenditures by a county above the amount of 
99.21 	the commissioner's allocation to the county must be made from county funds.

99.22 	Sec. 2. Minnesota Statutes 2008, section 256D.09, subdivision 6, is amended to read:
99.23 		Subd. 6.Recovery of overpayments. (a) If an amount of general assistance or 
99.24 	family general assistance is paid to a recipient in excess of the payment due, it shall be 
99.25 	recoverable by the county agency. The agency shall give written notice to the recipient of 
99.26 	its intention to recover the overpayment.
99.27 	(b) Except as provided for interim assistance in section 256D.06, subdivision 
99.28 	5, when an overpayment occurs, the county agency shall recover the overpayment 
99.29 	from a current recipient by reducing the amount of aid payable to the assistance unit of 
99.30 	which the recipient is a member, for one or more monthly assistance payments, until 
99.31 	the overpayment is repaid. All county agencies in the state shall reduce the assistance 
99.32 	payment by three percent of the assistance unit's standard of need in nonfraud cases and 
99.33 	ten percent where fraud has occurred, or the amount of the monthly payment, whichever is 
99.34 	less, for all overpayments.
100.1 	(c) In cases when there is both an overpayment and underpayment, the county 
100.2 	agency shall offset one against the other in correcting the payment.
100.3 	(d) Overpayments may also be voluntarily repaid, in part or in full, by the individual, 
100.4 	in addition to the aid reductions provided in this subdivision, to include further voluntary 
100.5 	reductions in the grant level agreed to in writing by the individual, until the total amount 
100.6 	of the overpayment is repaid.
100.7 	(e) The county agency shall make reasonable efforts to recover overpayments to 
100.8 	persons no longer on assistance under standards adopted in rule by the commissioner 
100.9 	of human services. The county agency need not attempt to recover overpayments of 
100.10 	less than $35 paid to an individual no longer on assistance if the individual does not 
100.11 	receive assistance again within three years, unless the individual has been convicted of 
100.12 	violating section 256.98. 
100.13 	(f) Establishment of an overpayment is limited to 12 months prior to the month of 
100.14 	discovery due to an agency error and six years prior to the month of discovery due to a 
100.15 	client error or an intentional program violation determined under section 256.046.

100.16 	Sec. 3. Minnesota Statutes 2008, section 256D.46, is amended to read:
100.17 	256D.46 EMERGENCY MINNESOTA SUPPLEMENTAL AID.
100.18 		Subdivision 1.Eligibility. A county agency must grant emergency Minnesota 
100.19 	supplemental aid, to the extent funds are available, if the recipient is without adequate 
100.20 	resources to resolve an emergency that, if unresolved, will threaten the health or safety 
100.21 	of the recipient. For the purposes of this section, the term "recipient" includes persons 
100.22 	for whom a group residential housing benefit is being paid under sections 256I.01 to 
100.23 	256I.06. Recipients of Minnesota supplemental aid who have emergent need may apply 
100.24 	for emergency general assistance medical care under section 256D.06, subdivision 2.
100.25 		Subd. 2.Income and resource test. All income and resources available to the 
100.26 	recipient must be considered in determining the recipient's ability to meet the emergency 
100.27 	need. Property that can be liquidated in time to resolve the emergency and income, 
100.28 	excluding an amount equal to the Minnesota supplemental aid standard of assistance, that 
100.29 	is normally disregarded or excluded under the Minnesota supplemental aid program must 
100.30 	be considered available to meet the emergency need.
100.31 		Subd. 3.Payment amount. The amount of assistance granted under emergency 
100.32 	Minnesota supplemental aid is limited to the amount necessary to resolve the emergency. 
100.33 	An emergency Minnesota supplemental aid grant is available to a recipient no more 
100.34 	than once in any 12-month period. Funding for emergency Minnesota supplemental 
100.35 	aid is limited to the appropriation. Each fiscal year, the commissioner shall allocate to 
101.1 	counties the money appropriated for emergency Minnesota supplemental aid grants based 
101.2 	on each county agency's average share of state's emergency Minnesota supplemental aid 
101.3 	expenditures for the immediate past three fiscal years as determined by the commissioner, 
101.4 	and may reallocate any unspent amounts to other counties. Any emergency Minnesota 
101.5 	supplemental aid expenditures by a county above the amount of the commissioner's 
101.6 	allocation to the county must be made from county funds.

101.7 	Sec. 4. Minnesota Statutes 2008, section 256D.49, subdivision 3, is amended to read:
101.8 		Subd. 3.Overpayment of monthly grants and recovery of ATM errors. (a) When 
101.9 	the county agency determines that an overpayment of the recipient's monthly payment 
101.10 	of Minnesota supplemental aid has occurred, it shall issue a notice of overpayment 
101.11 	to the recipient. If the person is no longer receiving Minnesota supplemental aid, the 
101.12 	county agency may request voluntary repayment or pursue civil recovery. If the person is 
101.13 	receiving Minnesota supplemental aid, the county agency shall recover the overpayment 
101.14 	by withholding an amount equal to three percent of the standard of assistance for the 
101.15 	recipient or the total amount of the monthly grant, whichever is less. 
101.16 	(b) Establishment of an overpayment is limited to 12 months prior to the month of 
101.17 	discovery due to an agency error and six years prior to the month of discovery due to a 
101.18 	client error or an intentional program violation determined under section 256.046.
101.19 	(c) For recipients receiving benefits via electronic benefit transfer, if the overpayment 
101.20 	is a result of an automated teller machine (ATM) dispensing funds in error to the recipient, 
101.21 	the agency may recover the ATM error by immediately withdrawing funds from the 
101.22 	recipient's electronic benefit transfer account, up to the amount of the error. 
101.23 	(d) Residents of nursing homes, regional treatment centers, andlicensed residential 
101.24 	facilities with negotiated rates shall not have overpayments recovered from their personal 
101.25 	needs allowance.

101.26 	Sec. 5. Minnesota Statutes 2008, section 256I.03, subdivision 7, is amended to read:
101.27 		Subd. 7.Countable income. "Countable income" means all income received by an 
101.28 	applicant or recipient less any applicable exclusions or disregards. For a recipient of any 
101.29 	cash benefit from the SSI program, countable income means the SSI benefit limit in effect 
101.30 	at the time the person is in a GRH setting less $20, less the medical assistance personal 
101.31 	needs allowance. If the SSI limit has been reduced for a person due to events occurring 
101.32 	prior to the persons entering the GRH setting, countable income means actual income less 
101.33 	any applicable exclusions and disregards.

102.1 	Sec. 6. Minnesota Statutes 2008, section 256J.38, subdivision 1, is amended to read:
102.2 		Subdivision 1.Scope of overpayment. (a) When a participant or former participant 
102.3 	receives an overpayment due to agency, client, or ATM error, or due to assistance received 
102.4 	while an appeal is pending and the participant or former participant is determined 
102.5 	ineligible for assistance or for less assistance than was received, the county agency must 
102.6 	recoup or recover the overpayment using the following methods:
102.7 	(1) reconstruct each affected budget month and corresponding payment month;
102.8 	(2) use the policies and procedures that were in effect for the payment month; and
102.9 	(3) do not allow employment disregards in section 256J.21, subdivision 3 or 4, in the 
102.10 	calculation of the overpayment when the unit has not reported within two calendar months 
102.11 	following the end of the month in which the income was received.  
102.12 	(b) Establishment of an overpayment is limited to 12 months prior to the month of 
102.13 	discovery due to agency error and six years prior to the month of discovery due to client 
102.14 	error or an intentional program violation determined under section 256.046.

102.15 	Sec. 7. Minnesota Statutes 2008, section 393.07, subdivision 10, is amended to read:
102.16 		Subd. 10.Food stamp program; Maternal and Child Nutrition Act. (a) The local 
102.17 	social services agency shall establish and administer the food stamp program according 
102.18 	to rules of the commissioner of human services, the supervision of the commissioner as 
102.19 	specified in section 256.01, and all federal laws and regulations. The commissioner of 
102.20 	human services shall monitor food stamp program delivery on an ongoing basis to ensure 
102.21 	that each county complies with federal laws and regulations. Program requirements to be 
102.22 	monitored include, but are not limited to, number of applications, number of approvals, 
102.23 	number of cases pending, length of time required to process each application and deliver 
102.24 	benefits, number of applicants eligible for expedited issuance, length of time required 
102.25 	to process and deliver expedited issuance, number of terminations and reasons for 
102.26 	terminations, client profiles by age, household composition and income level and sources, 
102.27 	and the use of phone certification and home visits. The commissioner shall determine the 
102.28 	county-by-county and statewide participation rate. 
102.29 	(b) On July 1 of each year, the commissioner of human services shall determine a 
102.30 	statewide and county-by-county food stamp program participation rate. The commissioner 
102.31 	may designate a different agency to administer the food stamp program in a county if the 
102.32 	agency administering the program fails to increase the food stamp program participation 
102.33 	rate among families or eligible individuals, or comply with all federal laws and regulations 
102.34 	governing the food stamp program. The commissioner shall review agency performance 
102.35 	annually to determine compliance with this paragraph.
103.1 	(c) A person who commits any of the following acts has violated section 256.98 or 
103.2 	609.821, or both, and is subject to both the criminal and civil penalties provided under 
103.3 	those sections: 
103.4 	(1) obtains or attempts to obtain, or aids or abets any person to obtain by means of a 
103.5 	willful statement or misrepresentation, or intentional concealment of a material fact, food 
103.6 	stamps or vouchers issued according to sections 145.891 to 145.897 to which the person 
103.7 	is not entitled or in an amount greater than that to which that person is entitled or which 
103.8 	specify nutritional supplements to which that person is not entitled; or 
103.9 	(2) presents or causes to be presented, coupons or vouchers issued according to 
103.10 	sections 145.891 to 145.897 for payment or redemption knowing them to have been 
103.11 	received, transferred or used in a manner contrary to existing state or federal law; or 
103.12 	(3) willfully uses, possesses, or transfers food stamp coupons, authorization to 
103.13 	purchase cards or vouchers issued according to sections 145.891 to 145.897 in any manner 
103.14 	contrary to existing state or federal law, rules, or regulations; or 
103.15 	(4) buys or sells food stamp coupons, authorization to purchase cards, other 
103.16 	assistance transaction devices, vouchers issued according to sections 145.891 to 145.897, 
103.17 	or any food obtained through the redemption of vouchers issued according to sections 
103.18 	145.891 to 145.897 for cash or consideration other than eligible food. 
103.19 	(d) A peace officer or welfare fraud investigator may confiscate food stamps, 
103.20 	authorization to purchase cards, or other assistance transaction devices found in the 
103.21 	possession of any person who is neither a recipient of the food stamp program nor 
103.22 	otherwise authorized to possess and use such materials. Confiscated property shall be 
103.23 	disposed of as the commissioner may direct and consistent with state and federal food 
103.24 	stamp law. The confiscated property must be retained for a period of not less than 30 days 
103.25 	to allow any affected person to appeal the confiscation under section 256.045. 
103.26 	(e) Food stamp overpayment claims which are due in whole or in part to client 
103.27 	error shall be established by the county agency for a period of six years from the date of 
103.28 	any resultant overpayment. Establishment of a food stamp overpayment is limited to 12 
103.29 	months prior to the month of discovery due to an agency error and six years prior to the 
103.30 	month of discovery due to a client error or an intentional program violation determined 
103.31 	under section 256.046.
103.32 	(f) With regard to the federal tax revenue offset program only, recovery incentives 
103.33 	authorized by the federal food and consumer service shall be retained at the rate of 50 
103.34 	percent by the state agency and 50 percent by the certifying county agency.
103.35 	(g) A peace officer, welfare fraud investigator, federal law enforcement official, 
103.36 	or the commissioner of health may confiscate vouchers found in the possession of any 
104.1 	person who is neither issued vouchers under sections 145.891 to 145.897, nor otherwise 
104.2 	authorized to possess and use such vouchers. Confiscated property shall be disposed of 
104.3 	as the commissioner of health may direct and consistent with state and federal law. The 
104.4 	confiscated property must be retained for a period of not less than 30 days. 
104.5 	(h) The commissioner of human services may seek a waiver from the United States 
104.6 	Department of Agriculture to allow the state to specify foods that may and may not be 
104.7 	purchased in Minnesota with benefits funded by the federal Food Stamp Program. The 
104.8 	commissioner shall consult with the members of the house of representatives and senate 
104.9 	policy committees having jurisdiction over food support issues in developing the waiver. 
104.10 	The commissioner, in consultation with the commissioners of health and education, shall 
104.11 	develop a broad public health policy related to improved nutrition and health status. The 
104.12 	commissioner must seek legislative approval prior to implementing the waiver.

104.13 	Sec. 8.  REPEALER.
 104.14 	(a) Minnesota Statutes 2008, section 256I.06, subdivision 9, is repealed.
104.15 	(b) Minnesota Rules, parts 9500.1243, subpart 3; and 9500.1261, subparts 3, 4, 5, 
104.16 	and 6, are repealed.

104.17 	ARTICLE 4
104.18 	PROGRAM INTEGRITY

104.19 	Section 1. Minnesota Statutes 2008, section 119B.02, subdivision 5, is amended to read:
104.20 		Subd. 5.Program integrity. For child care assistance programs under this 
104.21 	chapter, the commissioner shall enforce the requirements for program integrity and fraud 
104.22 	prevention investigations under sections 256.046, 256.98, and 256.983 256.9832.

104.23 	Sec. 2. Minnesota Statutes 2008, section 256.045, subdivision 3, is amended to read:
104.24 		Subd. 3.State agency hearings. (a) State agency hearings are available for the 
104.25 	following: 
104.26 	(1) any person applying for, receiving or having received public assistance, medical 
104.27 	care, or a program of social services granted by the state agency or a county agency or 
104.28 	the federal Food Stamp Act whose application for assistance is denied, not acted upon 
104.29 	with reasonable promptness, or whose assistance is suspended, reduced, terminated, or 
104.30 	claimed to have been incorrectly paid;
104.31 	(2) any patient or relative aggrieved by an order of the commissioner under section 
104.32 	252.27; 
104.33 	(3) a party aggrieved by a ruling of a prepaid health plan;
105.1 	(4) except as provided under chapter 245C, any individual or facility determined by 
105.2 	a lead agency to have maltreated a vulnerable adult under section 626.557 after they have 
105.3 	exercised their right to administrative reconsideration under section 626.557;
105.4 	(5) any person whose claim for foster care payment according to a placement of the 
105.5 	child resulting from a child protection assessment under section 626.556 is denied or not 
105.6 	acted upon with reasonable promptness, regardless of funding source;
105.7 	(6) any person to whom a right of appeal according to this section is given by other 
105.8 	provision of law;
105.9 	(7) an applicant aggrieved by an adverse decision to an application for a hardship 
105.10 	waiver under section 256B.15;
105.11 	(8) an applicant aggrieved by an adverse decision to an application or redetermination 
105.12 	for a Medicare Part D prescription drug subsidy under section 256B.04, subdivision 4a; 
105.13 	(9) except as provided under chapter 245A, an individual or facility determined 
105.14 	to have maltreated a minor under section 626.556, after the individual or facility has 
105.15 	exercised the right to administrative reconsideration under section 626.556; or
105.16 	(10) except as provided under chapter 245C, an individual disqualified under sections 
105.17 	245C.14 and 245C.15, on the basis of serious or recurring maltreatment; a preponderance 
105.18 	of the evidence that the individual has committed an act or acts that meet the definition 
105.19 	of any of the crimes listed in section 245C.15, subdivisions 1 to 4; or for failing to make 
105.20 	reports required under section 626.556, subdivision 3, or 626.557, subdivision 3. Hearings 
105.21 	regarding a maltreatment determination under clause (4) or (9) and a disqualification under 
105.22 	this clause in which the basis for a disqualification is serious or recurring maltreatment, 
105.23 	which has not been set aside under sections 245C.22 and 245C.23, shall be consolidated 
105.24 	into a single fair hearing. In such cases, the scope of review by the human services referee 
105.25 	shall include both the maltreatment determination and the disqualification. The failure to 
105.26 	exercise the right to an administrative reconsideration shall not be a bar to a hearing under 
105.27 	this section if federal law provides an individual the right to a hearing to dispute a finding 
105.28 	of maltreatment. Individuals and organizations specified in this section may contest the 
105.29 	specified action, decision, or final disposition before the state agency by submitting a 
105.30 	written request for a hearing to the state agency within 30 days after receiving written 
105.31 	notice of the action, decision, or final disposition, or within 90 days of such written notice 
105.32 	if the applicant, recipient, patient, or relative shows good cause why the request was not 
105.33 	submitted within the 30-day time limit.; or
105.34 	(11) any person with an outstanding debt resulting from receipt of public assistance, 
105.35 	medical care, or the federal Food Stamp Act who is contesting a setoff claim by the 
105.36 	Department of Human Services or a county agency. The scope of the appeal is the validity 
106.1 	of the claimant agency's intention to request setoff of a refund under chapter 270A against 
106.2 	the debt.
106.3 	(b) The hearing for an individual or facility under paragraph (a), clause (4), (9), or 
106.4 	(10), is the only administrative appeal to the final agency determination specifically, 
106.5 	including a challenge to the accuracy and completeness of data under section 13.04. 
106.6 	Hearings requested under paragraph (a), clause (4), apply only to incidents of maltreatment 
106.7 	that occur on or after October 1, 1995. Hearings requested by nursing assistants in nursing 
106.8 	homes alleged to have maltreated a resident prior to October 1, 1995, shall be held as a 
106.9 	contested case proceeding under the provisions of chapter 14. Hearings requested under 
106.10 	paragraph (a), clause (9), apply only to incidents of maltreatment that occur on or after 
106.11 	July 1, 1997. A hearing for an individual or facility under paragraph (a), clause (9), is 
106.12 	only available when there is no juvenile court or adult criminal action pending. If such 
106.13 	action is filed in either court while an administrative review is pending, the administrative 
106.14 	review must be suspended until the judicial actions are completed. If the juvenile court 
106.15 	action or criminal charge is dismissed or the criminal action overturned, the matter may be 
106.16 	considered in an administrative hearing.
106.17 	(c) For purposes of this section, bargaining unit grievance procedures are not an 
106.18 	administrative appeal.
106.19 	(d) The scope of hearings involving claims to foster care payments under paragraph 
106.20 	(a), clause (5), shall be limited to the issue of whether the county is legally responsible 
106.21 	for a child's placement under court order or voluntary placement agreement and, if so, 
106.22 	the correct amount of foster care payment to be made on the child's behalf and shall not 
106.23 	include review of the propriety of the county's child protection determination or child 
106.24 	placement decision.
106.25 	(e) A vendor of medical care as defined in section 256B.02, subdivision 7, or a 
106.26 	vendor under contract with a county agency to provide social services is not a party and 
106.27 	may not request a hearing under this section, except if assisting a recipient as provided in 
106.28 	subdivision 4.
106.29 	(f) An applicant or recipient is not entitled to receive social services beyond the 
106.30 	services prescribed under chapter 256M or other social services the person is eligible 
106.31 	for under state law.
106.32 	(g) The commissioner may summarily affirm the county or state agency's proposed 
106.33 	action without a hearing when the sole issue is an automatic change due to a change in 
106.34 	state or federal law.

106.35 	Sec. 3. [256.9832] STATE WELFARE FRAUD INVESTIGATIONS.
107.1 		Subdivision 1.Program established. Effective July 1, 2009, the commissioner of 
107.2 	human services shall establish a welfare fraud investigative unit to investigate allegations 
107.3 	of recipient fraud in welfare programs with a state or federal funding component and 
107.4 	quickly terminate benefits to ineligible recipients. Counties that received grants under 
107.5 	Minnesota Statutes 2008, section 256.983, for the fraud prevention investigation project 
107.6 	must use state investigators to investigate possible welfare fraud effective with termination 
107.7 	of their grants. The commissioner shall develop a process for counties that did not 
107.8 	participate in the former fraud prevention investigation project to begin use of state 
107.9 	investigators.
107.10 		Subd. 2.Relationship to county criminal welfare fraud investigative units.
 107.11 	An investigation resulting in discovery of facts that appear to merit the involvement of 
107.12 	the criminal justice system are to be referred to the county human services director or 
107.13 	designee for further referral to the county criminal justice system, or may be referred 
107.14 	directly to the county criminal justice system. The commissioner of human services must 
107.15 	be notified of the disposition of these cases within six months of referral. If the criminal 
107.16 	justice system has not acted on the referral or declined to act, the commissioner has the 
107.17 	option to pursue further action on those cases.
107.18 		Subd. 3.County agency responsibilities. State welfare fraud investigators shall 
107.19 	have unrestricted access to human services records as needed to conduct an investigation. 
107.20 	County agencies have 30 days after receipt of investigative findings to notify the 
107.21 	commissioner of effect on eligibility. County agencies shall calculate overpayments 
107.22 	identified through an investigation and establish a formal claim for repayment within 45 
107.23 	days of discovery.
107.24 		Subd. 4.Department responsibilities. The commissioner shall establish training 
107.25 	programs for state investigators, county welfare case workers, and supervisory staff. The 
107.26 	commissioner shall develop operational guidelines, forms, and reporting mechanisms, 
107.27 	which must be used by county agencies. The commissioner shall develop a process 
107.28 	to ensure county cooperation with making appropriate referrals for welfare fraud 
107.29 	investigations. An individuals's application or redetermination form for public assistance 
107.30 	benefits, including child care assistance programs and medical care programs, must 
107.31 	include an authorization by the individual for the release and sharing of information and 
107.32 	documentation between third parties and investigators who are conducting welfare fraud 
107.33 	investigations. The authorization for release and sharing of information is effective for 
107.34 	six months after public assistance benefits have ceased.

107.35 	EFFECTIVE DATE. This section is effective November 1, 2009.

108.1 	Sec. 4. Minnesota Statutes 2008, section 270A.09, is amended by adding a subdivision 
108.2 	to read:
108.3 		Subd. 1b.Department of Human Services claims. Notwithstanding subdivision 1, 
108.4 	any debtor contesting a setoff claim by the Department of Human Services or a county 
108.5 	agency whose claim relates to a debt resulting from receipt of public assistance, medical 
108.6 	care, or the federal Food Stamp Act shall have a hearing conducted in the same manner as 
108.7 	an appeal under sections 256.045 and 256.0451.

108.8 	Sec. 5.  REPEALER.
 108.9 	Minnesota Statutes 2008, section 256.983, is repealed effective November 1, 2009.

108.10 	ARTICLE 5
108.11 	CHILD SUPPORT

108.12 	Section 1. Minnesota Statutes 2008, section 518A.53, subdivision 1, is amended to 
108.13 	read:
108.14 		Subdivision 1.Definitions. (a) For the purpose of this section, the following terms 
108.15 	have the meanings provided in this subdivision unless otherwise stated.
108.16 	(b) "Payor of funds" means any person or entity that provides funds to an obligor, 
108.17 	including an employer as defined under chapter 24 of the Internal Revenue Code, 
108.18 	section 3401(d), an independent contractor, payor of worker's compensation benefits or 
108.19 	unemployment benefits, or a financial institution as defined in section 13B.06. 
108.20 	(c) "Business day" means a day on which state offices are open for regular business.
108.21 	(d) The term "arrears" means amounts owed under a support order that are past due
108.22 	as used in this section has the meaning provided in section 518A.26.

108.23 	EFFECTIVE DATE. This section is effective April 1, 2010.

108.24 	Sec. 2. Minnesota Statutes 2008, section 518A.53, subdivision 4, is amended to read:
108.25 		Subd. 4.Collection services. (a) The commissioner of human services shall prepare 
108.26 	and make available to the courts a notice of services that explains child support and 
108.27 	maintenance collection services available through the public authority, including income 
108.28 	withholding, and the fees for such services. Upon receiving a petition for dissolution of 
108.29 	marriage or legal separation, the court administrator shall promptly send the notice of 
108.30 	services to the petitioner and respondent at the addresses stated in the petition.
108.31 	(b) Either the obligee or obligor may at any time apply to the public authority for 
108.32 	either full IV-D services or for income withholding only services.
109.1 	(c) For those persons applying for income withholding only services, a monthly 
109.2 	service fee of $15 must be charged to the obligor. This fee is in addition to the amount of 
109.3 	the support order and shall be withheld through income withholding. The public authority 
109.4 	shall explain the service options in this section to the affected parties and encourage the 
109.5 	application for full child support collection services.
109.6 	(d) If the obligee is not a current recipient of public assistance as defined in section 
109.7 	256.741, the person who applied for services may at any time choose to terminate either 
109.8 	full IV-D services or income withholding only services regardless of whether income 
109.9 	withholding is currently in place. The obligee or obligor may reapply for either full IV-D 
109.10 	services or income withholding only services at any time. Unless the applicant is a 
109.11 	recipient of public assistance as defined in section 256.741, a $25 application fee shall be 
109.12 	charged at the time of each application. 
109.13 	(e) When a person terminates IV-D services, if an arrearage for public assistance as 
109.14 	defined in section 256.741 exists, the public authority may continue income withholding, 
109.15 	as well as use any other enforcement remedy for the collection of child support, until all 
109.16 	public assistance arrears are paid in full. Income withholding shall be in an amount equal 
109.17 	to 20 percent of the support order in effect at the time the services terminated., unless the 
109.18 	support order includes a specific monthly payback amount. If the support order includes a 
109.19 	specific monthly payback amount, income withholding shall be in the specific amount 
109.20 	ordered. The provisions of this paragraph apply to all support orders in effect on or before 
109.21 	January 1, 2010, and to all support orders in effect after January 1, 2010.

109.22 	EFFECTIVE DATE. This section is effective April 1, 2010.

109.23 	Sec. 3. Minnesota Statutes 2008, section 518A.53, subdivision 10, is amended to read:
109.24 		Subd. 10.Arrearage order. (a) This section does not prevent the court from 
109.25 	ordering the payor of funds to withhold amounts to satisfy the obligor's previous arrearage 
109.26 	in support order payments. This remedy shall not operate to exclude availability of other 
109.27 	remedies to enforce judgments. The employer or payor of funds shall withhold from 
109.28 	the obligor's income an additional amount equal to 20 percent of the monthly child 
109.29 	support or maintenance obligation until the arrearage is paid., unless the support order 
109.30 	includes a specific monthly payback amount. If the support order includes a specific 
109.31 	monthly payback amount, income withholding shall be in the specific amount ordered. 
109.32 	The provisions of this paragraph apply to all support orders in effect on or before January 
109.33 	1, 2010, and to all support orders in effect after January 1, 2010.
110.1 	(b) Notwithstanding any law to the contrary, funds from income sources included 
110.2 	in section 518A.26, subdivision 8, whether periodic or lump sum, are not exempt from 
110.3 	attachment or execution upon a judgment for child support arrearage. 
110.4 	(c) Absent an order to the contrary, if an arrearage exists at the time a support 
110.5 	order would otherwise terminate, income withholding shall continue in effect or may be 
110.6 	implemented in an amount equal to the support order plus an additional 20 percent of the 
110.7 	monthly child support obligation, until all arrears have been paid in full.

110.8 	EFFECTIVE DATE. This section is effective April 1, 2010.

110.9 	Sec. 4. Minnesota Statutes 2008, section 518A.60, is amended to read:
110.10 	518A.60 COLLECTION; ARREARS ONLY.
110.11 	(a) Remedies available for the collection and enforcement of support in this chapter 
110.12 	and chapters 256, 257, 518, and 518C also apply to cases in which the child or children 
110.13 	for whom support is owed are emancipated and the obligor owes past support or has an 
110.14 	accumulated arrearage as of the date of the youngest child's emancipation. Child support 
110.15 	arrearages under this section include arrearages for child support, medical support, child 
110.16 	care, pregnancy and birth expenses, and unreimbursed medical expenses as defined in 
110.17 	section 518A.41, subdivision 1, paragraph (h). 
110.18 	(b) This section applies retroactively to any support arrearage that accrued on or 
110.19 	before June 3, 1997, and to all arrearages accruing after June 3, 1997.
110.20 	(c) Past support or pregnancy and confinement expenses ordered for which the 
110.21 	obligor has specific court ordered terms for repayment may not be enforced using drivers' 
110.22 	and occupational or professional license suspension, and credit bureau reporting, and 
110.23 	additional income withholding under section 518A.53, subdivision 10, paragraph (a),
110.24 	unless the obligor fails to comply with the terms of the court order for repayment. 
110.25 	(d) If an arrearage exists at the time a support order would otherwise terminate 
110.26 	and section 518A.53, subdivision 10, paragraph (c), does not apply to this section, the 
110.27 	arrearage shall be repaid in an amount equal to the current support order until all arrears 
110.28 	have been paid in full, absent a court order to the contrary. 
110.29 	(e) If an arrearage exists according to a support order which fails to establish a 
110.30 	monthly support obligation in a specific dollar amount, the public authority, if it provides 
110.31 	child support services, or the obligee, may establish a payment agreement which shall 
110.32 	equal what the obligor would pay for current support after application of section 518A.34, 
110.33 	plus an additional 20 percent of the current support obligation, until all arrears have been 
110.34 	paid in full. If the obligor fails to enter into or comply with a payment agreement, the 
111.1 	public authority, if it provides child support services, or the obligee, may move the district 
111.2 	court or child support magistrate, if section 484.702 applies, for an order establishing 
111.3 	repayment terms. 

111.4 	EFFECTIVE DATE. This section is effective April 1, 2010.

111.5 	ARTICLE 6
111.6 	PROTECTING CHILDREN AND STRENGTHENING FAMILIES ACT

111.7 	Section 1. [256N.01] CITATION.
111.8 	Sections 256N.01 to 256N.09 may be cited as the "Protecting Children and 
111.9 	Strengthening Families Act," hereafter the "act." This act defines public child welfare 
111.10 	policy, sets state priorities, creates accountability mechanisms for achieving improved 
111.11 	outcomes for children and families, and establishes a fund to address the safety, 
111.12 	permanency, and well-being needs of children and adolescents who come to the attention 
111.13 	of the county as a result of a report of child maltreatment pursuant to section 626.556 or 
111.14 	are otherwise the responsibility of the county.

111.15 	Sec. 2. [256N.02] PUBLIC POLICY.
111.16 		Subdivision 1.General. The legislature hereby declares that the public policy 
111.17 	of the state is:
111.18 	(1) first and foremost, children should be safe from harm and protected from abuse 
111.19 	and neglect;
111.20 	(2) children should be maintained safely in their homes whenever possible and 
111.21 	appropriate;
111.22 	(3) when the ability of parents to keep their children safe is compromised it is in 
111.23 	the public interest to intervene early and provide services that promote parents' protective 
111.24 	capacities, mitigate risks of harm, and strengthen and support parents in their care giving 
111.25 	roles;
111.26 	(4) children should grow up in safe, permanent and nurturing homes and, when it is 
111.27 	not possible for their parents to provide safety and permanency, alternative permanency 
111.28 	options must be made available to children as quickly as possible;
111.29 	(5) whenever possible, alternative permanency options should be with children's 
111.30 	relatives or kin in order to maintain family relationships and preserve connections with 
111.31 	their communities and culture; and
111.32 	(6) once permanency is achieved, children and their families should receive the 
111.33 	services and supports necessary to maintain safe, stable, and permanent homes.
112.1 		Subd. 2.Racial disparities in child welfare. It is further the policy of the state to 
112.2 	reduce racial disparities and disproportionality that exists in the child welfare system by:
112.3 	(1) identifying and addressing structural factors contributing to inequities in 
112.4 	outcomes;
112.5 	(2) identifying and implementing promising and evidence-based strategies to reduce 
112.6 	racial disparities in treatment and outcomes;
112.7 	(3) using cultural values, beliefs and practices of families, communities and tribes to 
112.8 	shape family assessment, case planning, case service design, and case decision making 
112.9 	processes;
112.10 	(4) using placement and reunification strategies that maintain, honor, and support 
112.11 	relationships and connections between parents, siblings, children, kin, and significant 
112.12 	others, giving priority to kinship placements when placement is necessary; and
112.13 	(5) supporting families in the context of their communities and tribes so as to safely 
112.14 	divert them away from the child welfare system, whenever possible.

112.15 	Sec. 3. [256N.03] PUBLIC PRIORITIES.
112.16 	A broad continuum of services and a reform of practice are necessary across 
112.17 	Minnesota to keep children safe from abuse and neglect, prevent the trauma associated 
112.18 	with removing a child from their family home, and provide families with the necessary 
112.19 	supports and services to protect and nurture their children. Successful implementation 
112.20 	of state policy must result in improved outcomes for children and families and must be 
112.21 	measured by:
112.22 	(1) improved timeliness to initial investigations;
112.23 	(2) increased monthly caseworker visits;
112.24 	(3) reduced out-of-home placements;
112.25 	(4) reduced re-entry;
112.26 	(5) reduced recidivism;
112.27 	(6) reduced number of children aging out of foster care without achieving 
112.28 	permanency;
112.29 	(7) improved rate of relative care;
112.30 	(8) improved stability in foster care; and
112.31 	(9) reduced racial and ethnic disparities and disproportionality.

112.32 	Sec. 4. [256N.04] DEFINITIONS.
112.33 		Subdivision 1.Scope. For the purposes of sections 256N.01 to 256N.09, the terms 
112.34 	defined in this section have the meanings given them.
113.1 		Subd. 2.Adoptive care. "Adoptive care" means care to an adopted special needs 
113.2 	child under section 259.67.
113.3 		Subd. 3.Child protection investigation. "Child protection investigation" means 
113.4 	fact gathering by the child welfare agency related to the current safety of the child and the 
113.5 	risk of subsequent maltreatment that determines whether child maltreatment occurred and 
113.6 	whether child protective services are needed.
113.7 		Subd. 4.Children services. "Children services" means services provided or 
113.8 	arranged for by county boards for infants, children, and adolescents and may include, 
113.9 	but are not limited to: child protection investigation, family assessment response, 
113.10 	family-based crisis services, family foster care, family preservation services, foster care, 
113.11 	independent living services, permanency services, postpermanency support services, 
113.12 	reunification services, subsidized guardianship, and support for at-risk families.
113.13 		Subd. 5.Commissioner. "Commissioner" means the commissioner of human 
113.14 	services or the commissioner's designee.
113.15 		Subd. 6.County board. "County board" means the board of county commissioners 
113.16 	in each county.
113.17 		Subd. 7.Family assessment response. "Family assessment response" means a 
113.18 	comprehensive assessment of child safety, risk of subsequent maltreatment, and family 
113.19 	strengths and needs that is applied to a child maltreatment report that does not allege 
113.20 	substantial child endangerment.  Family assessment response includes assessing the need 
113.21 	for services and may include the provision of time-limited services.
113.22 		Subd. 8.Family-based crisis services. "Family-based crisis services" means 
113.23 	services provided to a family in the home, within 24 hours of referral, to help the family 
113.24 	resolve a relationship crisis to prevent placing a child outside of the home.
113.25 		Subd. 9.Foster care. "Foster care" means 24-hour substitute care in a family home 
113.26 	or facility licensed under Minnesota Rules, chapter 2960, for children placed away from 
113.27 	their parents or guardian and for whom a responsible social services agency has placement 
113.28 	and care responsibility pursuant to a court order or voluntary placement agreement.  Foster 
113.29 	care includes an emergency placement of a child in the home of a relative who has not yet 
113.30 	completed the licensure process.  Services are provided to children who are in immediate 
113.31 	need of out of home placement until a plan of care is established.
113.32 		Subd. 10.Family preservation services. "Family preservation services" means 
113.33 	services designed to maintain children in the home or in an outside setting, if needed to 
113.34 	help the family resolve personal, family, or situational problems.  These services are 
113.35 	provided to prevent placement of a child outside of the home or so that a child can be 
113.36 	returned home from placement.
114.1 		Subd. 11.Guardianship assistance. "Guardianship assistance" means financial 
114.2 	support to relatives who accept permanent and legal custody of a related child as a result 
114.3 	of a permanency proceeding under section 260C.317.
114.4 		Subd. 12.Human services board. "Human services board" means a board 
114.5 	established under section 402.02; Laws 1974, chapter 293; or Laws 1976, chapter 340.
114.6 		Subd. 13.Independent living services. "Independent living services" means 
114.7 	individual or group services designed to assist youth, ages 14 through 20, who are in 
114.8 	out-of-home placement, to prepare them for independent living. Eligible youth can 
114.9 	receive services until their 21st birthday. Services include an independent living skills 
114.10 	assessment and the development of an independent living plan by a case manager. 
114.11 	Services may include training in daily living skills, service coordination, educational and 
114.12 	career assistance, driver's education or transportation use, and the funding of activities 
114.13 	that promote self-reliance and self-esteem.
114.14 		Subd. 14.Permanency services. "Permanency services" means services designed 
114.15 	to plan for and finalize a safe and legally permanent alternative home for the child within 
114.16 	the timelines of section 260C.201, subdivision 11, when a child cannot return to the parent 
114.17 	or guardian from whom they were removed.  It also includes considering other permanent 
114.18 	alternative homes for a child, preferably through adoption or transfer of permanent legal 
114.19 	and physical custody of the child.  Concurrent permanency planning and family group 
114.20 	decision-making are included as permanency services.
114.21 		Subd. 15.Postpermanency support services. "Postpermanency support services" 
114.22 	means services designed to improve the likelihood that a child who has been in 
114.23 	out-of-home placement will be able to remain in their permanency situation, whether that 
114.24 	is reunification with their families, transfer of permanent legal and physical custody to a 
114.25 	relative, or in a finalized adoption.
114.26 		Subd. 16.Reunification services. "Reunification services" means services, 
114.27 	including family group decision-making, provided to a child and their legal caregiver to 
114.28 	facilitate the safe return of the child to the home.  Specific services are provided by the 
114.29 	local agency with legal responsibility pursuant to a court order or voluntary placement 
114.30 	agreement, and are in the out-of-home placement plan.
114.31 		Subd. 17.Services for at-risk families. "Services for at-risk families" means 
114.32 	voluntary services that are designed to reduce the likelihood of any future maltreatment 
114.33 	for families who have a maltreatment report that is not accepted under section 626.556, 
114.34 	are self referred or referred by a community provider, or who are on the Minnesota family 
114.35 	investment program under chapter 256J.

115.1 	Sec. 5. [256N.05] USE OF FUNDS.
115.2 	Funds under this act may be used to provide services under this act, or other services 
115.3 	needed based on an individualized assessment of the child and family. Funds must be 
115.4 	directed in the following order of priority:
115.5 	(1) family assessment response, time-limited targeted services and child protection 
115.6 	investigations;
115.7 	(2) support for at-risk families;
115.8 	(3) postpermanency support services;
115.9 	(4) independent living services;
115.10 	(5) family support and family preservation services;
115.11 	(6) family-based crisis services;
115.12 	(7) reunification services;
115.13 	(8) permanency services; and
115.14 	(9) foster care.

115.15 	Sec. 6. [256N.06] DUTIES OF COMMISSIONER OF HUMAN SERVICES.
115.16 		Subdivision 1.General supervision. In order to achieve the goals of this act, 
115.17 	the commissioner shall allocate funds, provide assistance, evaluate the performance of 
115.18 	counties, and ensure accountability for achieving improved outcomes for children and 
115.19 	families.
115.20 		Subd. 2.Allocation of funds. Each year the commissioner shall allocate available 
115.21 	funds to each county with an approved plan according to section 256N.07 and meeting the 
115.22 	requirements under this act. Funds must be allocated according to section 256N.08.
115.23 		Subd. 3.Assistance. The commissioner shall:
115.24 	(1) provide training, technical assistance, and other supports to each county to 
115.25 	assist in needs assessment, planning,  monitoring of outcomes and service quality, and 
115.26 	implementation of program improvement plans;
115.27 	(2) request waivers from federal programs as necessary to implement this act; and
115.28 	(3) have authority under sections 14.055 and 14.056 to grant a variance to existing 
115.29 	state rules as needed to eliminate barriers to achieving desired outcomes.
115.30 		Subd. 4.Accountability. (a) The commissioner shall maintain a quality assurance 
115.31 	system that measures county performance on federal and state outcome measures and 
115.32 	performance items regarding child safety, permanency, and well being and determine the 
115.33 	status of the public priorities identified in 256N.03. Performance measures may include:
115.34 	(1) timeliness to initial investigation;
115.35 	(2) monthly caseworker visits;
116.1 	(3) rate of entry into foster care;
116.2 	(4) rate of re-entry;
116.3 	(5) rate of recidivism;
116.4 	(6) number of children aging out of foster care without achieving permanency;
116.5 	(7) rate of relative care;
116.6 	(8) foster care stability; and
116.7 	(9) other federal or state performance measures.
116.8 	Performance measures may be modified by the federal Department of Health and 
116.9 	Human Services or the commissioner. The quality assurance system must support 
116.10 	and measure continuous quality improvement and work with counties to develop and 
116.11 	implement program improvement plans in any areas in which the county is not in 
116.12 	substantial conformity with federal and state performance standards.
116.13 	(b) The commissioner shall:
116.14 	(1) use data collection, evaluation of outcomes, and the review and approval of 
116.15 	county plans to supervise county performance in the delivery of services to children 
116.16 	and families;
116.17 	(2) specify requirements for reports, including fiscal reports to account for funds 
116.18 	distributed; and
116.19 	(3) adjust allocations to a county based on the commissioner's determination 
116.20 	regarding county performance under the act.
116.21 	(c) The following steps must be taken when the commissioner has determined that a 
116.22 	county has failed to meet performance standards and address the priorities under this act, 
116.23 	or failed to develop and implement a program improvement plan:
116.24 	(1) the commissioner shall notify the county, by mail, of the standards which the 
116.25 	county has not achieved;
116.26 	(2) the county has 60 days from notification to develop a program improvement plan 
116.27 	and submit it to the commissioner for approval; and
116.28 	(3) if the county fails to demonstrate achievement or fails to implement a program 
116.29 	improvement plan approved by the commissioner, the commissioner may withhold the 
116.30 	county's share of state or federal funds under this act.  The commissioner may withhold 
116.31 	future allocations until the county has achieved the standards applicable to the program 
116.32 	or has developed and implemented a program improvement plan. If a county does not 
116.33 	achieve standards to develop and implement a program improvement plan for more than 
116.34 	six consecutive months, the commissioner may reallocate the withheld funds to counties 
116.35 	that have achieved standards or are working to achieve them.

117.1 	Sec. 7. [256N.07] PLAN.
117.2 		Subdivision 1.Plan submitted to commissioner. Effective January 1, 2011, and 
117.3 	each two-year period thereafter, each county shall have a biennial plan approved by the 
117.4 	commissioner that addresses the public policy and priorities of this act in order to receive 
117.5 	funds.  The plan may be combined with other plans required by the commissioner and 
117.6 	counties may submit multicounty or regional plans.
117.7 		Subd. 2.Contents. The plan must be completed in a form prescribed by the 
117.8 	commissioner. The plan must include:
117.9 	(1) strategies the county must implement to keep children safe in their own homes 
117.10 	and support families in the context of their communities and tribes so as to safely divert 
117.11 	them away from the child welfare system, whenever possible;
117.12 	(2) strategies the county must engage in to address each of the public priorities 
117.13 	identified in section 256N.03;
117.14 	(3) strategies that the county must engage in to maintain connections between family 
117.15 	members and significant others, giving priority to kinship placements, when placement is 
117.16 	necessary;
117.17 	(4) strategies that address disparities in out-of-home placement for African-American 
117.18 	and American Indian children in their county and other populations of children 
117.19 	disproportionately represented, and when placement is necessary the strategies that must 
117.20 	be employed to maintain children's familial and cultural connections;
117.21 	(5) performance targets on state and federal indicators measuring outcomes of child 
117.22 	safety, permanency, and well-being;
117.23 	(6) strategies the county must implement  to achieve the performance targets, 
117.24 	including specification of how funds under this section and other community resources 
117.25 	must be used to achieve desired performance targets; and
117.26 	(7) a description of the county's process to solicit public input and a summary of 
117.27 	that input.
117.28 		Subd. 3.Timelines. The preliminary plan must be submitted to the commissioner 
117.29 	by October 15, 2010, and October 15 of every two years thereafter.
117.30 		Subd. 4.Public comment. The county board shall determine how citizens in the 
117.31 	county will participate in the development of the plan and provide opportunities for 
117.32 	such participation. The county shall allow a period of no less than 30 days prior to the 
117.33 	submission of the plan to the commissioner to solicit comments from the public on the 
117.34 	contents of the plan.
117.35 		Subd. 5.Commissioner's responsibilities. The commissioner shall, within 60 
117.36 	days of receiving each county plan, inform the county if the plan has been approved. 
118.1 	If the plan is not approved, the commissioner shall inform the county of any revisions 
118.2 	needed for approval.

118.3 	Sec. 8. [256N.08] GRANT ALLOCATION.
118.4 		Subdivision 1.Determination. The commissioner shall annually determine whether 
118.5 	a county has met the requirements under this act. In making this determination, the 
118.6 	commissioner shall consider factors addressed by the county in its plan under section 
118.7 	256N.07, whether the county fully participated in the state quality assurance process, and 
118.8 	actual county performance on measures of child safety, permanency, and well-being. The 
118.9 	commissioner shall continue to measure and monitor performance, and counties shall 
118.10 	continue to develop and employ appropriate strategies and procedures to continuously 
118.11 	improve their services  and outcomes. Performance standards for these measures must be 
118.12 	determined by the commissioner in consultation with counties, and must include those 
118.13 	prescribed by the federal Department of Human Services and those unique to the state.
118.14 		Subd. 2.Grant formula. (a) Beginning July 10, 2011, counties shall receive the 
118.15 	same allocation as was received the previous year under chapter 256M proportionately 
118.16 	to state Children and Community Services Act and federal Title XX funds that are 
118.17 	attributable to children services as determined by the commissioner. Allocations must be 
118.18 	comprised of both state appropriations under this act and federal Title XX funds, except 
118.19 	for Title XX funds allocated for administrative purposes and migrant day care. Beginning 
118.20 	July 10, 2012, the amount of money allocated to counties must first be allocated in 
118.21 	amounts equal to each county's guaranteed floor according to subdivision 3 provided they 
118.22 	meet the requirements under subdivision 1, and second, any remaining available funds 
118.23 	must be allocated as provided in paragraphs (b) to (f).
118.24 	(b) Beginning July 10, 2012, ninety percent of remaining funds must be allocated 
118.25 	proportionally to counties based on the previous year's allocation and ten percent must be 
118.26 	allocated by the following formula:
118.27 	(1) 50 percent of the funds must be allocated based on the county's performance on 
118.28 	the state and federal standards and the public priorities identified in section 256N.03 as 
118.29 	determined by the commissioner for that county;
118.30 	(2) 30 percent of the funds must be allocated based on the county's percentage 
118.31 	share of the number of accepted maltreatment reports in the most recent calendar year 
118.32 	available as determined by the commissioner;
118.33 	(3) ten percent of the funds must be allocated based on the county's percentage share 
118.34 	of the number of reports of family assessments and services to at-risk families, as defined 
119.1 	by section 256N.04, subdivisions 7 and 17, in the most recent calendar year available 
119.2 	as determined by the commissioner; and
119.3 	(4) ten percent of the funds must be allocated based on the average monthly 
119.4 	caseloads in each county in the Minnesota family investment program in the most recent 
119.5 	calendar year available as determined by the commissioner.
119.6 	(c) Beginning July 10, 2013, 70 percent of remaining funds must be allocated 
119.7 	proportionally to counties based on the previous year's allocation and 30 percent must be 
119.8 	allocated by the following formula:
119.9 	(1) 50 percent of the funds must be allocated based on the county's performance on 
119.10 	the state and federal standards and the public priorities identified in section 256N.03 as 
119.11 	determined by the commissioner for that county;
119.12 	(2) 30 percent of the funds must be allocated based on the county's percentage 
119.13 	share of the number of accepted maltreatment reports in the most recent calendar year 
119.14 	available as determined by the commissioner;
119.15 	(3) ten percent of the funds must be allocated based on the county's percentage share 
119.16 	of the number of reports of family assessments and services to at-risk families, as defined 
119.17 	by section 256N.04, subdivisions 7 and 17, in the most recent calendar year available 
119.18 	as determined by the commissioner; and
119.19 	(4) ten percent of the funds must be allocated based on the average monthly 
119.20 	caseloads in each county in the Minnesota family investment program in the most recent 
119.21 	calendar year available as determined by the commissioner.
119.22 	(d) Beginning July 10, 2014, 40 percent of remaining funds must be allocated 
119.23 	proportionally to counties based on the previous year's allocation and 60 percent must be 
119.24 	allocated by the following formula:
119.25 	(1) 50 percent of the funds must be allocated based on the county's performance on 
119.26 	the state and federal standards and the public priorities identified in section 256N.03 as 
119.27 	determined by the commissioner for that county;
119.28 	(2) 30 percent of the funds must be allocated based on the county's percentage 
119.29 	share of the number of accepted maltreatment reports in the most recent calendar year 
119.30 	available as determined by the commissioner;
119.31 	(3) ten percent of the funds must be allocated based on the county's percentage share 
119.32 	of the number of reports of family assessments and services to at-risk families, as defined 
119.33 	by section 256N.04, subdivisions 7 and 17, in the most recent calendar year available 
119.34 	as determined by the commissioner; and
120.1 	(4) ten percent of the funds must be allocated based on the average monthly 
120.2 	caseloads in each county in the Minnesota family investment program in the most recent 
120.3 	calendar year available as determined by the commissioner.
120.4 	(e) Beginning July 10, 2014, ten percent of remaining funds must be allocated 
120.5 	proportionally to counties based on the previous year's allocation and 90 percent must be 
120.6 	allocated by the following formula:
120.7 	(1) 50 percent of the funds must be allocated based on the county's performance on 
120.8 	the state and federal standards and the public priorities identified in section 256N.03 as 
120.9 	determined by the commissioner for that county;
120.10 	(2) 30 percent of the funds must be allocated based on the county's percentage 
120.11 	share of the number of accepted maltreatment reports in the most recent calendar year 
120.12 	available as determined by the commissioner;
120.13 	(3) ten percent of the funds must be allocated based on the county's percentage share 
120.14 	of the number of reports of family assessments and services to at-risk families, as defined 
120.15 	by section 256N.04, subdivisions 7 and 17, in the most recent calendar year available 
120.16 	as determined by the commissioner; and
120.17 	(4) ten percent of the funds must be allocated based on the average monthly 
120.18 	caseloads in each county in the Minnesota family investment program in the most recent 
120.19 	calendar year available as determined by the commissioner.
120.20 	(f) Beginning July 10, 2015, 100 percent of remaining funds must be allocated 
120.21 	by the following formula:
120.22 	(1) 50 percent of the funds must be allocated based on the county's performance on 
120.23 	the state and federal standards and the public priorities identified in section 256N.03 as 
120.24 	determined by the commissioner for that county;
120.25 	(2) 30 percent of the funds must be allocated based on the county's percentage 
120.26 	share of the number of accepted maltreatment reports in the most recent calendar year 
120.27 	available as determined by the commissioner;
120.28 	(3) ten percent of the funds shall be allocated based on the county's percentage share 
120.29 	of the number of reports of family assessments and services to at-risk families, as defined 
120.30 	by section 256N.04, subdivisions 7 and 17, in the most recent calendar year available 
120.31 	as determined by the commissioner; and
120.32 	(4) ten percent of the funds must be allocated based on the average monthly 
120.33 	caseloads in each county in the Minnesota family investment program in the most recent 
120.34 	calendar year available as determined by the commissioner.
120.35 		Subd. 3.Guaranteed floor. The guaranteed floor portion of funds must be 25 
120.36 	percent of the total allocation.  Each county must be allocated a guaranteed floor based on 
121.1 	the population of the county under age 19 years as compared to the state as a whole as 
121.2 	determined by the most recent data from the state demographer's office.  When the amount 
121.3 	of funds available for allocation is less than the amount available in the previous year, 
121.4 	each county's allocation must be reduced in proportion to the reduction in the statewide 
121.5 	funding, to establish each county's guaranteed floor.
121.6 		Subd. 4.Payments. Calendar year state allocations under subdivision 1 must be 
121.7 	paid to counties on or before July 10 of each year.  Federal Title XX funds must be 
121.8 	allocated as permissible under federal law and regulations.

121.9 	Sec. 9. [256N.09] DUTIES OF COUNTY BOARDS.
121.10 		Subdivision 1.Responsibilities. The county or human services board of each 
121.11 	county are responsible for administration and funding of children services in order to 
121.12 	achieve the public policy and priorities identified in sections 256N.02 and 256N.03. The 
121.13 	county board shall use funds under this act to support the strategies identified in its plan 
121.14 	under section 256N.07.
121.15 		Subd. 2.Reports. The county shall provide necessary reports and data as required 
121.16 	by the commissioner.
121.17 		Subd. 3.Exemption from liability. The state of Minnesota and the county in 
121.18 	the implementation and administration of services under this act must not be liable 
121.19 	for damages, injuries, or liabilities sustained through the purchase of services by the 
121.20 	individual, the individual's family, or the authorized representative under this section.
121.21 		Subd. 4.Fees for services. The county may establish a schedule of fees based upon 
121.22 	clients' ability to pay to be charged to recipients of children services. Payment, in whole or 
121.23 	in part, for services may be accepted from any person except that no fee may be charged to 
121.24 	persons or families whose adjusted gross household income is below the federal poverty 
121.25 	level. When services are provided to any person, including a recipient of aid administered 
121.26 	by the federal, state, or county government, payment of any charges due may be billed to 
121.27 	and accepted from a public assistance agency or from any public or private corporation.
121.28 		Subd. 5.Denial, reduction, or termination of services due to fiscal limitations.
 121.29 	Before a county denies, reduces, or terminates services to an individual, the county shall 
121.30 	notify the individual and the individual's guardian in writing of the reason for the denial, 
121.31 	reduction, or termination of services and their right to a fair hearing under section 256.045 
121.32 	and that the county will, upon request, meet to discuss alternatives before services are 
121.33 	terminated or reduced.

121.34 	Sec. 10. EFFECTIVE DATE.
 122.1 	Sections 1 to 9 are effective January 1, 2011.

122.2 	Sec. 11. REVISOR'S INSTRUCTION.
 122.3 	The revisor shall renumber section 256M.20, subdivision 3, as 256.01, subdivision 
122.4 	29, paragraph (a), and section 256M.20, subdivision 4, as section 256.01, subdivision 29, 
122.5 	paragraph (b), and correct any internal cross references resulting from this renumbering. 
122.6 	The revisor shall make any necessary technical, grammatical, or punctual changes to 
122.7 	accomplish this renumbering.

122.8 	ARTICLE 7
122.9 	NORTHSTAR CARE FOR CHILDREN

122.10 	Section 1. Minnesota Statutes 2008, section 256.991, is amended to read:
122.11 	256.991 RULES.
122.12 	The commissioner of human services may promulgate rules as necessary to 
122.13 	implement sections 256.01, subdivision 2; 256.82, subdivision 3;256.966, subdivision 1; 
122.14 	256D.03, subdivisions 3, 4, 6, and 7; and 261.23. The commissioner shall promulgate 
122.15 	rules to establish standards and criteria for deciding which medical assistance services 
122.16 	require prior authorization and for deciding whether a second medical opinion is required 
122.17 	for an elective surgery. The commissioner shall promulgate rules as necessary to establish 
122.18 	the methods and standards for determining inappropriate utilization of medical assistance 
122.19 	services.

122.20 	EFFECTIVE DATE. This section is effective January 1, 2011.

122.21 	Sec. 2. Minnesota Statutes 2008, section 256J.21, subdivision 2, is amended to read:
122.22 		Subd. 2.Income exclusions. The following must be excluded in determining a 
122.23 	family's available income:
122.24 	(1) payments for basic care, difficulty of care, and clothing allowances received for 
122.25 	providing family foster care to children or adults under Minnesota Rules, parts 9555.5050 
122.26 	to 9555.6265, 9560.0521, and 9560.0650 to 9560.0655, and payments received and used 
122.27 	for care and maintenance of a third-party beneficiary who is not a household member;
122.28 	(2) reimbursements for employment training received through the Workforce 
122.29 	Investment Act of 1998, United States Code, title 20, chapter 73, section 9201;
122.30 	(3) reimbursement for out-of-pocket expenses incurred while performing volunteer 
122.31 	services, jury duty, employment, or informal carpooling arrangements directly related to 
122.32 	employment;
123.1 	(4) all educational assistance, except the county agency must count graduate student 
123.2 	teaching assistantships, fellowships, and other similar paid work as earned income and, 
123.3 	after allowing deductions for any unmet and necessary educational expenses, shall 
123.4 	count scholarships or grants awarded to graduate students that do not require teaching 
123.5 	or research as unearned income;
123.6 	(5) loans, regardless of purpose, from public or private lending institutions, 
123.7 	governmental lending institutions, or governmental agencies;
123.8 	(6) loans from private individuals, regardless of purpose, provided an applicant or 
123.9 	participant documents that the lender expects repayment;
123.10 	(7)(i) state income tax refunds; and
123.11 	(ii) federal income tax refunds;
123.12 	(8)(i) federal earned income credits;
123.13 	(ii) Minnesota working family credits;
123.14 	(iii) state homeowners and renters credits under chapter 290A; and
123.15 	(iv) federal or state tax rebates;
123.16 	(9) funds received for reimbursement, replacement, or rebate of personal or real 
123.17 	property when these payments are made by public agencies, awarded by a court, solicited 
123.18 	through public appeal, or made as a grant by a federal agency, state or local government, 
123.19 	or disaster assistance organizations, subsequent to a presidential declaration of disaster;
123.20 	(10) the portion of an insurance settlement that is used to pay medical, funeral, and 
123.21 	burial expenses, or to repair or replace insured property;
123.22 	(11) reimbursements for medical expenses that cannot be paid by medical assistance;
123.23 	(12) payments by a vocational rehabilitation program administered by the state 
123.24 	under chapter 268A, except those payments that are for current living expenses;
123.25 	(13) in-kind income, including any payments directly made by a third party to a 
123.26 	provider of goods and services;
123.27 	(14) assistance payments to correct underpayments, but only for the month in which 
123.28 	the payment is received;
123.29 	(15) payments for short-term emergency needs under section 256J.626, subdivision 
123.30 	2;
123.31 	(16) funeral and cemetery payments as provided by section 256.935;
123.32 	(17) nonrecurring cash gifts of $30 or less, not exceeding $30 per participant in 
123.33 	a calendar month;
123.34 	(18) any form of energy assistance payment made through Public Law 97-35, 
123.35 	Low-Income Home Energy Assistance Act of 1981, payments made directly to energy 
124.1 	providers by other public and private agencies, and any form of credit or rebate payment 
124.2 	issued by energy providers;
124.3 	(19) Supplemental Security Income (SSI), including retroactive SSI payments and 
124.4 	other income of an SSI recipient, except as described in section 256J.37, subdivision 3b;
124.5 	(20) Minnesota supplemental aid, including retroactive payments;
124.6 	(21) proceeds from the sale of real or personal property;
124.7 	(22) state adoption assistance payments under section 259.67, adoption assistance 
124.8 	payments under chapter 256O, and up to an equal amount of county adoption assistance 
124.9 	payments;
124.10 	(23) state-funded family subsidy program payments made under section 252.32
124.11 	to help families care for children with developmental disabilities, consumer support 
124.12 	grant funds under section 256.476, and resources and services for a disabled household 
124.13 	member under one of the home and community-based waiver services programs under 
124.14 	chapter 256B;
124.15 	(24) interest payments and dividends from property that is not excluded from and 
124.16 	that does not exceed the asset limit;
124.17 	(25) rent rebates;
124.18 	(26) income earned by a minor caregiver, minor child through age 6, or a minor 
124.19 	child who is at least a half-time student in an approved elementary or secondary education 
124.20 	program;
124.21 	(27) income earned by a caregiver under age 20 who is at least a half-time student in 
124.22 	an approved elementary or secondary education program;
124.23 	(28) MFIP child care payments under section 119B.05;
124.24 	(29) all other payments made through MFIP to support a caregiver's pursuit of 
124.25 	greater economic stability;
124.26 	(30) income a participant receives related to shared living expenses;
124.27 	(31) reverse mortgages;
124.28 	(32) benefits provided by the Child Nutrition Act of 1966, United States Code, title 
124.29 	42, chapter 13A, sections 1771 to 1790;
124.30 	(33) benefits provided by the women, infants, and children (WIC) nutrition program, 
124.31 	United States Code, title 42, chapter 13A, section 1786;
124.32 	(34) benefits from the National School Lunch Act, United States Code, title 42, 
124.33 	chapter 13, sections 1751 to 1769e;
124.34 	(35) relocation assistance for displaced persons under the Uniform Relocation 
124.35 	Assistance and Real Property Acquisition Policies Act of 1970, United States Code, title 
125.1 	42, chapter 61, subchapter II, section 4636, or the National Housing Act, United States 
125.2 	Code, title 12, chapter 13, sections 1701 to 1750jj;
125.3 	(36) benefits from the Trade Act of 1974, United States Code, title 19, chapter 
125.4 	12, part 2, sections 2271 to 2322;
125.5 	(37) war reparations payments to Japanese Americans and Aleuts under United 
125.6 	States Code, title 50, sections 1989 to 1989d;
125.7 	(38) payments to veterans or their dependents as a result of legal settlements 
125.8 	regarding Agent Orange or other chemical exposure under Public Law 101-239, section 
125.9 	10405, paragraph (a)(2)(E);
125.10 	(39) income that is otherwise specifically excluded from MFIP consideration in 
125.11 	federal law, state law, or federal regulation;
125.12 	(40) security and utility deposit refunds;
125.13 	(41) American Indian tribal land settlements excluded under Public Laws 98-123, 
125.14 	98-124, and 99-377 to the Mississippi Band Chippewa Indians of White Earth, Leech 
125.15 	Lake, and Mille Lacs reservations and payments to members of the White Earth Band, 
125.16 	under United States Code, title 25, chapter 9, section 331, and chapter 16, section 1407;
125.17 	(42) all income of the minor parent's parents and stepparents when determining the 
125.18 	grant for the minor parent in households that include a minor parent living with parents or 
125.19 	stepparents on MFIP with other children;
125.20 	(43) income of the minor parent's parents and stepparents equal to 200 percent of the 
125.21 	federal poverty guideline for a family size not including the minor parent and the minor 
125.22 	parent's child in households that include a minor parent living with parents or stepparents 
125.23 	not on MFIP when determining the grant for the minor parent. The remainder of income is 
125.24 	deemed as specified in section 256J.37, subdivision 1b;
125.25 	(44) payments made to children eligible for relative custodyguardianship assistance 
125.26 	under section 257.85 chapter 256O;
125.27 	(45) vendor payments for goods and services made on behalf of a client unless the 
125.28 	client has the option of receiving the payment in cash; 
125.29 	(46) the principal portion of a contract for deed payment; and
125.30 	(47) cash payments to individuals enrolled for full-time service as a volunteer under 
125.31 	AmeriCorps programs including AmeriCorps VISTA, AmeriCorps State, AmeriCorps 
125.32 	National, and AmeriCorps NCCC.

125.33 	EFFECTIVE DATE. This section is effective January 1, 2011.

125.34 	Sec. 3. Minnesota Statutes 2008, section 256J.24, subdivision 3, is amended to read:
126.1 		Subd. 3.Individuals who must be excluded from an assistance unit. (a) The 
126.2 	following individuals who are part of the assistance unit determined under subdivision 2 
126.3 	are ineligible to receive MFIP:
126.4 	(1) individuals who are recipients of Supplemental Security Income or Minnesota 
126.5 	supplemental aid;
126.6 	(2) individuals disqualified from the food stamp or food support program or MFIP, 
126.7 	until the disqualification ends; and
126.8 	(3) children on whose behalf eligible for Northstar Care for Children under chapter 
126.9 	256O when the caregiver receives federal, state or local foster care; guardianship 
126.10 	assistance; or adoption assistance payments are made for them, except as provided in 
126.11 	sections  256J.13, subdivision 2, and  256J.74, subdivision 2; and.
126.12 	(4) children receiving ongoing monthly adoption assistance payments under section 
126.13 	259.67. 
126.14 	(b) The exclusion of a person under this subdivision does not alter the mandatory 
126.15 	assistance unit composition.

126.16 	EFFECTIVE DATE. This section is effective January 1, 2011.

126.17 	Sec. 4. Minnesota Statutes 2008, section 256J.24, subdivision 4, is amended to read:
126.18 		Subd. 4.Individuals who may elect to be included in the assistance unit. (a) The 
126.19 	minor child's eligible caregiver may choose to be in the assistance unit, if the caregiver 
126.20 	is not required to be in the assistance unit under subdivision 2. If the eligible caregiver 
126.21 	chooses to be in the assistance unit, that person's spouse must also be in the unit.
126.22 	(b) Any minor child not related as a sibling, stepsibling, or adopted sibling to the 
126.23 	minor child in the unit, but for whom there is an eligible caregiver may elect to be in 
126.24 	the unit.
126.25 	(c) A foster care provider of a minor child who is receiving federal, state, or 
126.26 	local foster care maintenance payments benefits for a child eligible for Northstar Care 
126.27 	for Children under chapter 256O may elect to receive MFIP if the provider meets the 
126.28 	definition of caregiver under section  256J.08, subdivision 11. If the provider chooses to 
126.29 	receive MFIP, the spouse of the provider must also be included in the assistance unit with 
126.30 	the provider. The provider and spouse are eligible for assistance MFIP even if the only 
126.31 	minor child living in the provider's home is receiving foster care maintenance payments
126.32 	benefits from Northstar Care for Children. 
126.33 	(d) The adult caregiver or caregivers of a minor parent are eligible to be a separate 
126.34 	assistance unit from the minor parent and the minor parent's child when:
126.35 	(1) the adult caregiver or caregivers have no other minor children in the household;
127.1 	(2) the minor parent and the minor parent's child are living together with the adult 
127.2 	caregiver or caregivers; and
127.3 	(3) the minor parent and the minor parent's child receive MFIP, or would be eligible 
127.4 	to receive MFIP, if they were not receiving SSI benefits.

127.5 	EFFECTIVE DATE. This section is effective January 1, 2011.

127.6 	Sec. 5. [256O.001] CITATION.
127.7 	Sections 256O.001 to 256O.270 may be cited as the "Northstar Care for Children 
127.8 	Act." Sections 256O.001 to 256O.270 establish Northstar Care for Children, which 
127.9 	authorizes certain benefits to support children in need who are served by the Minnesota 
127.10 	child welfare system and who are the responsibility of the state of Minnesota, local county 
127.11 	social service agencies, or tribal social service agencies under section 256.01, subdivision 
127.12 	14b. A child eligible for the benefit has experienced a child welfare intervention that has 
127.13 	resulted in the child being placed away from the child's parents' care and is receiving 
127.14 	foster care services under chapter 260B, 260C, or 260D or is in the permanent care of 
127.15 	relatives through a transfer of permanent legal and physical custody, or in the permanent 
127.16 	care of adoptive parents.

127.17 	Sec. 6. [256O.01] PUBLIC POLICY.
127.18 	(a) The legislature hereby declares that the public policy of this state is to keep 
127.19 	children safe from harm and to ensure that when children suffer harmful or injurious 
127.20 	experiences in their lives, appropriate services are immediately available to keep them safe.
127.21 	(b) Children do best in permanent, safe, nurturing homes with long-term 
127.22 	relationships with adults. Whenever safely possible, children are best served when they 
127.23 	can be nurtured and raised by their parents. Where services cannot be provided to allow a 
127.24 	child to remain safely at home, an out-of-home placement may be required. When this 
127.25 	occurs, reunification should be sought if it can be accomplished safely. When it is not 
127.26 	possible for parents to provide safety and permanency for their children, an alternative 
127.27 	permanent home must quickly be made available to the child, drawing from kinship 
127.28 	sources whenever possible.
127.29 	(c) Minnesota understands the importance of having a comprehensive approach to 
127.30 	temporary out-of-home care and to permanent homes for children who cannot be reunited 
127.31 	with their families. It is critical that stable benefits be available to caregivers to ensure 
127.32 	that the child's needs can be met whether the child's situation and best interests call for 
127.33 	temporary foster care, transfer of permanent legal and physical custody to a relative, or 
127.34 	adoption. Northstar Care for Children focuses on the child's needs and strengths, and 
128.1 	the actual level of care provided by the caregiver, without consideration for the type of 
128.2 	placement setting. In this way, caregivers are not faced with the burden of making specific 
128.3 	long-term decisions based upon competing financial incentives.

128.4 	Sec. 7. [256O.02] DEFINITIONS.
128.5 		Subdivision 1.Scope. For the purposes of sections 256O.001 to 256O.270, the 
128.6 	terms defined in this section have the meanings given them.
128.7 		Subd. 2.Adoption assistance. "Adoption assistance" means financial support, 
128.8 	medical coverage, or both, provided under agreement with the legally responsible agency 
128.9 	and the commissioner to the parents of an adoptive child whose special needs would 
128.10 	otherwise make it difficult to place the child for adoption, to assist with the cost of caring 
128.11 	for the child.
128.12 		Subd. 3.Assessment. "Assessment" means the process under section 256O.240 by 
128.13 	which is determined the benefits an eligible child may receive under section 256O.250.
128.14 		Subd. 4.At-risk child. "At-risk child" means a child who does not have a 
128.15 	documented disability but who is at risk of developing a physical, mental, emotional, or 
128.16 	behavioral disability based on being related within the first or second degree to persons 
128.17 	who have an inheritable physical, mental, emotional, or behavioral disabling condition, 
128.18 	or from a background which has the potential to cause the child to develop a physical, 
128.19 	mental, emotional, or behavioral disability. The disability that the child is at risk of 
128.20 	developing must be likely to manifest during childhood. A high-risk child under section 
128.21 	259.67 is considered an at-risk child.
128.22 		Subd. 5.Basic rate. "Basic rate" means the maintenance payment made on behalf 
128.23 	of a child to support the costs caregivers incur to meet a child's needs consistent with the 
128.24 	care parents customarily provide, including: food, clothing, shelter, daily supervision, 
128.25 	school supplies, child's personal incidentals, reasonable travel to the child's home for 
128.26 	visitation, and transportation needs associated with providing the listed items.
128.27 		Subd. 6.Caregiver. "Caregiver" means the foster parent of a child in foster care 
128.28 	who meets the requirements of emergency relative placement, a licensed foster parent 
128.29 	under chapter 245A, or approved by the tribe; the relative custodian; or the adoptive parent 
128.30 	who has legally adopted a child.
128.31 		Subd. 7.Child-placing agency. "Child-placing agency" means an agency licensed 
128.32 	under section 245A.03, subdivision 1, clauses (2) and (3).
128.33 		Subd. 8.Commissioner. "Commissioner" means the commissioner of human 
128.34 	services.
129.1 		Subd. 9.County board. "County board" means the board of county commissioners 
129.2 	in each county.
129.3 		Subd. 10.Disability. "Disability" means a professionally documented physical, 
129.4 	mental, emotional, or behavioral impairment that substantially limits one or more major 
129.5 	life activity. Major life activities include, but are not limited to: thinking, walking, 
129.6 	hearing, breathing, working, seeing, speaking, communicating, learning, developing and 
129.7 	maintaining healthy relationships, safely caring for oneself, and performing manual tasks. 
129.8 	The nature, duration, and severity of the impairment must be used in determining if the 
129.9 	limitation is substantial.
129.10 		Subd. 11.Foster care. "Foster care" means foster care as described either in section 
129.11 	260B.007, subdivision 7, or 260C.007, subdivision 18.
129.12 		Subd. 12.Guardianship assistance. "Guardianship assistance" means financial 
129.13 	support, medical coverage, or both, provided under agreement with the legally responsible 
129.14 	agency and the commissioner to a relative who has received permanent legal and physical 
129.15 	custody of a child, to assist with the cost of caring for the child.
129.16 		Subd. 13.Human services board. "Human services board" means a board 
129.17 	established under section 402.02; Laws 1974, chapter 293; or Laws 1976, chapter 340.
129.18 		Subd. 14.Legally responsible agency. "Legally responsible agency" means the 
129.19 	Minnesota agency that is assigned responsibility for placement, care, and supervision 
129.20 	of the child through a court order, voluntary placement agreement, or voluntary 
129.21 	relinquishment. These agencies include both local social service agencies under section 
129.22 	393.07 and tribal social service agencies authorized in section 256.01, subdivision 14b, 
129.23 	and Minnesota tribes when legal responsibility is transferred to the tribal social service 
129.24 	agency through a Minnesota district court order.
129.25 		Subd. 15.Maintenance payments. "Maintenance payments" means the basic 
129.26 	rate plus any supplemental difficulty of care rate under Northstar Care for Children. It 
129.27 	specifically does not include the cost of initial clothing allowance, payment for social 
129.28 	services, or administrative payments to a child-placing agency.
129.29 		Subd. 16.Permanent legal and physical custody. "Permanent legal and 
129.30 	physical custody" means permanent legal and physical custody ordered by a Minnesota 
129.31 	juvenile court under section 260C.201, subdivision 11, or for children under tribal 
129.32 	court jurisdiction, similar provision under tribal code which means that the individual 
129.33 	responsible for the child has responsibility for the protection, education, care, and control 
129.34 	of the child and decision making on behalf of the child.
130.1 		Subd. 17.Reassessment. "Reassessment" means an update of the previous 
130.2 	assessment through the process under section 256O.240 for a child who has been 
130.3 	continuously eligible for this benefit.
130.4 		Subd. 18.Relative. "Relative" as described in section 260C.007, subdivision 27, 
130.5 	means a person related to the child by blood, marriage, or adoption, or an individual who 
130.6 	is an important friend with whom the child has resided or had significant contact. For an 
130.7 	Indian child, relative includes members of the extended family as defined by the law or 
130.8 	custom of the Indian child's tribe or, in the absence of law or custom, nieces, nephews, 
130.9 	or first or second cousins, as provided in the Indian Child Welfare Act of 1978, United 
130.10 	States Code, title 25, section 1903.
130.11 		Subd. 19.Relative custodian. "Relative custodian" means a person to whom 
130.12 	permanent legal and physical custody of a child has been transferred under section 
130.13 	260C.201, subdivision 11, or for children under tribal court jurisdiction, a similar 
130.14 	provision under tribal code which means that the individual responsible for the child has 
130.15 	responsibility for the protection, education, care, and control of the child and decision 
130.16 	making on behalf of the child.
130.17 		Subd. 20.Supplemental difficulty of care rate. "Supplemental difficulty of care 
130.18 	rate" means the supplemental rating, if any, as determined by the legally responsible 
130.19 	agency or the state, based upon an assessment under section 256O.240. The supplemental 
130.20 	rate supports activities consistent with the care a parent would provide a child with special 
130.21 	needs and not the equivalent of a purchased service. The rate considers the capacity 
130.22 	and intensity of the activities associated with parenting duties provided in the home to 
130.23 	nurture the child, preserve the child's connections, and support the child's functioning in 
130.24 	the home and community.

130.25 	Sec. 8. [256O.200] NORTHSTAR CARE FOR CHILDREN.
130.26 		Subdivision 1.Eligibility. A child is eligible for Northstar Care for Children if 
130.27 	the child is eligible for:
130.28 	(1) foster care under section 256O.210;
130.29 	(2) guardianship assistance under section 256O.220; or
130.30 	(3) adoption assistance under section 256O.230.
130.31 		Subd. 2.Assessments and agreements. A child eligible for Northstar Care for 
130.32 	Children shall receive an assessment under section 256O.240. For a child eligible for 
130.33 	guardianship assistance or adoption assistance, negotiations with caregivers and the 
130.34 	development of a written, binding agreement must be conducted under section 256O.240.
131.1 		Subd. 3.Benefits and payments. A child eligible for Northstar Care for Children 
131.2 	is entitled to benefits specified in section 256O.250, based primarily on assessments, 
131.3 	negotiations, and agreements under section 256O.240. Although paid to the caregiver, 
131.4 	these benefits are considered benefits of the child rather than of the caregiver.
131.5 		Subd. 4.Shared cost of care. The cost of Northstar Care for Children must be 
131.6 	shared among the federal government, state, counties of financial responsibility, and 
131.7 	certain tribes as specified in section 256O.260.
131.8 		Subd. 5.Administration and appeals. The commissioner and legally responsible 
131.9 	agency shall administer Northstar Care for Children according to section 256O.270. The 
131.10 	notification and fair hearing process is defined in section 256O.270.
131.11 		Subd. 6.Transition. Provisions for the transition to Northstar Care for Children are 
131.12 	specified in sections 256O.240, subdivision 13, and 256O.270, subdivisions 2 and 7 to 
131.13 	10. Additional provisions for children in foster care are specified in section 256O.210, 
131.14 	subdivision 5; for children in relative custody assistance under section 257.85 are specified 
131.15 	in section 256O.220, subdivision 8; and for children in adoption assistance under section 
131.16 	259.67 are specified in section 256O.230, subdivision 14.

131.17 	Sec. 9. [256O.210] FOSTER CARE ASSISTANCE ELIGIBILITY.
131.18 		Subdivision 1.General eligibility requirements. This section establishes the 
131.19 	eligibility for benefits when children are placed in foster care.
131.20 	(a) A child that meets the requirements of subdivision 2 on or after January 1, 2011, 
131.21 	is eligible for the benefit.
131.22 	(b) The benefit to the child under Northstar Care for Children, if any, is determined 
131.23 	under sections 256O.240 and 256O.250.
131.24 	(c) When a child is eligible for additional services, subdivisions 3 and 4 govern 
131.25 	the co-occurrence of program eligibility.
131.26 	(d) The child's benefit is individually assessed and the information assessment is 
131.27 	used to determine future eligibility for guardianship assistance and adoption assistance, 
131.28 	if needed.
131.29 	(e) The county of financial responsibility, or, for children in the American Indian 
131.30 	Child Welfare Initiative, the responsible tribal social service agency authorized in section 
131.31 	256.01, subdivision 14b, shall make a title IV-E eligibility determination for all foster 
131.32 	children in Northstar Care for Children. To be eligible for title IV-E foster care, a child 
131.33 	must also meet any additional criteria specified in section 472 of the Social Security Act.
131.34 		Subd. 2.Placement in foster care. To be eligible for Northstar Care for Children, 
131.35 	all of the following criteria must be met:
132.1 	(1) the child is placed away from the child's legal parents or guardian and a legally 
132.2 	responsible agency has placement authority and care responsibility;
132.3 	(2) the legally responsible agency has authority to place the child with a voluntary 
132.4 	placement agreement or a court order, consistent with section 260C.001, 260B.175, or 
132.5 	260D.01, or continued eligibility consistent with section 260C.451; and
132.6 	(3) the child is placed in an emergency relative placement under section 245A.035, 
132.7 	a licensed foster family setting, foster residence setting, or treatment foster care setting 
132.8 	licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, or a family foster home 
132.9 	approved by a tribal agency.
132.10 		Subd. 3.Minor parent. A child who is a minor parent in placement with the 
132.11 	minor parent's child in the same home is eligible for the benefit. The benefit is limited 
132.12 	to the minor parent unless the legally responsible agency has separate legal authority 
132.13 	for placement of the minor parent's child.
132.14 		Subd. 4.Excluded activities. The basic and supplemental difficulty of care 
132.15 	payments represent costs for activities similar in nature to those expected of parents and do 
132.16 	not cover services rendered by the licensed foster parent or facility or any administrative 
132.17 	cost. The county of financial responsibility, or, for children in the American Indian Child 
132.18 	Welfare Initiative, the responsible tribal social service agency authorized in section 
132.19 	256.01, subdivision 14b, may pay a fee for specific services provided by the licensed 
132.20 	foster parent or facility. Any foster parent or residence setting must be able to distinguish 
132.21 	the service from the daily care of the child, as assessed in the universal assessment under 
132.22 	section 256O.240. Administrative costs or fees are not part of this benefit.
132.23 		Subd. 5.Transition from pre-2011. All children in family foster care who are the 
132.24 	financial responsibility of local social service agencies under section 393.07 or tribal 
132.25 	social service agencies authorized in section 256.01, subdivision 14b, are eligible for 
132.26 	Northstar Care for Children. All eligible foster children must be assessed according to 
132.27 	section 256O.240 and then transitioned into Northstar Care for Children according to 
132.28 	the process in section 256O.270.

132.29 	Sec. 10. [256O.220] GUARDIANSHIP ASSISTANCE ELIGIBILITY.
132.30 		Subdivision 1.General eligibility requirements. (a) To be eligible for guardianship 
132.31 	assistance, there must be a judicial determination under section 260C.201, subdivision 11, 
132.32 	paragraph (c), that a transfer of permanent legal and physical custody to a relative or, for 
132.33 	a child under tribal jurisdiction, a similar provision under tribal code which means that 
132.34 	the individual responsible for the child has responsibility for the protection, education, 
133.1 	care, and control of the child and decision making on behalf of the child, is in the child's 
133.2 	best interest. Additionally, a child must:
133.3 	(1) have been removed from the child's home pursuant to a voluntary placement 
133.4 	agreement or court order;
133.5 	(2)(i) have resided in foster care for at least six consecutive months in the home 
133.6 	of the prospective relative custodian; or
133.7 	(ii) have received an exemption from the requirement in item (i) from the court based 
133.8 	on a determination that an expedited move to permanency is in the child's best interest;
133.9 	(3) meet the judicial determination regarding permanency requirements in 
133.10 	subdivision 2;
133.11 	(4) meet the applicable citizenship and immigration requirements in subdivision 
133.12 	3; and
133.13 	(5) have been consulted regarding the proposed transfer of permanent legal and 
133.14 	physical custody to a relative, if the child has attained 14 years of age or is expected to 
133.15 	attain 14 years of age prior to the transfer of permanent legal and physical custody.
133.16 	(b) In addition to the requirements in paragraph (a), the child's prospective relative 
133.17 	custodian or custodians must meet the applicable background study requirements in 
133.18 	subdivision 4.
133.19 	(c) The legally responsible agency shall make a title IV-E guardianship assistance 
133.20 	eligibility determination for each child. To be eligible for title IV-E guardianship 
133.21 	assistance, a child must also meet any additional criteria specified in section 473(d) of 
133.22 	the Social Security Act. A child who meets all eligibility criteria, except those specific 
133.23 	to title IV-E guardianship assistance, is entitled to guardianship assistance paid through 
133.24 	state funds.
133.25 		Subd. 2.Judicial determinations regarding permanency. To be eligible for 
133.26 	guardianship assistance, the following judicial determinations regarding permanency must 
133.27 	be made for the child prior to the transfer of permanent legal and physical custody:
133.28 	(1) a judicial determination that reunification and adoption are not appropriate 
133.29 	permanency options for the child; and
133.30 	(2) a judicial determination that the child demonstrates a strong attachment to the 
133.31 	prospective relative custodian and the relative custodian has a strong commitment to 
133.32 	caring permanently for the child.
133.33 		Subd. 3.Citizenship and immigration status. (a) A child must be a citizen of the 
133.34 	United States or otherwise eligible for federal public benefits according to the Personal 
133.35 	Responsibility and Work Opportunity Reconciliation Act of 1996, as amended, in order to 
133.36 	be eligible for title IV-E guardianship assistance.
134.1 	(b) A child must be a citizen of the United States or meet the qualified alien 
134.2 	requirements as defined in the Personal Responsibility and Work Opportunity 
134.3 	Reconciliation Act of 1996, as amended, in order to be eligible for state-funded 
134.4 	guardianship assistance.
134.5 		Subd. 4.Background study. (a) A background study must be completed on each 
134.6 	prospective relative custodian. If a background study on the prospective relative custodian 
134.7 	was previously completed under section 245A.04 for the purposes of foster care licensure, 
134.8 	that background study may be used for the purposes of this section, provided that the 
134.9 	background study is current at the time of the application for guardianship assistance. 
134.10 	If the background study reveals:
134.11 	(1) a felony conviction at any time for child abuse or neglect;
134.12 	(2) spousal abuse;
134.13 	(3) a crime against children, including child pornography;
134.14 	(4) a crime involving violence, including rape, sexual assault, or homicide, but not 
134.15 	including other physical assault or battery; or
134.16 	(5) a felony conviction within the past five years for physical assault, battery, or a 
134.17 	drug-related offense,
134.18 	the prospective relative custodian is prohibited from receiving title IV-E guardianship 
134.19 	assistance payments on behalf of an otherwise eligible child.
134.20 	(b) An otherwise eligible prospective relative custodian who possesses one of the 
134.21 	felony convictions in paragraph (a) may receive state-funded guardianship assistance 
134.22 	payments on behalf of an otherwise eligible child if the court has made a judicial 
134.23 	determination that:
134.24 	(1) the legally responsible agency has thoroughly reviewed the felony conviction 
134.25 	and has considered the impact, if any, that the conviction may have on the child's safety, 
134.26 	well-being, and permanency;
134.27 	(2) the conviction likely does not pose a current or future safety risk to the child;
134.28 	(3) there is no other available permanency resource that is appropriate for the 
134.29 	child; and
134.30 	(4) the proposed transfer of permanent legal and physical custody is in the child's 
134.31 	best interest.
134.32 		Subd. 5.Residency. A child placed in the state from another state or a tribe outside 
134.33 	the state is not eligible for state-funded guardianship assistance through the state. A child 
134.34 	placed in the state from another state or a tribe outside of the state may be eligible for title 
134.35 	IV-E guardianship assistance through the state if all eligibility factors are met and there is 
134.36 	no state agency that has responsibility for placement and care of the child.
135.1 		Subd. 6.Exclusions. A child with a guardianship assistance agreement under 
135.2 	Northstar Care for Children is not eligible for the MFIP child-only grant under section 
135.3 	256J.88.
135.4 		Subd. 7.Termination. (a) A guardianship assistance agreement terminates in any 
135.5 	of the following circumstances:
135.6 	(1) the child reaches the age of 18;
135.7 	(2) the commissioner determines that the relative custodian is no longer legally 
135.8 	responsible for support of the child;
135.9 	(3) the commissioner determines that the relative custodian is no longer providing 
135.10 	financial support to the child;
135.11 	(4) death of the child; or
135.12 	(5) the relative custodian requests termination of the guardianship assistance 
135.13 	agreement in writing.
135.14 	(b) A relative custodian is considered no longer legally responsible for support of 
135.15 	the child in any of the following circumstances:
135.16 	(1) permanent legal and physical custody of the child is transferred to another 
135.17 	individual;
135.18 	(2) death of the relative custodian;
135.19 	(3) enlistment of the child in the military;
135.20 	(4) marriage of the child; or
135.21 	(5) emancipation of the child through legal action of another state.
135.22 		Subd. 8.Transitioning in from pre-2011. Effective December 31, 2010, all relative 
135.23 	custody assistance agreements under section 257.85 must terminate. A child who has a 
135.24 	relative custody assistance agreement executed on the child's behalf under section 257.85 
135.25 	on or before November 24, 2010, is eligible for Northstar Care for Children beginning 
135.26 	January 1, 2011, provided that all parties have signed the guardianship assistance 
135.27 	agreement on or before that date. All eligible children shall be assessed according to 
135.28 	section 256O.240 and transitioned into Northstar Care for Children according to the 
135.29 	process in section 256O.270. Effective November 25, 2010, a child who meets the 
135.30 	eligibility criteria for guardianship assistance in subdivision 1, may have a guardianship 
135.31 	assistance agreement negotiated on the child's behalf according to section 256O.240, 
135.32 	and the effective date of the agreement is January 1, 2011, or the date of the court order 
135.33 	transferring permanent legal and physical custody, whichever is later.

135.34 	Sec. 11. [256O.230] ADOPTION ASSISTANCE ELIGIBILITY.
136.1 		Subdivision 1.General eligibility requirements. (a) To be eligible for adoption 
136.2 	assistance, a child must:
136.3 	(1) be determined to be a child with special needs, according to subdivision 2;
136.4 	(2) meet the applicable citizenship and immigration requirements in subdivision 
136.5 	3; and
136.6 	(3)(i) meet the criteria outlined in section 473 of the Social Security Act; or
136.7 	(ii) have had foster care payments paid on the child's behalf while in out-of-home 
136.8 	placement through the county or tribe, and be either under the guardianship of the 
136.9 	commissioner or under the jurisdiction of a Minnesota tribe and adoption according to 
136.10 	tribal law is the child's documented permanency plan.
136.11 	(b) In addition to the requirements in paragraph (a), the child's adoptive parent or 
136.12 	parents must meet the applicable background study requirements in subdivision 4.
136.13 	(c) The legally responsible agency shall make a title IV-E adoption assistance 
136.14 	eligibility determination for each child. A child who meets all eligibility criteria, except 
136.15 	those specific to title IV-E adoption assistance, shall receive adoption assistance paid 
136.16 	through state funds.
136.17 		Subd. 2.Special needs determination. (a) A child is considered a child with special 
136.18 	needs under this section if all of the following criteria in paragraphs (b) to (d) are met.
136.19 	(b) There has been a determination that the child cannot or should not be returned to 
136.20 	the home of the child's parents as evidenced by:
136.21 	(1) a court-ordered termination of parental rights;
136.22 	(2) a petition to terminate parental rights;
136.23 	(3) a consent to adopt accepted by the court under sections 260C.201, subdivision 
136.24 	11, and 259.24;
136.25 	(4) in circumstances when tribal law permits the child to be adopted without a 
136.26 	termination of parental rights, a judicial determination by tribal court indicating the valid 
136.27 	reason why the child cannot or should not return home;
136.28 	(5) a voluntary relinquishment under section 259.25 or 259.47 or, if relinquishment 
136.29 	occurred in another state, the applicable laws in that state; or
136.30 	(6) the death of the legal parent.
136.31 	(c) There exists a specific factor or condition because of which it is reasonable to 
136.32 	conclude that the child cannot be placed with adoptive parents without providing adoption 
136.33 	assistance as evidenced by:
136.34 	(1) a determination by the Social Security Administration that the child meets all 
136.35 	medical or disability requirements of title XVI of the Social Security Act with respect to 
136.36 	eligibility for Supplemental Security Income benefits;
137.1 	(2) a documented physical, mental, emotional, or behavioral disability not covered 
137.2 	under clause (1);
137.3 	(3) membership in a sibling group being adopted at the same time by the same parent;
137.4 	(4) adoptive placement in the home of a parent who previously adopted another child 
137.5 	born of the same mother or father for whom they receive adoption assistance; or
137.6 	(5) documentation that the child is an at-risk child according to subdivision 7.
137.7 	(d) A reasonable but unsuccessful effort has been made to place the child with 
137.8 	adoptive parents without providing adoption assistance as evidenced by:
137.9 	(1)(i) a documented search for an appropriate adoptive placement; or
137.10 	(ii) a determination by the commissioner that such a search would not be in the best 
137.11 	interests of the child; and
137.12 	(2) a written statement from the identified prospective adoptive parents that they are 
137.13 	either unwilling or unable to adopt the child without adoption assistance.
137.14 	(e) To meet the requirement of a documented search for an appropriate adoptive 
137.15 	placement under paragraph (d), clause (1), item (i), the placing agency minimally shall:
137.16 	(1) give consideration as required by section 260C.212, subdivision 5, to placement 
137.17 	with a relative;
137.18 	(2) for an Indian child covered by the Indian Child Welfare Act, comply with the 
137.19 	placement preferences identified in the Indian Child Welfare Act and the Minnesota Indian 
137.20 	Family Preservation Act; and
137.21 	(3) review all families approved for adoption who are associated with the placing 
137.22 	agency.
137.23 	If the review of families associated with the placing agency results in the identification 
137.24 	of an appropriate adoptive placement for the child, the placing agency must provide 
137.25 	documentation of the placement decision to the commissioner as part of the application 
137.26 	for adoption assistance. If two or more appropriate families are not approved or available 
137.27 	within the placing agency, the agency shall locate additional prospective adoptive families 
137.28 	by registering the child with the state adoption exchange, as defined in section 259.75. If 
137.29 	registration with the state adoption exchange does not result in an appropriate family for 
137.30 	the child, the agency shall employ other recruitment methods as outlined in recruitment 
137.31 	policies and procedures prescribed by the commissioner, to meet this requirement.
137.32 	(f) The requirement for a documented search for an appropriate adoptive placement 
137.33 	including a review of all families approved for adoption that are associated with the 
137.34 	placing agency, registration of the child with the state adoption exchange, and additional 
137.35 	recruitment methods must be waived if:
137.36 	(1) the child is being adopted by a relative;
138.1 	(2) the child is being adopted by foster parents with whom the child has developed 
138.2 	significant emotional ties while in the foster parents' care as a foster child; or
138.3 	(3) the child is being adopted by a family that previously adopted a child of the 
138.4 	same mother or father;
138.5 	and the court determines that adoption by the identified family is in the child's best interest. 
138.6 	For an Indian child covered by the Indian Child Welfare Act, a waiver must not be granted 
138.7 	unless the placing agency has complied with the placement preferences identified in the 
138.8 	Indian Child Welfare Act and the Minnesota Indian Family Preservation Act.
138.9 	(g) Once the placing agency has determined that placement with an identified family 
138.10 	is in the child's best interest and made full written disclosure about the child's social and 
138.11 	medical history, the agency must ask the prospective adoptive parents if they are willing to 
138.12 	adopt the child without adoption assistance. If the identified family is either unwilling 
138.13 	or unable to adopt the child without adoption assistance, they must provide a written 
138.14 	statement to this effect to the placing agency to fulfill the requirement to make a reasonable 
138.15 	effort to place the child without adoption assistance, and a copy of this statement shall be 
138.16 	included in the adoption assistance application. If the identified family desires to adopt 
138.17 	the child without adoption assistance, they must provide a written statement to this effect 
138.18 	to the placing agency and the statement shall be maintained in the permanent adoption 
138.19 	record of the placing agency. For children under the commissioner's guardianship, the 
138.20 	placing agency shall submit a copy of this statement to the commissioner to be maintained 
138.21 	in the permanent adoption record.
138.22 		Subd. 3.Citizenship and immigration status. (a) A child must be a citizen of the 
138.23 	United States or otherwise eligible for federal public benefits according to the Personal 
138.24 	Responsibility and Work Opportunity Reconciliation Act of 1996, as amended, in order to 
138.25 	be eligible for title IV-E adoption assistance.
138.26 	(b) A child must be a citizen of the United States or meet the qualified alien 
138.27 	requirements as defined in the Personal Responsibility and Work Opportunity 
138.28 	Reconciliation Act of 1996, as amended, in order to be eligible for state-funded adoption 
138.29 	assistance.
138.30 		Subd. 4.Background study. (a) A background study under section 259.41 must be 
138.31 	completed on each prospective adoptive parent. If the background study reveals:
138.32 	(1) a felony conviction at any time for child abuse or neglect;
138.33 	(2) spousal abuse;
138.34 	(3) a crime against children, including child pornography;
138.35 	(4) a crime involving violence, including rape, sexual assault, or homicide, but not 
138.36 	including other physical assault or battery; or
139.1 	(5) a felony conviction within the past five years for physical assault, battery, or a 
139.2 	drug-related offense,
139.3 	the adoptive parent is prohibited from receiving title IV-E adoption assistance on behalf of 
139.4 	an otherwise eligible child.
139.5 	(b) A prospective adoptive parent who possesses one of the felony convictions in 
139.6 	paragraph (a) may receive state-funded adoption assistance on behalf of an otherwise 
139.7 	eligible child if the court has made a judicial determination that:
139.8 	(1) the legally responsible agency has thoroughly reviewed the felony conviction 
139.9 	and has considered the impact, if any, that the conviction may have on the child's safety, 
139.10 	well-being, and permanency;
139.11 	(2) the conviction likely does not pose a current or future safety risk to the child;
139.12 	(3) there is no other available permanency resource that is appropriate for the 
139.13 	child; and
139.14 	(4) the adoptive placement is in the child's best interest.
139.15 		Subd. 5.Residency. A child placed in the state from another state or a tribe outside 
139.16 	the state is not eligible for state-funded adoption assistance through the state. A child 
139.17 	placed in the state from another state or a tribe outside of the state may be eligible for title 
139.18 	IV-E adoption assistance through the state of Minnesota if all eligibility factors are met 
139.19 	and there is no state agency that has responsibility for placement and care of the child.
139.20 		Subd. 6.Exceptions and exclusions. Payments for adoption assistance must 
139.21 	not be made to a biological parent of the child or a stepparent who adopts the child. 
139.22 	Direct placement adoptions under section 259.47 or the equivalent in tribal code are 
139.23 	not eligible for state-funded adoption assistance. A child who is adopted by the child's 
139.24 	legal custodian or guardian is not eligible for state-funded adoption assistance. A child 
139.25 	who is adopted by the child's legal custodian or guardian may be eligible for title IV-E 
139.26 	adoption assistance if all required eligibility factors are met. International adoptions are 
139.27 	not eligible for adoption assistance unless the adopted child has been placed into foster 
139.28 	care through the public child welfare system subsequent to the failure of the adoption, 
139.29 	and all required eligibility factors are met.
139.30 		Subd. 7.Documentation. (a) Documentation must be provided to verify that a child 
139.31 	meets the special needs criteria in subdivision 2.
139.32 	(b) Documentation of the disability is limited to evidence deemed appropriate by 
139.33 	the commissioner.
139.34 	(c) To qualify as being an at-risk child, the placing agency shall provide to the 
139.35 	commissioner one or more of the following:
140.1 	(1) documented information in a county or tribal social service department record or 
140.2 	court record that a relative within the first or second degree has a medical diagnosis or 
140.3 	medical history, including diagnosis of a significant mental health or chemical dependency 
140.4 	issue, which could result in the child's development of a disability during childhood;
140.5 	(2) documented information that while in the public child welfare system, the child 
140.6 	has experienced three or more placements with extended family or different foster homes 
140.7 	that could affect the normal attachment process;
140.8 	(3) documented evidence in a county or tribal social service department record that 
140.9 	the child experienced neglect in the first three years of life or sustained physical injury, 
140.10 	sexual abuse, or physical disease that could have a long-term effect on physical, emotional 
140.11 	or mental development; or
140.12 	(4) documented evidence in a medical or hospital record, law enforcement record, 
140.13 	county or tribal social service department record, court record, or record of an agency 
140.14 	under a contract with a county social service agency or the state to provide child welfare 
140.15 	services that the birth mother used drugs or alcohol during pregnancy which could later 
140.16 	result in the child's development of a disability.
140.17 		Subd. 8.Termination. (a) An adoption assistance agreement terminates in any 
140.18 	of the following circumstances:
140.19 	(1) the child attains the age of 18, unless an extension according to subdivisions 10 
140.20 	to 13 are applied for by the adoptive parents and granted by the commissioner;
140.21 	(2) the commissioner determines that the adoptive parents are no longer legally 
140.22 	responsible for support of the child;
140.23 	(3) the commissioner determines that the adoptive parents are no longer providing 
140.24 	financial support to the child;
140.25 	(4) death of the child; or
140.26 	(5) the adoptive parents request termination of the adoption assistance agreement 
140.27 	in writing.
140.28 	(b) An adoptive parent is considered no longer legally responsible for support of the 
140.29 	child in any of the following circumstances:
140.30 	(1) parental rights to the child are legally terminated;
140.31 	(2) permanent legal and physical custody or guardianship of the child is transferred 
140.32 	to another individual;
140.33 	(3) death of the adoptive parent;
140.34 	(4) enlistment of the child in the military;
140.35 	(5) marriage of the child; or
140.36 	(6) emancipation of the child through legal action of another state.
141.1 		Subd. 9.Death of adoptive parent or adoption dissolution. (a) The adoption 
141.2 	assistance agreement ends upon death or termination of parental rights of both of the 
141.3 	adoptive parents, in the case of a two-parent adoption, or the sole adoptive parent, in the 
141.4 	case of a single-parent adoption, but the child maintains eligibility for state-funded or title 
141.5 	IV-E adoption assistance in a subsequent adoption if the following criteria are met:
141.6 	(1) the child is determined to be a child with special needs as described in 
141.7 	subdivision 2;
141.8 	(2) the subsequent adoptive parents reside in the state of Minnesota; and
141.9 	(3) no state agency outside the state has responsibility for placement and care of the 
141.10 	child at the time of the subsequent adoption.
141.11 	(b) According to federal regulations, if the child had a title IV-E adoption assistance 
141.12 	agreement prior to the death of the adoptive parents or dissolution of the adoption, and a 
141.13 	state agency outside of the state of Minnesota has responsibility for placement and care of 
141.14 	the child at the time of the subsequent adoption, the state of Minnesota is not responsible 
141.15 	for determining whether the child meets the definition of special needs, entering into the 
141.16 	adoption assistance agreement, and making any adoption assistance payments outlined in 
141.17 	the new agreement.
141.18 	(c) According to federal regulations, if the child had a title IV-E adoption assistance 
141.19 	agreement prior to the death of the adoptive parents or dissolution of the adoption, the 
141.20 	subsequent adoptive parents reside outside of the state of Minnesota, and no state agency 
141.21 	has responsibility for placement and care of the child at the time of the subsequent 
141.22 	adoption, the state of Minnesota is not responsible for determining whether the child 
141.23 	meets the definition of special needs, entering into the adoption assistance agreement, and 
141.24 	making any adoption assistance payments outlined in the new agreement.
141.25 		Subd. 10.Extension, past age 18. Under certain limited circumstances, a child may 
141.26 	qualify for extension of the adoption assistance agreement beyond the date the child attains 
141.27 	age 18. An application for extension must be completed and submitted by the adoptive 
141.28 	parent at least 90 days prior to the date the child attains age 18, unless the child's adoption 
141.29 	is scheduled to finalize less than 90 days prior to that date, in which case the application 
141.30 	for extension must be completed and submitted with the adoption assistance application. 
141.31 	The application for extension shall be made on forms established by the commissioner and 
141.32 	shall include documentation of eligibility as specified by the commissioner.
141.33 		Subd. 11.Extension based on a continuing physical or mental disability. (a) 
141.34 	Extensions based on a child's continuing physical or mental disability must be applied for 
141.35 	prior to the date the child attains age 18. The commissioner must not grant an extension on 
142.1 	this basis if an extension based on continued enrollment in a secondary education program 
142.2 	or being a child whose adoption finalized after age 16 was previously granted for the child.
142.3 	(b) A child is eligible for extension of the adoption assistance agreement to the date 
142.4 	the child attains age 21 if the following criteria are met:
142.5 	(1) the child has a mental or physical disability upon which eligibility for adoption 
142.6 	assistance was based which warrants the continuation of assistance;
142.7 	(2) the child is unable to obtain self-sustaining employment due to the 
142.8 	aforementioned mental or physical disability; and
142.9 	(3) the child needs significantly more care and support than what is typical for an 
142.10 	individual of the same age.
142.11 		Subd. 12.Extension based on continued enrollment in a secondary education 
142.12 	program. (a) If a child does not qualify for extension based on a continuing physical or 
142.13 	mental disability, or a parent chooses not to apply for an extension on that basis, the 
142.14 	adoptive parents may make an application for continuation of adoption assistance based 
142.15 	on enrollment in a secondary education program.
142.16 	(b) If a child is enrolled full time in a secondary education program or a program 
142.17 	leading to an equivalent credential, the child is eligible for extension to the expected 
142.18 	graduation date or the date the child attains age 19, whichever is earlier. If a child receives 
142.19 	a school-based extension and at any time ceases to be enrolled in a full-time secondary 
142.20 	education program or a program leading to an equivalent credential, the adoptive parents 
142.21 	must notify the commissioner and the agreement must terminate.
142.22 	(c) Extensions based on continuation in a secondary education program must be paid 
142.23 	from state funds only, unless the child meets the extension criteria in subdivision 13.
142.24 		Subd. 13.Extension for children whose adoption finalized after age 16. A 
142.25 	child who attained the age of 16 prior to finalization of the child's adoption is eligible 
142.26 	for extension of the adoption assistance agreement to the date the child attains age 21 
142.27 	if the child is:
142.28 	(1) completing a secondary education program or a program leading to an equivalent 
142.29 	credential;
142.30 	(2) enrolled in an institution which provides postsecondary or vocational education;
142.31 	(3) participating in a program or activity designed to promote or remove barriers to 
142.32 	employment;
142.33 	(4) employed for at least 80 hours per month; or
142.34 	(5) incapable of doing any of the activities described in clauses (1) to (4) due to a 
142.35 	medical condition, which incapability is supported by regularly updated information in 
142.36 	the case plan of the child.
143.1 		Subd. 14.Transitioning in from pre-2011. A child who has an adoption assistance 
143.2 	agreement executed on their behalf under section 259.67 on or before November 24, 2010, 
143.3 	is eligible for Northstar Care for Children beginning January 1, 2011, provided that all 
143.4 	parties have signed the renegotiated adoption assistance agreement on or before that date. 
143.5 	The adoption assistance agreement of eligible children whose adoptive parents decide to 
143.6 	opt in to Northstar Care for Children must be renegotiated according to the process in 
143.7 	section 256O.270. All eligible children whose adoptive parents decide to renegotiate 
143.8 	their adoption assistance agreement under Northstar Care for Children must be assessed 
143.9 	according to section 256O.240 and then transitioned into Northstar Care for Children 
143.10 	according to the process in section 256O.270. Effective November 25, 2010, a child 
143.11 	who meets the eligibility criteria for adoption assistance in subdivision 1 may have an 
143.12 	adoption assistance agreement negotiated on their behalf according to section 256O.240, 
143.13 	and the effective date of the agreement is January 1, 2011, or the date of the court order 
143.14 	finalizing the adoption, whichever is later.

143.15 	Sec. 12. [256O.240] ASSESSMENTS AND AGREEMENTS.
143.16 		Subdivision 1.Assessment. Every child eligible under sections 256O.210, 
143.17 	256O.220, and 256O.230 must be assessed to determine the benefits the child may receive 
143.18 	under section 256O.250 according to the tool, process, and requirements specified in 
143.19 	subdivision 2. A child eligible for guardianship assistance under section 256O.220 or 
143.20 	adoption assistance under section 256O.230 who is determined to be an at-risk child 
143.21 	must be assessed at level A under section 256O.250, subdivision 1. All other children 
143.22 	shall be assessed at the basic level, level B, or one of ten supplemental difficulty of care 
143.23 	levels, levels C to L.
143.24 		Subd. 2.Commissioner to establish the assessment tool, process, and 
143.25 	requirements. Consistent with sections 256O.001 to 256O.270, the commissioner 
143.26 	shall establish the tool to be used and the process to be followed, including appropriate 
143.27 	documentation and other requirements, when conducting the assessment of children 
143.28 	entering or continuing in Northstar Care for Children. The assessment tool must take 
143.29 	into consideration the needs of the child and the ability of the caregiver to meet the 
143.30 	child's needs.
143.31 		Subd. 3.Child care component of the assessment. (a) The assessment tool 
143.32 	established under subdivision 2 must include consideration of the caregiver's need 
143.33 	for child care according to this subdivision. Prior to including consideration of the 
143.34 	caregiver's need for child care on the child's assessment, prospective adoptive parents or 
143.35 	relative custodians shall apply to the child care assistance program under chapter 119B. 
144.1 	Foster parents are not required to apply to the child care assistance program to have the 
144.2 	caregiver's need for child care considered as part of the foster child's assessment.
144.3 	(b) The child's assessment must include consideration of the caregiver's need for 
144.4 	child care if all the following criteria are met:
144.5 	(1) the child has not attained the age of 13;
144.6 	(2) all available adult caregivers are employed or attending training or educational 
144.7 	programs;
144.8 	(3) the caregiver has applied for the child care assistance program under paragraph 
144.9 	(a); and
144.10 	(4) child care assistance under chapter 119B is not received for the child.
144.11 	Consideration of the caregiver's need for child care may be included on the child's 
144.12 	assessment for caregivers who are wait-listed for child care assistance or are eligible for 
144.13 	child care assistance but choose not to receive it.
144.14 	(c) The level determined by the balance of the assessment must be adjusted based on 
144.15 	the number of hours of child care needed each week due to employment or attending a 
144.16 	training or educational program as follows:
144.17 	(1) less than ten hours or if the caregiver is participating in the child care assistance 
144.18 	program under chapter 119B, no adjustment;
144.19 	(2) ten to 19 hours, increase one level;
144.20 	(3) 20 to 29 hours, increase two levels;
144.21 	(4) 30 to 39 hours, increase three levels; and
144.22 	(5) 40 or more hours, increase four levels.
144.23 	(d) When the child attains the age of 13, the level shall revert to the level assessed 
144.24 	for the child prior to any consideration of the caregiver's need for child care.
144.25 		Subd. 4.Timing of initial assessment. For an eligible child entering Northstar 
144.26 	Care for Children who is not part of the transition group under subdivision 13, the initial 
144.27 	assessment must be completed within 30 days of placement for children in foster care and 
144.28 	prior to the establishment of a guardianship assistance or adoption assistance agreement 
144.29 	on behalf of the child, if an initial assessment is required under subdivision 5.
144.30 		Subd. 5.Completing the assessment. (a) The assessment must be completed in 
144.31 	consultation with the child's caregiver. Face-to-face contact with the caregiver is not 
144.32 	required to complete the assessment.
144.33 	(b) For foster children eligible under section 256O.210, the initial assessment must 
144.34 	be completed by the county of financial responsibility or, for children in the American 
144.35 	Indian Child Welfare Initiative, the responsible tribal social service agency authorized 
144.36 	in section 256.01, subdivision 14b, within 30 days of the child's placement in foster 
145.1 	care. Reassessments must be completed by the legally responsible agency according to 
145.2 	subdivision 7. If the foster parent is unable or unwilling to cooperate with the assessment 
145.3 	process, the child must be assessed at the basic level, level B under section 256O.250, 
145.4 	subdivision 3. Notice to the foster parent must be provided as specified in subdivision 9.
145.5 	(c) For children eligible for guardianship assistance under section 256O.220, a 
145.6 	new assessment is required as part of the negotiation of the guardianship assistance 
145.7 	agreement if:
145.8 	(1) the child is determined to be an at-risk child;
145.9 	(2) the child was not placed in foster care with the proposed relative custodian 
145.10 	immediately prior to the negotiation of the guardianship assistance agreement under 
145.11 	subdivision 10; or
145.12 	(3) any requirement for reassessment under subdivision 7 is met.
145.13 	If a new assessment is required prior to the effective date of the guardianship assistance 
145.14 	agreement, the new assessment must be completed by the county of financial responsibility 
145.15 	or, for children in the American Indian Child Welfare Initiative, the responsible tribal 
145.16 	social service agency authorized in section 256.01, subdivision 14b. If reassessment 
145.17 	is required after the effective date of the guardianship assistance agreement, the new 
145.18 	assessment must be completed by the commissioner or the commissioner's designee. If 
145.19 	the proposed relative custodian is unable or unwilling to cooperate with the assessment 
145.20 	process, the child must be assessed at the basic level, level B under section 256O.250, 
145.21 	subdivision 3, unless the child is known to be an at-risk child, in which case, the child 
145.22 	must be assessed at level A under section 256O.250, subdivision 1. Notice to the proposed 
145.23 	relative custodian must be provided as specified in subdivision 9. 
145.24 	(d) For children eligible for adoption assistance under section 256O.230, a new 
145.25 	assessment is required as part of the negotiation of the adoption assistance agreement if:
145.26 	(1) the child is determined to be an at-risk child;
145.27 	(2) the child was not placed in foster care with the prospective adoptive parent 
145.28 	immediately prior to the negotiation of the adoption assistance agreement under 
145.29 	subdivision 10; or
145.30 	(3) any requirement for reassessment under subdivision 7 is met.
145.31 	If a new assessment is required prior to the effective date of the adoption assistance 
145.32 	agreement, it must be completed by the county of financial responsibility or, for children 
145.33 	in the American Indian Child Welfare Initiative, the responsible tribal social service 
145.34 	agency authorized in section 256.01, subdivision 14b. If there is no county of financial 
145.35 	responsibility and the child is not in the American Indian Child Welfare Initiative, or the 
145.36 	financially responsible agency is not a county social service or tribal agency in the state, 
146.1 	the assessment must be completed by the agency designated by the commissioner. If 
146.2 	reassessment is required after the effective date of the adoption assistance agreement, it 
146.3 	must be completed by the commissioner or the commissioner's designee. If the prospective 
146.4 	adoptive parent is unable or unwilling to cooperate with the assessment process, the child 
146.5 	must be assessed at the basic level, level B under section 256O.250, subdivision 3, unless 
146.6 	the child is known to be an at-risk child, in which case, the child shall be assessed at level 
146.7 	A under section 256O.250, subdivision 1. Notice to the prospective adoptive parent must 
146.8 	be provided as specified in subdivision 9.
146.9 		Subd. 6.Approval of assessments and reassessments. Each legally responsible 
146.10 	agency shall designate one or more staff to examine and approve completed assessments 
146.11 	and reassessments. The staff person approving the assessments and reassessments must 
146.12 	not be the case manger or staff member completing the forms. The new rate is effective 
146.13 	the calendar month that the assessment is approved or the effective date of the agreement, 
146.14 	whichever is later.
146.15 		Subd. 7.Timing of reassessments and requests for reassessments. For an eligible 
146.16 	child, reassessments must be completed within 30 days of any of the following events:
146.17 	(1) for a child in continuous foster care, six months since completion of the last 
146.18 	assessment;
146.19 	(2) for a child in continuous foster care, at a change of placement location;
146.20 	(3) for a child in foster care, at the request of the legally responsible agency;
146.21 	(4) at the request of the commissioner; or
146.22 	(5) at the request of the caregiver under subdivision 8.
146.23 		Subd. 8.Caregiver requests for reassessments. (a) For an eligible child, a 
146.24 	caregiver may initiate a reassessment request in writing to the county of financial 
146.25 	responsibility, or, for children in the American Indian Child Welfare Initiative, the 
146.26 	responsible tribal social service agency authorized in section 256.01, subdivision 14b, 
146.27 	for foster care cases, or the commissioner, or the commissioner's designee for adoption 
146.28 	assistance and guardianship assistance cases. The written request must include the 
146.29 	reason for the request and the name, address, and contact information of the caregivers. 
146.30 	For an eligible child with a guardianship assistance or adoption assistance agreement, 
146.31 	the caregiver may request a reassessment if at least six months have elapsed since any 
146.32 	previously requested review. A caregiver for a foster child may request reassessment in 
146.33 	less than six months with written documentation that there have been significant changes 
146.34 	in the child's needs that necessitate an earlier reassessment.
146.35 	(b) A caregiver may request a reassessment of an at-risk child for whom a 
146.36 	guardianship assistance or adoption assistance agreement has been executed if the 
147.1 	caregiver has written professional documentation that the potential disability upon which 
147.2 	eligibility for the agreement was based has manifested itself.
147.3 	(c) If the reassessment cannot be completed within 30 days of the caregiver's request, 
147.4 	the agency responsible for reassessment shall notify the caregiver of the reason for the 
147.5 	delay and a reasonable estimate of when the reassessment can be completed.
147.6 	(d) If the child's caregiver is unable or unwilling to cooperate with the reassessment, 
147.7 	the child must be assessed at level B under section 256O.250, subdivision 3, unless the 
147.8 	child has an adoption assistance or guardianship assistance agreement in place and is 
147.9 	known to be an at-risk child, in which case, the child shall be assessed at level A under 
147.10 	section 256O.250, subdivision 1. Within 60 days of the caregiver demonstrating they are 
147.11 	able or willing to cooperate with the assessment or reassessment process, the reassessment 
147.12 	for the child must be completed.
147.13 		Subd. 9.Notice for caregiver. (a) The agency responsible for completing the 
147.14 	assessment shall provide the child's caregiver with written notice of the initial assessment 
147.15 	or reassessment.
147.16 	(b) Initial assessment notices must be sent within 15 days of completion of the initial 
147.17 	assessment and must minimally include the following:
147.18 	(1) a summary of the completed child's individual assessment used to determine 
147.19 	the rating;
147.20 	(2) statement of rating and benefit level;
147.21 	(3) statement of the circumstances under which the agency shall reassess the child;
147.22 	(4) procedure to seek reassessment;
147.23 	(5) notice that the caregiver has the right to a fair hearing review of the assessment 
147.24 	and how to request a fair hearing, consistent with section 256.045, subdivision 3; and
147.25 	(6) name, telephone number, and, if available, electronic address of a contact person 
147.26 	at the responsible agency or state.
147.27 	(c) Reassessment notices must be sent within 15 days of the completion of the 
147.28 	reassessment and must minimally include the following:
147.29 	(1) a summary of the completed child's individual assessment used to determine 
147.30 	the new rating;
147.31 	(2) any change in rating and its effective date;
147.32 	(3) procedure to seek reassessment;
147.33 	(4) notice that if a change in rating results in a reduction of benefits, the caregiver 
147.34 	has the right to a fair hearing review of the assessment and how to request a fair hearing 
147.35 	consistent with section 256.045, subdivision 3;
148.1 	(5) notice that a caregiver who requests a fair hearing of the reassessed rating within 
148.2 	ten days may continue at the current rate pending the hearing, but the agency may recover 
148.3 	any overpayment; and
148.4 	(6) name, telephone number, and, if available, electronic address of a contact person 
148.5 	at the responsible agency or state.
148.6 		Subd. 10.Agreements. (a) In order to receive guardianship assistance or adoption 
148.7 	assistance benefits, a written, binding agreement on a form approved by the commissioner 
148.8 	must be established prior to finalization of the adoption or a transfer of permanent legal 
148.9 	and physical custody. The agreement must be negotiated with the caregivers according 
148.10 	to subdivision 11. The caregivers and the commissioner or the commissioner's designee 
148.11 	must sign the agreement. A copy of the signed agreement must be given to each party. 
148.12 	Termination or disruption of the preadoptive placement or the foster care placement 
148.13 	preceding assignment of custody makes the agreement with that family void.
148.14 	(b) The agreement must specify the following:
148.15 	(1) duration of the agreement;
148.16 	(2) the nature and amount of any payment, services, and assistance to be provided 
148.17 	under such agreement;
148.18 	(3) the child's eligibility for Medicaid services;
148.19 	(4) the terms of the payment;
148.20 	(5) eligibility for reimbursement of nonrecurring expenses associated with adopting 
148.21 	or obtaining permanent legal and physical custody of the child, to the extent that the 
148.22 	total cost does not exceed $2,000 per child;
148.23 	(6) that the agreement must remain in effect regardless of the state of which the 
148.24 	adoptive parents or relative custodians are residents at any given time;
148.25 	(7) provisions for modification of the terms of the agreement; and
148.26 	(8) the effective date of the agreement.
148.27 	(c) The effective date of the guardianship assistance agreement is the date of the 
148.28 	court order that transfers permanent legal and physical custody to the relative.
148.29 	(d)(1) For a child who receives Supplementary Security Income (SSI), Retirement, 
148.30 	Survivors, and Disability Insurance (RSDI), veteran's benefits, railroad retirement benefits, 
148.31 	or black lung benefits, the effective date of the adoption assistance agreement is the date 
148.32 	that the adoption is finalized.
148.33 	(2) For a child who does not receive SSI, RSDI, veteran's benefits, railroad 
148.34 	retirement benefits, or black lung benefits, and who has been in the prospective adoptive 
148.35 	parents' home as a foster child for at least six consecutive months prior to adoption 
149.1 	placement, the effective date of the agreement is the date of adoptive placement or the 
149.2 	date that the agreement is signed by all parties, whichever is later.
149.3 	(3) For a child who does not receive SSI, RSDI, veteran's benefits, railroad 
149.4 	retirement benefits, or black lung benefits, and who has been in the prospective adoptive 
149.5 	parents' home as a foster child for less than six consecutive months prior to adoptive 
149.6 	placement, the effective date of the agreement is the date that the child has resided in the 
149.7 	prospective adoptive parents' home as a foster child for at least six consecutive months 
149.8 	or the date the adoption is finalized, whichever is earlier.
149.9 		Subd. 11.Negotiation of the agreement. (a) A monthly payment is provided 
149.10 	as part of the adoption assistance or guardianship assistance agreement to support the 
149.11 	care of children who have manifested special needs. The amount of the payment made 
149.12 	on behalf of children eligible for guardianship assistance or adoption assistance is 
149.13 	determined through agreement between the relative custodian or the adoptive parent and 
149.14 	the commissioner or the commissioner's designee, using the assessment tool established 
149.15 	by the commissioner in subdivision 2 and the associated benefit and payments in section 
149.16 	256O.250. The assessment tool establishes the monthly benefit level for a child in foster 
149.17 	care. The monthly payment under a guardianship assistance agreement or adoption 
149.18 	assistance agreement may be negotiated up to the monthly benefit level under foster care. 
149.19 	In no case may the amount of the payment under a guardianship assistance agreement or 
149.20 	adoption assistance agreement exceed the foster care maintenance payment which would 
149.21 	have been paid during the month if the child with respect to whom the guardianship 
149.22 	assistance or adoption assistance payment is made had been in a foster family home 
149.23 	in the state. The income of the relative custodian or adoptive parent must not be taken 
149.24 	into consideration when determining eligibility for guardianship assistance or adoption 
149.25 	assistance or the amount of the payments under section 256O.250. With the concurrence 
149.26 	of the relative custodian or adoptive parent, the amount of the payment may be adjusted 
149.27 	periodically using the assessment tool established by the commissioner in subdivision 2 
149.28 	and the agreement renegotiated under subdivision 12 when there is a change in the child's 
149.29 	needs or the family's circumstances.
149.30 	(b) The guardianship assistance or adoption assistance agreement of a child who 
149.31 	is identified as an at-risk child must not include a monthly payment unless and until the 
149.32 	potential disability manifests itself, as documented by an appropriate professional, and 
149.33 	the commissioner authorizes commencement of payment by modifying the agreement 
149.34 	accordingly. A relative custodian or adoptive parent of an at-risk child with a guardianship 
149.35 	assistance or adoption assistance agreement may request a reassessment of the child under 
149.36 	subdivision 8 and renegotiation of the guardianship assistance or adoption assistance 
150.1 	agreement under subdivision 12 to include a monthly payment, if the caregiver has written 
150.2 	professional documentation that the potential disability upon which eligibility for the 
150.3 	agreement was based has manifested itself. Documentation of the disability must be 
150.4 	limited to evidence deemed appropriate by the commissioner.
150.5 	(c)(1) The initial amount of the monthly guardianship assistance payment must be 
150.6 	equivalent to the foster care rate in effect at the time that the agreement is signed less 
150.7 	any offsets in section 256O.250, subdivision 8, or a lesser negotiated amount if agreed 
150.8 	to by the prospective relative custodian and specified in that agreement, unless the child 
150.9 	is identified as an at-risk child.
150.10 	(2) An at-risk child must be assigned level A according to section 256O.250 
150.11 	and there shall be no monthly guardianship assistance payment unless and until the 
150.12 	potential disability manifests itself, as documented by an appropriate professional, and 
150.13 	the commissioner authorizes commencement of payment by modifying the agreement 
150.14 	accordingly.
150.15 	(d)(1) For a child in foster care with the prospective adoptive parent immediately 
150.16 	prior to adoptive placement, the initial amount of the monthly adoption assistance payment 
150.17 	must be equivalent to the foster care rate in effect at the time that the agreement is signed 
150.18 	less any offsets in section 256O.250, subdivision 8, or a lesser negotiated amount if agreed 
150.19 	to by the prospective adoptive parents and specified in that agreement, unless the child 
150.20 	is identified as an at-risk child.
150.21 	(2) An at-risk child must be assigned level A according to section 256O.250 and there 
150.22 	must be no monthly adoption assistance payment unless and until the potential disability 
150.23 	manifests itself, as documented by an appropriate professional, and the commissioner 
150.24 	authorizes commencement of payment by modifying the agreement accordingly.
150.25 	(3) For children who are in the guardianship assistance program immediately prior 
150.26 	to adoptive placement, the initial amount of the adoption assistance payment must be 
150.27 	equivalent to the guardianship assistance payment in effect at the time that the adoption 
150.28 	assistance agreement is signed or a lesser amount if agreed to by the prospective adoptive 
150.29 	parent and specified in that agreement.
150.30 	(4) For children who are not in foster care placement or the guardianship assistance 
150.31 	program immediately prior to adoptive placement or negotiation of the adoption assistance 
150.32 	agreement, the initial amount of the adoption assistance agreement must be determined 
150.33 	using the assessment tool and process in this section and the corresponding payment 
150.34 	amount in section 256O.250.
150.35 		Subd. 12.Renegotiation of the agreement. (a) A relative custodian or adoptive 
150.36 	parent of a child with a guardianship assistance or adoption assistance agreement may 
151.1 	request renegotiation of the agreement when there is a change in the needs of the child 
151.2 	or in the family's circumstances. When a relative custodian or adoptive parent requests 
151.3 	renegotiation of the agreement, a reassessment of the child must be completed. If the 
151.4 	reassessment indicates that the child's level has changed, the commissioner or the 
151.5 	commissioner's designee and the caregiver shall renegotiate the agreement to include a 
151.6 	payment with the level determined through the reassessment process. The agreement 
151.7 	must not be renegotiated unless the commissioner and the caregiver mutually agree to 
151.8 	the changes. The effective date of any renegotiated agreement must be determined by 
151.9 	the commissioner.
151.10 	(b) A relative custodian or adoptive parent of an at-risk child with a guardianship 
151.11 	assistance or adoption assistance agreement may request renegotiation of the agreement to 
151.12 	include a monthly payment, if the caregiver has written professional documentation that 
151.13 	the potential disability upon which eligibility for the agreement was based has manifested 
151.14 	itself. Documentation of the disability must be limited to evidence deemed appropriate by 
151.15 	the commissioner. Prior to renegotiating the agreement, a reassessment of the child must 
151.16 	be conducted according to subdivision 8. The reassessment must be used to renegotiate 
151.17 	the agreement to include an appropriate monthly payment. The agreement shall not be 
151.18 	renegotiated unless the commissioner and the caregiver mutually agree to the changes. 
151.19 	The effective date of any renegotiated agreement shall be determined by the commissioner.
151.20 		Subd. 13.Transition assessments. (a) For a child who might transition into 
151.21 	Northstar Care for Children under section 256O.210 subdivision 5; 256O.220, subdivision 
151.22 	8; or 256O.230, subdivision 14, initial transition assessments must be completed between 
151.23 	May 1, 2010, and December 31, 2010.
151.24 	(b) Transition assessments for a child in foster care completed between May 1, 
151.25 	2010, and August 31, 2010, must be considered valid under subdivision 7 until April 1, 
151.26 	2011, and those completed between September 1, 2010, and December 31, 2010, must be 
151.27 	considered valid under subdivision 7 until July 1, 2011.
151.28 	(c) Children with relative custody assistance agreements under section 257.85 that 
151.29 	are effective prior to May 1, 2010, shall have initial transition assessments completed 
151.30 	between May 1 and December 31, 2010. Children with relative custody assistance 
151.31 	agreements between May 1, 2010, and November 24, 2010, shall have an initial transition 
151.32 	assessment completed as the agreement is being established in conjunction with the 
151.33 	supplemental maintenance needs assessment and other required relative custody assistance 
151.34 	paperwork under section 257.85.
151.35 	(d) Children with adoption assistance agreements negotiated under section 
151.36 	259.67 and submitted to the commissioner for review and approval on or before April 
152.1 	30, 2010, who might transition into Northstar Care for Children, shall have initial 
152.2 	transition assessments completed by August 31, 2010. Children with adoption assistance 
152.3 	agreements negotiated under section 259.67 and submitted to the commissioner for 
152.4 	review and approval between May 1, 2010, and November 24, 2010, shall have an initial 
152.5 	transition assessment completed in conjunction with the supplemental maintenance needs 
152.6 	assessment and other required adoption assistance paperwork under section 259.67.
152.7 	(e) If the child's caregiver is unable or unwilling to cooperate with the initial 
152.8 	transition assessment process, the child shall be assessed at the basic level, level B under 
152.9 	section 256O.250, subdivision 3, unless the child is known to be an at-risk child, in 
152.10 	which case the child shall be assessed at level A under section 256O.250, subdivision 1. 
152.11 	Within 60 days of the caregiver indicating they are able or willing to cooperate with the 
152.12 	assessment process, the commissioner or the commissioner's designee shall complete a 
152.13 	reassessment for the child.
152.14 	(f) If the child's caregiver cannot be located to complete the initial transition 
152.15 	assessment process according to the time frames outlined in this section, the child shall 
152.16 	be assessed at the basic level, level B under section 256O.250, subdivision 3, unless the 
152.17 	child is known to be an at-risk child, in which case the child shall be assessed at level A 
152.18 	under section 256O.250, subdivision 1. Within 60 days of locating the caregiver, the 
152.19 	commissioner or the commissioner's designee shall complete a reassessment for the child.

152.20 	Sec. 13. [256O.250] BENEFITS AND PAYMENTS.
152.21 		Subdivision 1.Benefits. There are three potential benefits available under Northstar 
152.22 	Care for Children: medical assistance, basic payment, and supplemental difficulty of care 
152.23 	payment. An eligible child receives medical assistance under subdivision 2. An eligible 
152.24 	child receives the basic payment under subdivision 3, except for those assigned level A 
152.25 	because they are determined to be at-risk children in guardianship assistance or adoption 
152.26 	assistance. An eligible child may receive an additional supplemental difficulty of care 
152.27 	payment under subdivision 4, as determined by the assessment under section 256O.240.
152.28 		Subd. 2.Medical assistance. Eligibility for medical assistance under this chapter 
152.29 	continues to be determined according to section 256B.055.
152.30 		Subd. 3.Basic monthly rate. For the period January 1, 2011, to June 30, 2012, the 
152.31 	basic monthly rate is according to the following schedule:

152.32		Ages 0-5
	$500 per month
	
152.33		Ages 6-12
	$625 per month
	
152.34		Ages 13 and older
	$750 per month.
	
153.1 		Subd. 4.Difficulty of care supplemental monthly rate. For the period January 1, 
153.2 	2011, to June 30, 2012, the difficulty of care supplemental monthly rate is according to 
153.3 	the following schedule:

153.4		level B
	none
	
153.5		level C
	$60 per month
	
153.6		level D
	$120 per month
	
153.7		level E
	$180 per month
	
153.8		level F
	$240 per month
	
153.9		level G
	$300 per month
	
153.10		level H
	$360 per month
	
153.11		level I
	$420 per month
	
153.12		level J
	$480 per month
	
153.13		level K
	$540 per month
	
153.14		level L
	$600 per month.
	
153.15 	A child assigned level B is still eligible for basic monthly rate under subdivision 3.
153.16 		Subd. 5.Daily rates. The commissioner shall establish prorated daily rates to 
153.17 	the nearest cent for the monthly rates under subdivisions 3 and 4. Daily rates must be 
153.18 	routinely used when a partial month is involved for foster care, guardianship assistance, 
153.19 	and adoption assistance.
153.20 		Subd. 6.Revision. By April 1, 2013, for fiscal year 2013, and by each subsequent 
153.21 	April 1 for each subsequent fiscal year, the commissioner shall review and revise the 
153.22 	rates under subdivisions 3, 4, and 5 based on United States Department of Agriculture 
153.23 	Estimates of the Cost of Raising a Child, published by the United States Department of 
153.24 	Agriculture, Agricultural Resources Service, Publication 1411. The revision must be the 
153.25 	average percentage by which costs increase for the age ranges represented in the United 
153.26 	States Department of Agriculture Estimates of the Cost of Raising a Child. The monthly 
153.27 	rates must be revised to the nearest dollar and the daily rates to the nearest cent.
153.28 		Subd. 7.Home and vehicle modifications. A child who is eligible for an adoption 
153.29 	assistance agreement based on the child's physical disability or a child who is eligible 
153.30 	for a guardianship assistance agreement who possesses a physical disability must have 
153.31 	reimbursement of home and vehicle modifications necessary to accommodate the child's 
153.32 	physical disability included as part of the negotiation of the agreement under section 
153.33 	256O.240, subdivision 11. The total of all modifications must not exceed $25,000 and the 
153.34 	modifications must be requested during the first six months that the adoption assistance or 
153.35 	guardianship assistance agreement is in effect. The type and cost of each modification 
153.36 	must be preapproved by the commissioner. The type of home and vehicle modifications is 
153.37 	limited to those specified by the commissioner. The commissioner shall ensure that the 
153.38 	modifications are necessary to incorporate the child into the family and that the cost 
154.1 	is reasonable. Application for and reimbursement of modifications must be completed 
154.2 	according to a process specified by the commissioner.
154.3 		Subd. 8.Child income or income attributable to the child. (a) A monthly 
154.4 	adoption assistance or guardianship assistance payment must be considered income and 
154.5 	resource attributable to the child and must be inalienable by any assignment or transfer 
154.6 	and exempt from garnishment under the laws of the state.
154.7 	(b) When a child is placed into foster care, any income and resources attributable 
154.8 	to the child must be handled according to sections 252.27 and 260C.331 or 260B.331, if 
154.9 	applicable to the child being placed.
154.10 	(c) Consideration of income and resources attributable to the child must be part of 
154.11 	the negotiation process in section 256O.240, subdivision 11. In some circumstances, the 
154.12 	receipt of other income on behalf of the child may impact the amount of the monthly 
154.13 	payment received by the adoptive parent or relative custodian on behalf of the child 
154.14 	through Northstar Care for Children. Supplemental Security Income (SSI), Retirement, 
154.15 	Survivors, and Disability Insurance (RSDI), veteran's benefits, railroad retirement benefits, 
154.16 	and black lung benefits are considered income and resources attributable to the child.
154.17 		Subd. 9.Treatment of Supplemental Security Income. If a child placed in 
154.18 	foster care receives benefits through Supplemental Security Income (SSI) at the time of 
154.19 	foster care placement or subsequent to placement in foster care, the county of financial 
154.20 	responsibility, or, for children in the American Indian Child Welfare Initiative, the 
154.21 	responsible tribal social service agency authorized in section 256.01, subdivision 14b, 
154.22 	may apply to be the payee for the child for the duration of the child's placement in foster 
154.23 	care. If a child continues to be eligible for SSI after finalization of the adoption or transfer 
154.24 	of permanent legal and physical custody and is determined to be eligible for a payment 
154.25 	under Northstar Care for Children, a permanent caregiver may choose to receive payment 
154.26 	from both programs simultaneously. If the payment under Northstar Care for Children 
154.27 	is a title IV-E payment, the permanent caregiver is responsible to report the amount of 
154.28 	the payment to the Social Security Administration and the SSI payment will be reduced 
154.29 	by the amount of the payment under Northstar Care for Children, as required by the 
154.30 	Social Security Administration.
154.31 		Subd. 10.Treatment of RSDI, veteran's benefits, railroad retirement benefits, 
154.32 	and black lung benefits. (a) If a child placed in foster care receives RSDI, veteran's 
154.33 	benefits, railroad retirement benefits, or black lung benefits at the time of foster care 
154.34 	placement or subsequent to placement in foster care, the county of financial responsibility, 
154.35 	or, for children in the American Indian Child Welfare Initiative, the responsible tribal 
154.36 	social service agency authorized in section 256.01, subdivision 14b, may apply to be 
155.1 	the payee for the child for the duration of the child's placement in foster care. If it is 
155.2 	anticipated that a child will be eligible to receive RSDI, veteran's benefits, railroad 
155.3 	retirement benefits, or black lung benefits after finalization of the adoption or assignment 
155.4 	of permanent legal and physical custody, the permanent caregiver shall apply to be the 
155.5 	payee of those benefits on the child's behalf. The monthly amount of the other benefits 
155.6 	must be considered an offset to the amount of the payment the child is determined eligible 
155.7 	for under Northstar Care for Children.
155.8 	(b) If a child becomes eligible for RSDI, veteran's benefits, railroad retirement 
155.9 	benefits, or black lung benefits after the initial amount of the payment under Northstar 
155.10 	Care for Children is finalized, the permanent caregiver shall contact the commissioner 
155.11 	to renegotiate the payment under Northstar Care for Children. The monthly amount of 
155.12 	the other benefits must be considered an offset to the amount of the payment the child is 
155.13 	determined eligible for under Northstar Care for Children.
155.14 	(c) If a child ceases to be eligible for RSDI, veteran's benefits, railroad retirement 
155.15 	benefits, or black lung benefits after the initial amount of the payment under Northstar 
155.16 	Care for Children is finalized, the permanent caregiver shall contact the commissioner to 
155.17 	renegotiate the payment under Northstar Care for Children. The monthly amount of the 
155.18 	payment under Northstar Care for Children must be the amount the child was determined 
155.19 	to be eligible for prior to consideration of any offset.
155.20 	(d) If the monthly payment received on behalf of the child under RSDI, veteran's 
155.21 	benefits, railroad retirement benefits, or black lung benefits changes after the adoption 
155.22 	assistance or guardianship assistance agreement is finalized, the permanent caregiver shall 
155.23 	notify the commissioner as to the new monthly payment amount, regardless of the amount 
155.24 	of the change in payment. If the monthly payment changes by $75 or more, even if the 
155.25 	change occurs incrementally over the duration of the term of the adoption assistance 
155.26 	or guardianship assistance agreement, the monthly payment under Northstar Care for 
155.27 	Children must be renegotiated to reflect the amount of the increase or decrease in the 
155.28 	offset amount. Any subsequent change to the payment must be reported and handled in 
155.29 	the same manner. A change of monthly payments of less than $75 is not a permissible 
155.30 	reason to renegotiate the adoption assistance or guardianship assistance agreement under 
155.31 	section 256O.240, subdivision 12.
155.32 		Subd. 11.Treatment of child support and MFIP. (a) If a child placed in foster 
155.33 	care receives child support, the child support payment may be redirected to the county of 
155.34 	financial responsibility, or, for children in the American Indian Child Welfare Initiative, 
155.35 	the responsible tribal social service agency authorized in section 256.01, subdivision 
155.36 	14b, for the duration of the child's placement in foster care. In cases where the child 
156.1 	qualifies for Northstar Care for Children by meeting the adoption assistance eligibility 
156.2 	criteria or the guardianship assistance eligibility criteria, any court-ordered child support 
156.3 	must not be considered income attributable to the child and must have no impact on the 
156.4 	monthly payment.
156.5 	(b) Consistent with section 256J.24, children eligible for and receiving a payment 
156.6 	from Northstar Care for Children are excluded from a MFIP assistance unit.
156.7 		Subd. 12.Payments. (a) Payments to caregivers under Northstar Care for Children 
156.8 	must be made monthly.
156.9 	(b) The county of financial responsibility, or, for children in the American Indian 
156.10 	Child Welfare Initiative, the responsible tribal social service agency authorized in section 
156.11 	256.01, subdivision 14b, shall pay foster parents for eligible children in foster care.
156.12 	(c) The commissioner shall pay caregivers for eligible children in guardianship 
156.13 	assistance and adoption assistance. Payments must commence when the commissioner 
156.14 	receives the required documentation from the court, the legally responsible agency, or the 
156.15 	caregiver. In guardianship assistance or adoption assistance cases, monthly payments must 
156.16 	be prorated according to subdivision 5 based on the effective date of the agreement.
156.17 		Subd. 13.Effect of benefit on other aid. Payments received under this section shall 
156.18 	not be considered as income for child care assistance under chapter 119B or any other 
156.19 	financial benefit. Consistent with section 256J.24, all children receiving a maintenance 
156.20 	payment under Northstar Care for Children are excluded from any MFIP assistance unit.
156.21 		Subd. 14.Waivered service plans. A child in foster care may qualify for home and 
156.22 	community-based waivered services, consistent with section 256B.092 for developmental 
156.23 	disabilities, or section 256B.49 for community alternative care, community alternatives 
156.24 	for disabled individuals, or traumatic brain injury waivers. A waiver service must not be 
156.25 	substituted for the foster care program. When the child is eligible for waivered services 
156.26 	and eligible for this benefit, the local social service agency must assess and provide basic 
156.27 	and supplemental difficulty of care rates as determined by the universal assessment under 
156.28 	section 256O.240. If it is determined that additional services are needed to meet the child's 
156.29 	needs in the home that is not or cannot be met by the foster care program, the need would 
156.30 	be referred to the waivered service program.
156.31 		Subd. 15.Overpayments. The commissioner has the authority to collect any 
156.32 	amount of foster care, adoption assistance, and guardianship assistance paid to a 
156.33 	caregiver in excess of the payment due. Payments covered by this subdivision include 
156.34 	basic maintenance needs payments, supplemental difficulty of care payments, and 
156.35 	reimbursement of home and vehicle modifications under subdivision 7. Prior to any 
157.1 	collection, the commissioner or the commissioner's designee shall notify the caregiver in 
157.2 	writing, including:
157.3 	(1) the amount of the overpayment and an explanation of the cause of overpayment;
157.4 	(2) clarification of the corrected amount;
157.5 	(3) a statement of the legal authority for the decision;
157.6 	(4) information about how the caregiver can correct the overpayment;
157.7 	(5) if repayment is required, when the payment is due and a person to contact to 
157.8 	review a repayment plan;
157.9 	(6) a statement that the caregiver is entitled to a fair hearing review by the 
157.10 	department; and
157.11 	(7) the procedure for seeking the review in clause (6).
157.12 		Subd. 16.Payee. For adoption assistance and guardianship assistance cases, 
157.13 	the payment may only be made to the adoptive parent or relative custodian specified 
157.14 	on the agreement. If there is more than one adoptive parent or relative custodian, both 
157.15 	parties must be listed as the payee unless otherwise specified in writing according to 
157.16 	policies outlined by the commissioner. In the event of divorce or separation of the 
157.17 	caregivers, a change of payee may be made in writing according to policies outlined by 
157.18 	the commissioner. If both caregivers are in agreement as to the change, it may be made 
157.19 	according to a process outlined by the commissioner. If there is not agreement as to the 
157.20 	change, a court order indicating the party who is to receive the payment is needed before a 
157.21 	change can be processed. If the change of payee is disputed, the commissioner may 
157.22 	withhold the payment until agreement is reached. A noncustodial caregiver may request 
157.23 	notice in writing of review, modification, or termination of the adoption assistance or 
157.24 	guardianship assistance agreement. In the event of the death of a payee, a change of payee 
157.25 	consistent with sections 256O.220 and 256O.230 may be made in writing according 
157.26 	to policies outlined by the commissioner.
157.27 		Subd. 17.Notification of change. (a) Parents or relative custodians who have an 
157.28 	adoption assistance agreement or guardianship assistance agreement in place shall keep 
157.29 	the agency administering the program informed of the parent's or custodian's address and 
157.30 	circumstances which would make them ineligible for the payments or eligible for the 
157.31 	payments in a different amount.
157.32 	(b) For the duration of the agreement, the adoptive parent or relative custodian 
157.33 	agrees to notify the agency administering the program in writing within 30 days of the 
157.34 	following changes:
157.35 	(1) change in the family's address;
157.36 	(2) change in the legal custody status of the child;
158.1 	(3) child's completion of high school, if this occurs after the child attains age 18;
158.2 	(4) date of termination of the parental rights of the adoptive parent, transfer of 
158.3 	permanent legal and physical custody to another person, or other determination that the 
158.4 	adoptive parent or relative custodian is no longer legally responsible for support of the 
158.5 	child;
158.6 	(5) date the adoptive parent or relative custodian is no longer providing support to 
158.7 	the child;
158.8 	(6) date of death of the child;
158.9 	(7) date of death of the adoptive parent or relative custodian;
158.10 	(8) date the child enlists in the military;
158.11 	(9) date of marriage of the child;
158.12 	(10) date the child becomes an emancipated minor through legal action of another 
158.13 	state;
158.14 	(11) separation or divorce of the adoptive parent or relative custodian;
158.15 	(12) change of the caregiver's employment or educational enrollment status, if the 
158.16 	child has not attained age 13 and the child care component of the assessment under section 
158.17 	256O.240, subdivision 2, was used to determine the assessment level; and
158.18 	(13) residence of the child outside the home for a period of more than 30 consecutive 
158.19 	days.
158.20 		Subd. 18.Termination notice for caregiver. The responsible agency must provide 
158.21 	a child's caregiver written notice of termination of payment. Termination notices must be 
158.22 	sent at least 15 days before the final payment or in the case of an unplanned termination, 
158.23 	the notice is sent within three days of the end of the payment. The written notice must 
158.24 	minimally include the following:
158.25 	(1) the date payment will end;
158.26 	(2) the reason payments will end and the event that is the basis to terminate payment;
158.27 	(3) a statement that the provider is entitled to a fair hearing review by the department 
158.28 	consistent with section 256.045, subdivision 3;
158.29 	(4) the procedure to request a fair hearing; and
158.30 	(5) name, telephone number, and, if available, an electronic contact address of a 
158.31 	contact person at the county or state.

158.32 	Sec. 14. [256O.260] FEDERAL SHARE, STATE SHARE, LOCAL SHARE.
158.33 		Subdivision 1.Federal share. For the purposes of determining a child's eligibility 
158.34 	under title IV-E of the Social Security Act for a child in foster care, the county of 
158.35 	financial responsibility or, for children in the American Indian Child Welfare Initiative, 
159.1 	the responsible tribal social service agency authorized in section 256.01, subdivision 14b, 
159.2 	shall use the eligibility requirements outlined in section 472 of the Social Security Act. 
159.3 	For a child who qualifies for guardianship assistance or adoption assistance, the county of 
159.4 	financial responsibility or, for children in the American Indian Child Welfare Initiative, 
159.5 	the responsible tribal social service agency authorized in section 256.01, subdivision 14b, 
159.6 	shall use the eligibility requirements outlined in section 473 of the Social Security Act. 
159.7 	In each case, the agency paying the maintenance payments must be reimbursed for the 
159.8 	costs from the federal money available for this purpose.
159.9 		Subd. 2.State share. The commissioner shall pay the state share of the maintenance 
159.10 	payments as determined under subdivision 4, and an identical share of the pre-Northstar 
159.11 	Care adoption assistance program under section 259.67. The commissioner may transfer 
159.12 	funds into the account if a deficit occurs.
159.13 		Subd. 3.Local share. The county of financial responsibility under section 256G.02 
159.14 	or tribal social service agency authorized in section 256.01, subdivision 14b, at the 
159.15 	time of placement for foster care or finalization of the agreement for guardianship 
159.16 	assistance or adoption assistance, shall pay the local share of the maintenance payments as 
159.17 	determined under subdivision 4, and an identical share of the pre-Northstar Care adoption 
159.18 	assistance program under section 259.67. The county of financial responsibility under 
159.19 	section 256G.02 or tribal social service agency authorized in section 256.01, subdivision 
159.20 	14b, shall pay the entire cost of any initial clothing allowance, child-placing agency 
159.21 	administrative payments, or other support services it authorizes, except as provided under 
159.22 	other provisions of law. In cases of federally required adoption assistance where there is 
159.23 	no county of financial responsibility, or, for children in the American Indian Child Welfare 
159.24 	Initiative, the responsible tribal social service agency authorized in section 256.01, 
159.25 	subdivision 14b, as provided in section 256O.240, subdivision 5, the commissioner shall 
159.26 	pay the local share.
159.27 		Subd. 4.Nonfederal share. The commissioner shall establish a percentage share 
159.28 	of the maintenance payments, reduced by federal reimbursements under title IV-E of the 
159.29 	Social Security Act, to be paid by the state and to be paid by the county of financial 
159.30 	responsibility under section 256G.02 or tribal social service agency authorized in section 
159.31 	256.01, subdivision 14b. These state and local shares shall initially be calculated based 
159.32 	on the ratio of the average appropriate expenditures made by the state and all counties 
159.33 	and tribal social service agencies authorized in section 256.01, subdivision 14b, during 
159.34 	state fiscal years 2008, 2009, and 2010. For purposes of this calculation, appropriate 
159.35 	expenditures for the counties and tribal social service agencies shall include basic and 
159.36 	difficulty of care payments for foster care, not including any initial clothing allowance, 
160.1 	child-placing agency administrative payments, child care, or other ancillary expenditures, 
160.2 	reduced by federal reimbursements. For purposes of this calculation, appropriate 
160.3 	expenditures for the state must include adoption assistance and relative custody assistance, 
160.4 	reduced by federal reimbursements. For each of the periods January 1, 2011, to June 
160.5 	30, 2012, and fiscal years 2013 and 2014, the commissioner shall adjust this initial 
160.6 	percentage of state and local shares to reflect the relative expenditure trends during state 
160.7 	fiscal years 2008, 2009, and 2010. The fiscal year 2014 set of percentages must be used 
160.8 	for all subsequent years.
160.9 		Subd. 5.Adjustments for proportionate shares among legally responsible 
160.10 	agencies. For children who transition into Northstar Care for Children under section 
160.11 	256O.270, subdivision 7, and for children on the pre-Northstar Care adoption assistance 
160.12 	program under section 259.67, the commissioner shall adjust the expenditures by each 
160.13 	county or tribal social service agency so that its relative share is proportional to its foster 
160.14 	care expenditures as determined under subdivision 4 for state fiscal years 2008, 2009, and 
160.15 	2010 compared with similar costs of all county or tribal social service agencies.

160.16 	Sec. 15. [256O.270] ADMINISTRATION.
160.17 		Subdivision 1.Responsibilities. (a) The county of financial responsibility or, 
160.18 	for children in the American Indian Child Welfare Initiative, the responsible tribal 
160.19 	social service agency authorized in section 256.01, subdivision 14b, shall determine 
160.20 	the eligibility for Northstar Care for Children for children in foster care under section 
160.21 	256O.210, and for those children determined eligible, shall further determine each child's 
160.22 	eligibility for title IV-E of the Social Security Act.
160.23 	(b) Subject to commissioner approval, the legally responsible agency shall determine 
160.24 	the eligibility for Northstar Care for Children for children in guardianship assistance under 
160.25 	section 256O.220 and children in adoption assistance under section 256O.230, and for 
160.26 	those children determined eligible, shall further determine each child's eligibility for title 
160.27 	IV-E of the Social Security Act.
160.28 	(c) The legally responsible agency is responsible for the administration of Northstar 
160.29 	Care for Children for children in foster care, and for assisting the commissioner with the 
160.30 	administration of Northstar Care for Children for children in guardianship assistance and 
160.31 	adoption assistance by conducting assessments, reassessments, negotiations, and other 
160.32 	activities as specified by the commissioner under subdivision 2.
160.33 		Subd. 2.Procedures, requirements, and deadlines. The commissioner shall 
160.34 	specify procedures, requirements, and deadlines for the administration of Northstar Care 
160.35 	for Children according to sections 256O.001 to 256O.270, including for transitioning 
161.1 	children into Northstar Care for Children under subdivision 7. The commissioner shall 
161.2 	periodically review all such procedures, requirements, and deadlines, including the 
161.3 	assessment tool and process under section 256O.240, in consultation with counties, tribes, 
161.4 	and representatives of caregivers and may alter them as needed.
161.5 		Subd. 3.Administration of title IV-E programs. The title IV-E foster care, 
161.6 	guardianship assistance, and adoption assistance programs shall operate within the statutes 
161.7 	and rules set forth by the federal government in the Social Security Act and Code of 
161.8 	Federal Regulations.
161.9 		Subd. 4.Reporting. The commissioner shall specify required fiscal and statistical 
161.10 	reports under section 256.01, subdivision 2, paragraph (q), and other reports as necessary.
161.11 		Subd. 5.Promotion of programs. The commissioner or the commissioner's 
161.12 	designee shall actively seek ways to promote the guardianship assistance and adoption 
161.13 	assistance programs, including informing prospective relative custodians of eligible 
161.14 	children of the availability of guardianship assistance and prospective adoptive parents of 
161.15 	eligible children under the commissioner's guardianship of the availability of adoption 
161.16 	assistance. All families who adopt children under the commissioner's guardianship must 
161.17 	be informed as to the adoption tax credit.
161.18 		Subd. 6.Appeals and fair hearings. (a) A caregiver has the right to appeal to the 
161.19 	commissioner pursuant to section 256.045 when eligibility for Northstar Care for Children 
161.20 	is denied, and when payment or the agreement for eligible child is modified or terminated.
161.21 	(b) A relative custodian or adoptive parent has additional rights to appeal to 
161.22 	the commissioner under section 256.045. The rights include when the commissioner 
161.23 	terminates or modifies the guardianship assistance or adoption assistance agreement or 
161.24 	when the commissioner denies an application for guardianship assistance or adoption 
161.25 	assistance. A prospective relative custodian or adoptive parent who disagrees with a 
161.26 	decision by the commissioner prior to transfer of permanent legal and physical custody or 
161.27 	finalization of the adoption may request review of the decision by the commissioner or 
161.28 	may appeal the decision under section 256.045. A guardianship assistance or adoption 
161.29 	assistance agreement must be signed and in effect prior to the court order that transfers 
161.30 	permanent legal and physical custody or the adoption finalization, however in some cases, 
161.31 	there may be extenuating circumstances as to why an agreement was not entered into prior 
161.32 	to the finalization of permanency for the child. Caregivers who believe that extenuating 
161.33 	circumstances exist in the case of the caregiver's child may request a fair hearing. 
161.34 	Caregivers have the responsibility of proving that extenuating circumstances exist. 
161.35 	Caregivers are required to provide written documentation of each eligibility criterion at 
161.36 	the fair hearing. Examples of extenuating circumstances include: relevant facts regarding 
162.1 	the child were known by the placing agency and not presented to the caregiver prior to 
162.2 	transfer of permanent legal and physical custody or finalization of the adoption, failure by 
162.3 	the commissioner or the commissioner's designee to advise potential caregivers about the 
162.4 	availability of guardianship assistance or adoption assistance for children in the state foster 
162.5 	care system. If an appeals judge finds through the fair hearing process that extenuating 
162.6 	circumstances existed and that the child met all eligibility criteria at the time the transfer 
162.7 	of permanent legal and physical custody was ordered or the adoption was finalized, the 
162.8 	effective date and any associated federal financial participation must be retroactive to 
162.9 	the date of the request for a fair hearing.
162.10 		Subd. 7.Transition; timelines; assessments. (a) All eligible children shall 
162.11 	participate in an initial assessment under section 256O.240, subdivision 3.
162.12 	(b) All children in foster care, relative custody assistance, or adoption assistance are 
162.13 	eligible for Northstar Care for Children as specified in sections 256O.210, 256O.220, and 
162.14 	256O.230. All children in foster care or receiving relative custody assistance under section 
162.15 	257.85 on December 31, 2010, must be transitioned into Northstar Care for Children as of 
162.16 	January 1, 2011. Children in adoption assistance under section 259.67 on December 31, 
162.17 	2010, whose caregivers sign no later than November 24, 2010, an agreement to transition 
162.18 	to Northstar Care for Children as provided under sections 256O.230 and 256O.240 must 
162.19 	be added to Northstar Care for Children as of January 1, 2011. A child receiving adoption 
162.20 	assistance under section 259.67 whose caregivers sign an agreement to transition to 
162.21 	Northstar Care for Children as provided under sections 256O.230 and 256O.240 between 
162.22 	December 1, 2010, and March 31, 2011, must be added to Northstar Care for Children 
162.23 	for the first calendar month at least 31 calendar days after the date of the signing of the 
162.24 	agreement. A child receiving adoption assistance under section 259.67 whose caregivers 
162.25 	do not sign an agreement to transition to Northstar Care for Children by March 31, 2011, 
162.26 	must remain on the pre-Northstar Care adoption assistance program under section 259.67 
162.27 	until the child is no longer eligible for the program.
162.28 		Subd. 8.Transition; distribution of program information. Between May 1, 2010, 
162.29 	and June 30, 2010, all foster parents with a child placed in the foster parents' home, relative 
162.30 	custodians with executed or signed relative custody assistance agreements, adoptive 
162.31 	parents with executed or signed adoption assistance agreements, and preadoptive parents 
162.32 	with a preadoptive placement in the parents' home shall receive written information about 
162.33 	Northstar Care for Children. Foster parents with a child placed in the foster parents' home 
162.34 	between July 1, 2010, and December 31, 2010, shall receive written information about 
162.35 	Northstar Care for Children at the time of the child's placement. Relative custodians 
162.36 	who sign a relative custody assistance agreement and prospective adoptive parents who 
163.1 	sign an adoption assistance agreement subsequent to June 30, 2010, shall receive written 
163.2 	information about Northstar Care for Children no later than when the relative custody 
163.3 	assistance agreement or the adoption assistance agreement is signed by the caregiver.
163.4 	(1) The legally responsible agency shall mail, electronically distribute, or personally 
163.5 	provide foster parents with placed children with written information about Northstar 
163.6 	Care for Children.
163.7 	(2) The agency responsible for providing the relative custody assistance payment 
163.8 	shall mail, electronically distribute, or personally provide relative custodians with relative 
163.9 	custody assistance agreements with written information about Northstar Care for Children 
163.10 	when the relative custodians' mail or email address is known. The responsible social 
163.11 	service agency shall make reasonable efforts to locate relative custodians with signed or 
163.12 	executed relative custody assistance agreements whose mail or email address is known.
163.13 	(3) For cases where the adoption assistance agreement is executed or submitted to 
163.14 	the commissioner for review and approval prior to May 1, 2010, the commissioner shall 
163.15 	mail or electronically distribute information about Northstar Care for Children to the 
163.16 	adoptive parent. The commissioner shall make reasonable efforts to locate the adoptive 
163.17 	parent whose mail or email address is unknown. For cases where the adoption assistance 
163.18 	agreement is executed or submitted to the commissioner for review on or after May 1, 
163.19 	2010, and on or before November 24, 2010, the responsible social service agency shall 
163.20 	mail, electronically distribute, or personally provide preadoptive parents with written 
163.21 	information about Northstar Care for Children.
163.22 	(4) Information must minimally include a summary of the provisions of the new 
163.23 	program, an overview of the assessment process, the transition time frame, and actions 
163.24 	required by the foster parent, relative custodian, or adoptive parent during the transition 
163.25 	period, including the procedure to opt in to Northstar Care for Children and renegotiate 
163.26 	the adoption assistance agreement for adoption assistance cases.
163.27 		Subd. 9.Transition; renegotiation of adoption assistance agreements. Adoptive 
163.28 	parents shall provide written notice to the commissioner of the adoptive parents' intent 
163.29 	to renegotiate their adoption assistance program or remain on the pre-Northstar Care 
163.30 	adoption assistance program according to section 259.67 within 60 days of receiving 
163.31 	the written notice in subdivision 8. The commissioner may extend this time frame if 
163.32 	it is determined that the adoptive parent has good cause to warrant extension of this 
163.33 	consideration period. If adoptive parents decide to opt in to Northstar Care for Children, 
163.34 	the adoptive parents' adoption assistance agreement must be renegotiated according to 
163.35 	section 256O.240, subdivision 10. If an adoptive parent would like to opt in to Northstar 
163.36 	Care for Children, but does not believe that the assessment under section 256O.240 was 
164.1 	completed accurately, the adoptive parent shall indicate this in writing to the commissioner 
164.2 	and must be given an extension of the consideration period while a reassessment is 
164.3 	completed. The commissioner may not extend the time frame to renegotiate adoption 
164.4 	assistance agreements after March 31, 2011. All adoption assistance agreements under 
164.5 	Northstar Care for Children for children transitioning from the adoption assistance 
164.6 	program under section 259.67 must be renegotiated and signed by all parties no later than 
164.7 	March 31, 2011. The commissioner may establish additional requirements or deadlines 
164.8 	for implementing the transition.
164.9 		Subd. 10.Effective date of payment rates. The new rates for payment under 
164.10 	Northstar Care for Children must be determined under section 256O.250 and effective 
164.11 	according to the timelines in subdivision 7, paragraph (b).
164.12 		Subd. 11.Purchase of child-specific adoption services. The commissioner may 
164.13 	reimburse the placing agency for appropriate adoption services for children eligible under 
164.14 	section 259.67, subdivision 35.

164.15 	Sec. 16. Minnesota Statutes 2008, section 257.85, subdivision 2, is amended to read:
164.16 		Subd. 2.Scope. The provisions of this section apply to those situations in which 
164.17 	the legal and physical custody of a child is established with a relative or important friend 
164.18 	with whom the child has resided or had significant contact according to section 260C.201, 
164.19 	subdivision 11, by a district court order issued on or after July 1, 1997, and on or before 
164.20 	November 24, 2010, or a tribal court order issued on or after July 1, 2005, and on or 
164.21 	before November 24, 2010, when the child has been removed from the care of the parent 
164.22 	by previous district or tribal court order.

164.23 	EFFECTIVE DATE. This section is effective August 1, 2009.

164.24 	Sec. 17. Minnesota Statutes 2008, section 257.85, subdivision 5, is amended to read:
164.25 		Subd. 5.Relative custody assistance agreement. (a) A relative custody assistance 
164.26 	agreement will not be effective, unless it is signed by the local agency and the relative 
164.27 	custodian no later than 30 days after the date of the order establishing permanent legal and 
164.28 	physical custody, and on or before November 24, 2010, except that a local agency may 
164.29 	enter into a relative custody assistance agreement with a relative custodian more than 30 
164.30 	days after the date of the order if it certifies that the delay in entering the agreement was 
164.31 	through no fault of the relative custodian and the agreement is signed and in effect on or 
164.32 	before November 24, 2010. There must be a separate agreement for each child for whom 
164.33 	the relative custodian is receiving relative custody assistance.
165.1 	(b) Regardless of when the relative custody assistance agreement is signed by the 
165.2 	local agency and relative custodian, the effective date of the agreement shall be the date of 
165.3 	the order establishing permanent legal and physical custody.
165.4 	(c) If MFIP is not the applicable program for a child at the time that a relative 
165.5 	custody assistance agreement is entered on behalf of the child, when MFIP becomes 
165.6 	the applicable program, if the relative custodian had been receiving custody assistance 
165.7 	payments calculated based upon a different program, the amount of relative custody 
165.8 	assistance payment under subdivision 7 shall be recalculated under the Minnesota family 
165.9 	investment program.
165.10 	(d) The relative custody assistance agreement shall be in a form specified by the 
165.11 	commissioner and shall include provisions relating to the following:
165.12 	(1) the responsibilities of all parties to the agreement;
165.13 	(2) the payment terms, including the financial circumstances of the relative 
165.14 	custodian, the needs of the child, the amount and calculation of the relative custody 
165.15 	assistance payments, and that the amount of the payments shall be reevaluated annually;
165.16 	(3) the effective date of the agreement, which shall also be the anniversary date for 
165.17 	the purpose of submitting the annual affidavit under subdivision 8;
165.18 	(4) that failure to submit the affidavit as required by subdivision 8 will be grounds 
165.19 	for terminating the agreement;
165.20 	(5) the agreement's expected duration, which shall not extend beyond the child's 
165.21 	eighteenth birthday;
165.22 	(6) any specific known circumstances that could cause the agreement or payments 
165.23 	to be modified, reduced, or terminated and the relative custodian's appeal rights under 
165.24 	subdivision 9;
165.25 	(7) that the relative custodian must notify the local agency within 30 days of any of 
165.26 	the following:
165.27 	(i) a change in the child's status;
165.28 	(ii) a change in the relationship between the relative custodian and the child;
165.29 	(iii) a change in composition or level of income of the relative custodian's family;
165.30 	(iv) a change in eligibility or receipt of benefits under MFIP, or other assistance 
165.31 	program; and
165.32 	(v) any other change that could affect eligibility for or amount of relative custody 
165.33 	assistance;
165.34 	(8) that failure to provide notice of a change as required by clause (7) will be 
165.35 	grounds for terminating the agreement;
166.1 	(9) that the amount of relative custody assistance is subject to the availability of state 
166.2 	funds to reimburse the local agency making the payments;
166.3 	(10) that the relative custodian may choose to temporarily stop receiving payments 
166.4 	under the agreement at any time by providing 30 days' notice to the local agency and may 
166.5 	choose to begin receiving payments again by providing the same notice but any payments 
166.6 	the relative custodian chooses not to receive are forfeit; and
166.7 	(11) that the local agency will continue to be responsible for making relative custody 
166.8 	assistance payments under the agreement regardless of the relative custodian's place of 
166.9 	residence.

166.10 	EFFECTIVE DATE. This section is effective August 1, 2009.

166.11 	Sec. 18. Minnesota Statutes 2008, section 257.85, subdivision 6, is amended to read:
166.12 		Subd. 6.Eligibility criteria. (a) A local agency shall enter into a relative custody 
166.13 	assistance agreement under subdivision 5 if it certifies that the following criteria are met:
166.14 	(1) the juvenile court has determined or is expected to determine that the child, 
166.15 	under the former or current custody of the local agency, cannot return to the home of 
166.16 	the child's parents;
166.17 	(2) the court, upon determining that it is in the child's best interests, has issued 
166.18 	or is expected to issue an order transferring permanent legal and physical custody of 
166.19 	the child; and
166.20 	(3) the child either:
166.21 	(i) is a member of a sibling group to be placed together; or
166.22 	(ii) has a physical, mental, emotional, or behavioral disability that will require 
166.23 	financial support.
166.24 	When the local agency bases its certification that the criteria in clause (1) or (2) are 
166.25 	met upon the expectation that the juvenile court will take a certain action, the relative 
166.26 	custody assistance agreement does not become effective until and unless the court acts as 
166.27 	expected.
166.28 	(b) After November 24, 2010, no new relative custody assistance agreements shall 
166.29 	be executed. Agreements that were signed on or before November 24, 2010, and were not 
166.30 	in effect because the proposed transfer of permanent legal and physical custody of the 
166.31 	child did not occur on or before November 24, 2010, must be renegotiated according to 
166.32 	the terms of Northstar Care for Children in chapter 256O.

166.33 	EFFECTIVE DATE. This section is effective August 1, 2009.

167.1 	Sec. 19. Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision 
167.2 	to read:
167.3 		Subd. 11.Purpose and general eligibility requirements. (a) The purpose of the 
167.4 	adoption assistance program is to help make adoption possible for children who would 
167.5 	otherwise remain in foster care.
167.6 	(b) To be eligible for adoption assistance, a child must:
167.7 	(1) be determined to be a child with special needs, according to subdivision 12;
167.8 	(2) meet the applicable citizenship and immigration requirements in subdivision 
167.9 	13; and
167.10 	(3)(i) meet the criteria outlined in section 473 of the Social Security Act; or
167.11 	(ii) have had foster care payments paid on the child's behalf while in out-of-home 
167.12 	placement through the county or tribe, and be either under the guardianship of the 
167.13 	commissioner or under the jurisdiction of a Minnesota tribe, with adoption in accordance 
167.14 	with tribal law as the child's documented permanency plan.
167.15 	(c) In addition to the requirements in paragraph (b), the child's adoptive parents must 
167.16 	meet the applicable background study requirements outlined in subdivision 14.
167.17 	(d) The legally responsible agency shall make a title IV-E adoption assistance 
167.18 	eligibility determination for each child. Children who meet all eligibility criteria except 
167.19 	those specific to title IV-E adoption assistance shall receive adoption assistance paid 
167.20 	through state funds.

167.21 	EFFECTIVE DATE. This section is effective July 1, 2009.

167.22 	Sec. 20. Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision 
167.23 	to read:
167.24 		Subd. 12.Special needs determination. (a) A child is considered a child with 
167.25 	special needs under this section if all of the requirements in paragraphs (b) to (g) are met.
167.26 	(b) There has been a determination that the child cannot or should not be returned to 
167.27 	the home of the child's parents as evidenced by:
167.28 	(1) a court-ordered termination of parental rights;
167.29 	(2) a petition to terminate parental rights;
167.30 	(3) a consent to adopt accepted by the court under sections 260C.201, subdivision 
167.31 	11, and 259.24;
167.32 	(4) in circumstances when tribal law permits the child to be adopted without a 
167.33 	termination of parental rights, a judicial determination by tribal court indicating the valid 
167.34 	reason why the child cannot or should not return home;
168.1 	(5) a voluntary relinquishment under section 259.25 or 259.47 or, if relinquishment 
168.2 	occurred in another state, the applicable laws in that state; or
168.3 	(6) the death of the legal parent.
168.4 	(c) There exists a specific factor or condition because of which it is reasonable to 
168.5 	conclude that the child cannot be placed with adoptive parents without providing adoption 
168.6 	assistance as evidenced by:
168.7 	(1) a determination by the Social Security Administration that the child meets all 
168.8 	medical or disability requirements of title XVI of the Social Security Act with respect to 
168.9 	eligibility for Supplemental Security Income benefits;
168.10 	(2) a documented physical, mental, emotional, or behavioral disability not covered 
168.11 	under clause (1);
168.12 	(3) membership in a sibling group being adopted at the same time by the same parent;
168.13 	(4) adoptive placement in the home of a parent who previously adopted another child 
168.14 	born of the same mother or father for whom they receive adoption assistance; or
168.15 	(5) documentation that the child is a high-risk child, according to subdivision 17.
168.16 	(d) A reasonable but unsuccessful effort must have been made to place the child 
168.17 	with adoptive parents without providing adoption assistance as evidenced by:
168.18 	(1)(i) a documented search for an appropriate adoptive placement; or 
168.19 	(ii) a determination by the commissioner that such a search would not be in the best 
168.20 	interests of the child; and
168.21 	(2) a written statement from the identified prospective adoptive parents that they are 
168.22 	either unwilling or unable to adopt the child without adoption assistance.
168.23 	(e) To meet the requirement of a documented search for an appropriate adoptive 
168.24 	placement under paragraph (d), clause (1), item (i), the placing agency minimally must:
168.25 	(1) give consideration, as required by section 260C.212, subdivision 5, to placement 
168.26 	with a relative;
168.27 	(2) for an Indian child covered by the Indian Child Welfare Act, comply with the 
168.28 	placement preferences identified in the Indian Child Welfare Act and the Minnesota Indian 
168.29 	Family Preservation Act; and 
168.30 	(3) review all families approved for adoption who are associated with the placing 
168.31 	agency.
168.32 	If the review of families associated with the placing agency results in the 
168.33 	identification of an appropriate adoptive placement for the child, the placing agency must 
168.34 	provide documentation of the placement decision to the commissioner as part of the 
168.35 	application for adoption assistance.
169.1 	If two or more appropriate families are not approved or available within the placing 
169.2 	agency, the agency shall locate additional prospective adoptive families by registering the 
169.3 	child with the State Adoption Exchange, as required under section 259.75. If registration 
169.4 	with the State Adoption Exchange does not result in an appropriate family for the child, 
169.5 	the agency shall employ other recruitment methods, as outlined in recruitment policies and 
169.6 	procedures prescribed by the commissioner, to meet this requirement.
169.7 	(f) The requirement for a documented search for an appropriate adoptive placement 
169.8 	under paragraph (d), including review of all families approved for adoption that are 
169.9 	associated with the placing agency, registration of the child with the State Adoption 
169.10 	Exchange, and additional recruitment methods, must be waived if:
169.11 	(1) the child is being adopted by a relative;
169.12 	(2) the child is being adopted by foster parents with whom the child has developed 
169.13 	significant emotional ties while in their care as a foster child;
169.14 	(3) the child is being adopted by a family that previously adopted a child of the 
169.15 	same mother or father; or
169.16 	(4) the court determines that adoption by the identified family is in the child's best 
169.17 	interest.
169.18 	For an Indian child covered by the Indian Child Welfare Act, a waiver must not be 
169.19 	granted unless the placing agency has complied with the placement preferences identified 
169.20 	in the Indian Child Welfare Act and the Minnesota Indian Family Preservation Act.
169.21 	(g) Once the placing agency has determined that placement with an identified family 
169.22 	is in the child's best interest and made full written disclosure about the child's social 
169.23 	and medical history, the agency must ask the prospective adoptive parents if they are 
169.24 	willing to adopt the child without adoption assistance. If the identified family is either 
169.25 	unwilling or unable to adopt the child without adoption assistance, they must provide a 
169.26 	written statement to this effect to the placing agency to fulfill the requirement to make 
169.27 	a reasonable effort to place the child without adoption assistance, and a copy of this 
169.28 	statement shall be included in the adoption assistance application. If the identified family 
169.29 	desires to adopt the child without adoption assistance, the family must provide a written 
169.30 	statement to this effect to the placing agency and the statement must be maintained in the 
169.31 	permanent adoption record of the placing agency. For children under the commissioner's 
169.32 	guardianship, the placing agency shall submit a copy of this statement to the commissioner 
169.33 	to be maintained in the permanent adoption record.

169.34 	EFFECTIVE DATE. This section is effective July 1, 2009.

170.1 	Sec. 21. Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision 
170.2 	to read:
170.3 		Subd. 13.Citizenship and immigration status. (a) A child must be a citizen of the 
170.4 	United States or otherwise eligible for federal public benefits according to the Personal 
170.5 	Responsibility and Work Opportunity Reconciliation Act of 1996, as amended, in order to 
170.6 	be eligible for title IV-E adoption assistance.
170.7 	(b) A child must be a citizen of the United States or meet the qualified alien 
170.8 	requirements as defined in the Personal Responsibility and Work Opportunity 
170.9 	Reconciliation Act of 1996, as amended, in order to be eligible for state-funded adoption 
170.10 	assistance.

170.11 	EFFECTIVE DATE. This section is effective July 1, 2009.

170.12 	Sec. 22. Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision 
170.13 	to read:
170.14 		Subd. 14.Background study. (a) A background study under section 259.41 must 
170.15 	be completed on each prospective adoptive parent. If the background study reveals:
170.16 	(1) a felony conviction at any time for child abuse or neglect;
170.17 	(2) spousal abuse;
170.18 	(3) a crime against children, including child pornography;
170.19 	(4) a crime involving violence, including rape, sexual assault, or homicide, but not 
170.20 	including other physical assault or battery; or
170.21 	(5) a felony conviction within the past five years for physical assault, battery, or a 
170.22 	drug-related offense, 
170.23 	the adoptive parent is prohibited from receiving title IV-E adoption assistance on behalf of 
170.24 	an otherwise eligible child.
170.25 	(b) A prospective adoptive parent who possesses one of the felony convictions in 
170.26 	paragraph (a) may receive state-funded adoption assistance on behalf of an otherwise 
170.27 	eligible child if the court has made a judicial determination that:
170.28 	(1) the legally responsible agency has thoroughly reviewed the felony conviction 
170.29 	and has considered the impact, if any, that the conviction may have on the child's safety, 
170.30 	well-being, and permanency;
170.31 	(2) the conviction likely does not pose a current or future safety risk to the child;
170.32 	(3) there is no other available permanency resource that is appropriate for the 
170.33 	child; and 
170.34 	(4) the adoptive placement is in the child's best interest.

171.1 	EFFECTIVE DATE. This section is effective July 1, 2009.

171.2 	Sec. 23. Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision 
171.3 	to read:
171.4 		Subd. 15.Residency. A child placed in the state from another state or a tribe outside 
171.5 	of the state is not eligible for state-funded adoption assistance through the state. A child 
171.6 	placed in the state from another state or a tribe outside of the state may be eligible for title 
171.7 	IV-E adoption assistance through the state of Minnesota if all eligibility factors are met 
171.8 	and there is no state agency that has responsibility for placement and care of the child.

171.9 	EFFECTIVE DATE. This section is effective July 1, 2009.

171.10 	Sec. 24. Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision 
171.11 	to read:
171.12 		Subd. 16.Exceptions and exclusions. Payments for adoption assistance shall 
171.13 	not be made to a biological parent of the child or a stepparent who adopts the child. 
171.14 	Direct placement adoptions under section 259.47 or the equivalent in tribal code are 
171.15 	not eligible for state-funded adoption assistance. A child who is adopted by the child's 
171.16 	legal custodian or guardian is not eligible for state-funded adoption assistance. A child 
171.17 	who is adopted by the child's legal custodian or guardian may be eligible for title IV-E 
171.18 	adoption assistance if all required eligibility factors are met. International adoptions are 
171.19 	not eligible for adoption assistance unless the adopted child has been placed into foster 
171.20 	care through the public child welfare system subsequent to the failure of the adoption 
171.21 	and all required eligibility factors are met.

171.22 	EFFECTIVE DATE. This section is effective July 1, 2009.

171.23 	Sec. 25. Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision 
171.24 	to read:
171.25 		Subd. 17.Documentation. Documentation must be provided to verify that a child 
171.26 	meets the special needs criteria outlined in subdivision 12.
171.27 	(a) Documentation of a disability is limited to evidence deemed appropriate by 
171.28 	the commissioner.
171.29 	(b) To qualify as being a high-risk child, the placing agency must provide to the 
171.30 	commissioner one or more of the following:
171.31 	(1) documented information in a county or tribal social service department record 
171.32 	or court record that a relative within the first or second degree of the child has a medical 
172.1 	diagnosis or medical history, including diagnosis of a significant mental health or 
172.2 	chemical dependency issue, which could result in the child's development of a disability 
172.3 	during childhood;
172.4 	(2) documented information that while in the public child welfare system, the child 
172.5 	has experienced three or more placements with extended family or different foster homes 
172.6 	that could affect the normal attachment process;
172.7 	(3) documented evidence in a county or tribal social service department record 
172.8 	that the child experienced neglect in the first three years of life, or sustained physical 
172.9 	injury, sexual abuse, or physical disease that could have a long-term effect on physical, 
172.10 	emotional, or mental development; or
172.11 	(4) documented evidence in a medical or hospital record, law enforcement record, 
172.12 	county or tribal social service department record, court record, or record of an agency 
172.13 	under a contract with a county social service agency or the state to provide child welfare 
172.14 	services that the birth mother used drugs or alcohol during pregnancy which could later 
172.15 	result in the child's development of a disability.

172.16 	EFFECTIVE DATE. This section is effective July 1, 2009.

172.17 	Sec. 26. Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision 
172.18 	to read:
172.19 		Subd. 18.Termination. (a) An adoption assistance agreement shall terminate in 
172.20 	any of the following circumstances:
172.21 	(1) the child attains the age of 18, unless an extension as outlined in subdivisions 20 
172.22 	to 23, is applied for by the adoptive parents and granted by the commissioner;
172.23 	(2) the commissioner determines that the adoptive parents are no longer legally 
172.24 	responsible for support of the child;
172.25 	(3) the commissioner determines that the adoptive parents are no longer providing 
172.26 	financial support to the child;
172.27 	(4) death of the child; or
172.28 	(5) the adoptive parents request termination of the adoption assistance agreement 
172.29 	in writing.
172.30 	(b) An adoptive parent is considered no longer legally responsible for support of the 
172.31 	child in any of the following circumstances:
172.32 	(1) parental rights to the child are legally terminated;
172.33 	(2) permanent legal and physical custody or guardianship of the child is transferred 
172.34 	to another individual;
172.35 	(3) death of the adoptive parent;
173.1 	(4) enlistment of the child in the military;
173.2 	(5) marriage of the child; or
173.3 	(6) emancipation of the child through legal action of another state.

173.4 	EFFECTIVE DATE. This section is effective July 1, 2009.

173.5 	Sec. 27. Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision 
173.6 	to read:
173.7 		Subd. 19.Death of adoptive parent or adoption dissolution. (a) The adoption 
173.8 	assistance agreement ends upon death or termination of parental rights of both the adoptive 
173.9 	parents in the case of a two-parent adoption, or the sole adoptive parent in the case of a 
173.10 	single-parent adoption, but the child maintains eligibility for state-funded or title IV-E 
173.11 	adoption assistance in a subsequent adoption if the following criteria are met:
173.12 	(1) the child is determined to be a child with special needs as outlined in subdivision 
173.13 	12;
173.14 	(2) the subsequent adoptive parents reside in Minnesota; and
173.15 	(3) no state agency outside of Minnesota has responsibility for placement and care 
173.16 	of the child at the time of the subsequent adoption.
173.17 	(b) According to federal regulations, if the child had a title IV-E adoption assistance 
173.18 	agreement prior to the death of the adoptive parents or dissolution of the adoption, and a 
173.19 	state agency outside of the state of Minnesota has responsibility for placement and care of 
173.20 	the child at the time of the subsequent adoption, the state of Minnesota is not responsible 
173.21 	for determining whether the child meets the definition of special needs, entering into the 
173.22 	adoption assistance agreement, and making any adoption assistance payments outlined in 
173.23 	the new agreement.
173.24 	(c) According to federal regulations, if the child had a title IV-E adoption assistance 
173.25 	agreement prior to the death of the adoptive parents or dissolution of the adoption, the 
173.26 	subsequent adoptive parents reside outside of the state of Minnesota, and no state agency 
173.27 	has responsibility for placement and care of the child at the time of the subsequent 
173.28 	adoption, the state of Minnesota is not responsible for determining whether the child 
173.29 	meets the definition of special needs, entering into the adoption assistance agreement, and 
173.30 	making any adoption assistance payments outlined in the new agreement.

173.31 	EFFECTIVE DATE. This section is effective July 1, 2009.

173.32 	Sec. 28. Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision 
173.33 	to read:
174.1 		Subd. 20.Extension, past age 18. Under certain limited circumstances a child 
174.2 	may qualify for extension of the adoption assistance agreement beyond the date the 
174.3 	child attains age 18. An application for extension must be completed and submitted by 
174.4 	the adoptive parent at least 90 days prior to the date the child attains age 18, unless the 
174.5 	child's adoption is scheduled to finalize less than 90 days prior to that date in which 
174.6 	case the application for extension must be completed and submitted with the adoption 
174.7 	assistance application. The application for extension must be made according to policies 
174.8 	and procedures prescribed by the commissioner, including documentation of eligibility, 
174.9 	and on forms prescribed by the commissioner.

174.10 	EFFECTIVE DATE. This section is effective July 1, 2009.

174.11 	Sec. 29. Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision 
174.12 	to read:
174.13 		Subd. 21.Extension based on a continuing physical or mental disability. (a) 
174.14 	Extensions based on a child's continuing physical or mental disability must be applied 
174.15 	for prior to the date the child attains age 18 and according to the requirements under 
174.16 	subdivision 20. The commissioner must not grant an extension on this basis if an extension 
174.17 	based on continued enrollment in a secondary education or being a child whose adoption 
174.18 	finalized after age 16 was previously granted for the child.
174.19 	(b) A child is eligible for extension of the adoption assistance agreement up to the 
174.20 	date the child attains age 21 if the following criteria are met:
174.21 	(1) the child has a mental or physical disability upon which eligibility for adoption 
174.22 	assistance was based which warrants the continuation of assistance;
174.23 	(2) the child is unable to obtain self-sustaining employment due to the 
174.24 	aforementioned mental or physical disability; and 
174.25 	(3) the child needs significantly more care and support than what is typical for an 
174.26 	individual of the same age.

174.27 	EFFECTIVE DATE. This section is effective July 1, 2009.

174.28 	Sec. 30. Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision 
174.29 	to read:
174.30 		Subd. 22.Extension based on continued enrollment in a secondary education 
174.31 	program. (a) If a child does not qualify for extension based on a continuing physical or 
174.32 	mental disability or a parent chooses not to apply for such extension, the adoptive parents 
175.1 	may make an application for continuation of adoption assistance based on enrollment in 
175.2 	a secondary education program.
175.3 	(b) If a child is enrolled full-time in a secondary education program or a program 
175.4 	leading to an equivalent credential, the child is eligible for extension to the expected 
175.5 	gradation date or the date the child attains age 19, whichever is earlier. If a child receives 
175.6 	a school-based extension and at any time ceases to be enrolled in a full-time secondary 
175.7 	education program or a program leading to an equivalent credential, the adoptive parents 
175.8 	are responsible to notify the commissioner and the agreement must terminate.
175.9 	(c) Extensions based on continuation in a secondary education program must be paid 
175.10 	from state funds only, unless the child meets the extension criteria outlined in subdivision 
175.11 	23.

175.12 	EFFECTIVE DATE. This section is effective July 1, 2009.

175.13 	Sec. 31. Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision 
175.14 	to read:
175.15 		Subd. 23.Extension for children whose adoption finalized after age 16. A child 
175.16 	who attained the age of 16 prior to finalization of their adoption is eligible for extension of 
175.17 	the adoption assistance agreement to the date the child attains age 21 if the child is:
175.18 	(1) completing a secondary education program or a program leading to an equivalent 
175.19 	credential;
175.20 	(2) enrolled in an institution which provides postsecondary or vocational education;
175.21 	(3) participating in a program or activity designed to promote or remove barriers to 
175.22 	employment;
175.23 	(4) employed for at least 80 hours per month; or
175.24 	(5) incapable of doing any of the activities described in clauses (1) to (4) due to a 
175.25 	medical condition, which incapability is supported by regularly updated information in 
175.26 	the case plan of the child.

175.27 	EFFECTIVE DATE. This section is effective July 1, 2009.

175.28 	Sec. 32. Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision 
175.29 	to read:
175.30 		Subd. 24.Adoption assistance certification. The placing agency shall certify a 
175.31 	child as eligible for adoption assistance according to policies and procedures, and on 
175.32 	forms, prescribed by the commissioner. Professional documentation must be submitted 
175.33 	with the certification, and when applicable, the supplemental adoption assistance needs 
176.1 	assessment, to establish eligibility for the amount of payment requested. This form must 
176.2 	be submitted with the adoption assistance agreement under subdivision 25.

176.3 	EFFECTIVE DATE. This section is effective July 1, 2009.

176.4 	Sec. 33. Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision 
176.5 	to read:
176.6 		Subd. 25.Adoption assistance agreement. (a) In order to receive adoption 
176.7 	assistance benefits, a written, binding agreement on a form approved by the commissioner 
176.8 	must be established and completed by the placing agency prior to finalization of the 
176.9 	adoption. The agreement must be negotiated with the parents, in the case of a two-parent 
176.10 	adoption, or the adoptive parent, in the case of a single-parent adoption, as required in 
176.11 	subdivision 26. The parents, an approved representative from the placing agency, and 
176.12 	the commissioner or the commissioner's designee must sign the agreement prior to the 
176.13 	effective date of the adoption decree. The adoption assistance certification and agreement 
176.14 	must be granted or denied by the commissioner no later than 15 working days after receipt. 
176.15 	A fully executed copy of the signed agreement must be given to each party. Termination 
176.16 	or disruption of the preadoptive placement preceding adoption finalization makes the 
176.17 	agreement with that family void.
176.18 	(b) The agreement must specify the following:
176.19 	(1) duration of the agreement;
176.20 	(2) the nature and amount of any payment, services, and assistance to be provided 
176.21 	under such agreement;
176.22 	(3) the child's eligibility for Medicaid services;
176.23 	(4) the terms of the payment;
176.24 	(5) eligibility for reimbursement of nonrecurring expenses associated with adopting 
176.25 	the child, to the extent that the total cost does not exceed $2,000 per child;
176.26 	(6) that the agreement must remain in effect regardless of the state of which the 
176.27 	adoptive parents are residents at any given time;
176.28 	(7) provisions for modification of the terms of the agreement; and
176.29 	(8) the effective date of the agreement.
176.30 	(c) The agreement is effective the date of the adoption decree.

176.31 	EFFECTIVE DATE. This section is effective July 1, 2009.

176.32 	Sec. 34. Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision 
176.33 	to read:
177.1 		Subd. 26.Negotiation of the agreement. (a) A monthly payment is provided 
177.2 	as part of the adoption assistance agreement to support the care of a child who has 
177.3 	manifested special needs. The amount of the payment made on behalf of a child eligible 
177.4 	for adoption assistance is determined through agreement between the adoptive parents 
177.5 	and the commissioner or the commissioner's designee. The agreement shall take into 
177.6 	consideration the circumstances of the adopting parents and the needs of the child being 
177.7 	adopted. The income of the adoptive parents must not be taken into consideration when 
177.8 	determining eligibility for adoption assistance or the amount of the payments under 
177.9 	subdivision 28. At the written request of the adoptive parents, the amount of the payment 
177.10 	in the agreement may be renegotiated when there is a change in the child's needs or the 
177.11 	family's circumstances.
177.12 	(b) The adoption assistance agreement of a child who is identified as a high-risk child 
177.13 	must not include a monthly payment unless and until the potential disability manifests 
177.14 	itself, as documented by an appropriate professional, and the commissioner authorizes 
177.15 	commencement of payment by modifying the agreement accordingly. An adoptive parent 
177.16 	of a high-risk child with an adoption assistance agreement may request a renegotiation of 
177.17 	the adoption assistance agreement under subdivision 27 to include a monthly payment, 
177.18 	if the parent has written professional documentation that the potential disability upon 
177.19 	which eligibility for the agreement was based has manifested itself. Documentation of the 
177.20 	disability shall be limited to evidence deemed appropriate by the commissioner.

177.21 	EFFECTIVE DATE. This section is effective July 1, 2009.

177.22 	Sec. 35. Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision 
177.23 	to read:
177.24 		Subd. 27.Renegotiation of the agreement. (a) An adoptive parent of a child 
177.25 	with an adoption assistance agreement may request renegotiation of the agreement when 
177.26 	there is a change in the needs of the child or in the family's circumstances. When an 
177.27 	adoptive parent requests renegotiation of the agreement, a reassessment of the child 
177.28 	must be completed. If the reassessment indicates that the child's level has changed, 
177.29 	the commissioner or the commissioner's designee and the parent shall renegotiate the 
177.30 	agreement to include a payment with the level determined appropriate through the 
177.31 	reassessment process. The agreement must not be renegotiated unless the commissioner 
177.32 	and the parent mutually agree to the changes. The effective date of any renegotiated 
177.33 	agreement must be determined by the commissioner.
177.34 	(b) An adoptive parent of a high-risk child with an adoption assistance agreement 
177.35 	may request renegotiation of the agreement to include a monthly payment, if the parent 
178.1 	has written professional documentation that the potential disability upon which eligibility 
178.2 	for the agreement was based has manifested itself. Documentation of the disability must 
178.3 	be limited to evidence deemed appropriate by the commissioner. Prior to renegotiating 
178.4 	the agreement, a reassessment of the child must be conducted. The reassessment must 
178.5 	be used to renegotiate the agreement to include an appropriate monthly payment. The 
178.6 	agreement must not be renegotiated unless the commissioner and the adoptive parent 
178.7 	mutually agree to the changes. The effective date of any renegotiated agreement must be 
178.8 	determined by the commissioner.

178.9 	EFFECTIVE DATE. This section is effective July 1, 2009.

178.10 	Sec. 36. Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision 
178.11 	to read:
178.12 		Subd. 28.Benefits and payments. (a) Eligibility for medical assistance for children 
178.13 	receiving adoption assistance is as specified in section 256B.055.
178.14 	(b) The basic maintenance payments must be made according to the following 
178.15 	schedule for all children except those eligible for adoption assistance based on high risk of 
178.16 	developing a disability:

178.17		Birth through age five
	up to $247 per month
	
178.18		Age six through age 11
	up to $277 per month
	
178.19		Age 12 through age 14
	up to $307 per month
	
178.20		Age 15 and older
	up to $337 per month
	
178.21 	A child must receive the maximum payment amount for the child's age, unless a lesser 
178.22 	amount is negotiated with and agreed to by the prospective adoptive parent.
178.23 	(c) Supplemental adoption assistance needs payments, in addition to basic 
178.24 	maintenance payments, are available for a child whose disability necessitates care, 
178.25 	supervision, and structure beyond that ordinarily provided in a family setting to persons 
178.26 	of the same age. These payments are related to the severity of a child's disability and 
178.27 	the level of parenting required to care for the child, and must be made according to the 
178.28 	following schedule:

178.29		Level I
	up to $150 per month
	
178.30		Level II
	up to $275 per month
	
178.31		Level III
	up to $400 per month
	
178.32		Level IV
	up to $500 per month
	
178.33 	A child's level shall be assessed on a supplemental maintenance needs assessment form 
178.34 	prescribed by the commissioner. A child must receive the maximum payment amount for 
179.1 	the child's assessed level, unless a lesser amount is negotiated with and agreed to by 
179.2 	the prospective adoptive parent.
179.3 	(d) Reimbursement for special nonmedical expenses is available to all children 
179.4 	except those eligible for adoption assistance based on high risk of developing a disability. 
179.5 	Reimbursements under this paragraph will be made only after the adoptive parents 
179.6 	document that an application for the applicable service was denied by the local social 
179.7 	service agency, community agencies, local school district, local public health department, 
179.8 	the parent's insurance provider, or the child's Medicaid program. Reimbursements must 
179.9 	be made according to the policies and procedures prescribed by the commissioner and 
179.10 	are limited to:
179.11 	(1) child care;
179.12 	(2) respite care;
179.13 	(3) camping program;
179.14 	(4) home and vehicle modifications;
179.15 	(5) family counseling;
179.16 	(6) postadoption counseling;
179.17 	(7) services to children under age three who are developmentally delayed;
179.18 	(8) specialized communication equipment; and
179.19 	(9) burial expenses.

179.20 	EFFECTIVE DATE. This section is effective July 1, 2009.

179.21 	Sec. 37. Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision 
179.22 	to read:
179.23 		Subd. 29.Child income or income attributable to the child. If a child for whom a 
179.24 	parent is receiving adoption assistance is also receiving Supplemental Security Income 
179.25 	(SSI) or Retirement, Survivors, Disability Insurance (RSDI), the certifying agency shall 
179.26 	inform the adoptive parents that the child's adoption assistance must be reported to the 
179.27 	Social Security Administration.

179.28 	EFFECTIVE DATE. This section is effective July 1, 2009.

179.29 	Sec. 38. Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision 
179.30 	to read:
179.31 		Subd. 30.Payments. (a) Payments to parents under adoption assistance must 
179.32 	be made monthly.
180.1 	(b) Payments must commence when the commissioner receives the adoption decree 
180.2 	from the court, the legally responsible agency, or the parent. Payments must be made 
180.3 	according to policies and procedures prescribed by the commissioner.

180.4 	EFFECTIVE DATE. This section is effective July 1, 2009.

180.5 	Sec. 39. Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision 
180.6 	to read:
180.7 		Subd. 31.Overpayments. (a) The commissioner has the authority to collect any 
180.8 	amount of adoption assistance paid to a parent in excess of the payment due. Payments 
180.9 	covered by this subdivision include basic maintenance needs payments, supplemental 
180.10 	maintenance needs payments, and reimbursements of nonmedical expenses under 
180.11 	subdivision 28. Prior to any collection, the commissioner or designee shall notify the 
180.12 	parent in writing, including:
180.13 	(1) the amount of the overpayment and an explanation of the cause of overpayment;
180.14 	(2) clarification of the corrected amount;
180.15 	(3) a statement of the legal authority for the decision;
180.16 	(4) information about how the parent can correct the overpayment;
180.17 	(5) if repayment is required, when the payment is due and a person to contact to 
180.18 	review a repayment plan;
180.19 	(6) a statement that the parent has a right to a fair hearing review by the department; 
180.20 	and
180.21 	(7) the procedure for seeking such a review.

180.22 	EFFECTIVE DATE. This section is effective July 1, 2009.

180.23 	Sec. 40. Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision 
180.24 	to read:
180.25 		Subd. 32.Payee. For adoption assistance cases, the payment may only be made to 
180.26 	the adoptive parent specified on the agreement. If there is more than one adoptive parent, 
180.27 	both parties must be listed as the payee unless otherwise specified in writing according 
180.28 	to policies and procedures prescribed by the commissioner. In the event of divorce or 
180.29 	separation of the parents, a change of payee may be made in writing according to policies 
180.30 	and procedures prescribed by the commissioner. If both parents are in agreement as to 
180.31 	the change, it may be made according to a process prescribed by the commissioner. If 
180.32 	there is not agreement as to the change, a court order indicating the party who is to receive 
180.33 	the payment is needed before a change can be processed. In the event of the death of the 
181.1 	payee, a change of payee consistent with subdivision 19 may be made in writing according 
181.2 	to policies and procedures prescribed by the commissioner.

181.3 	EFFECTIVE DATE. This section is effective July 1, 2009.

181.4 	Sec. 41. Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision 
181.5 	to read:
181.6 		Subd. 33.Notification of change. (a) An adoptive parent who has an adoption 
181.7 	assistance agreement in place shall keep the agency administering the program informed 
181.8 	of the parent's address and circumstances which would make them ineligible for the 
181.9 	payments or eligible for the payments in a different amount.
181.10 	(b) For the duration of the agreement, the adoptive parent agrees to notify the agency 
181.11 	administering the program in writing within 30 days of the following changes:
181.12 	(1) change in the family's address;
181.13 	(2) change in the legal custody status of the child;
181.14 	(3) child's completion of high school, if this occurs after the child attains age 18;
181.15 	(4) date of termination of the parental rights of the adoptive parent, transfer of 
181.16 	permanent legal and physical custody to another person, or other determination that the 
181.17 	adoptive parent is no longer legally responsible for the support of the child;
181.18 	(5) date the adoptive parent is not longer providing support to the child;
181.19 	(6) date of death of the child;
181.20 	(7) date of death of the adoptive parent;
181.21 	(8) date the child enlists in the military;
181.22 	(9) date of marriage of the child;
181.23 	(10) date the child becomes an emancipated minor through legal action of another 
181.24 	state;
181.25 	(11) separation or divorce of the adoptive parent; and
181.26 	(12) residence of the child outside the home for a period of more than 30 consecutive 
181.27 	days.

181.28 	EFFECTIVE DATE. This section is effective July 1, 2009.

181.29 	Sec. 42. Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision 
181.30 	to read:
181.31 		Subd. 34.Termination notice for parent. The commissioner shall provide the 
181.32 	child's parent written notice of termination of payment. Termination notices must be sent 
181.33 	at least 15 days before the final payment or in the case of an unplanned termination, 
182.1 	the notice is sent within three days of the end of the payment. The written notice must 
182.2 	minimally include the following:
182.3 	(1) the date payment will end;
182.4 	(2) the reason payments will end and the event that is the basis to terminate payment;
182.5 	(3) a statement that the parent has a right to a fair hearing review by the department 
182.6 	consistent with section 256.045, subdivision 3;
182.7 	(4) the procedure to request a fair hearing; and
182.8 	(5) the agency name and address to which a fair hearing request must be sent.

182.9 	EFFECTIVE DATE. This section is effective July 1, 2009.

182.10 	Sec. 43. Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision 
182.11 	to read:
182.12 		Subd. 35.Reimbursement of costs through purchase of service. (a) Subject 
182.13 	to policies and procedures prescribed by the commissioner and the provisions of this 
182.14 	subdivision, a child-placing agency licensed in Minnesota or any other state, or local 
182.15 	or tribal social services agency shall receive a reimbursement from the commissioner 
182.16 	equal to 100 percent of the reasonable and appropriate cost of providing child-specific 
182.17 	adoption services. Adoption services under this subdivision may include child-specific 
182.18 	recruitment, child-specific training and home studies for prospective adoptive parents, 
182.19 	and placement services.
182.20 	(b) An eligible child must have a goal of adoption, which may include an adoption 
182.21 	according to tribal law, and meet one of the following criteria:
182.22 	(1) is a ward of the Minnesota commissioner of human services or a ward of a 
182.23 	Minnesota tribal court under section 260.755, subdivision 20, who meets one of the 
182.24 	criteria under subdivision 12, paragraph (b), and one of the criteria under subdivision 12, 
182.25 	paragraph (c), clauses (1) to (5); or
182.26 	(2) is under the guardianship of a Minnesota-licensed child-placing agency who 
182.27 	meets one of the eligibility criteria under subdivision 12, paragraph (b), and one of the 
182.28 	criteria in subdivision 12, paragraph (c), clauses (1) to (4).
182.29 	(c) A child-placing agency licensed in Minnesota or any other state shall receive 
182.30 	reimbursement for adoption services it purchase for or directly provides to an eligible 
182.31 	child. Tribal social services shall receive reimbursement for adoption services it purchases 
182.32 	for or directly provides to an eligible child. A local social services agency shall receive 
182.33 	reimbursement only for adoption services it purchases for an eligible child.
182.34 	(d) Before providing adoption services for which reimbursement is sought under this 
182.35 	subdivision, a reimbursement agreement, on the forms prescribed by the commissioner, 
183.1 	must be signed by the commissioner. No reimbursement under this subdivision must 
183.2 	be made to an agency for services provided prior to signatures by all required parties 
183.3 	on a reimbursement agreement. Separate reimbursement agreements must be made for 
183.4 	each child and separate records must be kept on each child for whom a reimbursement 
183.5 	agreement is made. Reimbursement shall not be made unless the commissioner of 
183.6 	human services agrees that the reimbursement costs are reasonable and appropriate. The 
183.7 	commissioner may spend up to $16,000 for each purchase of service agreement per 
183.8 	child. Only one agreement per child is allowed, unless an exception is granted by the 
183.9 	commissioner and agreed to in writing by the commissioner prior to commencement of 
183.10 	services. Funds encumbered and obligated under such an agreement for the child remain 
183.11 	available until the terms of the agreement are fulfilled or the agreement is terminated.
183.12 	(e) The commissioner shall make reimbursement payments directly to the agency 
183.13 	providing the service if direct reimbursement is specified by the purchase of service 
183.14 	agreement and if the request for reimbursement is submitted by the local or tribal social 
183.15 	services agency along with verification on a form prescribed by the commissioner that 
183.16 	the service was provided.
183.17 	(f) The commissioner shall set aside an amount not to exceed five percent of the 
183.18 	total amount of fiscal year appropriation from the state of Minnesota for the adoption 
183.19 	assistance program to reimburse placing agencies for adoption services. When adoption 
183.20 	assistance payments for children's needs exceed 95 percent of the total amount of fiscal 
183.21 	year appropriation from the state of Minnesota for the adoption assistance program, the 
183.22 	amount of reimbursement available to placing agencies for adoption services is reduced 
183.23 	correspondingly.

183.24 	EFFECTIVE DATE. This section is effective July 1, 2009.

183.25 	Sec. 44. Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision 
183.26 	to read:
183.27 		Subd. 36.Indian children. A child certified as eligible for adoption assistance 
183.28 	under this section who is protected under the Federal Indian Child Welfare Act of 1978 
183.29 	should, whenever possible, be served by the tribal governing body, tribal courts, or a 
183.30 	licensed Indian child-placing agency.

183.31 	EFFECTIVE DATE. This section is effective July 1, 2009.

183.32 	Sec. 45. Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision 
183.33 	to read:
184.1 		Subd. 37.Administration responsibilities. (a) Subject to commissioner approval, 
184.2 	the legally responsible agency shall determine the eligibility for adoption assistance under 
184.3 	this section, and for those children determined eligible, shall further determine each child's 
184.4 	eligibility for title IV-E of the Social Security Act.
184.5 	(b) The legally responsible agency is responsible for assisting the commissioner with 
184.6 	the administration of the adoption assistance by conducting assessments, reassessments, 
184.7 	negotiations, and other activities as specified by the commissioner under this section.
184.8 	(c) The certifying agency shall notify an adoptive parent of a child's eligibility 
184.9 	for Medicaid in their state of residence. The certifying agency shall refer the adoptive 
184.10 	parent to apply for Medicaid in the financial office in their county of residence. The 
184.11 	certifying agency shall inform adoptive parents of the requirement to comply with the 
184.12 	rules of the applicable Medicaid program.

184.13 	EFFECTIVE DATE. This section is effective July 1, 2009.

184.14 	Sec. 46. Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision 
184.15 	to read:
184.16 		Subd. 38.Procedures, requirements, and deadlines. The commissioner shall 
184.17 	specify procedures, requirements, and deadlines for the administration of adoption 
184.18 	assistance in accordance with this section. As needed, the commissioner shall review all 
184.19 	procedures, requirements, and deadlines, including the designated forms, in consultation 
184.20 	with counties, tribes, and representatives of parents, and may alter them as needed.

184.21 	EFFECTIVE DATE. This section is effective July 1, 2009.

184.22 	Sec. 47. Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision 
184.23 	to read:
184.24 		Subd. 39.Administration of title IV-E programs. The title IV-E adoption 
184.25 	assistance program shall operate within the statute and rules set forth by the federal 
184.26 	government in the Social Security Act and Code of Federal Regulations.

184.27 	EFFECTIVE DATE. This section is effective July 1, 2009.

184.28 	Sec. 48. Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision 
184.29 	to read:
184.30 		Subd. 40.Reporting. The commissioner shall specify required fiscal and statistical 
184.31 	reports under section 256.01, subdivision 2, paragraph (q), and other reports as necessary.

185.1 	EFFECTIVE DATE. This section is effective July 1, 2009.

185.2 	Sec. 49. Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision 
185.3 	to read:
185.4 		Subd. 41.Promotion of programs. The commissioner or the commissioner's 
185.5 	designee shall actively seek ways to promote the adoption assistance program, including 
185.6 	informing prospective adoptive parents of eligible children under the commissioner's 
185.7 	guardianship of the availability of adoption assistance. All families who adopt children 
185.8 	under the commissioner's guardianship must be informed as to the adoption tax credit.

185.9 	EFFECTIVE DATE. This section is effective July 1, 2009.

185.10 	Sec. 50. Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision 
185.11 	to read:
185.12 		Subd. 42.Appeals and fair hearings. (a) A prospective adoptive parent has the 
185.13 	right to appeal to the commissioner under section 256.045 when eligibility for adoption 
185.14 	assistance is denied, and when payment or the agreement for an eligible child is modified 
185.15 	or terminated.
185.16 	(b) An adoptive parent has additional rights to appeal to the commissioner under 
185.17 	section 256.045. These include when the commissioner terminates or modifies the 
185.18 	adoption assistance agreement or when the commissioner denies an application for 
185.19 	adoption assistance. A prospective adoptive parent who disagrees with a decision by the 
185.20 	commissioner prior to finalization of the adoption may request review of the decision 
185.21 	by the commissioner, or may appeal the decision under section 256.045. An adoption 
185.22 	assistance agrement must be signed and in effect prior to the court order that finalizes the 
185.23 	adoption; however, in some cases, there may be extenuating circumstances as to why an 
185.24 	agreement was not entered into prior to the adoption finalization. An adoptive parent who 
185.25 	believes that extenuating circumstances exist in the case of an adoption finalizing prior to 
185.26 	entering of an adoption assistance agreement may request a fair hearing. Parents have 
185.27 	the responsibility of proving that extenuating circumstances exist. Parents are required to 
185.28 	provide written documentation of each eligibility criterion at the fair hearing. Examples 
185.29 	of extenuating circumstances include: relevant facts regarding the child were known by 
185.30 	the placing agency and not presented to the parent prior to finalization of the adoption, or 
185.31 	failure by the commissioner or the commissioner's designee to advise a potential parent 
185.32 	about the availability of adoption assistance for a child in the state foster care system. If 
185.33 	an appeals judge finds through the fair hearing process that extenuating circumstances 
185.34 	existed and that the child met all eligibility criteria at the time the adoption was finalized, 
186.1 	the effective date and any associated federal financial participation shall be retroactive to 
186.2 	the date of the request for a fair hearing.

186.3 	EFFECTIVE DATE. This section is effective July 1, 2009.

186.4 	Sec. 51. Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision 
186.5 	to read:
186.6 		Subd. 43.No new executions of adoption assistance agreements. After November 
186.7 	24, 2010, no new adoption assistance agreements must be executed under this section. 
186.8 	Agreements that were signed on or before November 24, 2010, and were not in effect 
186.9 	because the adoption finalization of the child did not occur on or before November 24, 
186.10 	2010, must be renegotiated according to the terms of Northstar Care for Children under 
186.11 	section 256O.001 to 256O.270. Agreements signed and in effect on or before November 
186.12 	24, 2010, must continue according to the terms of this section and applicable rules for 
186.13 	the duration of the agreement, unless the adoptive parents choose to renegotiate their 
186.14 	agreement in accordance with the terms of Northstar Care for Children. After November 
186.15 	24, 2010, this section and associated rules must apply to a child whose adoption assistance 
186.16 	agreements were in effect on or before November 24, 2010, and whose adoptive parents 
186.17 	have chosen not to renegotiate their agreement according to the terms of Northstar Care 
186.18 	for Children.

186.19 	EFFECTIVE DATE. This section is effective July 1, 2009.

186.20 	Sec. 52. Minnesota Statutes 2008, section 260B.441, is amended to read:
186.21 	260B.441 COST, PAYMENT FOR FOSTER CARE, RESIDENTIAL 
186.22 	PLACEMENT, AND CLOTHING ALLOWANCE.
186.23 		Subdivision 1.Responsibility for placement costs. In addition to the usual 
186.24 	care and services given by public and private agencies, the necessary cost incurred by 
186.25 	the commissioner of human services in providing care for such child shall be paid by 
186.26 	the county committing such child which, subject to uniform rules established by the 
186.27 	commissioner of human services, may receive a reimbursement not exceeding one-half of 
186.28 	such costs from funds made available for this purpose by the legislature during the period 
186.29 	beginning July 1, 1985, and ending December 31, 1985. Beginning January 1, 1986, the 
186.30 	necessary cost incurred by the commissioner of human services in providing care for 
186.31 	the child must be paid by the county committing the child.Chapter 256O establishes 
186.32 	the responsibility for cost and payment for eligible children placed in family foster 
186.33 	care settings or in permanent placement with a relative custodian or adoptive parent. 
187.1 	Responsibility for placement costs and payment in any other setting is with the county, 
187.2 	consistent with chapter 256G, or the tribes authorized in section 256.01, subdivision 14b.
187.3 		Subd. 2.Federal title IV-E. Foster care maintenance payments under title IV-E of 
187.4 	the Social Security Act are defined in subdivisions 4 and 5 and section 256O.020. Every 
187.5 	effort must be made to establish a child's eligibility for title IV-E, using the criteria in the 
187.6 	Social Security Act, United States Code, title 42, sections 670 to 676. Payment of title 
187.7 	IV-E funds in Northstar Care for Children is specified in section 256O.260. In all other 
187.8 	circumstances, the county or tribal agency authorized in section 256.01, subdivision 14b, 
187.9 	responsible for payment of the maintenance costs must be reimbursed from the federal 
187.10 	funds available for the purpose.
187.11 		Subd. 3.Child resources. Where such When a child in foster care is eligible to 
187.12 	receive a grant of Minnesota family investment program Retirement, Survivors, and 
187.13 	Disability Insurance (RSDI), or Supplemental Security Income for the aged, blind, and 
187.14 	disabled, or a foster care maintenance payment under title IV-E of the Social Security Act, 
187.15 	United States Code, title 42, sections 670 to 676, the child's needs shall be met through 
187.16 	these programs.
187.17 		Subd. 4.Group residential maintenance payments. When a child is placed in 
187.18 	a group residential setting, foster care maintenance payments are payments made on 
187.19 	behalf of a child to cover the cost of providing food, clothing, shelter, daily supervision, 
187.20 	school supplies, child's personal incidentals, and transportation needs associated with 
187.21 	providing the items listed, including transportation to the child's home for visitation. 
187.22 	Daily supervision in group residential settings includes routine day-to-day direction 
187.23 	and arrangements to ensure the well-being and safety of the child. It may also include 
187.24 	reasonable costs of administration and operation of the facility.
187.25 		Subd. 5.Initial clothing allowance. An initial clothing allowance must be available 
187.26 	to all children eligible for Northstar Care for Children under section 256O.210 and foster 
187.27 	children placed in group residential settings based on the child's individual needs during 
187.28 	the first 60 days of the initial placement. The agency shall consider the parent's ability 
187.29 	to provide for the child's clothing needs and the residential facility contracts. A clothing 
187.30 	allowance must be approved that is consistent with the child's needs. The amount of 
187.31 	the initial clothing allowance must not exceed the monthly basic rate for the child's age 
187.32 	group under section 256O.260.

187.33 	EFFECTIVE DATE. This section is effective January 1, 2011.

187.34 	Sec. 53.  REPEALER.
 188.1 	(a) Minnesota Statutes 2008, sections 256.82, subdivisions 2, 3, 4, and 5; and 
188.2 	257.85, are repealed effective January 1, 2011.
188.3 	(b) Minnesota Statutes 2008, section 259.67, subdivisions 1, 2, 3, 3a, 4, 5, 6, 7, 8, 9, 
188.4 	and 10, are repealed effective July 1, 2009.
188.5 	(c) Minnesota Rules, parts 9560.0521, subparts 7 and 10; 9560.0650, subparts 1, 3, 
188.6 	and 6; 9560.0651; 9560.0652; 9560.0653; 9560.0654; 9560.0655; 9560.0656; 9560.0657; 
188.7 	and 9560.0665, subparts 2, 3, 4, 5, 6, 7, 8, and 9, are repealed effective January 1, 2011.
188.8 	(d) Minnesota Rules, parts 9560.0071; 9560.0081; 9560.0082; 9560.0083; 
188.9 	9560.0091; 9560.0093, subparts 1, 3, and 4; 9560.0101; and 9560.0102, are repealed 
188.10 	effective July 1, 2009.

188.11 	ARTICLE 8
188.12 	LICENSING

188.13 	Section 1. Minnesota Statutes 2008, section 245A.10, subdivision 2, is amended to 
188.14 	read:
188.15 		Subd. 2.County fees for background studies and licensing inspections. (a) For 
188.16 	purposes of family and group family child care licensing under this chapter, a county 
188.17 	agency may charge a fee to an applicant or license holder to recover the actual cost of 
188.18 	background studies, but in any case not to exceed $100 annually. A county agency may 
188.19 	also charge a license fee to an applicant or license holder not to exceed $50 for a one-year 
188.20 	license or $100 for a two-year license.
188.21 	(b) A county agency may charge a fee to a legal nonlicensed child care provider or 
188.22 	applicant for authorization to recover the actual cost of background studies completed 
188.23 	under section 119B.125, but in any case not to exceed $100 annually. 
188.24 	(c) Counties may elect to reduce or waive the fees in paragraph (a) or (b):
188.25 	(1) in cases of financial hardship;
188.26 	(2)  if the county has a shortage of providers in the county's area;
188.27 	(3) for new providers; or
188.28 	(4) for providers who have attained at least 16 hours of training before seeking 
188.29 	initial licensure.
188.30 	(d) Counties may allow providers to pay the applicant fees in paragraph (a) or (b) on 
188.31 	an installment basis for up to one year. If the provider is receiving child care assistance 
188.32 	payments from the state, the provider may have the fees under paragraph (a) or (b) 
188.33 	deducted from the child care assistance payments for up to one year and the state shall 
188.34 	reimburse the county for the county fees collected in this manner.
189.1 	(e) For purposes of adult foster care and child foster care licensing under this 
189.2 	chapter, a county agency may charge a fee to a corporate applicant or corporate license 
189.3 	holder to recover the actual cost of background studies. A county agency may also charge 
189.4 	a fee to a corporate applicant or corporate license holder to recover the actual cost of 
189.5 	licensing inspections, not to exceed $500 annually.
189.6 	(f) Counties may elect to reduce or waive the fees in paragraph (e) under the 
189.7 	following circumstances: 
189.8 	(1) in cases of financial hardship; 
189.9 	(2) if the county has a shortage of providers in the county's area; or
189.10 	(3) for new providers.

189.11 	Sec. 2. Minnesota Statutes 2008, section 245A.10, subdivision 3, is amended to read:
189.12 		Subd. 3.Application fee for initial license or certification. (a) For fees required 
189.13 	under subdivision 1, an applicant for an initial license or certification issued by the 
189.14 	commissioner shall submit a $500 $750 application fee with each new application required 
189.15 	under this subdivision. The application fee shall not be prorated, is nonrefundable, and 
189.16 	is in lieu of the annual license or certification fee that expires on December 31. The 
189.17 	commissioner shall not process an application until the application fee is paid.
189.18 	(b) Except as provided in clauses (1) to (3), an applicant shall apply for a license 
189.19 	to provide services at a specific location.
189.20 	(1) For a license to provide waivered residential-based habilitation services to 
189.21 	persons with developmental disabilities or related conditions under chapter 245B, an 
189.22 	applicant shall submit an application for each county in which the waivered services 
189.23 	will be provided.
189.24 	(2) For a license to provide supported employment, crisis respite, or 
189.25 	semi-independent living services to persons with developmental disabilities or related 
189.26 	conditions under chapter 245B, an applicant shall submit a single application to provide 
189.27 	services statewide.
189.28 	(3) For a license to provide independent living assistance for youth under section 
189.29 	245A.22, an applicant shall submit a single application to provide services statewide. 

189.30 	Sec. 3. Minnesota Statutes 2008, section 245A.10, subdivision 4, is amended to read:
189.31 		Subd. 4. License or certification fee for certain programs a child care center.
 189.32 	(a) A child care centers and programs with a licensed capacity center shall pay an annual 
189.33 	nonrefundable license or certification fee based on the following schedule: 

190.1
190.2
190.3
190.4		Licensed Capacity
	Child Care Center
License Fee Fiscal Year 
2010
	Other Program
License FeeFiscal 
Year 2011 and 
thereafter
	
190.5		1 to 24 persons
	$225 $295
		$400 $360
	
190.6		25 to 49 persons
	$340 $410
		$600 $475
	
190.7		50 to 74 persons
	$450 $520
		$800 $585
	
190.8		75 to 99 persons
	$565 $635
		$1,000 $700
	
190.9		100 to 124 persons
	$675 $745
		$1,200 $810
	
190.10		125 to 149 persons
	$900 $970
		$1,400$1,035
	
190.11
190.12		150 to 174 persons
	$1,050
 $1,120
		$1,600 $1,185
	
190.13
190.14		175 to 199 persons
	$1,200
 $1,270
		$1,800 $1,335
	
190.15
190.16		200 to 224 persons
	$1,350
 $1,420
		$2,000 $1,485
	
190.17
190.18		225 or more persons
	$1,500
 $1,570
		$2,500 $1,635
	
190.19 	(b) A day training and habilitation program serving persons with developmental 
190.20 	disabilities or related conditions shall be assessed a license fee based on the schedule in 
190.21 	paragraph (a) unless the license holder serves more than 50 percent of the same persons 
190.22 	at two or more locations in the community. Except as provided in paragraph (c), when a 
190.23 	day training and habilitation program serves more than 50 percent of the same persons in 
190.24 	two or more locations in a community, the day training and habilitation program shall pay 
190.25 	a license fee based on the licensed capacity of the largest facility and the other facility 
190.26 	or facilities shall be charged a license fee based on a licensed capacity of a residential 
190.27 	program serving one to 24 persons. 
190.28 	(c) When a day training and habilitation program serving persons with developmental 
190.29 	disabilities or related conditions seeks a single license allowed under section 245B.07, 
190.30 	subdivision 12, clause (2) or (3), the licensing fee must be based on the combined licensed 
190.31 	capacity for each location. 

190.32 	Sec. 4. Minnesota Statutes 2008, section 245A.10, is amended by adding a subdivision 
190.33 	to read:
190.34 		Subd. 4a.License fee for an adult day care center. An adult day care center 
190.35 	licensed under Minnesota Rules, parts 9555.9600 to 9555.9730, shall pay an annual 
190.36 	nonrefundable license fee based on the following schedule:

190.37
190.38		Licensed Capacity
	License Fee Fiscal 
Year 2010
	License Fee Fiscal Year 
2011 and thereafter

190.39		1 to 24 persons
	$930
	$1,460
	
191.1		25 to 49 persons
	$1,130
	$1,660
	
191.2		50 to 74 persons
	$1,330
	$1,860
	
191.3		75 to 99 persons
	$1,530
	$2,060
	
191.4		100 or more persons
	$1,730
	$2,260

191.5 	Sec. 5. Minnesota Statutes 2008, section 245A.10, is amended by adding a subdivision 
191.6 	to read:
191.7 		Subd. 4b.License fee for day training and habilitation program. (a) A day 
191.8 	training and habilitation program licensed under chapter 245B to provide services to 
191.9 	persons with developmental disabilities shall pay an annual nonrefundable license fee 
191.10 	based on the following schedule:

191.11
191.12		Licensed Capacity
	License Fee Fiscal 
Year 2010
	License Fee Fiscal Year 
2011 and thereafter

191.13		1 to 24 persons
	$925
	$1,430
	
191.14		25 to 49 persons
	$1,125
	$1,630
	
191.15		50 to 74 persons
	$1,325
	$1,830
	
191.16		75 to 99 persons
	$1,525
	$2,030
	
191.17		100 to 124 persons
	$1,725
	$2,230
	
191.18		125 to 149 persons
	$1,925
	$2,430
	
191.19		150 to 174 persons
	$2,125
	$2,630
	
191.20		175 to 199 persons
	$2,325
	$2,830
	
191.21		200 to 224 persons
	$2,525
	$3,030
	
191.22		225 or more persons
	$3,025
	$3,530
	
191.23 	(b) A day training and habilitation program licensed under chapter 245B must 
191.24 	be assessed a license fee based on the schedule in paragraph (a) unless the license 
191.25 	holder serves more than 50 percent of the same persons at two or more locations in the 
191.26 	community. Except as provided in paragraph (c), when a day training and habilitation 
191.27 	program serves more than 50 percent of the same persons in two or more locations in a 
191.28 	community, the day training and habilitation program shall pay a license fee based on the 
191.29 	licensed capacity of the largest facility and the other facility or facilities must be charged a 
191.30 	license fee based on a licensed capacity of a residential program serving one to 24 persons.
191.31 	(c) When a day training and habilitation program serving persons with developmental 
191.32 	disabilities seeks a single license allowed under section 245B.07, subdivision 12, clause (2) 
191.33 	or (3), the licensing fee must be based on the combined licensed capacity for each location.

191.34 	Sec. 6. Minnesota Statutes 2008, section 245A.10, is amended by adding a subdivision 
191.35 	to read:
192.1 		Subd. 4c.License fee for residential program serving persons with 
192.2 	developmental disabilities. A residential program licensed under chapter 245B whether 
192.3 	certified as an intermediate care facility for persons with developmental disabilities or not 
192.4 	shall pay an annual nonrefundable license fee based on the following schedule:

192.5
192.6		Licensed Capacity
	License Fee Fiscal 
Year 2010
	License Fee Fiscal Year 
2011 and thereafter

192.7		1 to 24 persons
	$1,000
	$1,600
	
192.8		25 to 49 persons
	$1,200
	$1,800
	
192.9		50 to 74 persons
	$1,400
	$2,000
	
192.10		75 or more persons
	$1,600
	$2,200

192.11 	Sec. 7. Minnesota Statutes 2008, section 245A.10, is amended by adding a subdivision 
192.12 	to read:
192.13 		Subd. 4d.License fee for program providing crisis respite. (a) In fiscal year 
192.14 	2010, a program licensed to provide crisis respite services for persons with developmental 
192.15 	disabilities under chapter 245B shall pay an annual nonrefundable license fee of $1,600.
192.16 	(b) In fiscal year 2011 and thereafter, a program licensed to provide crisis respite 
192.17 	services for persons with developmental disabilities under chapter 245B shall pay an 
192.18 	annual nonrefundable license fee of $2,000.

192.19 	Sec. 8. Minnesota Statutes 2008, section 245A.10, is amended by adding a subdivision 
192.20 	to read:
192.21 		Subd. 4e.License fee for program providing residential-based habilitation 
192.22 	services. (a) In fiscal year 2010, a program licensed to provide residential-based 
192.23 	habilitation services for persons with developmental disabilities under chapter 245B 
192.24 	shall pay an annual nonrefundable license fee that is based on a base rate of $715 plus 
192.25 	$50 times the number of clients served on the first day of August of the current license 
192.26 	year. State-operated programs are exempt from the license fee under this paragraph and 
192.27 	paragraph (b).
192.28 	(b) In fiscal year 2011 and thereafter, a program licensed to provide residential-based 
192.29 	habilitation services for persons with developmental disabilities under chapter 245B shall 
192.30 	pay an annual nonrefundable license fee that is based on a base rate of $1,000 plus $70 
192.31 	times the number of clients served on the first day of August of the current license year.

192.32 	Sec. 9. Minnesota Statutes 2008, section 245A.10, is amended by adding a subdivision 
192.33 	to read:
193.1 		Subd. 4f.License fee for program providing semi-independent living services 
193.2 	or supported employment services. (a) In fiscal year 2010, a program licensed to 
193.3 	provide semi-independent living services for persons with developmental disabilities 
193.4 	under chapter 245B or supported employment services for persons with developmental 
193.5 	disabilities under chapter 245B shall pay an annual nonrefundable license fee of $1,250.
193.6 	(b) In fiscal year 2011 and thereafter, a program licensed to provide semi-independent 
193.7 	living services for persons with developmental disabilities under chapter 245B or 
193.8 	supported employment services for persons with developmental disabilities under chapter 
193.9 	245B shall pay an annual nonrefundable license fee of $2,000.

193.10 	Sec. 10. Minnesota Statutes 2008, section 245A.10, is amended by adding a 
193.11 	subdivision to read:
193.12 		Subd. 4g.License fee for residential program serving persons with physical 
193.13 	disabilities. A residential program licensed under Minnesota Rules, parts 9570.2000 to 
193.14 	9570.3400, to serve persons with physical disabilities shall pay an annual nonrefundable 
193.15 	license fee based on the following schedule:

193.16
193.17		Licensed Capacity
	License Fee Fiscal 
Year 2010
	License Fee Fiscal Year 
2011 and thereafter

193.18		1 to 24 persons
	$713
	$1,025
	
193.19		25 to 49 persons
	$913
	$1,225
	
193.20		50 to 74 persons
	$1,113
	$1,425
	
193.21		75 to 99 persons
	$1,313
	$1,625
	
193.22		100 to 124 persons
	$1,513
	$1,825
	
193.23		125 or more persons
	$1,713
	$2,025

193.24 	Sec. 11. Minnesota Statutes 2008, section 245A.10, is amended by adding a 
193.25 	subdivision to read:
193.26 		Subd. 4h.License fee for residential programs serving adults with mental 
193.27 	illness. (a) In fiscal year 2010, a residential program licensed under Minnesota Rules, 
193.28 	parts 9520.0500 to 9520.0670, to serve adults with mental illness shall pay an annual 
193.29 	nonrefundable license fee of $2,450.
193.30 	(b) In fiscal year 2011 and thereafter, a residential program licensed under Minnesota 
193.31 	Rules, parts 9520.0500 to 9520.0670, to serve adults with mental illness shall pay an 
193.32 	annual nonrefundable license fee of $4,400.

193.33 	Sec. 12. Minnesota Statutes 2008, section 245A.10, is amended by adding a 
193.34 	subdivision to read:
194.1 		Subd. 4i.License fee for a children's residential program. (a) In fiscal year 2010, 
194.2 	a children's residential program licensed under Minnesota Rules, chapter 2960, shall pay 
194.3 	an annual nonrefundable license fee of $2,450.
194.4 	(b) In fiscal year 2011 and thereafter, a children's residential program licensed under 
194.5 	Minnesota Rules, chapter 2960, shall pay an annual nonrefundable license fee of $4,400.

194.6 	Sec. 13. Minnesota Statutes 2008, section 245A.10, is amended by adding a 
194.7 	subdivision to read:
194.8 		Subd. 4j.License fee for programs licensed to provide drug or chemical 
194.9 	dependency treatment. (a) A program licensed under Minnesota Rules, parts 9530.6405 
194.10 	to 9530.6505 or 9530.6510 to 9530.6590, to provide drug or chemical dependency 
194.11 	treatment shall pay an annual nonrefundable license fee based on the following schedule:

194.12
194.13		Licensed Capacity
	License Fee Fiscal 
Year 2010
	License Fee Fiscal Year 
2011 and thereafter

194.14		1 to 24 persons
	$755
	$1,035
	
194.15		25 to 49 persons
	$955
	$1,235
	
194.16		50 to 74 persons
	$1,155
	$1,435
	
194.17		75 to 99 persons
	$1,355
	$1,635
	
194.18		100 to 124 persons
	$1,555
	$1,835
	
194.19		125 or more persons
	$1,755
	$2,035
	
194.20 	(b) In fiscal year 2010, if a license issued to a program under Minnesota Rules, parts 
194.21 	9530.6405 to 9530.6505, does not have a stated licensed capacity, the drug or chemical 
194.22 	dependency treatment program shall pay an annual nonrefundable license fee based on a 
194.23 	licensed capacity of one to 24 persons for fiscal year 2010.
194.24 	(c) In fiscal year 2011 and thereafter, if a license issued to a program under Minnesota 
194.25 	Rules, parts 9530.6405 to 9530.6505, does not have a stated licensed capacity, the drug or 
194.26 	chemical dependency treatment program shall pay an annual nonrefundable license fee 
194.27 	based on a licensed capacity of one to 24 persons for fiscal year 2011 and thereafter.

194.28 	Sec. 14. Minnesota Statutes 2008, section 245A.10, is amended by adding a 
194.29 	subdivision to read:
194.30 		Subd. 4k.License fee for independent living assistance for youth. A program 
194.31 	licensed to provide independent living assistance for youth under section 245A.22, shall 
194.32 	pay an annual nonrefundable license fee of $2,000.

194.33 	Sec. 15. Minnesota Statutes 2008, section 245A.10, is amended by adding a 
194.34 	subdivision to read:
195.1 		Subd. 4l.License fee for private agencies that provide child foster care or 
195.2 	adoption services. A private agency licensed under Minnesota Rules, parts 9545.0755 
195.3 	to 9545.0845, to provide child foster care or adoption services shall pay an annual 
195.4 	nonrefundable license fee of $400.

195.5 	Sec. 16. Minnesota Statutes 2008, section 245A.10, subdivision 5, is amended to read:
195.6 		Subd. 5.License or Mental health center or mental health clinic certification fee 
195.7 	for other programs. (a) Except as provided in paragraphs (b) and (c), a program without 
195.8 	a stated licensed capacity shall pay a license or certification fee of $400.
195.9 	(b) A mental health center or mental health clinic requesting certification for 
195.10 	purposes of insurance and subscriber contract reimbursement under Minnesota Rules, 
195.11 	parts 9520.0750 to 9520.0870, shall pay a certification fee of $1,000 per year. If the 
195.12 	mental health center or mental health clinic provides services at a primary location with 
195.13 	satellite facilities, the satellite facilities shall be certified with the primary location without 
195.14 	an additional charge.
195.15 	(c) A program licensed to provide residential-based habilitation services under the 
195.16 	home and community-based waiver for persons with developmental disabilities shall pay 
195.17 	an annual license fee that includes a base rate of $250 plus $38 times the number of clients 
195.18 	served on the first day of August of the current license year. State-operated programs are 
195.19 	exempt from the license fee under this paragraph.

195.20 	Sec. 17. Minnesota Statutes 2008, section 245A.10, is amended by adding a 
195.21 	subdivision to read:
195.22 		Subd. 7.Human services licensing revenue and appropriations. Effective July 
195.23 	1, 2011:
195.24 	(1) departmental earnings collected under subdivisions 3, 4 to 4l, and 5 shall be 
195.25 	deposited in the state government special revenue fund; and
195.26 	(2) the direct appropriation to the department for licensing activities in subdivisions 
195.27 	3, 4 to 4l, and 5 shall be transferred from the general fund to the state government special 
195.28 	revenue fund.

195.29 	Sec. 18. Minnesota Statutes 2008, section 245C.10, is amended by adding a 
195.30 	subdivision to read:
195.31 		Subd. 8.Private agencies. The commissioner shall recover the cost of conducting 
195.32 	background studies under section 245C.33 for studies initiated by private agencies for the 
195.33 	purpose of adoption through a fee of no more than $70 per study charged to the private 
196.1 	agency. The fees collected under this subdivision are appropriated to the commissioner for 
196.2 	the purpose of conducting background studies.

196.3 	ARTICLE 9
196.4 	HEALTH CARE

196.5 	Section 1. Minnesota Statutes 2008, section 62J.692, subdivision 7, is amended to read:
196.6 		Subd. 7.Transfers from the commissioner of human services. (a) The amount 
196.7 	transferred according to section 256B.69, subdivision 5c, paragraph (a), clause (1), shall be 
196.8 	distributed by the commissioner annually to clinical medical education programs that meet 
196.9 	the qualifications of subdivision 3 based on the formula in subdivision 4, paragraph (a).
196.10 	(b) Fifty percent of the amount transferred according to section 256B.69, subdivision 
196.11 	5c, paragraph (a), clause (2), shall be distributed by the commissioner to the University of 
196.12 	Minnesota Board of Regents for the purposes described in sections 137.38 to 137.40. Of 
196.13 	the remaining amount transferred according to section 256B.69, subdivision 5c, paragraph 
196.14 	(a), clause (2), 24 percent of the amount shall be distributed by the commissioner to 
196.15 	the Hennepin County Medical Center for clinical medical education. The remaining 26 
196.16 	percent of the amount transferred shall be distributed by the commissioner in accordance 
196.17 	with subdivision 7a. If the federal approval is not obtained for the matching funds under 
196.18 	section 256B.69, subdivision 5c, paragraph (a), clause (2), 100 percent of the amount 
196.19 	transferred under this paragraph shall be distributed by the commissioner to the University 
196.20 	of Minnesota Board of Regents for the purposes described in sections 137.38 to 137.40.
196.21 	(c) The amount transferred according to section 256B.69, subdivision 5c, paragraph 
196.22 	(a), clauses (3) and (4), shall be distributed by the commissioner upon receipt to the 
196.23 	University of Minnesota Board of Regents for the purposes of clinical graduate medical 
196.24 	education.
196.25 	(a) Of the amount transferred under section 256B.69, subdivision 5c, paragraph (a), 
196.26 	clauses (1) to (4), $21,714,000 must be distributed as follows:
196.27 	(1) $2,157,000 must be distributed by the commissioner to the University of 
196.28 	Minnesota Board of Regents for the purposes described in sections 137.38 to 137.40;
196.29 	(2) $1,035,360 must be distributed by the commissioner to the Hennepin County 
196.30 	Medical Center for clinical medical education;
196.31 	(3) $17,400,000 must be distributed by the commissioner to the University of 
196.32 	Minnesota Board of Regents for purposes of medical education;
196.33 	(4) $1,121,640 must be distributed by the commissioner to clinical medical 
196.34 	education dental innovation grants under subdivision 7a; and
197.1 	(5) the remainder of the amount transferred under section 256B.69, subdivision 5c, 
197.2 	clauses (1) to (4), must be distributed by the commissioner annually to clinical medical 
197.3 	education programs that meet the qualifications of subdivision 3 based on the formula 
197.4 	in subdivision 4, paragraph (a).

197.5 	Sec. 2. Minnesota Statutes 2008, section 125A.744, subdivision 3, is amended to read:
197.6 		Subd. 3.Implementation. Consistent with section 256B.0625, subdivision 26, 
197.7 	school districts may enroll as medical assistance providers or subcontractors and bill 
197.8 	the Department of Human Services under the medical assistance fee for service claims 
197.9 	processing system for special education services which are covered services under chapter 
197.10 	256B, which are provided in the school setting for a medical assistance recipient, and for 
197.11 	whom the district has secured informed consent consistent with section 13.05, subdivision 
197.12 	4, paragraph (d), and section 256B.77, subdivision 2, paragraph (p), to bill for each type 
197.13 	of covered service. School districts shall be reimbursed by the commissioner of human 
197.14 	services for the federal share of individual education plan health-related services that 
197.15 	qualify for reimbursement by medical assistance, minus up to five percent retained by the 
197.16 	commissioner of human services for administrative costs, not to exceed $350,000 per 
197.17 	fiscal year. The commissioner may withhold up to five percent of each payment to a 
197.18 	school district. Following the end of each fiscal year, the commissioner shall settle up with 
197.19 	each school district in order to ensure that collections from each district for departmental 
197.20 	administrative costs are made on a pro rata basis according to federal earnings for these 
197.21 	services in each district. A school district is not eligible to enroll as a home care provider 
197.22 	or a personal care provider organization for purposes of billing home care services under 
197.23 	sections 256B.0651 and 256B.0653 to 256B.0656 until the commissioner of human 
197.24 	services issues a bulletin instructing county public health nurses on how to assess for the 
197.25 	needs of eligible recipients during school hours. To use private duty nursing services or 
197.26 	personal care services at school, the recipient or responsible party must provide written 
197.27 	authorization in the care plan identifying the chosen provider and the daily amount 
197.28 	of services to be used at school.

197.29 	Sec. 3. Minnesota Statutes 2008, section 256.01, subdivision 2b, is amended to read:
197.30 		Subd. 2b. Performance payments. (a) The commissioner shall develop and 
197.31 	implement a pay-for-performance system to provide performance payments to eligible 
197.32 	medical groups and clinics that demonstrate optimum care in serving individuals 
197.33 	with chronic diseases who are enrolled in health care programs administered by the 
197.34 	commissioner under chapters 256B, 256D, and 256L. The commissioner may receive any 
198.1 	federal matching money that is made available through the medical assistance program 
198.2 	for managed care oversight contracted through vendors, including consumer surveys, 
198.3 	studies, and external quality reviews as required by the federal Balanced Budget Act of 
198.4 	1997, Code of Federal Regulations, title 42, part 438-managed care, subpart E-external 
198.5 	quality review. Any federal money received for managed care oversight is appropriated 
198.6 	to the commissioner for this purpose. The commissioner may expend the federal money 
198.7 	received in either year of the biennium. 
198.8 	(b) Effective July 1, 2008, or upon federal approval, whichever is later, the 
198.9 	commissioner shall develop and implement a patient incentive health program to provide 
198.10 	incentives and rewards to patients who are enrolled in health care programs administered 
198.11 	by the commissioner under chapters 256B, 256D, and 256L, and who have agreed to and 
198.12 	have met personal health goals established with the patients' primary care providers to 
198.13 	manage a chronic disease or condition, including but not limited to diabetes, high blood 
198.14 	pressure, and coronary artery disease. 

198.15 	Sec. 4. Minnesota Statutes 2008, section 256.01, is amended by adding a subdivision 
198.16 	to read:
198.17 		Subd. 18a.Public Assistance Reporting Information System. (a) Effective July 
198.18 	1, 2009, the commissioner shall comply with the federal requirements in Public Law 
198.19 	110-379 in implementing the Public Assistance Reporting Information System (PARIS) to 
198.20 	determine eligibility for all individuals applying for:
198.21 	(1) health care benefits under chapters 256B, 256D, and 256L; and
198.22 	(2) public benefits under chapters 119B, 256D, 256I, and the supplemental nutrition 
198.23 	assistance program.
198.24 	(b) The commissioner shall determine eligibility under paragraph (a) by performing 
198.25 	data matches, including matching with medical assistance, cash, child care, and 
198.26 	supplemental assistance programs operated by other states.

198.27 	EFFECTIVE DATE. This section is effective July 1, 2009.

198.28 	Sec. 5. Minnesota Statutes 2008, section 256.969, subdivision 2b, is amended to read:
198.29 		Subd. 2b.Operating payment rates. In determining operating payment rates for 
198.30 	admissions occurring on or after the rate year beginning January 1, 1991, and every two 
198.31 	years after, or more frequently as determined by the commissioner, the commissioner shall 
198.32 	obtain operating data from an updated base year and establish operating payment rates 
198.33 	per admission for each hospital based on the cost-finding methods and allowable costs of 
198.34 	the Medicare program in effect during the base year. Rates under the general assistance 
199.1 	medical care, medical assistance, and MinnesotaCare programs shall not be rebased to 
199.2 	more current data on January 1, 1997, January 1, 2005, and for the first 24 months of the 
199.3 	rebased period beginning January 1, 2009, and for the first three months of the rebased 
199.4 	period beginning January 1, 2011. The base year operating payment rate per admission is 
199.5 	standardized by the case mix index and adjusted by the hospital cost index, relative values, 
199.6 	and disproportionate population adjustment. The cost and charge data used to establish 
199.7 	operating rates shall only reflect inpatient services covered by medical assistance and shall 
199.8 	not include property cost information and costs recognized in outlier payments.

199.9 	Sec. 6. Minnesota Statutes 2008, section 256.969, subdivision 3a, is amended to read:
199.10 		Subd. 3a.Payments. (a) Acute care hospital billings under the medical 
199.11 	assistance program must not be submitted until the recipient is discharged. However, 
199.12 	the commissioner shall establish monthly interim payments for inpatient hospitals that 
199.13 	have individual patient lengths of stay over 30 days regardless of diagnostic category. 
199.14 	Except as provided in section 256.9693, medical assistance reimbursement for treatment 
199.15 	of mental illness shall be reimbursed based on diagnostic classifications. Individual 
199.16 	hospital payments established under this section and sections 256.9685, 256.9686, and 
199.17 	256.9695, in addition to third party and recipient liability, for discharges occurring during 
199.18 	the rate year shall not exceed, in aggregate, the charges for the medical assistance covered 
199.19 	inpatient services paid for the same period of time to the hospital. This payment limitation 
199.20 	shall be calculated separately for medical assistance and general assistance medical 
199.21 	care services. The limitation on general assistance medical care shall be effective for 
199.22 	admissions occurring on or after July 1, 1991. Services that have rates established under 
199.23 	subdivision 11 or 12, must be limited separately from other services. After consulting with 
199.24 	the affected hospitals, the commissioner may consider related hospitals one entity and 
199.25 	may merge the payment rates while maintaining separate provider numbers. The operating 
199.26 	and property base rates per admission or per day shall be derived from the best Medicare 
199.27 	and claims data available when rates are established. The commissioner shall determine 
199.28 	the best Medicare and claims data, taking into consideration variables of recency of the 
199.29 	data, audit disposition, settlement status, and the ability to set rates in a timely manner. 
199.30 	The commissioner shall notify hospitals of payment rates by December 1 of the year 
199.31 	preceding the rate year. The rate setting data must reflect the admissions data used to 
199.32 	establish relative values. Base year changes from 1981 to the base year established for the 
199.33 	rate year beginning January 1, 1991, and for subsequent rate years, shall not be limited 
199.34 	to the limits ending June 30, 1987, on the maximum rate of increase under subdivision 
199.35 	1. The commissioner may adjust base year cost, relative value, and case mix index data 
200.1 	to exclude the costs of services that have been discontinued by the October 1 of the year 
200.2 	preceding the rate year or that are paid separately from inpatient services. Inpatient stays 
200.3 	that encompass portions of two or more rate years shall have payments established based 
200.4 	on payment rates in effect at the time of admission unless the date of admission preceded 
200.5 	the rate year in effect by six months or more. In this case, operating payment rates for 
200.6 	services rendered during the rate year in effect and established based on the date of 
200.7 	admission shall be adjusted to the rate year in effect by the hospital cost index.
200.8 	(b) For fee-for-service admissions occurring on or after July 1, 2002, the total 
200.9 	payment, before third-party liability and spenddown, made to hospitals for inpatient 
200.10 	services is reduced by .5 percent from the current statutory rates.
200.11 	(c) In addition to the reduction in paragraph (b), the total payment for fee-for-service 
200.12 	admissions occurring on or after July 1, 2003, made to hospitals for inpatient services 
200.13 	before third-party liability and spenddown, is reduced five percent from the current 
200.14 	statutory rates. Mental health services within diagnosis related groups 424 to 432, and 
200.15 	facilities defined under subdivision 16 are excluded from this paragraph.
200.16 	(d) In addition to the reduction in paragraphs (b) and (c), the total payment for 
200.17 	fee-for-service admissions occurring on or after July 1, 2005, made to hospitals for 
200.18 	inpatient services before third-party liability and spenddown, is reduced 6.0 percent 
200.19 	from the current statutory rates. Mental health services within diagnosis related groups 
200.20 	424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph. 
200.21 	Notwithstanding section 256.9686, subdivision 7, for purposes of this paragraph, medical 
200.22 	assistance does not include general assistance medical care. Payments made to managed 
200.23 	care plans shall be reduced for services provided on or after January 1, 2006, to reflect 
200.24 	this reduction.
200.25 	(e) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for 
200.26 	fee-for-service admissions occurring on or after July 1, 2008, through June 30, 2009, made 
200.27 	to hospitals for inpatient services before third-party liability and spenddown, is reduced 
200.28 	3.46 percent from the current statutory rates. Mental health services with diagnosis related 
200.29 	groups 424 to 432 and facilities defined under subdivision 16 are excluded from this 
200.30 	paragraph. Payments made to managed care plans shall be reduced for services provided 
200.31 	on or after January 1, 2009, through June 30, 2009, to reflect this reduction.
200.32 	(f) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for 
200.33 	fee-for-service admissions occurring on or after July 1, 2009, through June 30, 2010, made 
200.34 	to hospitals for inpatient services before third-party liability and spenddown, is reduced 
200.35 	1.9 percent from the current statutory rates. Mental health services with diagnosis related 
200.36 	groups 424 to 432 and facilities defined under subdivision 16 are excluded from this 
201.1 	paragraph. Payments made to managed care plans shall be reduced for services provided 
201.2 	on or after July 1, 2009, through June 30, 2010, to reflect this reduction.
201.3 	(g) In addition to the reductions in paragraphs (b), (c), and (d), the total payment 
201.4 	for fee-for-service admissions occurring on or after July 1, 2010, made to hospitals for 
201.5 	inpatient services before third-party liability and spenddown, is reduced 1.79 percent 
201.6 	from the current statutory rates. Mental health services with diagnosis related groups 
201.7 	424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph. 
201.8 	Payments made to managed care plans shall be reduced for services provided on or after 
201.9 	July 1, 2010, to reflect this reduction.
201.10 	(h) In addition to the reductions in paragraphs (b), (c), (d), (f), and (g), the total 
201.11 	payment for fee-for-service admissions occurring on or after July 1, 2009, made to 
201.12 	hospitals for inpatient services before third-party liability and spenddown, is reduced 
201.13 	3.0 percent from the current statutory rates. Facilities defined under subdivision 16 are 
201.14 	excluded from this paragraph. Payments made to managed care plans shall be reduced for 
201.15 	services provided on or after January 1, 2010, to reflect this reduction.
201.16 	(i) In addition to the reductions in paragraphs (b) and (h), the total payment for 
201.17 	fee-for-service admissions occurring on or after July 1, 2009, made to hospitals for mental 
201.18 	health services within diagnosis-related groups 424 to 432 before third-party liability and 
201.19 	spenddown, is reduced 5.2 percent from the current statutory rates. Facilities defined under 
201.20 	subdivision 16 are excluded from this paragraph. Payments made to managed care plans 
201.21 	shall be reduced for services provided on or after January 1, 2010, to reflect this reduction.

201.22 	Sec. 7. Minnesota Statutes 2008, section 256B.04, subdivision 14, is amended to read:
201.23 		Subd. 14.Competitive bidding. (a) When determined to be effective, economical, 
201.24 	and feasible, the commissioner may utilize volume purchase through competitive bidding 
201.25 	and negotiation under the provisions of chapter 16C, to provide items under the medical 
201.26 	assistance program including but not limited to the following:
201.27 	(1) eyeglasses;
201.28 	(2) oxygen. The commissioner shall provide for oxygen needed in an emergency 
201.29 	situation on a short-term basis, until the vendor can obtain the necessary supply from 
201.30 	the contract dealer;
201.31 	(3) hearing aids and supplies; and
201.32 	(4) durable medical equipment, including but not limited to:
201.33 	(i) hospital beds;
201.34 	(ii) commodes;
201.35 	(iii) glide-about chairs;
202.1 	(iv) patient lift apparatus;
202.2 	(v) wheelchairs and accessories;
202.3 	(vi) oxygen administration equipment;
202.4 	(vii) respiratory therapy equipment;
202.5 	(viii) electronic diagnostic, therapeutic and life-support systems;
202.6 	(5) nonemergency medical transportation level of need determinations, disbursement 
202.7 	of public transportation passes and tokens, and volunteer and recipient mileage and 
202.8 	parking reimbursements; and
202.9 	(6) drugs.
202.10 	(b) Rate changes under this chapter and chapters 256D and 256L do not affect 
202.11 	contract payments under this subdivision unless specifically identified.
202.12 	(c) The commissioner may not utilize volume purchase through competitive bidding 
202.13 	and negotiation for special transportation services under the provisions of chapter 16C.

202.14 	Sec. 8. Minnesota Statutes 2008, section 256B.056, subdivision 3b, is amended to read:
202.15 		Subd. 3b.Treatment of trusts. (a) A "medical assistance qualifying trust" is a 
202.16 	revocable or irrevocable trust, or similar legal device, established on or before August 
202.17 	10, 1993, by a person or the person's spouse under the terms of which the person 
202.18 	receives or could receive payments from the trust principal or income and the trustee 
202.19 	has discretion in making payments to the person from the trust principal or income. 
202.20 	Notwithstanding that definition, a medical assistance qualifying trust does not include: 
202.21 	(1) a trust set up by will; (2) a trust set up before April 7, 1986, solely to benefit a person 
202.22 	with a developmental disability living in an intermediate care facility for persons with 
202.23 	developmental disabilities; or (3) a trust set up by a person with payments made by the 
202.24 	Social Security Administration pursuant to the United States Supreme Court decision in 
202.25 	Sullivan v. Zebley, 110 S. Ct. 885 (1990). The maximum amount of payments that a 
202.26 	trustee of a medical assistance qualifying trust may make to a person under the terms of 
202.27 	the trust is considered to be available assets to the person, without regard to whether the 
202.28 	trustee actually makes the maximum payments to the person and without regard to the 
202.29 	purpose for which the medical assistance qualifying trust was established.
202.30 	(b) Except as provided in paragraphs (c) and (d), trusts established after August 10, 
202.31 	1993, are treated according to section 13611(b) of the Omnibus Budget Reconciliation 
202.32 	Act of 1993 (OBRA), Public Law 103-66.
202.33 	(c) For purposes of paragraph (d), a pooled trust means a trust established under 
202.34 	United States Code, title 42, section 1396p(d)(4)(C).
203.1 	(d) A beneficiary's interest in a pooled trust is considered an available asset unless 
203.2 	the trust provides that upon the death of the beneficiary or termination of the trust during 
203.3 	the beneficiary's lifetime, whichever is sooner, the department receives any amount in 
203.4 	excess of reasonable administrative fees remaining in the beneficiary's trust account up to 
203.5 	the amount of medical assistance benefits paid on behalf of the beneficiary.

203.6 	EFFECTIVE DATE. This section is effective for pooled trust accounts established 
203.7 	on or after July 1, 2009.

203.8 	Sec. 9. Minnesota Statutes 2008, section 256B.056, subdivision 3c, is amended to read:
203.9 		Subd. 3c.Asset limitations for families and children. A household of two or 
203.10 	more persons must not own more than $20,000$6,000 in total net assets, plus $200 for 
203.11 	each additional legal dependent, and a household of one person must not own more than 
203.12 	$10,000$3,000 in total net assets. In addition to these maximum amounts, an eligible 
203.13 	individual or family may accrue interest on these amounts, but they must be reduced to 
203.14 	the maximum at the time of an eligibility redetermination. The value of assets that are 
203.15 	not considered in determining eligibility for medical assistance for families and children 
203.16 	is the value of those assets excluded under the AFDC state plan as of July 16, 1996, as 
203.17 	required by the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 
203.18 	(PRWORA), Public Law 104-193, with the following exceptions:
203.19 	(1) household goods and personal effects are not considered;
203.20 	(2) capital and operating assets of a trade or business up to $200,000 are not 
203.21 	considered;
203.22 	(3) one motor vehicle is excluded for each person of legal driving age who is 
203.23 	employed or seeking employment;
203.24 	(4) one burial plot and all other burial expenses equal to the supplemental security 
203.25 	income program asset limit are not considered for each individual;
203.26 	(5) court-ordered settlements up to $10,000 are not considered;
203.27 	(6) individual retirement accounts and funds are not considered; and
203.28 	(7) assets owned by children are not considered.

203.29 	EFFECTIVE DATE. This section is effective January 1, 2010.

203.30 	Sec. 10. Minnesota Statutes 2008, section 256B.056, subdivision 3d, is amended to 
203.31 	read:
203.32 		Subd. 3d.Reduction of excess assets. Assets in excess of the limits in subdivisions 
203.33 	3 to 3c may be reduced to allowable limits as follows:
204.1 	(a) Assets may be reduced in any of the three calendar months before the month 
204.2 	of application in which the applicant seeks coverage by:
204.3 	(1) designating burial funds up to $1,500 for each applicant, spouse, and MA-eligible 
204.4 	dependent child; and
204.5 	(2) paying health service bills for health services that are incurred in the retroactive 
204.6 	period for which the applicant seeks eligibility, starting with the oldest bill. After assets 
204.7 	are reduced to allowable limits, eligibility begins with the next dollar of MA-covered 
204.8 	health services incurred in the retroactive period. Applicants reducing assets under this 
204.9 	subdivision who also have excess income shall first spend excess assets to pay health 
204.10 	service bills and may meet the income spenddown on remaining bills.
204.11 	(b) Assets may be reduced beginning the month of application by:
204.12 	(1) paying bills for health services that are incurred during the period specified in 
204.13 	Minnesota Rules, part 9505.0090, subpart 2, that would otherwise be paid by medical 
204.14 	assistance; and. After assets are reduced to allowable limits, eligibility begins with the 
204.15 	next dollar of medical assistance covered health services incurred in the period. Applicants 
204.16 	reducing assets under this subdivision who also have excess income shall first spend excess 
204.17 	assets to pay health service bills and may meet the income spenddown on remaining bills.
204.18 	(2) using any means other than a transfer of assets for less than fair market value as 
204.19 	defined in section 256B.0595, subdivision 1, paragraph (b).

204.20 	EFFECTIVE DATE. This section is effective for requests for medical assistance 
204.21 	submitted on or after July 1, 2009.

204.22 	Sec. 11. Minnesota Statutes 2008, section 256B.056, subdivision 10, is amended to 
204.23 	read:
204.24 		Subd. 10.Eligibility verification. (a) The commissioner shall require women who 
204.25 	are applying for the continuation of medical assistance coverage following the end of the 
204.26 	60-day postpartum period to update their income and asset information and to submit 
204.27 	any required income or asset verification.
204.28 	(b) The commissioner shall determine the eligibility of private-sector health care 
204.29 	coverage for infants less than one year of age eligible under section 256B.055, subdivision 
204.30 	10, or 256B.057, subdivision 1, paragraph (d), and shall pay for private-sector coverage 
204.31 	if this is determined to be cost-effective.
204.32 	(c) The commissioner shall verify assets, including capital and operating assets of a 
204.33 	trade or business, and income for all applicants, and for all recipients upon renewal.

204.34 	EFFECTIVE DATE. This section is effective July 1, 2011.

205.1 	Sec. 12. Minnesota Statutes 2008, section 256B.057, subdivision 3, is amended to read:
205.2 		Subd. 3.Qualified Medicare beneficiaries. A person who is entitled to Part A 
205.3 	Medicare benefits, whose income is equal to or less than 100 percent of the federal 
205.4 	poverty guidelines, and whose assets are no more than $10,000 for a single individual 
205.5 	and $18,000 for a married couple or family of two or more the maximum resource 
205.6 	level applied for the year for an individual or an individual and the individual's spouse 
205.7 	according to United States Code, title 42, section 1396d(p)(1)(C), is eligible for medical 
205.8 	assistance reimbursement of Part A and Part B premiums, Part A and Part B coinsurance 
205.9 	and deductibles, and cost-effective premiums for enrollment with a health maintenance 
205.10 	organization or a competitive medical plan under section 1876 of the Social Security Act. 
205.11 	Reimbursement of the Medicare coinsurance and deductibles, when added to the amount 
205.12 	paid by Medicare, must not exceed the total rate the provider would have received for the 
205.13 	same service or services if the person were a medical assistance recipient with Medicare 
205.14 	coverage. Increases in benefits under Title II of the Social Security Act shall not be 
205.15 	counted as income for purposes of this subdivision until July 1 of each year.

205.16 	EFFECTIVE DATE. This section is effective January 1, 2010.

205.17 	Sec. 13. Minnesota Statutes 2008, section 256B.057, subdivision 9, is amended to read:
205.18 		Subd. 9.Employed persons with disabilities. (a) Medical assistance may be paid 
205.19 	for a person who is employed and who:
205.20 	(1) meets the definition of disabled under the supplemental security income program;
205.21 	(2) is at least 16 but less than 65 years of age;
205.22 	(3) meets the asset limits in paragraph (c); and
205.23 	(4) effective November 1, 2003, pays a premium and other obligations under 
205.24 	paragraph (e).
205.25 	Any spousal income or assets shall be disregarded for purposes of eligibility and premium 
205.26 	determinations.
205.27 	(b) After the month of enrollment, a person enrolled in medical assistance under 
205.28 	this subdivision who:
205.29 	(1) is temporarily unable to work and without receipt of earned income due to a 
205.30 	medical condition, as verified by a physician, may retain eligibility for up to four calendar 
205.31 	months; or
205.32 	(2) effective January 1, 2004, loses employment for reasons not attributable to the 
205.33 	enrollee, may retain eligibility for up to four consecutive months after the month of job 
205.34 	loss. To receive a four-month extension, enrollees must verify the medical condition or 
206.1 	provide notification of job loss. All other eligibility requirements must be met and the 
206.2 	enrollee must pay all calculated premium costs for continued eligibility.
206.3 	(c) For purposes of determining eligibility under this subdivision, a person's assets 
206.4 	must not exceed $20,000, excluding:
206.5 	(1) all assets excluded under section 256B.056;
206.6 	(2) retirement accounts, including individual accounts, 401(k) plans, 403(b) plans, 
206.7 	Keogh plans, and pension plans; and
206.8 	(3) medical expense accounts set up through the person's employer.
206.9 	(d)(1) Effective January 1, 2004, for purposes of eligibility, there will be a $65 
206.10 	earned income disregard. To be eligible, a person applying for medical assistance under 
206.11 	this subdivision must have earned income above the disregard level.
206.12 	(2) Effective January 1, 2004, to be considered earned income, Medicare, Social 
206.13 	Security, and applicable state and federal income taxes must be withheld. To be eligible, 
206.14 	a person must document earned income tax withholding.
206.15 	(e)(1) A person whose earned and unearned income is equal to or greater than 100 
206.16 	percent of federal poverty guidelines for the applicable family size must pay a premium 
206.17 	to be eligible for medical assistance under this subdivision. The premium shall be based 
206.18 	on the person's gross earned and unearned income and the applicable family size using a 
206.19 	sliding fee scale established by the commissioner, which begins at one percent of income 
206.20 	at 100 percent of the federal poverty guidelines and increases to 7.5 percent of income 
206.21 	for those with incomes at or above 300 percent of the federal poverty guidelines. Annual 
206.22 	adjustments in the premium schedule based upon changes in the federal poverty guidelines 
206.23 	shall be effective for premiums due in July of each year.
206.24 	(2) Effective January 1, 2004, all enrollees must pay a premium to be eligible for 
206.25 	medical assistance under this subdivision. An enrollee shall pay the greater of a $35$50 
206.26 	premium or the premium calculated in clause (1).
206.27 	(3) Effective November 1, 2003, all enrollees who receive unearned income must 
206.28 	pay one-half of one2.5 percent of unearned income in addition to the premium amount.
206.29 	(4) Effective November 1, 2003, for enrollees whose income does not exceed 200 
206.30 	percent of the federal poverty guidelines and who are also enrolled in Medicare, the 
206.31 	commissioner must reimburse the enrollee for Medicare Part B premiums under section 
206.32 	256B.0625, subdivision 15, paragraph (a).
206.33 	(5) Increases in benefits under title II of the Social Security Act shall not be counted 
206.34 	as income for purposes of this subdivision until July 1 of each year.
207.1 	(f) A person's eligibility and premium shall be determined by the local county 
207.2 	agency. Premiums must be paid to the commissioner. All premiums are dedicated to 
207.3 	the commissioner.
207.4 	(g) Any required premium shall be determined at application and redetermined at 
207.5 	the enrollee's six-month income review or when a change in income or household size is 
207.6 	reported. Enrollees must report any change in income or household size within ten days 
207.7 	of when the change occurs. A decreased premium resulting from a reported change in 
207.8 	income or household size shall be effective the first day of the next available billing month 
207.9 	after the change is reported. Except for changes occurring from annual cost-of-living 
207.10 	increases, a change resulting in an increased premium shall not affect the premium amount 
207.11 	until the next six-month review.
207.12 	(h) Premium payment is due upon notification from the commissioner of the 
207.13 	premium amount required. Premiums may be paid in installments at the discretion of 
207.14 	the commissioner.
207.15 	(i) Nonpayment of the premium shall result in denial or termination of medical 
207.16 	assistance unless the person demonstrates good cause for nonpayment. Good cause exists 
207.17 	if the requirements specified in Minnesota Rules, part 9506.0040, subpart 7, items B to 
207.18 	D, are met. Except when an installment agreement is accepted by the commissioner, 
207.19 	all persons disenrolled for nonpayment of a premium must pay any past due premiums 
207.20 	as well as current premiums due prior to being reenrolled. Nonpayment shall include 
207.21 	payment with a returned, refused, or dishonored instrument. The commissioner may 
207.22 	require a guaranteed form of payment as the only means to replace a returned, refused, 
207.23 	or dishonored instrument.

207.24 	Sec. 14. Minnesota Statutes 2008, section 256B.0575, is amended to read:
207.25 	256B.0575 AVAILABILITY OF INCOME FOR INSTITUTIONALIZED 
207.26 	PERSONS.
207.27 		Subdivision 1.Income deductions. When an institutionalized person is determined 
207.28 	eligible for medical assistance, the income that exceeds the deductions in paragraphs (a) 
207.29 	and (b) must be applied to the cost of institutional care.
207.30 	(a) The following amounts must be deducted from the institutionalized person's 
207.31 	income in the following order:
207.32 	(1) the personal needs allowance under section 256B.35 or, for a veteran who 
207.33 	does not have a spouse or child, or a surviving spouse of a veteran having no child, the 
207.34 	amount of an improved pension received from the veteran's administration not exceeding 
207.35 	$90 per month;
208.1 	(2) the personal allowance for disabled individuals under section 256B.36;
208.2 	(3) if the institutionalized person has a legally appointed guardian or conservator, 
208.3 	five percent of the recipient's gross monthly income up to $100 as reimbursement for 
208.4 	guardianship or conservatorship services;
208.5 	(4) a monthly income allowance determined under section 256B.058, subdivision 
208.6 	2, but only to the extent income of the institutionalized spouse is made available to the 
208.7 	community spouse;
208.8 	(5) a monthly allowance for children under age 18 which, together with the net 
208.9 	income of the children, would provide income equal to the medical assistance standard 
208.10 	for families and children according to section 256B.056, subdivision 4, for a family size 
208.11 	that includes only the minor children. This deduction applies only if the children do not 
208.12 	live with the community spouse and only to the extent that the deduction is not included 
208.13 	in the personal needs allowance under section 256B.35, subdivision 1, as child support 
208.14 	garnished under a court order;
208.15 	(6) a monthly family allowance for other family members, equal to one-third of the 
208.16 	difference between 122 percent of the federal poverty guidelines and the monthly income 
208.17 	for that family member;
208.18 	(7) reparations payments made by the Federal Republic of Germany and reparations 
208.19 	payments made by the Netherlands for victims of Nazi persecution between 1940 and 
208.20 	1945;
208.21 	(8) all other exclusions from income for institutionalized persons as mandated by 
208.22 	federal law; and
208.23 	(9) amounts for reasonable expenses as defined in subdivision 2, incurred for 
208.24 	necessary medical or remedial care for the institutionalized person that are not medical 
208.25 	assistance covered expenses and that are not subject to payment by a third party.
208.26 	Reasonable expenses are limited to expenses that have not been previously used as a 
208.27 	deduction from income and are incurred during the enrollee's current period of eligibility, 
208.28 	including retroactive months associated with the current period of eligibility, for medical 
208.29 	assistance payment of long-term care services.
208.30 	For purposes of clause (6), "other family member" means a person who resides 
208.31 	with the community spouse and who is a minor or dependent child, dependent parent, or 
208.32 	dependent sibling of either spouse. "Dependent" means a person who could be claimed as 
208.33 	a dependent for federal income tax purposes under the Internal Revenue Code.
208.34 	(b) Income shall be allocated to an institutionalized person for a period of up to three 
208.35 	calendar months, in an amount equal to the medical assistance standard for a family 
208.36 	size of one if:
209.1 	(1) a physician certifies that the person is expected to reside in the long-term care 
209.2 	facility for three calendar months or less;
209.3 	(2) if the person has expenses of maintaining a residence in the community; and
209.4 	(3) if one of the following circumstances apply:
209.5 	(i) the person was not living together with a spouse or a family member as defined in 
209.6 	paragraph (a) when the person entered a long-term care facility; or
209.7 	(ii) the person and the person's spouse become institutionalized on the same date, in 
209.8 	which case the allocation shall be applied to the income of one of the spouses.
209.9 	For purposes of this paragraph, a person is determined to be residing in a licensed nursing 
209.10 	home, regional treatment center, or medical institution if the person is expected to remain 
209.11 	for a period of one full calendar month or more.
209.12 		Subd. 2.Reasonable expenses. (a) For the purposes of subdivision 1, paragraph 
209.13 	(a), clause (9), reasonable expenses are limited to expenses that have not been previously 
209.14 	used as a deduction from income and are incurred:
209.15 	(1) during the enrollee's current period of eligibility including retroactive months 
209.16 	associated with the current period of eligibility for medical assistance payment of 
209.17 	long-term care services; or
209.18 	(2) within three months before the effective date of the period of eligibility identified 
209.19 	in subdivision 1, paragraph (b), clause (3), item (i).
209.20 	(b) For expenses incurred during the period identified in paragraph (a), clause (1), 
209.21 	reasonable expenses do not include:
209.22 	(1) expenses for services or equipment covered under chapter 256B by medical 
209.23 	assistance or a home and community-based waiver; or
209.24 	(2) any additional expenses for services and equipment otherwise covered under 
209.25 	chapter 256B.
209.26 	(c) For expenses incurred during the period identified in paragraph (a), clause (2), 
209.27 	reasonable expenses do not include any amount incurred for long-term care services 
209.28 	during a period of ineligibility due to uncompensated transfers, or long-term care facility 
209.29 	expenses incurred without a timely preadmission screening under section 256B.0911.

209.30 	Sec. 15. Minnesota Statutes 2008, section 256B.0595, subdivision 1, is amended to 
209.31 	read:
209.32 		Subdivision 1. Prohibited transfers. (a) For transfers of assets made on or before 
209.33 	August 10, 1993, if an institutionalized person or the institutionalized person's spouse has 
209.34 	given away, sold, or disposed of, for less than fair market value, any asset or interest 
209.35 	therein, except assets other than the homestead that are excluded under the supplemental 
210.1 	security program, within 30 months before or any time after the date of institutionalization 
210.2 	if the person has been determined eligible for medical assistance, or within 30 months 
210.3 	before or any time after the date of the first approved application for medical assistance 
210.4 	if the person has not yet been determined eligible for medical assistance, the person is 
210.5 	ineligible for long-term care services for the period of time determined under subdivision 
210.6 	2. 
210.7 	(b) Effective for transfers made after August 10, 1993, an institutionalized person, an 
210.8 	institutionalized person's spouse, or any person, court, or administrative body with legal 
210.9 	authority to act in place of, on behalf of, at the direction of, or upon the request of the 
210.10 	institutionalized person or institutionalized person's spouse, may not give away, sell, or 
210.11 	dispose of, for less than fair market value, any asset or interest therein, except assets other 
210.12 	than the homestead that are excluded under the Supplemental Security Income program, 
210.13 	for the purpose of establishing or maintaining medical assistance eligibility. This applies 
210.14 	to all transfers, including those made by a community spouse after the month in which 
210.15 	the institutionalized spouse is determined eligible for medical assistance. For purposes of 
210.16 	determining eligibility for long-term care services, any transfer of such assets within 36 
210.17 	months before or any time after an institutionalized person requests medical assistance 
210.18 	payment of long-term care services, or 36 months before or any time after a medical 
210.19 	assistance recipient becomes an institutionalized person, for less than fair market value 
210.20 	may be considered. Any such transfer is presumed to have been made for the purpose 
210.21 	of establishing or maintaining medical assistance eligibility and the institutionalized 
210.22 	person is ineligible for long-term care services for the period of time determined under 
210.23 	subdivision 2, unless the institutionalized person furnishes convincing evidence to 
210.24 	establish that the transaction was exclusively for another purpose, or unless the transfer is 
210.25 	permitted under subdivision 3 or 4.  In the case of payments from a trust or portions of a 
210.26 	trust that are considered transfers of assets under federal law, or in the case of any other 
210.27 	disposal of assets made on or after February 8, 2006, any transfers made within 60 months 
210.28 	before or any time after an institutionalized person requests medical assistance payment of 
210.29 	long-term care services and within 60 months before or any time after a medical assistance 
210.30 	recipient becomes an institutionalized person, may be considered. 
210.31 	(c) This section applies to transfers, for less than fair market value, of income 
210.32 	or assets, including assets that are considered income in the month received, such as 
210.33 	inheritances, court settlements, and retroactive benefit payments or income to which the 
210.34 	institutionalized person or the institutionalized person's spouse is entitled but does not 
210.35 	receive due to action by the institutionalized person, the institutionalized person's spouse, 
210.36 	or any person, court, or administrative body with legal authority to act in place of, on 
211.1 	behalf of, at the direction of, or upon the request of the institutionalized person or the 
211.2 	institutionalized person's spouse. 
211.3 	(d) This section applies to payments for care or personal services provided by a 
211.4 	relative, unless the compensation was stipulated in a notarized, written agreement which 
211.5 	was in existence when the service was performed, the care or services directly benefited 
211.6 	the person, and the payments made represented reasonable compensation for the care 
211.7 	or services provided. A notarized written agreement is not required if payment for the 
211.8 	services was made within 60 days after the service was provided. 
211.9 	(e) This section applies to the portion of any asset or interest that an institutionalized 
211.10 	person, an institutionalized person's spouse, or any person, court, or administrative body 
211.11 	with legal authority to act in place of, on behalf of, at the direction of, or upon the request 
211.12 	of the institutionalized person or the institutionalized person's spouse, transfers to any 
211.13 	annuity that exceeds the value of the benefit likely to be returned to the institutionalized 
211.14 	person or institutionalized person's spouse while alive, based on estimated life expectancy 
211.15 	as determined according to the current actuarial tables published by the Office of the 
211.16 	Chief Actuary of the Social Security Administration. The commissioner may adopt rules 
211.17 	reducing life expectancies based on the need for long-term care. This section applies to an 
211.18 	annuity purchased on or after March 1, 2002, that: 
211.19 	(1) is not purchased from an insurance company or financial institution that is 
211.20 	subject to licensing or regulation by the Minnesota Department of Commerce or a similar 
211.21 	regulatory agency of another state; 
211.22 	(2) does not pay out principal and interest in equal monthly installments; or 
211.23 	(3) does not begin payment at the earliest possible date after annuitization. 
211.24 	(f) Effective for transactions, including the purchase of an annuity, occurring on or 
211.25 	after February 8, 2006, by or on behalf of an institutionalized person who has applied for 
211.26 	or is receiving long-term care services or the institutionalized person's spouse shall be 
211.27 	treated as the disposal of an asset for less than fair market value unless the department is 
211.28 	named a preferred remainder beneficiary  as described in section 256B.056, subdivision 
211.29 	11. Any subsequent change to the designation of the department as a preferred remainder 
211.30 	beneficiary shall result in the annuity being treated as a disposal of assets for less than 
211.31 	fair market value. The amount of such transfer shall be the maximum amount the 
211.32 	institutionalized person or the institutionalized person's spouse could receive from the 
211.33 	annuity or similar financial instrument. Any change in the amount of the income or 
211.34 	principal being withdrawn from the annuity or other similar financial instrument at the 
211.35 	time of the most recent disclosure shall be deemed to be a transfer of assets for less than 
211.36 	fair market value unless the institutionalized person or the institutionalized person's spouse 
212.1 	demonstrates that the transaction was for fair market value. In the event a distribution 
212.2 	of income or principal has been improperly distributed or disbursed from an annuity or 
212.3 	other retirement planning instrument of an institutionalized person or the institutionalized 
212.4 	person's spouse, a cause of action exists against the individual receiving the improper 
212.5 	distribution for the cost of medical assistance services provided or the amount of the 
212.6 	improper distribution, whichever is less. 
212.7 	(g) Effective for transactions, including the purchase of an annuity, occurring on 
212.8 	or after February 8, 2006, by or on behalf of an institutionalized person applying for or 
212.9 	receiving long-term care services shall be treated as a disposal of assets for less than fair 
212.10 	market value unless it is: 
212.11 	(i) an annuity described in subsection (b) or (q) of section 408 of the Internal 
212.12 	Revenue Code of 1986; or 
212.13 	(ii) purchased with proceeds from: 
212.14 	(A) an account or trust described in subsection (a), (c), or (p) of section 408 of the 
212.15 	Internal Revenue Code; 
212.16 	(B) a simplified employee pension within the meaning of section 408(k) of the 
212.17 	Internal Revenue Code; or 
212.18 	(C) a Roth IRA described in section 408A of the Internal Revenue Code; or 
212.19 	(iii) an annuity that is irrevocable and nonassignable; is actuarially sound as 
212.20 	determined in accordance with actuarial publications of the Office of the Chief Actuary of 
212.21 	the Social Security Administration; and provides for payments in equal amounts during 
212.22 	the term of the annuity, with no deferral and no balloon payments made.
212.23 	 (h) For purposes of this section, long-term care services include services in a nursing 
212.24 	facility, services that are eligible for payment according to section 256B.0625, subdivision 
212.25 	2, because they are provided in a swing bed, intermediate care facility for persons with 
212.26 	developmental disabilities, and home and community-based services provided pursuant 
212.27 	to sections 256B.0915, 256B.092, and 256B.49. For purposes of this subdivision and 
212.28 	subdivisions 2, 3, and 4, "institutionalized person" includes a person who is an inpatient 
212.29 	in a nursing facility or in a swing bed, or intermediate care facility for persons with 
212.30 	developmental disabilities or who is receiving home and community-based services under 
212.31 	sections 256B.0915, 256B.092, and 256B.49. 
212.32 	(i) This section applies to funds used to purchase a promissory note, loan, or 
212.33 	mortgage unless the note, loan, or mortgage: 
212.34 	(1) has a repayment term that is actuarially sound; 
212.35 	(2) provides for payments to be made in equal amounts during the term of the loan, 
212.36 	with no deferral and no balloon payments made; and 
213.1 	(3) prohibits the cancellation of the balance upon the death of the lender. 
213.2 	In the case of a promissory note, loan, or mortgage that does not meet an exception 
213.3 	in clauses (1) to (3), the value of such note, loan, or mortgage shall be the outstanding 
213.4 	balance due as of the date of the institutionalized person's request for medical assistance 
213.5 	payment of long-term care services. 
213.6 	(j) This section applies to the purchase of a life estate interest in another person's 
213.7 	home unless the purchaser resides in the home for a period of at least one year after the 
213.8 	date of purchase. 
213.9 	(k) This section applies to transfers into a pooled trust that qualifies under United 
213.10 	States Code, title 42, section 1396p(d)(4)(C), by:
213.11 	(1) a person age 65 or older or the person's spouse; or
213.12 	(2) any person, court, or administrative body with legal authority to act in place 
213.13 	of, on behalf of, at the direction of, or upon the request of a person age 65 or older or 
213.14 	the person's spouse.

213.15 	Sec. 16. Minnesota Statutes 2008, section 256B.0595, subdivision 2, is amended to 
213.16 	read:
213.17 		Subd. 2. Period of ineligibility for long-term care services. (a) For any 
213.18 	uncompensated transfer occurring on or before August 10, 1993, the number of months 
213.19 	of ineligibility for long-term care services shall be the lesser of 30 months, or the 
213.20 	uncompensated transfer amount divided by the average medical assistance rate for nursing 
213.21 	facility services in the state in effect on the date of application. The amount used to 
213.22 	calculate the average medical assistance payment rate shall be adjusted each July 1 to 
213.23 	reflect payment rates for the previous calendar year. The period of ineligibility begins 
213.24 	with the month in which the assets were transferred. If the transfer was not reported to 
213.25 	the local agency at the time of application, and the applicant received long-term care 
213.26 	services during what would have been the period of ineligibility if the transfer had been 
213.27 	reported, a cause of action exists against the transferee for the cost of long-term care 
213.28 	services provided during the period of ineligibility, or for the uncompensated amount of 
213.29 	the transfer, whichever is less. The uncompensated transfer amount is the fair market 
213.30 	value of the asset at the time it was given away, sold, or disposed of, less the amount of 
213.31 	compensation received. 
213.32 	(b) For uncompensated transfers made after August 10, 1993, the number of months 
213.33 	of ineligibility for long-term care services shall be the total uncompensated value of the 
213.34 	resources transferred divided by the average medical assistance rate for nursing facility 
213.35 	services in the state in effect on the date of application. The amount used to calculate 
214.1 	the average medical assistance payment rate shall be adjusted each July 1 to reflect 
214.2 	payment rates for the previous calendar year. The period of ineligibility begins with the 
214.3 	first day of the month after the month in which the assets were transferred except that 
214.4 	if one or more uncompensated transfers are made during a period of ineligibility, the 
214.5 	total assets transferred during the ineligibility period shall be combined and a penalty 
214.6 	period calculated to begin on the first day of the month after the month in which the first 
214.7 	uncompensated transfer was made. If the transfer was reported to the local agency after 
214.8 	the date that advance notice of a period of ineligibility that affects the next month could 
214.9 	be provided to the recipient and the recipient received medical assistance services or the 
214.10 	transfer was not reported to the local agency, and the applicant or recipient received 
214.11 	medical assistance services during what would have been the period of ineligibility if 
214.12 	the transfer had been reported, a cause of action exists against the transferee for that 
214.13 	portion of long-term care services provided during the period of ineligibility, or for the 
214.14 	uncompensated amount of the transfer, whichever is less. The uncompensated transfer 
214.15 	amount is the fair market value of the asset at the time it was given away, sold, or disposed 
214.16 	of, less the amount of compensation received. Effective for transfers made on or after 
214.17 	March 1, 1996, involving persons who apply for medical assistance on or after April 13, 
214.18 	1996, no cause of action exists for a transfer unless: 
214.19 	(1) the transferee knew or should have known that the transfer was being made by a 
214.20 	person who was a resident of a long-term care facility or was receiving that level of care in 
214.21 	the community at the time of the transfer; 
214.22 	(2) the transferee knew or should have known that the transfer was being made to 
214.23 	assist the person to qualify for or retain medical assistance eligibility; or 
214.24 	(3) the transferee actively solicited the transfer with intent to assist the person to 
214.25 	qualify for or retain eligibility for medical assistance. 
214.26 	(c) For uncompensated transfers made on or after February 8, 2006, the period 
214.27 	of ineligibility: 
214.28 	(1) for uncompensated transfers by or on behalf of individuals receiving medical 
214.29 	assistance payment of long-term care services, begins the first day of the month following 
214.30 	advance notice of the penalty period of ineligibility, but no later than the first day of the 
214.31 	month that follows three full calendar months from the date of the report or discovery 
214.32 	of the transfer; or 
214.33 	(2) for uncompensated transfers by individuals requesting medical assistance 
214.34 	payment of long-term care services, begins the date on which the individual is eligible 
214.35 	for medical assistance under the Medicaid state plan and would otherwise be receiving 
214.36 	long-term care services based on an approved application for such care but for the 
215.1 	application of the penalty period of ineligibility resulting from the uncompensated 
215.2 	transfer; and 
215.3 	(3) cannot begin during any other period of ineligibility. 
215.4 	(d) If a calculation of a penalty period of ineligibility results in a partial month, 
215.5 	payments for long-term care services shall be reduced in an amount equal to the fraction. 
215.6 	(e) In the case of multiple fractional transfers of assets in more than one month for 
215.7 	less than fair market value on or after February 8, 2006, the period of ineligibility is 
215.8 	calculated by treating the total, cumulative, uncompensated value of all assets transferred 
215.9 	during all months on or after February 8, 2006, as one transfer. 
215.10 	(f) A period of ineligibility established under paragraph (c) may be eliminated if 
215.11 	all of the assets transferred for less than fair market value used to calculate the period of 
215.12 	ineligibility, or cash equal to the value of the assets at the time of the transfer, are returned 
215.13 	within 12 months after the date the period of ineligibility begins. A period of ineligibility 
215.14 	must not be adjusted if less than the full amounts of the transferred assets or the full cash 
215.15 	values of the transferred assets are returned.

215.16 	EFFECTIVE DATE. This section is effective for periods of ineligibility established 
215.17 	on or after July 1, 2009.

215.18 	Sec. 17. Minnesota Statutes 2008, section 256B.0625, is amended by adding a 
215.19 	subdivision to read:
215.20 		Subd. 3g.Chiropractic services. Chiropractic services are not covered.

215.21 	Sec. 18. Minnesota Statutes 2008, section 256B.0625, is amended by adding a 
215.22 	subdivision to read:
215.23 		Subd. 3h.Podiatric services. Podiatric services are not covered.

215.24 	Sec. 19. Minnesota Statutes 2008, section 256B.0625, subdivision 8, is amended to 
215.25 	read:
215.26 		Subd. 8.Physical therapy. Medical assistance covers physical therapy and related 
215.27 	services, including specialized maintenance therapy for eligible recipients under 21 years 
215.28 	of age. Services provided by a physical therapy assistant shall be reimbursed at the same 
215.29 	rate as services performed by a physical therapist when the services of the physical 
215.30 	therapy assistant are provided under the direction of a physical therapist who is on the 
215.31 	premises. Services provided by a physical therapy assistant that are provided under the 
215.32 	direction of a physical therapist who is not on the premises shall be reimbursed at 65 
215.33 	percent of the physical therapist rate.

216.1 	Sec. 20. Minnesota Statutes 2008, section 256B.0625, subdivision 8a, is amended to 
216.2 	read:
216.3 		Subd. 8a.Occupational therapy. Medical assistance covers occupational therapy 
216.4 	and related services, including specialized maintenance therapy for eligible recipients 
216.5 	under 21 years of age. Services provided by an occupational therapy assistant shall be 
216.6 	reimbursed at the same rate as services performed by an occupational therapist when the 
216.7 	services of the occupational therapy assistant are provided under the direction of the 
216.8 	occupational therapist who is on the premises. Services provided by an occupational 
216.9 	therapy assistant that are provided under the direction of an occupational therapist who is 
216.10 	not on the premises shall be reimbursed at 65 percent of the occupational therapist rate.

216.11 	Sec. 21. Minnesota Statutes 2008, section 256B.0625, subdivision 8b, is amended to 
216.12 	read:
216.13 		Subd. 8b.Speech language pathology and audiology services. Medical assistance 
216.14 	covers speech language pathology and related services, including specialized maintenance 
216.15 	therapy for eligible recipients under 21 years of age. Medical assistance covers audiology 
216.16 	services and related services. Services provided by a person who has been issued a 
216.17 	temporary registration under section 148.5161 shall be reimbursed at the same rate 
216.18 	as services performed by a speech language pathologist or audiologist as long as the 
216.19 	requirements of section 148.5161, subdivision 3, are met. 

216.20 	Sec. 22. Minnesota Statutes 2008, section 256B.0625, subdivision 9, is amended to 
216.21 	read:
216.22 		Subd. 9.Dental services. Medical assistance covers dental services for children 
216.23 	under 21 years of age and pregnant women. Dental services include, with prior 
216.24 	authorization, fixed bridges that are cost-effective for persons who cannot use removable 
216.25 	dentures because of their medical condition.

216.26 	Sec. 23. Minnesota Statutes 2008, section 256B.0625, subdivision 13e, is amended to 
216.27 	read:
216.28 		Subd. 13e.Payment rates. (a) The basis for determining the amount of payment 
216.29 	shall be the lower of the actual acquisition costs of the drugs plus a fixed dispensing fee; 
216.30 	the maximum allowable cost set by the federal government or by the commissioner plus 
216.31 	the fixed dispensing fee; or the usual and customary price charged to the public. The 
216.32 	amount of payment basis must be reduced to reflect all discount amounts applied to the 
216.33 	charge by any provider/insurer agreement or contract for submitted charges to medical 
217.1 	assistance programs. The net submitted charge may not be greater than the patient liability 
217.2 	for the service. The pharmacy dispensing fee shall be $3.65, except that the dispensing fee 
217.3 	for intravenous solutions which must be compounded by the pharmacist shall be $8 per 
217.4 	bag, $14 per bag for cancer chemotherapy products, and $30 per bag for total parenteral 
217.5 	nutritional products dispensed in one liter quantities, or $44 per bag for total parenteral 
217.6 	nutritional products dispensed in quantities greater than one liter. Actual acquisition 
217.7 	cost includes quantity and other special discounts except time and cash discounts. 
217.8 	Effective July 1, 2008, the actual acquisition cost of a drug shall be estimated by the 
217.9 	commissioner, at average wholesale price minus 1415 percent. The actual acquisition 
217.10 	cost of antihemophilic factor drugs shall be estimated at the average wholesale price 
217.11 	minus 30 percent. The maximum allowable cost of a multisource drug may be set by the 
217.12 	commissioner and it shall be comparable to, but no higher than, the maximum amount 
217.13 	paid by other third-party payors in this state who have maximum allowable cost programs. 
217.14 	Establishment of the amount of payment for drugs shall not be subject to the requirements 
217.15 	of the Administrative Procedure Act.
217.16 	(b) An additional dispensing fee of $.30 may be added to the dispensing fee paid 
217.17 	to pharmacists for legend drug prescriptions dispensed to residents of long-term care 
217.18 	facilities when a unit dose blister card system, approved by the department, is used. Under 
217.19 	this type of dispensing system, the pharmacist must dispense a 30-day supply of drug. 
217.20 	The National Drug Code (NDC) from the drug container used to fill the blister card must 
217.21 	be identified on the claim to the department. The unit dose blister card containing the 
217.22 	drug must meet the packaging standards set forth in Minnesota Rules, part 6800.2700, 
217.23 	that govern the return of unused drugs to the pharmacy for reuse. The pharmacy provider 
217.24 	will be required to credit the department for the actual acquisition cost of all unused 
217.25 	drugs that are eligible for reuse. Over-the-counter medications must be dispensed in the 
217.26 	manufacturer's unopened package. The commissioner may permit the drug clozapine to be 
217.27 	dispensed in a quantity that is less than a 30-day supply.
217.28 	(c) Whenever a generically equivalent product is available, payment shall be on the 
217.29 	basis of the actual acquisition cost of the generic drug, or on the maximum allowable cost 
217.30 	established by the commissioner.
217.31 	(d) The basis for determining the amount of payment for drugs administered in an 
217.32 	outpatient setting shall be the lower of the usual and customary cost submitted by the 
217.33 	provider or the amount established for Medicare by the United States Department of 
217.34 	Health and Human Services pursuant to title XVIII, section 1847a of the federal Social 
217.35 	Security Act.
218.1 	(e) The commissioner may negotiate lower reimbursement rates for specialty 
218.2 	pharmacy products than the rates specified in paragraph (a). The commissioner may 
218.3 	require individuals enrolled in the health care programs administered by the department 
218.4 	to obtain specialty pharmacy products from providers with whom the commissioner has 
218.5 	negotiated lower reimbursement rates. Specialty pharmacy products are defined as those 
218.6 	used by a small number of recipients or recipients with complex and chronic diseases 
218.7 	that require expensive and challenging drug regimens. Examples of these conditions 
218.8 	include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis 
218.9 	C, growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms 
218.10 	of cancer. Specialty pharmaceutical products include injectable and infusion therapies, 
218.11 	biotechnology drugs, high-cost therapies, and therapies that require complex care. The 
218.12 	commissioner shall consult with the formulary committee to develop a list of specialty 
218.13 	pharmacy products subject to this paragraph. In consulting with the formulary committee 
218.14 	in developing this list, the commissioner shall take into consideration the population 
218.15 	served by specialty pharmacy products, the current delivery system and standard of care in 
218.16 	the state, and access to care issues. The commissioner shall have the discretion to adjust 
218.17 	the reimbursement rate to prevent access to care issues.

218.18 	EFFECTIVE DATE. This section is effective retroactively from July 1, 2008.

218.19 	Sec. 24. Minnesota Statutes 2008, section 256B.0625, subdivision 17, is amended to 
218.20 	read:
218.21 		Subd. 17.Transportation costs. (a) Medical assistance covers transportation costs 
218.22 	incurred solely for obtaining emergency medical care or transportation costs incurred 
218.23 	by eligible persons in obtaining emergency or nonemergency medical care when paid 
218.24 	directly to an ambulance company, common carrier, or other recognized providers of 
218.25 	transportation services.
218.26 	(b) Medical assistance covers special transportation, as defined in Minnesota Rules, 
218.27 	part 9505.0315, subpart 1, item F, if the recipient has a physical or mental impairment that 
218.28 	would prohibit the recipient from safely accessing and using a bus, taxi, other commercial 
218.29 	transportation, or private automobile.
218.30 	The commissioner may use an order by the recipient's attending physician to certify that 
218.31 	the recipient requires special transportation services. Special transportation includes 
218.32 	driver-assisted service to eligible individuals. Driver-assisted service includes passenger 
218.33 	pickup at and return to the individual's residence or place of business, assistance with 
218.34 	admittance of the individual to the medical facility, and assistance in passenger securement 
219.1 	or in securing of wheelchairs or stretchers in the vehicle. Special transportation providers 
219.2 	must obtain written documentation from the health care service provider who is serving 
219.3 	the recipient being transported, identifying the time that the recipient arrived. Special 
219.4 	transportation providers may not bill for separate base rates for the continuation of a trip 
219.5 	beyond the original destination. Special transportation providers must take recipients to 
219.6 	the nearest appropriate health care provider, using the most direct route available. The 
219.7 	maximum medical assistance reimbursement rates for special transportation services are:
219.8 	(1) $17 for the base rate and $1.35$1.95 per mile for services to eligible persons 
219.9 	who need a wheelchair-accessible van;
219.10 	(2) $11.50$8.50 for the base rate and $1.30 per mile for services to eligible persons 
219.11 	who do not need a wheelchair-accessible van; and
219.12 	(3) $60 for the base rate and $2.40 per mile, and an attendant rate of $9 per trip, for 
219.13 	services to eligible persons who need a stretcher-accessible vehicle.

219.14 	Sec. 25. Minnesota Statutes 2008, section 256B.0625, subdivision 26, is amended to 
219.15 	read:
219.16 		Subd. 26.Special education services. (a) Medical assistance covers medical 
219.17 	services identified in a recipient's individualized education plan and covered under the 
219.18 	medical assistance state plan. Covered services include occupational therapy, physical 
219.19 	therapy, speech-language therapy, clinical psychological services, nursing services, 
219.20 	school psychological services, school social work services, personal care assistants 
219.21 	serving as management aides, assistive technology devices, transportation services, 
219.22 	health assessments, and other services covered under the medical assistance state plan. 
219.23 	Mental health services eligible for medical assistance reimbursement must be provided or 
219.24 	coordinated through a children's mental health collaborative where a collaborative exists if 
219.25 	the child is included in the collaborative operational target population. The provision or 
219.26 	coordination of services does not require that the individual education plan be developed 
219.27 	by the collaborative.
219.28 	The services may be provided by a Minnesota school district that is enrolled as a 
219.29 	medical assistance provider or its subcontractor, and only if the services meet all the 
219.30 	requirements otherwise applicable if the service had been provided by a provider other 
219.31 	than a school district, in the following areas: medical necessity, physician's orders, 
219.32 	documentation, personnel qualifications, and prior authorization requirements. The 
219.33 	nonfederal share of costs for services provided under this subdivision is the responsibility 
219.34 	of the local school district as provided in section 125A.74. Services listed in a child's 
220.1 	individual education plan are eligible for medical assistance reimbursement only if those 
220.2 	services meet criteria for federal financial participation under the Medicaid program. 
220.3 	(b) Approval of health-related services for inclusion in the individual education plan 
220.4 	does not require prior authorization for purposes of reimbursement under this chapter. 
220.5 	The commissioner may require physician review and approval of the plan not more than 
220.6 	once annually or upon any modification of the individual education plan that reflects a 
220.7 	change in health-related services.
220.8 	(c) Services of a speech-language pathologist provided under this section are covered 
220.9 	notwithstanding Minnesota Rules, part 9505.0390, subpart 1, item L, if the person:
220.10 	(1) holds a masters degree in speech-language pathology;
220.11 	(2) is licensed by the Minnesota Board of Teaching as an educational 
220.12 	speech-language pathologist; and
220.13 	(3) either has a certificate of clinical competence from the American Speech and 
220.14 	Hearing Association, has completed the equivalent educational requirements and work 
220.15 	experience necessary for the certificate or has completed the academic program and is 
220.16 	acquiring supervised work experience to qualify for the certificate.
220.17 	(d) Medical assistance coverage for medically necessary services provided under 
220.18 	other subdivisions in this section may not be denied solely on the basis that the same or 
220.19 	similar services are covered under this subdivision.
220.20 	(e) The commissioner shall develop and implement package rates, bundled rates, or 
220.21 	per diem rates for special education services under which separately covered services are 
220.22 	grouped together and billed as a unit in order to reduce administrative complexity.
220.23 	(f) The commissioner shall develop a cost-based payment structure for payment 
220.24 	of these services. The commissioner shall reimburse claims submitted based on an 
220.25 	interim rate, and shall settle at a final rate once the department has determined it. The 
220.26 	commissioner shall notify the school district of the final rate. The school district has 60 
220.27 	days to appeal the final rate. To appeal the final rate, the school district shall file a written 
220.28 	appeal request to the commissioner within 60 days of the date the final rate determination 
220.29 	was mailed. The appeal request shall specify (1) the disputed items and (2) the name and 
220.30 	address of the person to contact regarding the appeal.
220.31 	(g) Effective July 1, 2000, medical assistance services provided under an individual 
220.32 	education plan or an individual family service plan by local school districts shall not count 
220.33 	against medical assistance authorization thresholds for that child.
220.34 	(h) Nursing services as defined in section 148.171, subdivision 15, and provided 
220.35 	as an individual education plan health-related service, are eligible for medical assistance 
220.36 	payment if they are otherwise a covered service under the medical assistance program. 
221.1 	Medical assistance covers the administration of prescription medications by a licensed 
221.2 	nurse who is employed by or under contract with a school district when the administration 
221.3 	of medications is identified in the child's individualized education plan. The simple 
221.4 	administration of medications alone is not covered under medical assistance when 
221.5 	administered by a provider other than a school district or when it is not identified in the 
221.6 	child's individualized education plan. 

221.7 	Sec. 26. Minnesota Statutes 2008, section 256B.15, subdivision 1a, is amended to read:
221.8 		Subd. 1a.Estates subject to claims. (a) If a person receives any medical assistance 
221.9 	hereunder, on the person's death, if single, or on the death of the survivor of a married 
221.10 	couple, either or both of whom received medical assistance, or as otherwise provided 
221.11 	for in this section, the total amount paid for medical assistance rendered for the person 
221.12 	and spouse shall be filed as a claim against the estate of the person or the estate of the 
221.13 	surviving spouse in the court having jurisdiction to probate the estate or to issue a decree 
221.14 	of descent according to sections 525.31 to 525.313. 
221.15 	(b) For the purposes of this section, the person's estate must consist of:
221.16 	(1) the person's probate estate;
221.17 	(2) all of the person's interests or proceeds of those interests in real property the 
221.18 	person owned as a life tenant or as a joint tenant with a right of survivorship at the time of 
221.19 	the person's death;
221.20 	(3) all of the person's interests or proceeds of those interests in securities the person 
221.21 	owned in beneficiary form as provided under sections 524.6-301 to 524.6-311 at the time 
221.22 	of the person's death, to the extent the interests or proceeds of those interests become part 
221.23 	of the probate estate under section 524.6-307;
221.24 	(4) all of the person's interests in joint accounts, multiple-party accounts, and 
221.25 	pay-on-death accounts, brokerage accounts, investment accounts, or the proceeds of 
221.26 	those accounts, as provided under sections 524.6-201 to 524.6-214 at the time of the 
221.27 	person's death to the extent the interests become part of the probate estate under section 
221.28 	524.6-207; and
221.29 	(5) assets conveyed to a survivor, heir, or assign of the person through survivorship, 
221.30 	living trust, or other arrangements.
221.31 	(c) For the purpose of this section and recovery in a surviving spouse's estate for 
221.32 	medical assistance paid for a predeceased spouse, the estate must consist of all of the legal 
221.33 	title and interests the deceased individual's predeceased spouse had in jointly owned or 
221.34 	marital property at the time of the spouse's death, as defined in subdivision 2b, and the 
221.35 	proceeds of those interests, that passed to the deceased individual or another individual, a 
222.1 	survivor, an heir, or an assign of the predeceased spouse through a joint tenancy, tenancy 
222.2 	in common, survivorship, life estate, living trust, or other arrangement. A deceased 
222.3 	recipient who, at death, owned the property jointly with the surviving spouse shall have 
222.4 	an interest in the entire property.
222.5 	(d) For the purpose of recovery in a single person's estate or the estate of a survivor 
222.6 	of a married couple, "other arrangement" includes any other means by which title to all or 
222.7 	any part of the jointly owned or marital property or interest passed from the predeceased 
222.8 	spouse to another including, but not limited to, transfers between spouses which are 
222.9 	permitted, prohibited, or penalized for purposes of medical assistance.
222.10 	(e) A claim shall be filed if medical assistance was rendered for either or both 
222.11 	persons under one of the following circumstances:
222.12 	(a) (1) the person was over 55 years of age, and received services under this chapter;
222.13 	(b) (2) the person resided in a medical institution for six months or longer, received 
222.14 	services under this chapter, and, at the time of institutionalization or application for 
222.15 	medical assistance, whichever is later, the person could not have reasonably been expected 
222.16 	to be discharged and returned home, as certified in writing by the person's treating 
222.17 	physician. For purposes of this section only, a "medical institution" means a skilled 
222.18 	nursing facility, intermediate care facility, intermediate care facility for persons with 
222.19 	developmental disabilities, nursing facility, or inpatient hospital; or
222.20 	(c) (3) the person received general assistance medical care services under chapter 
222.21 	256D.
222.22 	(f) The claim shall be considered an expense of the last illness of the decedent for the 
222.23 	purpose of section 524.3-805. Notwithstanding any law or rule to the contrary, a state or 
222.24 	county agency with a claim under this section must be a creditor under section 524.6-307.
222.25 	Any statute of limitations that purports to limit any county agency or the state agency, 
222.26 	or both, to recover for medical assistance granted hereunder shall not apply to any claim 
222.27 	made hereunder for reimbursement for any medical assistance granted hereunder. Notice 
222.28 	of the claim shall be given to all heirs and devisees of the decedent whose identity can be 
222.29 	ascertained with reasonable diligence. The notice must include procedures and instructions 
222.30 	for making an application for a hardship waiver under subdivision 5; time frames for 
222.31 	submitting an application and determination; and information regarding appeal rights and 
222.32 	procedures. Counties are entitled to one-half of the nonfederal share of medical assistance 
222.33 	collections from estates that are directly attributable to county effort. Counties are entitled 
222.34 	to ten percent of the collections for alternative care directly attributable to county effort. 

222.35 	Sec. 27. Minnesota Statutes 2008, section 256B.15, subdivision 1h, is amended to read:
223.1 		Subd. 1h. Estates of specific persons receiving medical assistance. (a) For 
223.2 	purposes of this section, paragraphs (b) to (k) (j) apply if a person received medical 
223.3 	assistance for which a claim may be filed under this section and died single, or the 
223.4 	surviving spouse of the couple and was not survived by any of the persons described 
223.5 	in subdivisions 3 and 4. 
223.6 	(b) For purposes of this section, the person's estate consists of: (1) the person's 
223.7 	probate estate; (2) all of the person's interests or proceeds of those interests in real property 
223.8 	the person owned as a life tenant or as a joint tenant with a right of survivorship at the 
223.9 	time of the person's death; (3) all of the person's interests or proceeds of those interests in 
223.10 	securities the person owned in beneficiary form as provided under sections 524.6-301 to 
223.11 	524.6-311 at the time of the person's death, to the extent they become part of the probate 
223.12 	estate under section 524.6-307; (4) all of the person's interests in joint accounts, multiple 
223.13 	party accounts, and pay on death accounts, or the proceeds of those accounts, as provided 
223.14 	under sections 524.6-201 to 524.6-214 at the time of the person's death to the extent 
223.15 	they become part of the probate estate under section 524.6-207; and (5) the person's 
223.16 	legal title or interest at the time of the person's death in real property transferred under 
223.17 	a transfer on death deed under section 507.071, or in the proceeds from the subsequent 
223.18 	sale of the person's interest in the real property. Notwithstanding any law or rule to the 
223.19 	contrary, a state or county agency with a claim under this section shall be a creditor under 
223.20 	section 524.6-307. 
223.21 	(c) (b) Notwithstanding any law or rule to the contrary, the person's life estate or joint 
223.22 	tenancy interest in real property not subject to a medical assistance lien under sections 
223.23 	514.980 to 514.985 on the date of the person's death shall not end upon the person's death 
223.24 	and shall continue as provided in this subdivision. The life estate in the person's estate 
223.25 	shall be that portion of the interest in the real property subject to the life estate that is equal 
223.26 	to the life estate percentage factor for the life estate as listed in the Life Estate Mortality 
223.27 	Table of the health care program's manual for a person who was the age of the medical 
223.28 	assistance recipient on the date of the person's death. The joint tenancy interest in real 
223.29 	property in the estate shall be equal to the fractional interest the person would have owned 
223.30 	in the jointly held interest in the property had they and the other owners held title to the 
223.31 	property as tenants in common on the date the person died. 
223.32 	(d) (c) The court upon its own motion, or upon motion by the personal representative 
223.33 	or any interested party, may enter an order directing the remaindermen or surviving joint 
223.34 	tenants and their spouses, if any, to sign all documents, take all actions, and otherwise 
223.35 	fully cooperate with the personal representative and the court to liquidate the decedent's 
223.36 	life estate or joint tenancy interests in the estate and deliver the cash or the proceeds of 
224.1 	those interests to the personal representative and provide for any legal and equitable 
224.2 	sanctions as the court deems appropriate to enforce and carry out the order, including an 
224.3 	award of reasonable attorney fees. 
224.4 	(e) (d) The personal representative may make, execute, and deliver any conveyances 
224.5 	or other documents necessary to convey the decedent's life estate or joint tenancy interest 
224.6 	in the estate that are necessary to liquidate and reduce to cash the decedent's interest or 
224.7 	for any other purposes. 
224.8 	(f) (e) Subject to administration, all costs, including reasonable attorney fees, 
224.9 	directly and immediately related to liquidating the decedent's life estate or joint tenancy 
224.10 	interest in the decedent's estate, shall be paid from the gross proceeds of the liquidation 
224.11 	allocable to the decedent's interest and the net proceeds shall be turned over to the personal 
224.12 	representative and applied to payment of the claim presented under this section. 
224.13 	(g) (f) The personal representative shall bring a motion in the district court in which 
224.14 	the estate is being probated to compel the remaindermen or surviving joint tenants to 
224.15 	account for and deliver to the personal representative all or any part of the proceeds of any 
224.16 	sale, mortgage, transfer, conveyance, or any disposition of real property allocable to the 
224.17 	decedent's life estate or joint tenancy interest in the decedent's estate, and do everything 
224.18 	necessary to liquidate and reduce to cash the decedent's interest and turn the proceeds of 
224.19 	the sale or other disposition over to the personal representative. The court may grant any 
224.20 	legal or equitable relief including, but not limited to, ordering a partition of real estate 
224.21 	under chapter 558 necessary to make the value of the decedent's life estate or joint tenancy 
224.22 	interest available to the estate for payment of a claim under this section. 
224.23 	(h) (g) Subject to administration, the personal representative shall use all of the cash 
224.24 	or proceeds of interests to pay an allowable claim under this section. The remaindermen 
224.25 	or surviving joint tenants and their spouses, if any, may enter into a written agreement 
224.26 	with the personal representative or the claimant to settle and satisfy obligations imposed at 
224.27 	any time before or after a claim is filed. 
224.28 	(i) (h) The personal representative may, at their discretion, provide any or all of the 
224.29 	other owners, remaindermen, or surviving joint tenants with an affidavit terminating the 
224.30 	decedent's estate's interest in real property the decedent owned as a life tenant or as a joint 
224.31 	tenant with others, if the personal representative determines in good faith that neither the 
224.32 	decedent nor any of the decedent's predeceased spouses received any medical assistance 
224.33 	for which a claim could be filed under this section, or if the personal representative has 
224.34 	filed an affidavit with the court that the estate has other assets sufficient to pay a claim, as 
224.35 	presented, or if there is a written agreement under paragraph (h) (g), or if the claim, as 
224.36 	allowed, has been paid in full or to the full extent of the assets the estate has available 
225.1 	to pay it. The affidavit may be recorded in the office of the county recorder or filed in 
225.2 	the Office of the Registrar of Titles for the county in which the real property is located. 
225.3 	Except as provided in section 514.981, subdivision 6, when recorded or filed, the affidavit 
225.4 	shall terminate the decedent's interest in real estate the decedent owned as a life tenant or a 
225.5 	joint tenant with others. The affidavit shall:
225.6 	(1) be signed by the personal representative;
225.7 	(2) identify the decedent and the interest being terminated;
225.8 	(3) give recording information sufficient to identify the instrument that created the 
225.9 	interest in real property being terminated;
225.10 	(4) legally describe the affected real property;
225.11 	(5) state that the personal representative has determined that neither the decedent 
225.12 	nor any of the decedent's predeceased spouses received any medical assistance for which 
225.13 	a claim could be filed under this section;
225.14 	(6) state that the decedent's estate has other assets sufficient to pay the claim, as 
225.15 	presented, or that there is a written agreement between the personal representative and 
225.16 	the claimant and the other owners or remaindermen or other joint tenants to satisfy the 
225.17 	obligations imposed under this subdivision; and
225.18 	(7) state that the affidavit is being given to terminate the estate's interest under this 
225.19 	subdivision, and any other contents as may be appropriate.
225.20 	The recorder or registrar of titles shall accept the affidavit for recording or filing. The 
225.21 	affidavit shall be effective as provided in this section and shall constitute notice even if it 
225.22 	does not include recording information sufficient to identify the instrument creating the 
225.23 	interest it terminates. The affidavit shall be conclusive evidence of the stated facts. 
225.24 	(j) (i) The holder of a lien arising under subdivision 1c shall release the lien at 
225.25 	the holder's expense against an interest terminated under paragraph (h) (g) to the extent 
225.26 	of the termination. 
225.27 	(k) (j) If a lien arising under subdivision 1c is not released under paragraph (j) (i), 
225.28 	prior to closing the estate, the personal representative shall deed the interest subject to the 
225.29 	lien to the remaindermen or surviving joint tenants as their interests may appear. Upon 
225.30 	recording or filing, the deed shall work a merger of the recipient's life estate or joint 
225.31 	tenancy interest, subject to the lien, into the remainder interest or interest the decedent and 
225.32 	others owned jointly. The lien shall attach to and run with the property to the extent of 
225.33 	the decedent's interest at the time of the decedent's death. 

225.34 	Sec. 28. Minnesota Statutes 2008, section 256B.15, subdivision 2, is amended to read:
226.1 		Subd. 2.Limitations on claims. The claim shall include only the total amount 
226.2 	of medical assistance rendered after age 55 or during a period of institutionalization 
226.3 	described in subdivision 1a, clause (b) paragraph (e), and the total amount of general 
226.4 	assistance medical care rendered, and shall not include interest. Claims that have been 
226.5 	allowed but not paid shall bear interest according to section 524.3-806, paragraph (d). A 
226.6 	claim against the estate of a surviving spouse who did not receive medical assistance, for 
226.7 	medical assistance rendered for the predeceased spouse, shall be payable from the full 
226.8 	value of all of the predeceased spouse's assets and interests which are part of the surviving 
226.9 	spouse's estate under subdivisions 1a and 2b. Recovery of medical assistance expenses in 
226.10 	the nonrecipient surviving spouse's estate is limited to the value of the assets of the estate 
226.11 	that were marital property or jointly owned property at any time during the marriage. The 
226.12 	claim is not payable from the value of assets or proceeds of assets in the estate attributable 
226.13 	to a predeceased spouse whom the individual married after the death of the predeceased 
226.14 	recipient spouse for whom the claim is filed or from assets and the proceeds of assets in the 
226.15 	estate which the nonrecipient decedent spouse acquired with assets which were not marital 
226.16 	property or jointly owned property after the death of the predeceased recipient spouse.
226.17 	Claims for alternative care shall be net of all premiums paid under section 256B.0913, 
226.18 	subdivision 12, on or after July 1, 2003, and shall be limited to services provided on or 
226.19 	after July 1, 2003. Claims against marital property shall be limited to claims against 
226.20 	recipients who died on or after July 1, 2009.

226.21 	Sec. 29. Minnesota Statutes 2008, section 256B.15, is amended by adding a 
226.22 	subdivision to read:
226.23 		Subd. 2b.Controlling provisions. (a) For purposes of this subdivision and 
226.24 	subdivisions 1a and 2, paragraphs (b) to (d) apply.
226.25 	(b) At the time of death of a recipient spouse and solely for purpose of recovery of 
226.26 	medical assistance benefits received, a predeceased recipient spouse shall have a legal 
226.27 	title or interest in the undivided whole of all of the property which the recipient and the 
226.28 	recipient's surviving spouse owned jointly or which was marital property at any time 
226.29 	during their marriage regardless of the form of ownership and regardless of whether 
226.30 	it was owned or titled in the names of one or both the recipient and the recipient's 
226.31 	spouse. Title and interest in the property of a predeceased recipient spouse shall not end 
226.32 	or extinguish upon the person's death and shall continue for the purpose of allowing 
226.33 	recovery of medical assistance in the estate of the surviving spouse. Upon the death of 
226.34 	the predeceased recipient spouse, title and interest in the predeceased spouse's property 
226.35 	shall vest in the surviving spouse by operation of law and without the necessity for any 
227.1 	probate or decree of descent proceedings and shall continue to exist after the death of the 
227.2 	predeceased spouse and the surviving spouse to permit recovery of medical assistance. 
227.3 	The recipient spouse and the surviving spouse of a deceased recipient spouse shall not 
227.4 	encumber, disclaim, transfer, alienate, hypothecate, or otherwise divest themselves of 
227.5 	these interests before or upon death.
227.6 	(c) For purposes of this section, "marital property" includes any and all real or 
227.7 	personal property of any kind or interests in such property the predeceased recipient 
227.8 	spouse and their spouse, or either of them, owned at the time of their marriage to each 
227.9 	other or acquired during their marriage regardless of whether it was owned or titled in 
227.10 	the names of one or both of them. If either or both spouses of a married couple received 
227.11 	medical assistance, all property owned during the marriage or which either or both spouses 
227.12 	acquired during their marriage shall be presumed to be marital property for purposes of 
227.13 	recovering medical assistance unless there is clear and convincing evidence to the contrary.
227.14 	(d) The agency responsible for the claim for medical assistance for a recipient spouse 
227.15 	may, at its discretion, release specific real and personal property from the provisions of 
227.16 	this section. The release shall extinguish the interest created under paragraph (b) in the 
227.17 	land it describes upon filing or recording. The release need not be attested, certified, or 
227.18 	acknowledged as a condition of filing or recording and shall be filed or recorded in the 
227.19 	office of the county recorder or registrar of titles, as appropriate, in the county where the 
227.20 	real property is located. The party to whom the release is given shall be responsible for 
227.21 	paying all fees and costs necessary to record and file the release. If the property described 
227.22 	in the release is registered property, the registrar of titles shall accept it for recording and 
227.23 	shall record it on the certificate of title for each parcel of property described in the release. 
227.24 	If the property described in the release is abstract property, the recorder shall accept it 
227.25 	for filing and file it in the county's grantor-grantee indexes and any tract index the county 
227.26 	maintains for each parcel of property described in the release.

227.27 	Sec. 30. Minnesota Statutes 2008, section 256B.15, is amended by adding a 
227.28 	subdivision to read:
227.29 		Subd. 9.Commissioner's intervention. The commissioner shall be permitted to 
227.30 	intervene as a party in any proceeding involving recovery of medical assistance upon 
227.31 	filing a notice of intervention and serving such notice on the other parties.

227.32 	Sec. 31. Minnesota Statutes 2008, section 256B.199, is amended to read:
227.33 	256B.199 PAYMENTS REPORTED BY GOVERNMENTAL ENTITIES.
228.1 	(a) Effective July 1, 2007, the commissioner shall apply for federal matching funds 
228.2 	for the expenditures in paragraphs (b) and (c). The funds in paragraphs (b) and (c) are 
228.3 	appropriated to the commissioner to offset medical assistance expenditures.
228.4 	(b) The commissioner shall apply for federal matching funds for certified public 
228.5 	expenditures as follows:
228.6 	(1) Hennepin County,and Hennepin County Medical Center, Ramsey County, 
228.7 	Regions Hospital, the University of Minnesota, and Fairview-University Medical Center
228.8 	shall report quarterly to the commissioner beginning June 1, 2007, payments made during 
228.9 	the second previous quarter that may qualify for reimbursement under federal law;
228.10 	 (2) based on these reports, the commissioner shall apply for federal matching 
228.11 	funds. These funds are appropriated to the commissioner for the payments under section 
228.12 	256.969, subdivision 27; and
228.13 	 (3) by May 1 of each year, beginning May 1, 2007, the commissioner shall inform 
228.14 	the nonstate entities listed in paragraph (a) of the amount of federal disproportionate share 
228.15 	hospital payment money expected to be available in the current federal fiscal year.
228.16 	(c) The commissioner shall apply for federal matching funds for general assistance 
228.17 	medical care expenditures as follows:
228.18 	(1) for hospital services occurring on or after July 1, 2007, general assistance medical 
228.19 	care expenditures for fee-for-service inpatient and outpatient hospital payments made by 
228.20 	the department shall be used to apply for federal matching funds, except as limited below:
228.21 	(i) only those general assistance medical care expenditures made to an individual 
228.22 	hospital that would not cause the hospital to exceed its individual hospital limits under 
228.23 	section 1923 of the Social Security Act may be considered; and
228.24 	(ii) general assistance medical care expenditures may be considered only to the extent 
228.25 	of Minnesota's aggregate allotment under section 1923 of the Social Security Act; and
228.26 	(2) all hospitals must provide any necessary expenditure, cost, and revenue 
228.27 	information required by the commissioner as necessary for purposes of obtaining federal 
228.28 	Medicaid matching funds for general assistance medical care expenditures.

228.29 	Sec. 32. Minnesota Statutes 2008, section 256B.69, subdivision 5a, is amended to read:
228.30 		Subd. 5a.Managed care contracts. (a) Managed care contracts under this section 
228.31 	and sections 256L.12 and 256D.03, shall be entered into or renewed on a calendar year 
228.32 	basis beginning January 1, 1996. Managed care contracts which were in effect on June 
228.33 	30, 1995, and set to renew on July 1, 1995, shall be renewed for the period July 1, 1995 
228.34 	through December 31, 1995 at the same terms that were in effect on June 30, 1995. The 
229.1 	commissioner may issue separate contracts with requirements specific to services to 
229.2 	medical assistance recipients age 65 and older.
229.3 	(b) A prepaid health plan providing covered health services for eligible persons 
229.4 	pursuant to chapters 256B, 256D, and 256L, is responsible for complying with the terms 
229.5 	of its contract with the commissioner. Requirements applicable to managed care programs 
229.6 	under chapters 256B, 256D, and 256L, established after the effective date of a contract 
229.7 	with the commissioner take effect when the contract is next issued or renewed.
229.8 	(c) Effective for services rendered on or after January 1, 2003, the commissioner 
229.9 	shall withhold five percent of managed care plan payments under this section for the 
229.10 	prepaid medical assistance and general assistance medical care programs pending 
229.11 	completion of performance targets. Each performance target must be quantifiable, 
229.12 	objective, measurable, and reasonably attainable, except in the case of a performance 
229.13 	target based on a federal or state law or rule. Criteria for assessment of each performance 
229.14 	target must be outlined in writing prior to the contract effective date. The managed 
229.15 	care plan must demonstrate, to the commissioner's satisfaction, that the data submitted 
229.16 	regarding attainment of the performance target is accurate. The commissioner shall 
229.17 	periodically change the administrative measures used as performance targets in order 
229.18 	to improve plan performance across a broader range of administrative services. The 
229.19 	performance targets must include measurement of plan efforts to contain spending 
229.20 	on health care services and administrative activities. The commissioner may adopt 
229.21 	plan-specific performance targets that take into account factors affecting only one plan, 
229.22 	including characteristics of the plan's enrollee population. The withheld funds must be 
229.23 	returned no sooner than July of the following year if performance targets in the contract 
229.24 	are achieved. The commissioner may exclude special demonstration projects under 
229.25 	subdivision 23. A managed care plan or a county-based purchasing plan under section 
229.26 	256B.692 may include as admitted assets under section 62D.044 any amount withheld 
229.27 	under this paragraph that is reasonably expected to be returned.
229.28 	(d)(1) Effective for services rendered on or after January 1, 2009, the commissioner 
229.29 	shall withhold three percent of managed care plan payments under this section for the 
229.30 	prepaid medical assistance and general assistance medical care programs. The withheld 
229.31 	funds must be returned no sooner than July 1 and no later than July 31 of the following 
229.32 	year. The commissioner may exclude special demonstration projects under subdivision 23.
229.33 	(2) A managed care plan or a county-based purchasing plan under section 256B.692 
229.34 	may include as admitted assets under section 62D.044 any amount withheld under 
229.35 	this paragraph. The return of the withhold under this paragraph is not subject to the 
229.36 	requirements of paragraph (c).

230.1 	Sec. 33. Minnesota Statutes 2008, section 256B.69, subdivision 5c, is amended to read:
230.2 		Subd. 5c.Medical education and research fund. (a) Except as provided in 
230.3 	paragraph (c), the commissioner of human services shall transfer each year to the medical 
230.4 	education and research fund established under section 62J.692, the following: 
230.5 	(1) an amount equal to the reduction in the prepaid medical assistance and prepaid 
230.6 	general assistance medical care payments as specified in this clause. Until January 1, 
230.7 	2002, the county medical assistance and general assistance medical care capitation base 
230.8 	rate prior to plan specific adjustments and after the regional rate adjustments under section 
230.9 	256B.69, subdivision 5b, is reduced 6.3 percent for Hennepin County, two percent for 
230.10 	the remaining metropolitan counties, and no reduction for nonmetropolitan Minnesota 
230.11 	counties; and after January 1, 2002, the county medical assistance and general assistance 
230.12 	medical care capitation base rate prior to plan specific adjustments is reduced 6.3 percent 
230.13 	for Hennepin County, two percent for the remaining metropolitan counties, and 1.6 percent 
230.14 	for nonmetropolitan Minnesota counties. Nursing facility and elderly waiver payments 
230.15 	and demonstration project payments operating under subdivision 23 are excluded from 
230.16 	this reduction. The amount calculated under this clause shall not be adjusted for periods 
230.17 	already paid due to subsequent changes to the capitation payments; 
230.18 	(2) beginning July 1, 2003, $2,157,000 $4,314,000 from the capitation rates paid 
230.19 	under this section plus any federal matching funds on this amount;
230.20 	(3) beginning July 1, 2002, an additional $12,700,000 from the capitation rates 
230.21 	paid under this section; and
230.22 	(4) beginning July 1, 2003, an additional $4,700,000 from the capitation rates paid 
230.23 	under this section.
230.24 	(b) This subdivision shall be effective upon approval of a federal waiver which 
230.25 	allows federal financial participation in the medical education and research fund. Effective 
230.26 	July 1, 2009, and thereafter, the transfers required by paragraph (a), clauses (1) to (4), 
230.27 	must not exceed the total amount transferred for fiscal year 2009. Any excess must first 
230.28 	reduce the amounts otherwise required to be transferred under paragraph (a), clauses (2) to 
230.29 	(4), and then proportionally reduce the transfers under paragraph (a), clause (1).
230.30 	(c) Effective July 1, 2003, the amount reduced from the prepaid general assistance 
230.31 	medical care payments under paragraph (a), clause (1), shall be transferred to the general 
230.32 	fund.
230.33 	(d) Beginning July 1, 2010, of the amounts in paragraph (a), the commissioner shall 
230.34 	transfer $21,714,000 each fiscal year to the medical education and research fund. The 
230.35 	balance of the transfers under paragraph (a) must be transferred to the medical education 
230.36 	and research fund no earlier than July 1 of the following fiscal year.

231.1 	Sec. 34. Minnesota Statutes 2008, section 256B.69, subdivision 5f, is amended to read:
231.2 		Subd. 5f.Capitation rates. (a) Beginning July 1, 2002, the capitation rates paid 
231.3 	under this section are increased by $12,700,000 per year. Beginning July 1, 2003, the 
231.4 	capitation rates paid under this section are increased by $4,700,000 per year.
231.5 	(b) Beginning July 1, 2009, the capitation rates paid under this section are increased 
231.6 	each year by the lesser of $21,714,000 or an amount equal to the difference between the 
231.7 	estimated value of the reductions described in subdivision 5c, paragraph (a), clause (1), 
231.8 	and the amount of the limit described in subdivision 5c, paragraph (b).

231.9 	Sec. 35. [256B.695] PAYMENT FOR BASIC CARE SERVICES.
231.10 	Effective service date July 1, 2009, total payments for basic care services, 
231.11 	except prescription drugs, medical supplies, prosthetics, lab, radiology, and medical 
231.12 	transportation, shall be reduced by 3.0 percent, prior to third-party liability and spenddown 
231.13 	calculation. Payments made to managed care plans shall be reduced for services provided 
231.14 	on or after January 1, 2010, to reflect this reduction.

231.15 	Sec. 36. Minnesota Statutes 2008, section 256D.03, subdivision 3, is amended to read:
231.16 		Subd. 3. General assistance medical care; eligibility. (a) General assistance 
231.17 	medical care may be paid for any person who is not eligible for medical assistance 
231.18 	under chapter 256B, including eligibility for medical assistance based on a spenddown 
231.19 	of excess income according to section 256B.056, subdivision 5, or MinnesotaCare as 
231.20 	defined in paragraph (b), except as provided in paragraph (c), and who satisfies one of the 
231.21 	requirements in clause (1) or clauses (2) and (3): 
231.22 	(1) who isthe person must be receiving assistance under section 256D.05, except 
231.23 	for families with children who are eligible under Minnesota family investment program 
231.24 	(MFIP), or who is having a payment made on the person's behalf under sections 256I.01
231.25 	to 256I.06; or
231.26 	(2) who isthe person must be a resident of Minnesota; and:
231.27 	(i) who has gross countable income not in excess of 75 percent of the federal poverty 
231.28 	guidelines for the family size, using a six-month budget period and whose equity in assets 
231.29 	is not in excess of $1,000 per assistance unit. General assistance medical care is not 
231.30 	available for applicants or enrollees who are otherwise eligible for medical assistance but 
231.31 	fail to verify their assets. Enrollees who become eligible for medical assistance shall be 
231.32 	terminated and transferred to medical assistance. Exempt assets, the reduction of excess 
231.33 	assets, and the waiver of excess assets must conform to the medical assistance program in 
231.34 	section 256B.056, subdivisions 3 and 3d, with the following exception: the maximum 
232.1 	amount of undistributed funds in a trust that could be distributed to or on behalf of the 
232.2 	beneficiary by the trustee, assuming the full exercise of the trustee's discretion under the 
232.3 	terms of the trust, must be applied toward the asset maximum; or
232.4 	(ii) who has gross countable income above 75 percent of the federal poverty 
232.5 	guidelines but not in excess of 175 percent of the federal poverty guidelines for the family 
232.6 	size, using a six-month budget period, whose equity in assets is not in excess of the limits 
232.7 	in section 256B.056, subdivision 3c, and who applies during an inpatient hospitalization
232.8 	that occurs on or before January 1, 2010; or 
232.9 	(iii) the commissioner shall adjust the income standards under this section each July 
232.10 	1 by the annual update of the federal poverty guidelines following publication by the 
232.11 	United States Department of Health and Human Services. 
232.12 	(b) Effective for applications and renewals processed on or after September 1, 2006, 
232.13 	general assistance medical care may not be paid for applicants or recipients who are adults 
232.14 	with dependent children under 21 whose gross family income is equal to or less than 275 
232.15 	percent of the federal poverty guidelines who are not described in paragraph (e). 
232.16 	(c) Effective for applications and renewals processed on or after September 1, 2006, 
232.17 	general assistance medical care may be paid for applicants and recipients who meet all 
232.18 	eligibility requirements of paragraph (a), clause (2), item (i), for a temporary period 
232.19 	beginning the date of application. Immediately following approval of general assistance 
232.20 	medical care, enrollees shall be enrolled in MinnesotaCare under section 256L.04, 
232.21 	subdivision 7, with covered services as provided in section 256L.03 for the rest of the 
232.22 	six-month general assistance medical care eligibility period, until their six-month renewal. 
232.23 	(d) To be eligible for general assistance medical care following enrollment in 
232.24 	MinnesotaCare as required by paragraph (c), an individual must complete a new 
232.25 	application. 
232.26 	(e) Applicants and recipients eligible under paragraph (a), clause (1), are exempt 
232.27 	from the MinnesotaCare enrollment requirements in this subdivision if they: 
232.28 	(1) have applied for and are awaiting a determination of blindness or disability by 
232.29 	the state medical review team or a determination of eligibility for Supplemental Security 
232.30 	Income or Social Security Disability Insurance by the Social Security Administration; 
232.31 	(2) fail to meet the requirements of section 256L.09, subdivision 2; 
232.32 	(3) are homeless as defined by United States Code, title 42, section 11301, et seq.; 
232.33 	(4) are classified as end-stage renal disease beneficiaries in the Medicare program; 
232.34 	(5) are enrolled in private health care coverage as defined in section 256B.02, 
232.35 	subdivision 9; 
232.36 	(6) are eligible under paragraph (j); 
233.1 	(7) receive treatment funded pursuant to section 254B.02; or 
233.2 	(8) reside in the Minnesota sex offender program defined in chapter 246B. 
233.3 	(3) the person must meet at least one of the following criteria:
233.4 	(i) the person has applied for and is awaiting a determination of blindness 
233.5 	or disability by the state medical review team or a determination of eligibility for 
233.6 	Supplemental Security Income or Social Security Disability Insurance by the Social 
233.7 	Security Administration;
233.8 	(ii) the person is homeless as defined by United States Code, title 42, section 11301, 
233.9 	et seq.;
233.10 	(iii) the person is classified as an end-stage renal disease beneficiary in the Medicare 
233.11 	program;
233.12 	(iv) the person is enrolled in private health care coverage as defined in section 
233.13 	256B.02, subdivision 9;
233.14 	(v) the person is:
233.15 	(A) detained by law for less than one year in a county correctional or detention 
233.16 	facility as a person accused or convicted of a crime, or admitted as an inpatient to a 
233.17 	hospital on a criminal hold order;
233.18 	(B) is a recipient of general assistance medical care at the time the person is detained 
233.19 	by law or admitted on a criminal hold order; and
233.20 	(C) continues to meet other eligibility requirements of this subdivision;
233.21 	(vi) the person receives treatment funded under section 254B.02; or
233.22 	(vii) the person resides in the Minnesota sex offender program defined in chapter 
233.23 	246B.
233.24 	(f)(b) For applications received on or after October 1, 2003, eligibility may begin no 
233.25 	earlier than the date of application. For individuals eligible under paragraph (a), clause 
233.26 	(2), item (i), a redetermination of eligibility must occur every 12 months. Individuals are 
233.27 	eligible under paragraph (a), clause (2), item (ii), only during inpatient hospitalization but 
233.28 	may reapply if there is a subsequent period of inpatient hospitalization that occurs on or 
233.29 	before January 1, 2010. 
233.30 	(g) Beginning September 1, 2006, Minnesota health care program applications and 
233.31 	renewals completed by recipients and applicants who are persons described in paragraph 
233.32 	(c) and submitted to the county agency shall be determined for MinnesotaCare eligibility 
233.33 	by the county agency. If all other eligibility requirements of this subdivision are met, 
233.34 	eligibility for general assistance medical care shall be available in any month during which 
233.35 	MinnesotaCare enrollment is pending. Upon notification of eligibility for MinnesotaCare, 
233.36 	notice of termination for eligibility for general assistance medical care shall be sent to 
234.1 	an applicant or recipient. If all other eligibility requirements of this subdivision are 
234.2 	met, eligibility for general assistance medical care shall be available until enrollment in 
234.3 	MinnesotaCare subject to the provisions of paragraphs (c), (e), and (f). 
234.4 	(h)(c) The date of an initial Minnesota health care program application necessary to 
234.5 	begin a determination of eligibility shall be the date the applicant has provided a name, 
234.6 	address, and Social Security number, signed and dated, to the county agency or the 
234.7 	Department of Human Services. If the applicant is unable to provide a name, address, 
234.8 	Social Security number, and signature when health care is delivered due to a medical 
234.9 	condition or disability, a health care provider may act on an applicant's behalf to establish 
234.10 	the date of an initial Minnesota health care program application by providing the county 
234.11 	agency or Department of Human Services with provider identification and a temporary 
234.12 	unique identifier for the applicant. The applicant must complete the remainder of the 
234.13 	application and provide necessary verification before eligibility can be determined. The 
234.14 	county agency must assist the applicant in obtaining verification if necessary. 
234.15 	(i)(d) County agencies are authorized to use all automated databases containing 
234.16 	information regarding recipients' or applicants' income in order to determine eligibility for 
234.17 	general assistance medical care or MinnesotaCare. Such use shall be considered sufficient 
234.18 	in order to determine eligibility and premium payments by the county agency. 
234.19 	(j) General assistance medical care is not available for a person in a correctional 
234.20 	facility unless the person is detained by law for less than one year in a county correctional 
234.21 	or detention facility as a person accused or convicted of a crime, or admitted as an 
234.22 	inpatient to a hospital on a criminal hold order, and the person is a recipient of general 
234.23 	assistance medical care at the time the person is detained by law or admitted on a criminal 
234.24 	hold order and as long as the person continues to meet other eligibility requirements 
234.25 	of this subdivision. 
234.26 	(k)(e) General assistance medical care is not available for applicants or recipients 
234.27 	who do not cooperate with the county agency to meet the requirements of medical 
234.28 	assistance. 
234.29 	(l)(f) In determining the amount of assets of an individual eligible under paragraph 
234.30 	(a), clause (2), item (i), there shall be included any asset or interest in an asset, including 
234.31 	an asset excluded under paragraph (a), that was given away, sold, or disposed of for 
234.32 	less than fair market value within the 60 months preceding application for general 
234.33 	assistance medical care or during the period of eligibility. Any transfer described in this 
234.34 	paragraph shall be presumed to have been for the purpose of establishing eligibility for 
234.35 	general assistance medical care, unless the individual furnishes convincing evidence to 
234.36 	establish that the transaction was exclusively for another purpose. For purposes of this 
235.1 	paragraph, the value of the asset or interest shall be the fair market value at the time it 
235.2 	was given away, sold, or disposed of, less the amount of compensation received. For any 
235.3 	uncompensated transfer, the number of months of ineligibility, including partial months, 
235.4 	shall be calculated by dividing the uncompensated transfer amount by the average monthly 
235.5 	per person payment made by the medical assistance program to skilled nursing facilities 
235.6 	for the previous calendar year. The individual shall remain ineligible until this fixed period 
235.7 	has expired. The period of ineligibility may exceed 30 months, and a reapplication for 
235.8 	benefits after 30 months from the date of the transfer shall not result in eligibility unless 
235.9 	and until the period of ineligibility has expired. The period of ineligibility begins in the 
235.10 	month the transfer was reported to the county agency, or if the transfer was not reported, 
235.11 	the month in which the county agency discovered the transfer, whichever comes first. For 
235.12 	applicants, the period of ineligibility begins on the date of the first approved application. 
235.13 	(m)(g) When determining eligibility for any state benefits under this subdivision, 
235.14 	the income and resources of all noncitizens shall be deemed to include their sponsor's 
235.15 	income and resources as defined in the Personal Responsibility and Work Opportunity 
235.16 	Reconciliation Act of 1996, title IV, Public Law 104-193, sections 421 and 422, and 
235.17 	subsequently set out in federal rules. 
235.18 	(n)(h) Undocumented noncitizens and nonimmigrants are ineligible for general 
235.19 	assistance medical care. For purposes of this subdivision, a nonimmigrant is an individual 
235.20 	in one or more of the classes listed in United States Code, title 8, section 1101(a)(15), and 
235.21 	an undocumented noncitizen is an individual who resides in the United States without the 
235.22 	approval or acquiescence of the United States Citizenship and Immigration Services. 
235.23 	(o)(i) Notwithstanding any other provision of law, a noncitizen who is ineligible for 
235.24 	medical assistance due to the deeming of a sponsor's income and resources, is ineligible 
235.25 	for general assistance medical care. 
235.26 	(p)(j) Effective July 1, 2003, general assistance medical care emergency services 
235.27 	end. 
235.28 	(k) The commissioner shall adjust the income standards under this section each July 
235.29 	1 by the annual update of the federal poverty guidelines following publication by the 
235.30 	United States Department of Health and Human Services.

235.31 	EFFECTIVE DATE. This section is effective January 1, 2010.

235.32 	Sec. 37. Minnesota Statutes 2008, section 256D.03, subdivision 4, is amended to read:
235.33 		Subd. 4.General assistance medical care; services. (a)(i) For a person who is 
235.34 	eligible under subdivision 3, paragraph (a), clause (2), item (i), general assistance medical 
235.35 	care covers, except as provided in paragraph (c):
236.1 	(1) inpatient hospital services;
236.2 	(2) outpatient hospital services;
236.3 	(3) services provided by Medicare certified rehabilitation agencies;
236.4 	(4) prescription drugs and other products recommended through the process 
236.5 	established in section 256B.0625, subdivision 13;
236.6 	(5) equipment necessary to administer insulin and diagnostic supplies and equipment 
236.7 	for diabetics to monitor blood sugar level;
236.8 	(6) eyeglasses and eye examinations provided by a physician or optometrist;
236.9 	(7) hearing aids;
236.10 	(8) prosthetic devices;
236.11 	(9) laboratory and X-ray services;
236.12 	(10) physician's services;
236.13 	(11) medical transportation except special transportation;
236.14 	(12) chiropractic services as covered under the medical assistance program;
236.15 	(13) podiatric services;
236.16 	(14) dental services as covered under the medical assistance program;
236.17 	(15) mental health services covered under chapter 256B;
236.18 	(16) prescribed medications for persons who have been diagnosed as mentally ill as 
236.19 	necessary to prevent more restrictive institutionalization;
236.20 	(17) medical supplies and equipment, and Medicare premiums, coinsurance and 
236.21 	deductible payments;
236.22 	(18) medical equipment not specifically listed in this paragraph when the use of 
236.23 	the equipment will prevent the need for costlier services that are reimbursable under 
236.24 	this subdivision;
236.25 	(19) services performed by a certified pediatric nurse practitioner, a certified family 
236.26 	nurse practitioner, a certified adult nurse practitioner, a certified obstetric/gynecological 
236.27 	nurse practitioner, a certified neonatal nurse practitioner, or a certified geriatric nurse 
236.28 	practitioner in independent practice, if (1) the service is otherwise covered under this 
236.29 	chapter as a physician service, (2) the service provided on an inpatient basis is not included 
236.30 	as part of the cost for inpatient services included in the operating payment rate, and (3) the 
236.31 	service is within the scope of practice of the nurse practitioner's license as a registered 
236.32 	nurse, as defined in section 148.171;
236.33 	(20) services of a certified public health nurse or a registered nurse practicing in 
236.34 	a public health nursing clinic that is a department of, or that operates under the direct 
236.35 	authority of, a unit of government, if the service is within the scope of practice of the 
236.36 	public health nurse's license as a registered nurse, as defined in section 148.171;
237.1 	(21) telemedicine consultations, to the extent they are covered under section 
237.2 	256B.0625, subdivision 3b; 
237.3 	(22) care coordination and patient education services provided by a community 
237.4 	health worker according to section 256B.0625, subdivision 49; and
237.5 	(23) regardless of the number of employees that an enrolled health care provider 
237.6 	may have, sign language interpreter services when provided by an enrolled health care 
237.7 	provider during the course of providing a direct, person-to-person covered health care 
237.8 	service to an enrolled recipient who has a hearing loss and uses interpreting services.
237.9 	(ii) Effective October 1, 2003, for a person who is eligible under subdivision 3, 
237.10 	paragraph (a), clause (2), item (ii), general assistance medical care coverage is limited 
237.11 	to inpatient hospital services, including physician services provided during the inpatient 
237.12 	hospital stay. A $1,000 deductible is required for each inpatient hospitalization.
237.13 	(b) Effective August 1, 2005, sex reassignment surgery is not covered under this 
237.14 	subdivision.
237.15 	(c) In order to contain costs, the commissioner of human services shall select 
237.16 	vendors of medical care who can provide the most economical care consistent with high 
237.17 	medical standards and shall where possible contract with organizations on a prepaid 
237.18 	capitation basis to provide these services. The commissioner shall consider proposals by 
237.19 	counties and vendors for prepaid health plans, competitive bidding programs, block grants, 
237.20 	or other vendor payment mechanisms designed to provide services in an economical 
237.21 	manner or to control utilization, with safeguards to ensure that necessary services are 
237.22 	provided. Before implementing prepaid programs in counties with a county operated or 
237.23 	affiliated public teaching hospital or a hospital or clinic operated by the University of 
237.24 	Minnesota, the commissioner shall consider the risks the prepaid program creates for the 
237.25 	hospital and allow the county or hospital the opportunity to participate in the program in a 
237.26 	manner that reflects the risk of adverse selection and the nature of the patients served by 
237.27 	the hospital, provided the terms of participation in the program are competitive with the 
237.28 	terms of other participants considering the nature of the population served. Payment for 
237.29 	services provided pursuant to this subdivision shall be as provided to medical assistance 
237.30 	vendors of these services under sections 256B.02, subdivision 8, and 256B.0625. For 
237.31 	payments made during fiscal year 1990 and later years, the commissioner shall consult 
237.32 	with an independent actuary in establishing prepayment rates, but shall retain final control 
237.33 	over the rate methodology.
237.34 	(d) Effective January 1, 2008, drug coverage under general assistance medical 
237.35 	care is limited to prescription drugs that:
238.1 	(i) are covered under the medical assistance program as described in section 
238.2 	256B.0625, subdivisions 13 and 13d; and
238.3 	(ii) are provided by manufacturers that have fully executed general assistance 
238.4 	medical care rebate agreements with the commissioner and comply with the agreements. 
238.5 	Prescription drug coverage under general assistance medical care must conform to 
238.6 	coverage under the medical assistance program according to section 256B.0625, 
238.7 	subdivisions 13 to 13g.
238.8 	 (e) Recipients eligible under subdivision 3, paragraph (a), shall pay the following 
238.9 	co-payments for services provided on or after October 1, 2003, and before January 1, 2009:
238.10 	(1) $25 for eyeglasses;
238.11 	(2) $25 for nonemergency visits to a hospital-based emergency room;
238.12 	(3) $3 per brand-name drug prescription and $1 per generic drug prescription, 
238.13 	subject to a $12 per month maximum for prescription drug co-payments. No co-payments 
238.14 	shall apply to antipsychotic drugs when used for the treatment of mental illness; and
238.15 	(4) 50 percent coinsurance on restorative dental services.
238.16 	(f) Recipients eligible under subdivision 3, paragraph (a), shall include the following 
238.17 	co-payments for services provided on or after January 1, 2009: 
238.18 	(1) $25 for nonemergency visits to a hospital-based emergency room; and
238.19 	(2) $3 per brand-name drug prescription and $1 per generic drug prescription, 
238.20 	subject to a $7 per month maximum for prescription drug co-payments. No co-payments 
238.21 	shall apply to antipsychotic drugs when used for the treatment of mental illness.
238.22 	(g) MS 2007 Supp [Expired]
238.23 	(h) Effective January 1, 2009, co-payments shall be limited to one per day per 
238.24 	provider for nonemergency visits to a hospital-based emergency room. Recipients of 
238.25 	general assistance medical care are responsible for all co-payments in this subdivision. 
238.26 	The general assistance medical care reimbursement to the provider shall be reduced by the 
238.27 	amount of the co-payment, except that reimbursement for prescription drugs shall not be 
238.28 	reduced once a recipient has reached the $7 per month maximum for prescription drug 
238.29 	co-payments. The provider collects the co-payment from the recipient. Providers may not 
238.30 	deny services to recipients who are unable to pay the co-payment.
238.31 	(i) General assistance medical care reimbursement to fee-for-service providers 
238.32 	and payments to managed care plans shall not be increased as a result of the removal of 
238.33 	the co-payments effective January 1, 2009.
238.34 	(j) Any county may, from its own resources, provide medical payments for which 
238.35 	state payments are not made.
239.1 	(k) Chemical dependency services that are reimbursed under chapter 254B must not 
239.2 	be reimbursed under general assistance medical care.
239.3 	(l) The maximum payment for new vendors enrolled in the general assistance 
239.4 	medical care program after the base year shall be determined from the average usual and 
239.5 	customary charge of the same vendor type enrolled in the base year.
239.6 	(m) The conditions of payment for services under this subdivision are the same 
239.7 	as the conditions specified in rules adopted under chapter 256B governing the medical 
239.8 	assistance program, unless otherwise provided by statute or rule.
239.9 	 (n) Inpatient and outpatient payments shall be reduced by five percent, effective July 
239.10 	1, 2003. This reduction is in addition to the five percent reduction effective July 1, 2003, 
239.11 	and incorporated by reference in paragraph (l).
239.12 	(o) Payments for all other health services except inpatient, outpatient, and pharmacy 
239.13 	services shall be reduced by five percent, effective July 1, 2003.
239.14 	(p) Payments to managed care plans shall be reduced by five percent for services 
239.15 	provided on or after October 1, 2003.
239.16 	(q) A hospital receiving a reduced payment as a result of this section may apply the 
239.17 	unpaid balance toward satisfaction of the hospital's bad debts.
239.18 	(r) Fee-for-service payments for nonpreventive visits shall be reduced by $3 for 
239.19 	services provided on or after January 1, 2006. For purposes of this subdivision, a visit 
239.20 	means an episode of service which is required because of a recipient's symptoms, 
239.21 	diagnosis, or established illness, and which is delivered in an ambulatory setting by 
239.22 	a physician or physician ancillary, chiropractor, podiatrist, advance practice nurse, 
239.23 	audiologist, optician, or optometrist.
239.24 	(s) Payments to managed care plans shall not be increased as a result of the removal 
239.25 	of the $3 nonpreventive visit co-payment effective January 1, 2006.
239.26 	(t) Payments for mental health services added as covered benefits after December 
239.27 	31, 2007, are not subject to the reductions in paragraphs (l), (n), (o), and (p).
239.28 	(u) In addition to the reductions in paragraphs (k) and (l), effective service date 
239.29 	July 1, 2009, total payments for basic care services, except prescription drugs, medical 
239.30 	supplies, prosthetics, lab, radiology, and medical transportation, shall be reduced by 3.0 
239.31 	percent, prior to third-party liability and spenddown calculation. Payments made to 
239.32 	managed care plans shall be reduced for services provided on or after January 1, 2010, 
239.33 	to reflect this reduction.

239.34 	Sec. 38. Minnesota Statutes 2008, section 256L.01, subdivision 1a, is amended to read:
240.1 		Subd. 1a.Child. (a) "Child" means an individual under 21 years of age, including 
240.2 	the unborn child of a pregnant woman, an emancipated minor, and an emancipated minor's 
240.3 	spouse. This paragraph expires July 1, 2010, or upon federal approval, whichever is later.
240.4 	(b) Effective July 1, 2010, or upon federal approval, whichever is later, "child" 
240.5 	means an individual under 21 years of age, an emancipated minor, and an emancipated 
240.6 	minor's spouse.

240.7 	Sec. 39. Minnesota Statutes 2008, section 256L.01, subdivision 3a, is amended to read:
240.8 		Subd. 3a.Family with children. (a) "Family with children" means:
240.9 	(1) parents and their children residing in the same household; or
240.10 	(2) grandparents, foster parents, relative caretakers as defined in the medical 
240.11 	assistance program, or legal guardians; and their wards who are children residing in the 
240.12 	same household.
240.13 	(b) The term includes children who are temporarily absent from the household in 
240.14 	settings such as schools, camps, or parenting time with noncustodial parents.
240.15 	(c) This subdivision expires July 1, 2010, or upon federal approval, whichever is 
240.16 	later.

240.17 	Sec. 40. Minnesota Statutes 2008, section 256L.01, is amended by adding a subdivision 
240.18 	to read:
240.19 		Subd. 3b.Family premium. Effective July 1, 2011, or upon federal approval, 
240.20 	whichever is later, "family premium" means the premium determined according to section 
240.21 	256L.15, subdivision 2a or 2b, based on gross individual or gross family income.

240.22 	Sec. 41. Minnesota Statutes 2008, section 256L.01, subdivision 4, is amended to read:
240.23 		Subd. 4.Gross individual or gross family income. (a) "Gross individual or gross 
240.24 	family income" for nonfarm self-employed means income calculated for the 12-month 
240.25 	period of eligibility using the net profit or loss reported on the applicant's federal income 
240.26 	tax form for the previous year and using the medical assistance families with children 
240.27 	methodology for determining allowable and nonallowable self-employment expenses 
240.28 	and countable income. This subdivision expires July 1, 2011, or upon federal approval, 
240.29 	whichever is later.
240.30 	(b) "Gross individual or gross family income" for farm self-employed means income 
240.31 	calculated for the 12-month period of eligibility using as the baseline the adjusted gross 
240.32 	income reported on the applicant's federal income tax form for the previous year. This 
240.33 	subdivision expires July 1, 2011, or upon federal approval, whichever is later.
241.1 	(c) "Gross individual or gross family income" means the total income for all family 
241.2 	members, calculated for the 12-month period of eligibility. This subdivision expires July 
241.3 	1, 2011, or upon federal approval, whichever is later.
241.4 	(d) Beginning July 1, 2011, or upon federal approval, whichever is later, "gross 
241.5 	individual or gross family income" means the total income for all family members, 
241.6 	calculated for the six-month period of eligibility, for purposes of determining the premium 
241.7 	under section 256L.15.

241.8 	Sec. 42. Minnesota Statutes 2008, section 256L.01, subdivision 5, is amended to read:
241.9 		Subd. 5.Income. (a) "Income" has the meaning given for earned and unearned 
241.10 	income for families and children in the medical assistance program, according to the state's 
241.11 	aid to families with dependent children plan in effect as of July 16, 1996. The definition 
241.12 	does not include medical assistance income methodologies and deeming requirements. 
241.13 	The earned income of full-time and part-time students under age 19 is not counted as 
241.14 	income. Public assistance payments and supplemental security income are not excluded 
241.15 	income. This paragraph expires July 1, 2011, or upon federal approval, whichever is later.
241.16 	(b) Effective July 1, 2011, or upon federal approval, whichever is later, "income" has 
241.17 	the meaning given for earned and unearned income for families and children in the medical 
241.18 	assistance program, according to the methodologies for families with children in section 
241.19 	256B.056, subdivision 1a. The deductions in section 256B.056, subdivision 1c, paragraph 
241.20 	(a), clause (3), must apply to the income calculated to determine eligibility for children 
241.21 	age two through 18. The deductions in section 256B.056, subdivision 1c, paragraph (b), 
241.22 	must apply to the income calculated to determine eligibility for children ages 19 and 20.
241.23 	(b) (c) For purposes of this subdivision, and unless otherwise specified in this 
241.24 	section, the commissioner shall use reasonable methods to calculate gross earned and 
241.25 	unearned income including, but not limited to, projecting income based on income 
241.26 	received within the past 30 days, the last 90 days, or the last 12 months.

241.27 	Sec. 43. Minnesota Statutes 2008, section 256L.02, subdivision 1, is amended to read:
241.28 		Subdivision 1.Purpose. (a) The MinnesotaCare program is established to promote 
241.29 	access to appropriate health care services to assure ensure healthy children and adults.
241.30 	This paragraph expires July 1, 2010, or upon federal approval, whichever is later.
241.31 	(b) Effective July 1, 2010, or upon federal approval, whichever is later, the purpose 
241.32 	of the MinnesotaCare program is to promote access to appropriate health care services to 
241.33 	ensure healthy children.

242.1 	Sec. 44. Minnesota Statutes 2008, section 256L.02, subdivision 3, is amended to read:
242.2 		Subd. 3.Financial management. (a) The commissioner shall manage spending for 
242.3 	the MinnesotaCare program in a manner that maintains a minimum reserve. As part of 
242.4 	each state revenue and expenditure forecast, the commissioner must make an assessment 
242.5 	of the expected expenditures for the covered services for the remainder of the current 
242.6 	biennium and for the following biennium. The estimated expenditure, including the 
242.7 	reserve, shall be compared to an estimate of the revenues that will be available in the health 
242.8 	care access fund. Based on this comparison, and after consulting with the chairs of the 
242.9 	house of representatives Ways and Means Committee and the senate Finance Committee, 
242.10 	and the Legislative Commission on Health Care Access, the commissioner shall, as 
242.11 	necessary, make the adjustments specified in paragraph (b) to ensure that expenditures 
242.12 	remain within the limits of available revenues for the remainder of the current biennium 
242.13 	and for the following biennium. The commissioner shall not hire additional staff using 
242.14 	appropriations from the health care access fund until the commissioner of finance makes 
242.15 	a determination that the adjustments implemented under paragraph (b) are sufficient to 
242.16 	allow MinnesotaCare expenditures to remain within the limits of available revenues for 
242.17 	the remainder of the current biennium and for the following biennium.
242.18 	(b) The adjustments the commissioner shall use must be implemented in this order: 
242.19 	first, stop enrollment of single adults and households without children; second, upon 45 
242.20 	days' notice, stop coverage of single adults and households without children already 
242.21 	enrolled in the MinnesotaCare program; third, upon 90 days' notice, decrease the premium 
242.22 	subsidy amounts by ten percent for families with gross annual income above 200 percent 
242.23 	of the federal poverty guidelines; fourth second, upon 90 days' notice, decrease the 
242.24 	premium subsidy amounts by ten percent for families with gross annual income at or 
242.25 	below 200 percent; and fifth third, require applicants to be uninsured for at least six months 
242.26 	prior to eligibility in the MinnesotaCare program. If these measures are insufficient to 
242.27 	limit the expenditures to the estimated amount of revenue, the commissioner shall further 
242.28 	limit enrollment or decrease premium subsidies.

242.29 	EFFECTIVE DATE. This section is effective January 1, 2010.

242.30 	Sec. 45. Minnesota Statutes 2008, section 256L.03, subdivision 1, is amended to read:
242.31 		Subdivision 1.Covered health services.  "Covered health services" means the 
242.32 	health services reimbursed under chapter 256B, with the exception of inpatient hospital 
242.33 	services, special education services, private duty nursing services, adult dental care 
242.34 	services other than services covered under section 256B.0625, subdivision 9, orthodontic 
242.35 	services, nonemergency medical transportation services, personal care assistant and case 
243.1 	management services, nursing home or intermediate care facilities services, inpatient 
243.2 	mental health services, and chemical dependency services.
243.3 	No public funds shall be used for coverage of abortion under MinnesotaCare 
243.4 	except where the life of the female would be endangered or substantial and irreversible 
243.5 	impairment of a major bodily function would result if the fetus were carried to term; or 
243.6 	where the pregnancy is the result of rape or incest.
243.7 	Covered health services shall be expanded as provided in this section.

243.8 	Sec. 46. Minnesota Statutes 2008, section 256L.03, subdivision 1a, is amended to read:
243.9 		Subd. 1a.Pregnant women and children; MinnesotaCare health care reform 
243.10 	waiver. (a) Beginning January 1, 1999, children and pregnant women are eligible for 
243.11 	coverage of all services that are eligible for reimbursement under the medical assistance 
243.12 	program according to chapter 256B, except that abortion services under MinnesotaCare 
243.13 	shall be limited as provided under subdivision 1. Pregnant women and children are 
243.14 	exempt from the provisions of subdivision 5, regarding co-payments. Pregnant women 
243.15 	and children who are lawfully residing in the United States but who are not "qualified 
243.16 	noncitizens" under title IV of the Personal Responsibility and Work Opportunity 
243.17 	Reconciliation Act of 1996, Public Law 104-193, Statutes at Large, volume 110, page 
243.18 	2105, are eligible for coverage of all services provided under the medical assistance 
243.19 	program according to chapter 256B. This paragraph expires July 1, 2010, or upon federal 
243.20 	approval, whichever is later.
243.21 	(b) Beginning July 1, 2010, or upon federal approval, whichever is later, children 
243.22 	are eligible for coverage of all services that are eligible for reimbursement under the 
243.23 	medical assistance program under chapter 256B, except that abortion services under 
243.24 	MinnesotaCare shall be limited as provided under subdivision 1. Children who are 
243.25 	lawfully residing in the United States but who are not "qualified noncitizens" under title IV 
243.26 	of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, Public 
243.27 	Law 104-193, Statutes at Large, volume 110, page 2105, are eligible for coverage of all 
243.28 	services provided under the medical assistance program according to chapter 256B.

243.29 	Sec. 47. Minnesota Statutes 2008, section 256L.03, subdivision 1b, is amended to read:
243.30 		Subd. 1b.Pregnant women; eligibility for full medical assistance services.
 243.31 	A pregnant woman enrolled in MinnesotaCare is eligible for coverage of all services 
243.32 	provided under the medical assistance program according to chapter 256B retroactive 
243.33 	to the date of conception. Co-payments totaling $30 or more, paid after the date of 
244.1 	conception, shall be refunded. This subdivision expires July 1, 2010, or upon federal 
244.2 	approval, whichever is later.

244.3 	Sec. 48. Minnesota Statutes 2008, section 256L.03, subdivision 3, is amended to read:
244.4 		Subd. 3.Inpatient hospital services. (a) Covered health services shall include 
244.5 	inpatient hospital services, including inpatient hospital mental health services and inpatient 
244.6 	hospital and residential chemical dependency treatment, subject to those limitations 
244.7 	necessary to coordinate the provision of these services with eligibility under the medical 
244.8 	assistance spenddown. The inpatient hospital benefit for adult enrollees who qualify under 
244.9 	section 256L.04, subdivision 7, or who qualify under section 256L.04, subdivisions 1 and 
244.10 	2, with family gross income that exceeds 200 percent of the federal poverty guidelines or 
244.11 	215 percent of the federal poverty guidelines on or after July 1, 2009, and who are not 
244.12 	pregnant, is subject to an annual limit of $10,000. This paragraph expires July 1, 2010, or 
244.13 	upon federal approval, whichever is later.
244.14 	(b) Effective July 1, 2010, or upon federal approval, whichever is later, covered 
244.15 	health services shall include inpatient hospital services, including inpatient hospital mental 
244.16 	health services and inpatient hospital and residential chemical dependency treatment, 
244.17 	subject to those limitations necessary to coordinate the provision of these services with 
244.18 	eligibility under the medical assistance spend down.
244.19 	(b) (c) Admissions for inpatient hospital services paid for under section 256L.11, 
244.20 	subdivision 3, must be certified as medically necessary in accordance with Minnesota 
244.21 	Rules, parts 9505.0500 to 9505.0540, except as provided in clauses (1) and (2): 
244.22 	(1) all admissions must be certified, except those authorized under rules established 
244.23 	under section 254A.03, subdivision 3, or approved under Medicare; and 
244.24 	(2) payment under section 256L.11, subdivision 3, shall be reduced by five percent 
244.25 	for admissions for which certification is requested more than 30 days after the day of 
244.26 	admission. The hospital may not seek payment from the enrollee for the amount of the 
244.27 	payment reduction under this clause. 

244.28 	Sec. 49. Minnesota Statutes 2008, section 256L.03, subdivision 5, is amended to read:
244.29 		Subd. 5.Co-payments and coinsurance. (a) Except as provided in paragraphs (b) 
244.30 	and (c), the MinnesotaCare benefit plan shall include the following co-payments and 
244.31 	coinsurance requirements for all enrollees:
244.32 	(1) ten percent of the paid charges for inpatient hospital services for adult enrollees, 
244.33 	subject to an annual inpatient out-of-pocket maximum of $1,000 per individual and 
244.34 	$3,000 per family;
245.1 	(2) $3 per prescription for adult enrollees;
245.2 	(3) $25 for eyeglasses for adult enrollees;
245.3 	(4) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an 
245.4 	episode of service which is required because of a recipient's symptoms, diagnosis, or 
245.5 	established illness, and which is delivered in an ambulatory setting by a physician or 
245.6 	physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse, 
245.7 	audiologist, optician, or optometrist; and
245.8 	(5) $6 for nonemergency visits to a hospital-based emergency room.
245.9 	(b) Paragraph (a), clause (1), does not apply to parents and relative caretakers of 
245.10 	children under the age of 21.
245.11 	(c) Paragraph (a) does not apply to pregnant women and children under the age of 21.
245.12 	(d) Paragraph (a), clause (4), does not apply to mental health services.
245.13 	(e) Adult enrollees with family gross income that exceeds 200 percent of the federal 
245.14 	poverty guidelines or 215 percent of the federal poverty guidelines on or after July 1, 2009, 
245.15 	and who are not pregnant shall be financially responsible for the coinsurance amount, if 
245.16 	applicable, and amounts which exceed the $10,000 inpatient hospital benefit limit.
245.17 	(f) When a MinnesotaCare enrollee becomes a member of a prepaid health plan, 
245.18 	or changes from one prepaid health plan to another during a calendar year, any charges 
245.19 	submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket 
245.20 	expenses incurred by the enrollee for inpatient services, that were submitted or incurred 
245.21 	prior to enrollment, or prior to the change in health plans, shall be disregarded.
245.22 	(g) This subdivision expires July 1, 2010, or upon federal approval, whichever is 
245.23 	later.

245.24 	Sec. 50. Minnesota Statutes 2008, section 256L.04, subdivision 1, is amended to read:
245.25 		Subdivision 1.Families with children. (a)(1) Families with children with family 
245.26 	income equal to or less than 275 percent of the federal poverty guidelines for the 
245.27 	applicable family size shall be eligible for MinnesotaCare according to this section. All 
245.28 	other provisions of sections 256L.01 to 256L.18, including the insurance-related barriers 
245.29 	to enrollment under section 256L.07, shall apply unless otherwise specified. This clause 
245.30 	expires upon implementation of clause (2).
245.31 	(2) Effective July 1, 2010, or upon federal approval, whichever is later, children with 
245.32 	family income equal to or less than 275 percent of the federal poverty guidelines for the 
245.33 	applicable family size shall be eligible for MinnesotaCare according to this section.
245.34 	(b)(1) Parents who enroll in the MinnesotaCare program must also enroll their 
245.35 	children, if the children are eligible. Children may be enrolled separately without 
246.1 	enrollment by parents. However, if one parent in the household enrolls, both parents must 
246.2 	enroll, unless other insurance is available. If one child from a family is enrolled, all 
246.3 	children must be enrolled, unless other insurance is available. If one spouse in a household 
246.4 	enrolls, the other spouse in the household must also enroll, unless other insurance is 
246.5 	available. Families cannot choose to enroll only certain uninsured members. This clause 
246.6 	expires upon implementation of clause (2).
246.7 	(2) Effective July 1, 2010, or upon federal approval, whichever is later, if one child 
246.8 	from a family is enrolled, all children must be enrolled, unless other insurance in available. 
246.9 	Families cannot choose to enroll only certain uninsured children.
246.10 	(c) Beginning October 1, 2003, the dependent sibling definition no longer applies 
246.11 	to the MinnesotaCare program. These persons are no longer counted in the parental 
246.12 	household and may apply as a separate household.
246.13 	(d) Beginning July 1, 2003, or upon federal approval, whichever is later, parents are 
246.14 	not eligible for MinnesotaCare if their gross income exceeds $57,500. This paragraph 
246.15 	expires July 1, 2010, or upon federal approval, whichever is later.
246.16 	(e) Children formerly enrolled in medical assistance and automatically deemed 
246.17 	eligible for MinnesotaCare according to section 256B.057, subdivision 2c, are exempt 
246.18 	from the requirements of this section until renewal. This paragraph expires July 1, 2009, 
246.19 	or upon federal approval, whichever is later.
246.20 	(f) Effective July 1, 2011, or upon federal approval, whichever is later, children ages 
246.21 	two through 18 whose countable income is above 150 percent of the federal poverty 
246.22 	guidelines but not in excess of 275 percent of the federal poverty guidelines shall be 
246.23 	eligible for MinnesotaCare according to this section.
246.24 	(g) Effective July 1, 2011, or upon federal approval, whichever is later, children ages 
246.25 	19 and 20 whose countable income is above 100 percent of the federal poverty guidelines 
246.26 	but not in excess of 275 percent of the federal poverty guidelines shall be eligible for 
246.27 	MinnesotaCare according to this section.

246.28 	Sec. 51. Minnesota Statutes 2008, section 256L.04, subdivision 1a, is amended to read:
246.29 		Subd. 1a.Social Security number required. (a) Individuals and families applying 
246.30 	for MinnesotaCare coverage must provide a Social Security number.
246.31 	(b) The commissioner shall not deny eligibility to an otherwise eligible applicant 
246.32 	who has applied for a Social Security number and is awaiting issuance of that Social 
246.33 	Security number.
247.1 	(c) Newborns enrolled under section 256L.05, subdivision 3, are exempt from the 
247.2 	requirements of this subdivision. This paragraph expires July 1, 2011, or upon federal 
247.3 	approval, whichever is later.
247.4 	(d) Individuals who refuse to provide a Social Security number because of 
247.5 	well-established religious objections are exempt from the requirements of this subdivision. 
247.6 	The term "well-established religious objections" has the meaning given in Code of Federal 
247.7 	Regulations, title 42, section 435.910.

247.8 	Sec. 52. Minnesota Statutes 2008, section 256L.04, subdivision 2, is amended to read:
247.9 		Subd. 2.Third-party liability, paternity, and other medical support. (a) To be 
247.10 	eligible for MinnesotaCare, individuals and families must cooperate with the state agency 
247.11 	to identify potentially liable third-party payers and assist the state in obtaining third-party 
247.12 	payments. "Cooperation" includes, but is not limited to, complying with the notice 
247.13 	requirements in section 256B.056, subdivision 9, identifying any third party who may be 
247.14 	liable for care and services provided under MinnesotaCare to the enrollee, providing 
247.15 	relevant information to assist the state in pursuing a potentially liable third party, and 
247.16 	completing forms necessary to recover third-party payments. This paragraph expires July 
247.17 	1, 2010, or upon federal approval, whichever is later.
247.18 	(b) Beginning July 1, 2010, or upon federal approval, whichever is later, to be 
247.19 	eligible for MinnesotaCare, children and parents, guardians, and relative caretakers of 
247.20 	enrolled children must cooperate with the state agency to identify potentially liable 
247.21 	third-party payers and assist the state in obtaining third-party payments. "Cooperation" 
247.22 	includes, but is not limited to, complying with the notice requirements in section 
247.23 	256B.056, subdivision 9, identifying any third party who may be liable for care and 
247.24 	services provided under MinnesotaCare to the enrollee, providing relevant information to 
247.25 	assist the state in pursuing a potentially liable third party, and completing forms necessary 
247.26 	to recover third-party payments.
247.27 	(b) (c) A parent, guardian, relative caretaker, or child enrolled in the MinnesotaCare 
247.28 	program must cooperate with the Department of Human Services and the local agency in 
247.29 	establishing the paternity of an enrolled child and in obtaining medical care support and 
247.30 	payments for the child and any other person for whom the person can legally assign rights, 
247.31 	in accordance with applicable laws and rules governing the medical assistance program. A 
247.32 	child shall not be ineligible for or disenrolled from the MinnesotaCare program solely 
247.33 	because the child's parent, relative caretaker, or guardian fails to cooperate in establishing 
247.34 	paternity or obtaining medical support. This paragraph expires July 1, 2010, or upon 
247.35 	federal approval, whichever is later.
248.1 	(d) Beginning July 1, 2010, or upon federal approval, whichever is later, a parent, 
248.2 	guardian, or relative caretaker of a child enrolled in the MinnesotaCare program must 
248.3 	cooperate with the Department of Human Services and the local agency in establishing the 
248.4 	paternity of an enrolled child and in obtaining medical care support and payments for the 
248.5 	child and any other person for whom the person can legally assign rights, according to 
248.6 	applicable laws and rules governing the medical assistance program. A child shall not be 
248.7 	ineligible for or disenrolled from the MinnesotaCare program based solely on the child's 
248.8 	parent, relative caretaker, or guardian failure to cooperate in establishing paternity or 
248.9 	obtaining medical support.

248.10 	Sec. 53. Minnesota Statutes 2008, section 256L.04, subdivision 8, is amended to read:
248.11 		Subd. 8.Applicants potentially eligible for medical assistance. (a) Individuals 
248.12 	who receive supplemental security income or retirement, survivors, or disability benefits 
248.13 	due to a disability, or other disability-based pension, who qualify under subdivision 7, but 
248.14 	who are potentially eligible for medical assistance without a spenddown shall be allowed 
248.15 	to enroll in MinnesotaCare for a period of 60 days, so long as the applicant meets all other 
248.16 	conditions of eligibility. The commissioner shall identify and refer the applications of 
248.17 	such individuals to their county social service agency. The county and the commissioner 
248.18 	shall cooperate to ensure that the individuals obtain medical assistance coverage for any 
248.19 	months for which they are eligible. This paragraph expires January 1, 2010.
248.20 	(b) The enrollee must cooperate with the county social service agency in determining 
248.21 	medical assistance eligibility within the 60-day enrollment period. Enrollees who do not 
248.22 	cooperate with medical assistance within the 60-day enrollment period shall be disenrolled 
248.23 	from the plan within one calendar month. Persons disenrolled for nonapplication for 
248.24 	medical assistance may not reenroll until they have obtained a medical assistance 
248.25 	eligibility determination. Persons disenrolled for noncooperation with medical assistance 
248.26 	may not reenroll until they have cooperated with the county agency and have obtained a 
248.27 	medical assistance eligibility determination. This paragraph expires January 1, 2010.
248.28 	(c) Beginning January 1, 2000, counties that choose to become MinnesotaCare 
248.29 	enrollment sites shall consider MinnesotaCare applications to also be applications for 
248.30 	medical assistance. Applicants who are potentially eligible for medical assistance, except 
248.31 	for those described in paragraph (a), may choose to enroll in either MinnesotaCare or 
248.32 	medical assistance. This paragraph expires July 1, 2011, or upon federal approval, 
248.33 	whichever is later.
249.1 	(d) Beginning July 1, 2011, or upon federal approval, whichever is later, children 
249.2 	who become ineligible due to a decrease in income must be redetermined for medical 
249.3 	assistance.
249.4 	(d) (e) The commissioner shall redetermine provider payments made under 
249.5 	MinnesotaCare to the appropriate medical assistance payments for those enrollees who 
249.6 	subsequently become eligible for medical assistance.

249.7 	Sec. 54. Minnesota Statutes 2008, section 256L.04, subdivision 10, is amended to read:
249.8 		Subd. 10.Citizenship requirements. (a) Eligibility for MinnesotaCare is limited 
249.9 	to citizens or nationals of the United States, qualified noncitizens, and other persons 
249.10 	residing lawfully in the United States as described in section 256B.06, subdivision 4, 
249.11 	paragraphs (a) to (e) and (j). Undocumented noncitizens and nonimmigrants are ineligible 
249.12 	for MinnesotaCare. For purposes of this subdivision, a nonimmigrant is an individual in 
249.13 	one or more of the classes listed in United States Code, title 8, section 1101(a)(15), and 
249.14 	an undocumented noncitizen is an individual who resides in the United States without 
249.15 	the approval or acquiescence of the United States Citizenship and Immigration Services. 
249.16 	Families with children who are citizens or nationals of the United States must cooperate in 
249.17 	obtaining satisfactory documentary evidence of citizenship or nationality according to 
249.18 	the requirements of the federal Deficit Reduction Act of 2005, Public Law 109-171. This 
249.19 	paragraph expires July 1, 2010, or upon federal approval, whichever is later.
249.20 	(b) Beginning July 1, 2010, or upon federal approval, whichever is later, eligibility 
249.21 	for MinnesotaCare is limited to citizens or nationals of the United States, qualified 
249.22 	noncitizens, and other persons residing lawfully in the United States as described in 
249.23 	section 256B.06, subdivision 4, paragraphs (a) to (e) and (j). Undocumented noncitizens 
249.24 	and nonimmigrants are ineligible for MinnesotaCare. For purposes of this subdivision, 
249.25 	a nonimmigrant is an individual in one or more of the classes listed in United States 
249.26 	Code, title 8, section 1101(a)(15), and an undocumented noncitizen is an individual 
249.27 	who resides in the United States without the approval or acquiescence of the United 
249.28 	States Citizenship and Immigration Services. Children who are citizens or nationals 
249.29 	of the United States must cooperate in obtaining satisfactory documentary evidence of 
249.30 	citizenship or nationality according to the requirements of the federal Deficit Reduction 
249.31 	Act of 2005, Public Law 109-171.

249.32 	Sec. 55. Minnesota Statutes 2008, section 256L.04, subdivision 13, is amended to read:
249.33 		Subd. 13.Families with relative caretakers, foster parents, or legal guardians.
 249.34 	(a) Beginning January 1, 1999, in families that include a relative caretaker as defined in the 
250.1 	medical assistance program, foster parent, or legal guardian, the relative caretaker, foster 
250.2 	parent, or legal guardian may apply as a family or may apply separately for the children. If 
250.3 	the caretaker applies separately for the children, only the children's income is counted and 
250.4 	the provisions of subdivision 1, paragraph (b), do not apply. If the relative caretaker, foster 
250.5 	parent, or legal guardian applies with the children, their income is included in the gross 
250.6 	family income for determining eligibility and premium amount. This paragraph expires 
250.7 	July 1, 2010, or upon federal approval, whichever is later.
250.8 	(b) Beginning July 1, 2010, or upon federal approval, whichever is later, if a relative 
250.9 	caretaker, foster parent, or legal guardian applies for the children in the household, only 
250.10 	the children's income is counted for purposes of eligibility under this chapter.

250.11 	Sec. 56. Minnesota Statutes 2008, section 256L.05, subdivision 3, is amended to read:
250.12 		Subd. 3.Effective date of coverage. (a) Beginning July 1, 2005, the effective 
250.13 	date of coverage is the first day of the month following the month in which eligibility is 
250.14 	approved and the first premium payment has been received. This paragraph expires upon 
250.15 	implementation of paragraph (d).
250.16 	(b) As provided in section 256B.057, coverage for newborns is automatic from the 
250.17 	date of birth and must be coordinated with other health coverage. This paragraph expires 
250.18 	upon implementation of paragraph (d).
250.19 	(c) The effective date of coverage for eligible newly adoptive children added to a 
250.20 	family receiving covered health services is the date of entry into the family. The effective 
250.21 	date of coverage for other new recipients added to the family receiving covered health 
250.22 	services is the first day of the month following the month in which eligibility is approved 
250.23 	or at renewal, whichever the family receiving covered health services prefers. All 
250.24 	eligibility criteria must be met by the family at the time the new family member is added. 
250.25 	The income of the new family member is included with the family's gross income and the 
250.26 	adjusted premium begins in the month the new family member is added. This paragraph 
250.27 	expires upon implementation of paragraph (d).
250.28 	(d) Effective July 1, 2009, the effective date of coverage is the first day of the month 
250.29 	following the month in which eligibility is approved and the first premium payment has 
250.30 	been received. As provided in section 256B.057, coverage for newborns is automatic from 
250.31 	the date of birth and must be coordinated with other health coverage. The effective date 
250.32 	of coverage for eligible newly adoptive children added to a family receiving covered 
250.33 	health services is the month of placement. The effective date of coverage for other new 
250.34 	members added to the family is the first day of the month following the month in which 
250.35 	the change is reported. All eligibility criteria must be met by the family at the time the 
251.1 	new family member is added. The income of the new family member is included with 
251.2 	the family's gross income and the adjusted premium begins in the month the new family 
251.3 	member is added.
251.4 	(b) (e) The initial premium must be received by the last working day of the month 
251.5 	for coverage to begin the first day of the following month.
251.6 	(c) (f) Benefits are not available until the day following discharge if an enrollee is 
251.7 	hospitalized on the first day of coverage.
251.8 	(d) (g) Notwithstanding any other law to the contrary, benefits under sections 
251.9 	256L.01 to 256L.18 are secondary to a plan of insurance or benefit program under which 
251.10 	an eligible person may have coverage and the commissioner shall use cost avoidance 
251.11 	techniques to ensure coordination of any other health coverage for eligible persons. The 
251.12 	commissioner shall identify eligible persons who may have coverage or benefits under 
251.13 	other plans of insurance or who become eligible for medical assistance.
251.14 	(e) (h) Effective September 1, 2006, the effective date of coverage for single adults 
251.15 	and households with no children formerly enrolled in general assistance medical care 
251.16 	and enrolled in MinnesotaCare according to section 256D.03, subdivision 3, is the first 
251.17 	day of the month following the last day of general assistance medical care coverage.
251.18 	This paragraph expires January 1, 2010.

251.19 	Sec. 57. Minnesota Statutes 2008, section 256L.05, subdivision 3a, is amended to read:
251.20 		Subd. 3a.Renewal of eligibility. (a)(1) Beginning July 1, 2007, an enrollee's 
251.21 	eligibility must be renewed every 12 months. The 12-month period begins in the month 
251.22 	after the month the application is approved. This clause expires upon implementation 
251.23 	of clause (2).
251.24 	(2) Effective July 1, 2011, or upon federal approval, whichever is later, an enrollee's 
251.25 	eligibility must be renewed every six months. The six-month period begins in the month 
251.26 	after the month the application is approved.
251.27 	(b) Each new period of eligibility must take into account any changes in 
251.28 	circumstances that impact eligibility and premium amount. An enrollee must provide all 
251.29 	the information needed to redetermine eligibility by the first day of the month that ends 
251.30 	the eligibility period. 
251.31 	(c) If there is no change in circumstances, the enrollee may renew eligibility at 
251.32 	designated locations that include community clinics and health care providers' offices. The 
251.33 	designated sites shall forward the renewal forms to the commissioner. The commissioner 
251.34 	may establish criteria and timelines for sites to forward applications to the commissioner 
251.35 	or county agencies.
252.1 	(d) The premium for the new period of eligibility must be received as provided in 
252.2 	section 256L.06 in order for eligibility to continue.
252.3 	(c) (e) Effective September 1, 2006, for single adults and households with 
252.4 	no children formerly enrolled in general assistance medical care and enrolled in 
252.5 	MinnesotaCare according to section 256D.03, subdivision 3, the first period of eligibility 
252.6 	begins the month the enrollee submitted the application or renewal for general assistance 
252.7 	medical care. This paragraph expires January 1, 2010.
252.8 	(d) (f) An enrollee who fails to submit renewal forms and related documentation 
252.9 	necessary for verification of continued eligibility in a timely manner shall remain eligible 
252.10 	for one additional month beyond the end of the current eligibility period before being 
252.11 	disenrolled. The enrollee remains responsible for MinnesotaCare premiums for the 
252.12 	additional month. This paragraph expires July 1, 2009.

252.13 	Sec. 58. Minnesota Statutes 2008, section 256L.05, subdivision 3b, is amended to read:
252.14 		Subd. 3b.Reapplication. (a) Beginning January 1, 1999, families and individuals 
252.15 	must reapply after a lapse in coverage of one calendar month or more and must meet 
252.16 	all eligibility criteria. This paragraph expires July 1, 2010, or upon federal approval, 
252.17 	whichever is later.
252.18 	(b) Beginning July 1, 2010, or upon federal approval, whichever is later, children 
252.19 	must reapply after a lapse in coverage of one calendar month or more and must meet all 
252.20 	eligibility criteria.

252.21 	Sec. 59. Minnesota Statutes 2008, section 256L.05, subdivision 3c, is amended to read:
252.22 		Subd. 3c.Retroactive coverage. (a) Notwithstanding subdivision 3, the effective 
252.23 	date of coverage shall be the first day of the month following termination from medical 
252.24 	assistance or general assistance medical care for families and individuals who are eligible 
252.25 	for MinnesotaCare and who submitted a written request for retroactive MinnesotaCare 
252.26 	coverage with a completed application within 30 days of the mailing of notification of 
252.27 	termination from medical assistance or general assistance medical care. The applicant 
252.28 	must provide all required verifications within 30 days of the written request for 
252.29 	verification. For retroactive coverage, premiums must be paid in full for any retroactive 
252.30 	month, current month, and next month within 30 days of the premium billing. This 
252.31 	paragraph expires July 1, 2010, or upon federal approval, whichever is later.
252.32 	(b) Beginning July 1, 2010, or upon federal approval, whichever is later, 
252.33 	notwithstanding subdivision 3, the effective date of coverage shall be the first day of 
252.34 	the month following termination from medical assistance for children who are eligible 
253.1 	for MinnesotaCare and who submitted a written request for retroactive MinnesotaCare 
253.2 	coverage with a completed application within 30 days of the mailing of notification of 
253.3 	termination from medical assistance. The applicant must provide all required verifications 
253.4 	within 30 days of the written request for verification. For retroactive coverage, premiums 
253.5 	must be paid in full for any retroactive month, current month, and next month within 
253.6 	30 days of the premium billing.

253.7 	Sec. 60. Minnesota Statutes 2008, section 256L.05, subdivision 5, is amended to read:
253.8 		Subd. 5.Availability of private insurance. (a) The commissioner, in consultation 
253.9 	with the commissioners of health and commerce, shall provide information regarding the 
253.10 	availability of private health insurance coverage and the possibility of disenrollment 
253.11 	under section 256L.07, subdivision 1, paragraphs (b) and (c), to all: (1) families enrolled 
253.12 	in the MinnesotaCare program whose gross family income is equal to or more than 225 
253.13 	percent of the federal poverty guidelines; and (2) single adults and households without 
253.14 	children enrolled in the MinnesotaCare program whose gross family income is equal 
253.15 	to or more than 165 percent of the federal poverty guidelines. This information must 
253.16 	be provided upon initial enrollment and annually thereafter. The commissioner shall 
253.17 	also include information regarding the availability of private health insurance coverage 
253.18 	in the notice of ineligibility provided to persons subject to disenrollment under section 
253.19 	256L.07, subdivision 1, paragraphs (b) and (c). This paragraph expires July 1, 2010, or 
253.20 	upon federal approval, whichever is later.
253.21 	(b) Effective July 1, 2010, or upon federal approval, whichever is later, the 
253.22 	commissioner, in consultation with the commissioners of health and commerce, shall 
253.23 	provide information regarding the availability of private health insurance coverage and the 
253.24 	possibility of disenrollment under section 256L.07, subdivision 1, to all children enrolled 
253.25 	in the MinnesotaCare program whose income is equal to or more than 225 percent of the 
253.26 	federal poverty guidelines. This information must be provided upon initial enrollment 
253.27 	and annually thereafter. The commissioner shall also include information regarding the 
253.28 	availability of private health insurance coverage in the notice of ineligibility provided to 
253.29 	persons subject to disenrollment under section 256L.07, subdivision 1.

253.30 	Sec. 61. Minnesota Statutes 2008, section 256L.06, subdivision 3, is amended to read:
253.31 		Subd. 3.Commissioner's duties and payment. (a) Premiums are dedicated to the 
253.32 	commissioner for MinnesotaCare.
253.33 	(b) The commissioner shall develop and implement procedures to: (1) require 
253.34 	enrollees to report changes in income; (2)(i) adjust sliding scale premium payments, based 
254.1 	upon both increases and decreases in enrollee income, at the time the change in income is 
254.2 	reported; or (ii) beginning July 1, 2011, or upon federal approval, whichever is later, adjust 
254.3 	sliding scale premium payments based upon both increases and decreases in gross family 
254.4 	income, at the time the change in income is reported; and (3) disenroll enrollees from 
254.5 	MinnesotaCare for failure to pay required premiums. Failure to pay includes payment 
254.6 	with a dishonored check, a returned automatic bank withdrawal, or a refused credit card 
254.7 	or debit card payment. The commissioner may demand a guaranteed form of payment, 
254.8 	including a cashier's check or a money order, as the only means to replace a dishonored, 
254.9 	returned, or refused payment.
254.10 	(c) Premiums are calculated on a calendar month basis and may be paid on a 
254.11 	monthly, quarterly, or semiannual basis, with the first payment due upon notice from the 
254.12 	commissioner of the premium amount required. The commissioner shall inform applicants 
254.13 	and enrollees of these premium payment options. Premium payment is required before 
254.14 	enrollment is complete and to maintain eligibility in MinnesotaCare. Premium payments 
254.15 	received before noon are credited the same day. Premium payments received after noon 
254.16 	are credited on the next working day.
254.17 	(d)(1) Effective upon federal approval, nonpayment of the premium will result in 
254.18 	disenrollment from the plan effective the first day of the calendar month following the 
254.19 	calendar month for which the premium was due. Persons disenrolled for nonpayment 
254.20 	or who voluntarily terminate coverage from the program may not reenroll until four 
254.21 	calendar months have elapsed. The commissioner shall waive premiums for coverage 
254.22 	provided under this paragraph to persons disenrolled for nonpayment who reapply under 
254.23 	section 256L.05, subdivision 3b. Persons disenrolled for nonpayment or who voluntarily 
254.24 	terminate coverage from the program may not reenroll for four calendar months unless the 
254.25 	person demonstrates good cause for nonpayment. Good cause does not exist if a person 
254.26 	chooses to pay other family expenses instead of the premium. The commissioner shall 
254.27 	define good cause in rule. This paragraph expires July 1, 2009.
254.28 	(2) Effective July 1, 2009, nonpayment of the premium will result in disenrollment 
254.29 	from the plan effective for the calendar month for which the premium was due. Persons 
254.30 	disenrolled for nonpayment or who voluntarily terminate coverage from the program may 
254.31 	not reenroll until four calendar months have elapsed. Persons disenrolled for nonpayment 
254.32 	who pay all past due premiums as well as current premiums due, including premiums 
254.33 	due for the period of disenrollment, within 20 days of disenrollment, shall be reenrolled 
254.34 	retroactively to the first day of disenrollment. Persons disenrolled for nonpayment or 
254.35 	who voluntarily terminate coverage from the program may not reenroll for four calendar 
254.36 	months unless the person demonstrates good cause for nonpayment. Good cause does 
255.1 	not exist if a person chooses to pay other family expenses instead of the premium. The 
255.2 	commissioner shall define good cause in rule.

255.3 	Sec. 62. Minnesota Statutes 2008, section 256L.07, is amended by adding a subdivision 
255.4 	to read:
255.5 		Subd. 1a.General requirements. (a) Children enrolled in the original children's 
255.6 	health plan as of September 30, 1992; children who enrolled in the MinnesotaCare 
255.7 	program after September 30, 1992, under Laws 1992, chapter 549, article 4, section 17; 
255.8 	and children who have family gross incomes that are equal to or less than 150 percent of 
255.9 	the federal poverty guidelines are eligible without meeting the requirements of subdivision 
255.10 	2 and the four-month requirement in subdivision 3, as long as they maintain continuous 
255.11 	coverage in the MinnesotaCare program or medical assistance. Children who apply for 
255.12 	MinnesotaCare on or after the implementation date of the employer-subsidized health 
255.13 	coverage program described in Laws 1998, chapter 407, article 5, section 45, who have 
255.14 	family gross incomes that are equal to or less than 150 percent of the federal poverty 
255.15 	guidelines, must meet the requirements of subdivision 2 to be eligible for MinnesotaCare. 
255.16 	(b) Families enrolled in MinnesotaCare under section 256L.04, subdivision 1, whose 
255.17 	income increases above 275 percent of the federal poverty guidelines, are no longer 
255.18 	eligible for the program and shall be disenrolled by the commissioner. For persons 
255.19 	disenrolled under this subdivision, MinnesotaCare coverage terminates the last day of 
255.20 	the calendar month following the month in which the commissioner determines that the 
255.21 	income of a family or individual exceeds program income limits.
255.22 	(c) Notwithstanding paragraph (b), children may remain enrolled in MinnesotaCare 
255.23 	if ten percent of their annual family income is less than the annual premium for a 
255.24 	policy with a $500 deductible available through the Minnesota Comprehensive Health 
255.25 	Association. Children who are no longer eligible for MinnesotaCare under this paragraph 
255.26 	shall be given a 12-month notice period from the date that ineligibility is determined before 
255.27 	disenrollment. The premium for children remaining eligible under this paragraph shall be 
255.28 	the maximum premium determined under section 256L.15, subdivision 2a, paragraph (b). 
255.29 	(d) Notwithstanding paragraphs (b) and (c), parents are not eligible for 
255.30 	MinnesotaCare if gross household income exceeds $50,000. 
255.31 	(e) This subdivision is effective August 1, 2005, and expires July 1, 2011, or upon 
255.32 	federal approval, whichever is later.

255.33 	Sec. 63. Minnesota Statutes 2008, section 256L.07, is amended by adding a subdivision 
255.34 	to read:
256.1 		Subd. 1b.General requirements; contingent on federal approval. (a) 
256.2 	Effective July 1, 2011, or upon federal approval, whichever is later, children enrolled in 
256.3 	MinnesotaCare under section 256L.04, subdivision 1, whose income increases above 
256.4 	275 percent of the federal poverty guidelines, are no longer eligible for the program and 
256.5 	shall be disenrolled by the commissioner. For persons disenrolled under this subdivision, 
256.6 	MinnesotaCare coverage terminates the last day of the calendar month following the 
256.7 	month in which the commissioner determines that the income of a family or individual 
256.8 	exceeds program income limits.
256.9 	(b) Beginning January 1, 2008, individuals enrolled in MinnesotaCare under section 
256.10 	256L.04, subdivision 7, whose income increases above 200 percent of the federal poverty 
256.11 	guidelines or 250 percent of the federal poverty guidelines on or after July 1, 2009, are 
256.12 	no longer eligible for the program and shall be disenrolled by the commissioner. This 
256.13 	paragraph expires January 1, 2010.
256.14 	(c) Notwithstanding paragraphs (a) and (b), and subdivision 1a, paragraph (a), 
256.15 	children may remain enrolled in MinnesotaCare if ten percent of their gross individual 
256.16 	or gross family income as defined in section 256L.01, subdivision 4, is less than the 
256.17 	annual premium for a policy with a $500 deductible available through the Minnesota 
256.18 	Comprehensive Health Association. Beginning July 1, 2011, or upon federal approval, 
256.19 	whichever is later, children may remain enrolled in MinnesotaCare if ten percent of their 
256.20 	income as defined in section 256L.01, subdivision 5, is less than the annual premium for a 
256.21 	policy with a $500 deductible available through the Minnesota Comprehensive Health 
256.22 	Association. Children who are no longer eligible for MinnesotaCare under this paragraph 
256.23 	shall be given a 12-month notice period from the date that ineligibility is determined before 
256.24 	disenrollment. The premium for children remaining eligible under this paragraph shall be 
256.25 	the maximum premium determined under section 256L.15, subdivision 2b, paragraph (b).
256.26 	(d) Notwithstanding paragraphs (a) and (b), and subdivision 1a, paragraph (a), 
256.27 	parents are not eligible for MinnesotaCare if gross household income exceeds $57,500 for 
256.28 	the 12-month period of eligibility. This paragraph expires July 1, 2010, or upon federal 
256.29 	approval, whichever is later.

256.30 	Sec. 64. Minnesota Statutes 2008, section 256L.07, subdivision 2, is amended to read:
256.31 		Subd. 2.Must not have access to employer-subsidized coverage. (a) To be 
256.32 	eligible, a family or individual must not have access to subsidized health coverage through 
256.33 	an employer and must not have had access to employer-subsidized coverage through 
256.34 	a current employer for 18 months prior to application or reapplication. A family or 
256.35 	individual whose employer-subsidized coverage is lost due to an employer terminating 
257.1 	health care coverage as an employee benefit during the previous 18 months is not eligible.
257.2 	This paragraph expires July 1, 2010, or upon federal approval, whichever is later.
257.3 	(b) Beginning July 1, 2010, or upon federal approval, whichever is later, to be 
257.4 	eligible for MinnesotaCare, a child must not have access to subsidized health coverage 
257.5 	through an employer and must not have had access to employer-subsidized coverage 
257.6 	through a current employer for 18 months prior to application or reapplication. A child 
257.7 	whose employer-subsidized coverage is lost due to an employer terminating health care 
257.8 	coverage as an employee benefit during the previous 18 months is not eligible. This 
257.9 	subdivision does not apply to a child who was enrolled in MinnesotaCare within six 
257.10 	months or less of reapplication and who no longer has employer-subsidized coverage due 
257.11 	to the employer terminating health care coverage as an employee benefit.
257.12 	(b) (c) This subdivision does not apply to a family or individual who was enrolled 
257.13 	in MinnesotaCare within six months or less of reapplication and who no longer has 
257.14 	employer-subsidized coverage due to the employer terminating health care coverage as 
257.15 	an employee benefit. This paragraph expires July 1, 2010, or upon federal approval, 
257.16 	whichever is later.
257.17 	(c) (d) For purposes of this requirement, subsidized health coverage means health 
257.18 	coverage for which the employer pays at least 50 percent of the cost of coverage for 
257.19 	the employee or dependent, or a higher percentage as specified by the commissioner. 
257.20 	Children are eligible for employer-subsidized coverage through either parent, including 
257.21 	the noncustodial parent. The commissioner must treat employer contributions to Internal 
257.22 	Revenue Code Section 125 plans and any other employer benefits intended to pay 
257.23 	health care costs as qualified employer subsidies toward the cost of health coverage for 
257.24 	employees for purposes of this subdivision.

257.25 	Sec. 65. Minnesota Statutes 2008, section 256L.07, subdivision 3, is amended to read:
257.26 		Subd. 3.Other health coverage. (a) Families and individuals enrolled in the 
257.27 	MinnesotaCare program must have no health coverage while enrolled or for at least four 
257.28 	months prior to application and renewal. Children enrolled in the original children's health 
257.29 	plan and children in families with income equal to or less than 150 percent of the federal 
257.30 	poverty guidelines, who have other health insurance, are eligible if the coverage:
257.31 	(1) lacks two or more of the following:
257.32 	(i) basic hospital insurance;
257.33 	(ii) medical-surgical insurance;
257.34 	(iii) prescription drug coverage;
257.35 	(iv) dental coverage; or
258.1 	(v) vision coverage;
258.2 	(2) requires a deductible of $100 or more per person per year; or
258.3 	(3) lacks coverage because the child has exceeded the maximum coverage for a 
258.4 	particular diagnosis or the policy excludes a particular diagnosis.
258.5 	The commissioner may change this eligibility criterion for sliding scale premiums 
258.6 	in order to remain within the limits of available appropriations. The requirement of no 
258.7 	health coverage does not apply to newborns. This paragraph expires July 1, 2011, or 
258.8 	upon federal approval, whichever is later.
258.9 	(b) Effective July 1, 2011, or upon federal approval, whichever is later, children 
258.10 	enrolled in the MinnesotaCare program must have no health coverage while enrolled or 
258.11 	for at least four months prior to application and renewal.
258.12 	(b) (c) Medical assistance, general assistance medical care, and the Civilian Health 
258.13 	and Medical Program of the Uniformed Service, CHAMPUS, or other coverage provided 
258.14 	under United States Code, title 10, subtitle A, part II, chapter 55, are not considered 
258.15 	insurance or health coverage for purposes of the four-month requirement described in this 
258.16 	subdivision. This paragraph expires July 1, 2011, or upon federal approval, whichever is 
258.17 	later.
258.18 	(d) Beginning July 1, 2011, or upon federal approval, whichever is later, medical 
258.19 	assistance and the Civilian Health and Medical Program of the Uniformed Service, 
258.20 	CHAMPUS, or other coverage provided under United States Code, title 10, subtitle A, 
258.21 	part II, chapter 55, are not considered insurance or health coverage for purposes of the 
258.22 	four-month requirement described in this subdivision.
258.23 	(c) (e) For purposes of this subdivision, an applicant or enrollee who is entitled to 
258.24 	Medicare Part A or enrolled in Medicare Part B coverage under title XVIII of the Social 
258.25 	Security Act, United States Code, title 42, sections 1395c to 1395w-152, is considered to 
258.26 	have health coverage. An applicant or enrollee who is entitled to premium-free Medicare 
258.27 	Part A may not refuse to apply for or enroll in Medicare coverage to establish eligibility 
258.28 	for MinnesotaCare.
258.29 	(d) (f) Applicants who were recipients of medical assistance or general assistance 
258.30 	medical care within one month of application must meet the provisions of this subdivision 
258.31 	and subdivision 2. This paragraph expires July 1, 2011, or upon federal approval, 
258.32 	whichever is later.
258.33 	(g) Beginning July 1, 2011, or upon federal approval, whichever is later, applicants 
258.34 	who were recipients of medical assistance within one month of application must meet the 
258.35 	provisions of this subdivision and subdivision 2.
259.1 	(e) (h) Cost-effective health insurance that was paid for by medical assistance is 
259.2 	not considered health coverage for purposes of the four-month requirement under this 
259.3 	section, except if the insurance continued after medical assistance no longer considered it 
259.4 	cost-effective or after medical assistance closed.

259.5 	Sec. 66. Minnesota Statutes 2008, section 256L.07, subdivision 5, is amended to read:
259.6 		Subd. 5. Voluntary disenrollment for members of military. (a) Notwithstanding 
259.7 	section 256L.05, subdivision 3b, MinnesotaCare enrollees who are members of the 
259.8 	military and their families, who choose to voluntarily disenroll from the program when 
259.9 	one or more family members are called to active duty, may reenroll during or following 
259.10 	that member's tour of active duty. Those individuals and families shall be considered 
259.11 	to have good cause for voluntary termination under section 256L.06, subdivision 3, 
259.12 	paragraph (d). Income and asset increases reported at the time of reenrollment shall be 
259.13 	disregarded. All provisions of sections 256L.01 to 256L.18 shall apply to individuals and 
259.14 	families enrolled under this subdivision upon 12-month renewal. This paragraph expires 
259.15 	July 1, 2010, or upon federal approval, whichever is later.
259.16 	(b) Beginning July 1, 2010, or upon federal approval, whichever is later, 
259.17 	notwithstanding section 256L.05, subdivision 3b, MinnesotaCare enrollees who are 
259.18 	members of the military under age 21 and children whose parents are military members 
259.19 	may choose to voluntarily disenroll from the program when one or more family members 
259.20 	are called to active duty, and may reenroll during or following that member's tour of active 
259.21 	duty. Those children shall be considered to have good cause for voluntary termination 
259.22 	under section 256L.06, subdivision 3, paragraph (d). Income and asset increases reported 
259.23 	at the time of reenrollment shall be disregarded. All provisions of sections 256L.01 to 
259.24 	256L.18 shall apply to children enrolled under this subdivision upon renewal.

259.25 	Sec. 67. Minnesota Statutes 2008, section 256L.07, subdivision 7, is amended to read:
259.26 		Subd. 7.Exception for certain children. (a) Children formerly enrolled in medical 
259.27 	assistance and automatically deemed eligible for MinnesotaCare according to section 
259.28 	256B.057, subdivision 2c, are exempt from the requirements of this section until renewal.
259.29 	(b) This subdivision expires July 1, 2009.

259.30 	Sec. 68. Minnesota Statutes 2008, section 256L.09, subdivision 2, is amended to read:
259.31 		Subd. 2.Residency requirement. (a) To be eligible for health coverage under 
259.32 	the MinnesotaCare program, adults without children must be permanent residents of 
259.33 	Minnesota. This paragraph expires January 1, 2010.
260.1 	(b) To be eligible for health coverage under the MinnesotaCare program, pregnant 
260.2 	women, families, and children must meet the residency requirements as provided by Code 
260.3 	of Federal Regulations, title 42, section 435.403, except that the provisions of section 
260.4 	256B.056, subdivision 1, shall apply upon receipt of federal approval. This paragraph 
260.5 	expires July 1, 2010, or upon federal approval, whichever is later.
260.6 	(c) Effective July 1, 2010, or upon federal approval, whichever is later, to be eligible 
260.7 	for health coverage under the MinnesotaCare program, children must meet the residency 
260.8 	requirements as provided by Code of Federal Regulations, title 42, section 435.403.

260.9 	Sec. 69. Minnesota Statutes 2008, section 256L.11, subdivision 1, is amended to read:
260.10 		Subdivision 1.Medical assistance rate to be used. (a) Payment to providers under 
260.11 	sections 256L.01 to 256L.11 shall be at the same rates and conditions established for 
260.12 	medical assistance, except as provided in subdivisions 2 to 6. 
260.13 	(b) Effective service date July 1, 2009, total payments for basic care services, 
260.14 	except prescription drugs, medical supplies, prosthetics, lab, radiology, and medical 
260.15 	transportation, shall be reduced by 3.0 percent, prior to third-party liability and spenddown 
260.16 	calculation. Payments made to managed care plans shall be reduced for services provided 
260.17 	on or after January 1, 2010, to reflect this reduction.

260.18 	Sec. 70. Minnesota Statutes 2008, section 256L.11, subdivision 2a, is amended to read:
260.19 		Subd. 2a.Payment rates; services for families and children under the 
260.20 	MinnesotaCare health care reform waiver. (a) Subdivision 2 shall not apply to services 
260.21 	provided to families with children who are eligible according to section 256L.04, 
260.22 	subdivision 1, paragraph (a). This paragraph expires July 1, 2010, or upon federal 
260.23 	approval, whichever is later.
260.24 	(b) Beginning July 1, 2010, or upon federal approval, whichever is later, subdivision 
260.25 	2 must not apply to services provided to children who are eligible according to section 
260.26 	256L.04, subdivision 1, paragraph (a).

260.27 	Sec. 71. Minnesota Statutes 2008, section 256L.11, subdivision 6, is amended to read:
260.28 		Subd. 6.Enrollees 18 or older. Payment by the MinnesotaCare program for 
260.29 	inpatient hospital services provided to MinnesotaCare enrollees eligible under section 
260.30 	256L.04, subdivision 7, or who qualify under section 256L.04, subdivisions 1 and 2, 
260.31 	with family gross income that exceeds 175 percent of the federal poverty guidelines 
260.32 	and who are not pregnant, who are 18 years old or older on the date of admission to the 
260.33 	inpatient hospital must be in accordance with paragraphs (a) and (b). Payment for adults 
261.1 	who are not pregnant and are eligible under section 256L.04, subdivisions 1 and 2, and 
261.2 	whose incomes are equal to or less than 175 percent of the federal poverty guidelines, 
261.3 	shall be as provided for under paragraph (c). 
261.4 	(a) If the medical assistance rate minus any co-payment required under section 
261.5 	256L.03, subdivision 4, is less than or equal to the amount remaining in the enrollee's 
261.6 	benefit limit under section 256L.03, subdivision 3, payment must be the medical 
261.7 	assistance rate minus any co-payment required under section 256L.03, subdivision 4. The 
261.8 	hospital must not seek payment from the enrollee in addition to the co-payment. The 
261.9 	MinnesotaCare payment plus the co-payment must be treated as payment in full. 
261.10 	(b) If the medical assistance rate minus any co-payment required under section 
261.11 	256L.03, subdivision 4, is greater than the amount remaining in the enrollee's benefit limit 
261.12 	under section 256L.03, subdivision 3, payment must be the lesser of: 
261.13 	(1) the amount remaining in the enrollee's benefit limit; or
261.14 	(2) charges submitted for the inpatient hospital services less any co-payment 
261.15 	established under section 256L.03, subdivision 4. 
261.16 	The hospital may seek payment from the enrollee for the amount by which usual and 
261.17 	customary charges exceed the payment under this paragraph. If payment is reduced under 
261.18 	section 256L.03, subdivision 3, paragraph (b), the hospital may not seek payment from the 
261.19 	enrollee for the amount of the reduction. 
261.20 	(c) For admissions occurring during the period of July 1, 1997, through June 30, 
261.21 	1998, for adults who are not pregnant and are eligible under section 256L.04, subdivisions 
261.22 	1 and 2, and whose incomes are equal to or less than 175 percent of the federal poverty 
261.23 	guidelines, the commissioner shall pay hospitals directly, up to the medical assistance 
261.24 	payment rate, for inpatient hospital benefits in excess of the $10,000 annual inpatient 
261.25 	benefit limit. 

261.26 	EFFECTIVE DATE. This section is effective January 1, 2010.

261.27 	Sec. 72. Minnesota Statutes 2008, section 256L.12, subdivision 6, is amended to read:
261.28 		Subd. 6.Co-payments and benefit limits. (a) Enrollees are responsible for all 
261.29 	co-payments in sections 256L.03, subdivision 5, and 256L.035, and shall pay co-payments 
261.30 	to the managed care plan or to its participating providers. The enrollee is also responsible 
261.31 	for payment of inpatient hospital charges which exceed the MinnesotaCare benefit limit.
261.32 	(b) This subdivision expires July 1, 2010, or upon federal approval, whichever is 
261.33 	later.

261.34 	Sec. 73. Minnesota Statutes 2008, section 256L.12, subdivision 9, is amended to read:
262.1 		Subd. 9.Rate setting; performance withholds. (a) Rates will be prospective, 
262.2 	per capita, where possible. The commissioner may allow health plans to arrange for 
262.3 	inpatient hospital services on a risk or nonrisk basis. The commissioner shall consult with 
262.4 	an independent actuary to determine appropriate rates.
262.5 	(b) For services rendered on or after January 1, 2003, to December 31, 2003, the 
262.6 	commissioner shall withhold .5 percent of managed care plan payments under this section 
262.7 	pending completion of performance targets. The withheld funds must be returned no 
262.8 	sooner than July 1 and no later than July 31 of the following year if performance targets 
262.9 	in the contract are achieved. A managed care plan may include as admitted assets under 
262.10 	section 62D.044 any amount withheld under this paragraph that is reasonably expected 
262.11 	to be returned. 
262.12 	(c) For services rendered on or after January 1, 2004, the commissioner shall 
262.13 	withhold five percent of managed care plan payments under this section pending 
262.14 	completion of performance targets. Each performance target must be quantifiable, 
262.15 	objective, measurable, and reasonably attainable, except in the case of a performance target 
262.16 	based on a federal or state law or rule. Criteria for assessment of each performance target 
262.17 	must be outlined in writing prior to the contract effective date. The managed care plan 
262.18 	must demonstrate, to the commissioner's satisfaction, that the data submitted regarding 
262.19 	attainment of the performance target is accurate. The commissioner shall periodically 
262.20 	change the administrative measures used as performance targets in order to improve plan 
262.21 	performance across a broader range of administrative services. The performance targets 
262.22 	must include measurement of plan efforts to contain spending on health care services and 
262.23 	administrative activities. The commissioner may adopt plan-specific performance targets 
262.24 	that take into account factors affecting only one plan, such as characteristics of the plan's 
262.25 	enrollee population. The withheld funds must be returned no sooner than July 1 and no 
262.26 	later than July 31 of the following calendar year if performance targets in the contract are 
262.27 	achieved. A managed care plan or a county-based purchasing plan under section 256B.692 
262.28 	may include as admitted assets under section 62D.044 any amount withheld under this 
262.29 	paragraph that is reasonably expected to be returned. 
262.30 	(d) For services rendered on or after January 1, 2010, the commissioner shall 
262.31 	withhold an additional three percent of managed care plan payments under this section. 
262.32 	The withheld funds must be returned no sooner than July 1 and no later than July 31 
262.33 	of the following calendar year.
262.34 	(e) A managed care plan or a county-based purchasing plan under section 256B.692 
262.35 	may include as admitted assets under section 62D.044 any amount withheld under 
263.1 	this paragraph. The return of the withhold under this paragraph is not subject to the 
263.2 	requirements of paragraph (b) or (c).

263.3 	Sec. 74. Minnesota Statutes 2008, section 256L.15, subdivision 1, is amended to read:
263.4 		Subdivision 1.Premium determination. (a) Families with children and individuals 
263.5 	shall pay a premium determined according to subdivision 2 2a. This paragraph expires 
263.6 	July 1, 2010, or upon federal approval, whichever is later.
263.7 	(b) Beginning July 1, 2010, or upon federal approval, whichever is later, children 
263.8 	shall pay a premium determined according to subdivision 2b.
263.9 	(b) (c) Pregnant women and children under age two are exempt from the provisions 
263.10 	of section 256L.06, subdivision 3, paragraph (b), clause (3), requiring disenrollment 
263.11 	for failure to pay premiums. For pregnant women, this exemption continues until the 
263.12 	first day of the month following the 60th day postpartum. Women who remain enrolled 
263.13 	during pregnancy or the postpartum period, despite nonpayment of premiums, shall be 
263.14 	disenrolled on the first of the month following the 60th day postpartum for the penalty 
263.15 	period that otherwise applies under section 256L.06, unless they begin paying premiums. 
263.16 	This paragraph expires July 1, 2011, or upon federal approval, whichever is later.
263.17 	(c) (d) Effective upon federal approval, members of the military and their families 
263.18 	who meet the eligibility criteria for MinnesotaCare upon eligibility approval made within 
263.19 	24 months following the end of the member's tour of active duty shall have their premiums 
263.20 	paid by the commissioner. The effective date of coverage for an individual or family 
263.21 	who meets the criteria of this paragraph shall be the first day of the month following the 
263.22 	month in which eligibility is approved. This exemption applies for 12 months. This 
263.23 	paragraph expires June 30, 2010. 

263.24 	Sec. 75. Minnesota Statutes 2008, section 256L.15, is amended by adding a subdivision 
263.25 	to read:
263.26 		Subd. 2a.Sliding fee scale to determine percentage of gross individual or family 
263.27 	income. (a) Effective August 1, 2005, the commissioner shall establish a sliding fee 
263.28 	scale to determine the percentage of gross individual or family income that households at 
263.29 	different income levels must pay to obtain coverage through the MinnesotaCare program. 
263.30 	The sliding fee scale must be based on the enrollee's gross individual or family income. 
263.31 	The sliding fee scale must contain separate tables based on enrollment of one, two, or 
263.32 	three or more persons. The sliding fee scale begins with a premium of 1.5 percent of gross 
263.33 	individual or family income for individuals or families with incomes below the limits for 
263.34 	the medical assistance program for families and children in effect on January 1, 1999, 
264.1 	and proceeds through the following evenly spaced steps: 1.8, 2.3, 3.1, 3.8, 4.8, 5.9, 7.4, 
264.2 	and 8.8 percent. These percentages are matched to evenly spaced income steps ranging 
264.3 	from the medical assistance income limit for families and children in effect on January 
264.4 	1, 1999, to 275 percent of the federal poverty guidelines for the applicable family size, 
264.5 	up to a family size of five. The sliding fee scale for a family of five must be used for 
264.6 	families of more than five. Effective October 1, 2003, the commissioner shall increase 
264.7 	each percentage by 0.5 percentage points for enrollees with income greater than 100 
264.8 	percent but not exceeding 200 percent of the federal poverty guidelines and shall increase 
264.9 	each percentage by 1.0 percentage points for families and children with incomes greater 
264.10 	than 200 percent of the federal poverty guidelines. The sliding fee scale and percentages 
264.11 	are not subject to the provisions of chapter 14. If a family or individual reports increased 
264.12 	income after enrollment, premiums shall not be adjusted until eligibility renewal.
264.13 	(b) Effective August 1, 2005, children in families whose gross income is above 275 
264.14 	percent of the federal poverty guidelines shall pay the maximum premium. The maximum 
264.15 	premium is defined as a base charge for one, two, or three or more enrollees so that if all 
264.16 	MinnesotaCare cases paid the maximum premium, the total revenue would equal the 
264.17 	total cost of MinnesotaCare medical coverage and administration. In this calculation, 
264.18 	administrative costs shall be assumed to equal ten percent of the total. The costs of 
264.19 	medical coverage for children under age two and pregnant women and the enrollees in 
264.20 	these groups shall be excluded from the total. The maximum premium for two enrollees 
264.21 	shall be twice the maximum premium for one, and the maximum premium for three or 
264.22 	more enrollees shall be three times the maximum premium for one.
264.23 	(c) This subdivision expires July 1, 2010, or upon federal approval, whichever is 
264.24 	later.

264.25 	Sec. 76. Minnesota Statutes 2008, section 256L.15, is amended by adding a subdivision 
264.26 	to read:
264.27 		Subd. 2b.Sliding fee scale to determine monthly gross income. (a) Effective July 
264.28 	1, 2010, or upon federal approval, whichever is later, the commissioner shall establish 
264.29 	a sliding fee scale to determine the percentage of monthly gross individual or family 
264.30 	income that households at different income levels must pay to obtain coverage through the 
264.31 	MinnesotaCare program. The sliding fee scale must be based on the enrollee's monthly 
264.32 	gross individual or family income. The sliding fee scale must contain separate tables 
264.33 	based on enrollment of one, two, or three or more persons. The sliding fee scale begins 
264.34 	with a premium of 1.5 percent of monthly gross family income for children with family 
264.35 	incomes below the limits for the medical assistance program for families and children in 
265.1 	effect on January 1, 1999, and proceeds through the following evenly spaced steps: 1.8, 
265.2 	2.3, 3.1, 3.8, 4.8, 5.9, 7.4, and 8.8 percent. These percentages are matched to evenly 
265.3 	spaced income steps ranging from the medical assistance income limit for families and 
265.4 	children in effect on January 1, 1999, to 275 percent of the federal poverty guidelines for 
265.5 	the applicable family size, up to a family size of five. The sliding fee scale for children in 
265.6 	a family of five must be used for children in families of more than five. Effective July 
265.7 	1, 2009, the commissioner shall increase each percentage by 0.5 percentage points for 
265.8 	enrollees with income greater than 100 percent but not exceeding 200 percent of the 
265.9 	federal poverty guidelines and shall increase each percentage by 1.0 percentage points 
265.10 	for families and children with incomes greater than 200 percent of the federal poverty 
265.11 	guidelines. The sliding fee scale and percentages are not subject to the provisions of 
265.12 	chapter 14. If a child or individual reports increased income after enrollment, premiums 
265.13 	shall be adjusted at the time the change in income is reported.
265.14 	(b) Effective July 1, 2010, or upon federal approval, whichever is later, children in 
265.15 	families whose gross income is above 275 percent of the federal poverty guidelines shall 
265.16 	pay the maximum premium. The maximum premium is defined as a base charge for one, 
265.17 	two, or three or more enrollees so that if all MinnesotaCare cases paid the maximum 
265.18 	premium, the total revenue would equal the total cost of MinnesotaCare medical coverage 
265.19 	and administration. In this calculation, administrative costs shall be assumed to equal 
265.20 	ten percent of the total. The maximum premium for two enrollees shall be twice the 
265.21 	maximum premium for one, and the maximum premium for three or more enrollees shall 
265.22 	be three times the maximum premium for one.

265.23 	Sec. 77. Minnesota Statutes 2008, section 256L.15, is amended by adding a subdivision 
265.24 	to read:
265.25 		Subd. 3a.Exceptions to sliding scale. Effective July 1, 2011, or upon federal 
265.26 	approval, whichever is later, children ages 19 and 20 enrolled under section 256L.04, 
265.27 	subdivision 1, paragraph (a), in families with income at or below 150 percent of the 
265.28 	federal poverty guidelines pay a monthly premium of $4.

265.29 	Sec. 78. Minnesota Statutes 2008, section 256L.17, is amended by adding a subdivision 
265.30 	to read:
265.31 		Subd. 8.Expiration. This section expires July 1, 2010, or upon federal approval, 
265.32 	whichever is later.

266.1 	Sec. 79. Minnesota Statutes 2008, section 501B.89, is amended by adding a 
266.2 	subdivision to read:
266.3 		Subd. 4.Annual filing requirement for supplemental needs trusts. (a) A trustee 
266.4 	of a trust under subdivision 3 and United States Code, title 42, section 1396p(d)(4)(A) or 
266.5 	(C), shall submit to the commissioner of human services, at the time of a beneficiary's 
266.6 	request for medical assistance, the following information about the trust:
266.7 	(1) a copy of the trust instrument; and
266.8 	(2) an inventory of the beneficiary's trust account assets and the value of those assets.
266.9 	(b) A trustee of a trust under subdivision 3 and United States Code, title 42, section 
266.10 	1396p(d)(4)(A) or (C), shall submit an accounting of the beneficiary's trust account to the 
266.11 	commissioner of human services at least annually until the trust, or the beneficiary's 
266.12 	interest in the trust, terminates. Accountings are due on the anniversary of the execution 
266.13 	date of the trust unless another annual date is established by the terms of the trust. The 
266.14 	accounting must include the following information for the accounting period:
266.15 	(1) an inventory of trust assets and the value of those assets at the beginning of the 
266.16 	accounting period;
266.17 	(2) additions to the trust during the accounting period and the source of those 
266.18 	additions;
266.19 	(3) itemized distributions from the trust during the accounting period, including the 
266.20 	purpose of the distributions and to whom the distributions were made;
266.21 	(4) an inventory of trust assets and the value of those assets at the end of the 
266.22 	accounting period; and
266.23 	(5) changes to the trust instrument during the accounting period.
266.24 	(c) For the purpose of paragraph (b), an accounting period is 12 months unless an 
266.25 	accounting period of a different length is permitted by the commissioner.

266.26 	EFFECTIVE DATE. This section is effective for applications for medical 
266.27 	assistance and renewals of medical assistance submitted on or after July 1, 2009.

266.28 	Sec. 80. Minnesota Statutes 2008, section 519.05, is amended to read:
266.29 	519.05 LIABILITY OF HUSBAND AND WIFE.
266.30 	(a) A spouse is not liable to a creditor for any debts of the other spouse. Where 
266.31 	husband and wife are living together, they shall be jointly and severally liable for 
266.32 	necessary medical services that have been furnished to either spouse, including any claims 
266.33 	arising under section 246.53, 256B.15, 256D.16, or 261.04, and necessary household 
267.1 	articles and supplies furnished to and used by the family. Notwithstanding this paragraph, 
267.2 	in a proceeding under chapter 518 the court may apportion such debt between the spouses.
267.3 	(b) Either spouse may close a credit card account or other unsecured consumer line 
267.4 	of credit on which both spouses are contractually liable, by giving written notice to the 
267.5 	creditor.

267.6 	Sec. 81. Laws 2005, First Special Session chapter 4, article 8, section 66, the effective 
267.7 	date, is amended to read:

267.8 	EFFECTIVE DATE. Paragraph (a) is effective August 1, 2007, or upon 
267.9 	HealthMatch implementation, whichever is later, and Paragraph (e) is effective September 
267.10 	1, 2006.

267.11 	Sec. 82. Laws 2008, chapter 358, article 3, section 8, the effective date, is amended to 
267.12 	read:

267.13 	EFFECTIVE DATE. This section is effective January 1, 2009, or upon federal 
267.14 	approval, whichever is later. The commissioner of human services shall notify the revisor 
267.15 	of statutes when federal approval is obtained.

267.16 	Sec. 83.  REPEALER.
 267.17 	(a) Minnesota Statutes 2008, sections 256.962, subdivisions 1, 2, 5, and 7; 256B.76, 
267.18 	subdivision 4; 256L.07, subdivision 1; 256L.09, subdivision 2; 256L.11, subdivision 7; 
267.19 	and 256L.15, subdivisions 2 and 3, are repealed.
267.20 	(b) Minnesota Statutes 2008, sections 256B.057, subdivision 2c; and 256L.07, 
267.21 	subdivision 7, are repealed effective July 1, 2009, or upon federal approval, whichever is 
267.22 	later. The commissioner of human services shall notify the revisor when federal approval 
267.23 	is obtained.
267.24 	(c) Minnesota Statutes 2008, section 256.969, subdivisions 26 and 27, are repealed 
267.25 	effective July 1, 2009.
267.26 	(d) Minnesota Statutes 2008, sections 256L.04, subdivisions 7 and 9; 256L.05, 
267.27 	subdivision 1b; 256L.07, subdivision 6; 256L.09, subdivisions 4, 5, and 6; and 256L.15, 
267.28 	subdivision 4, are repealed effective January 1, 2010.
267.29 	(e) Laws 2005, chapter 10, article 1, sections 56; and 57; Laws 2005, First Special 
267.30 	Session chapter 4, article 8, sections 67; 69; 74; and 75; Laws 2007, chapter 147, article 5, 
267.31 	sections 28; and 33; and Laws 2008, chapter 358, article 3, sections 10; 11; and 14, are 
267.32 	repealed.
268.1 	(f) Laws 2005, First Special Session chapter 4, article 8, section 61, the effective 
268.2 	date; Laws 2007, chapter 147, article 13, section 2, the effective date; Laws 2007, chapter 
268.3 	147, article 5, section 32, the effective date; and Laws 2008, chapter 358, article 3, 
268.4 	sections 8, the effective date; and 9, the effective date, are repealed.

268.5 	ARTICLE 10
268.6 	STATE-OPERATED SERVICES COST OF CARE

268.7 	Section 1. Minnesota Statutes 2008, section 246.50, subdivision 5, is amended to read:
268.8 		Subd. 5.Cost of care. "Cost of care" means the commissioner's charge for services 
268.9 	provided to any person admitted to a state facility.
268.10 	For purposes of this subdivision, "charge for services" means the cost of services, 
268.11 	treatment, maintenance, bonds issued for capital improvements, depreciation of buildings 
268.12 	and equipment, and indirect costs related to the operation of state facilities. The 
268.13 	commissioner may determine the charge for services on an anticipated average per diem 
268.14 	basis as an all inclusive charge per facility, per disability group, or per treatment program. 
268.15 	The commissioner may determine a charge per service, using a method that includes direct 
268.16 	and indirect costs. usual and customary fee charged for services provided to clients. The 
268.17 	usual and customary fee shall be established in a manner required to appropriately bill 
268.18 	services to all payers and shall include the costs related to the operations of any program 
268.19 	offered by the state.

268.20 	Sec. 2. Minnesota Statutes 2008, section 246.50, is amended by adding a subdivision 
268.21 	to read:
268.22 		Subd. 10.State-operated community-based program.  "State-operated 
268.23 	community-based program" means any program operated in the community including 
268.24 	community behavioral health hospitals, crisis centers, residential facilities, outpatient 
268.25 	services, and other community-based services developed and operated by the state and 
268.26 	under the commissioner's control.

268.27 	Sec. 3. Minnesota Statutes 2008, section 246.50, is amended by adding a subdivision 
268.28 	to read:
268.29 		Subd. 11.Health plan company. "Health plan company" has the meaning given it 
268.30 	in section 62Q.01, subdivision 4, and also includes a demonstration provider as defined in 
268.31 	section 256B.69, subdivision 2, paragraph (b), a county or group of counties participating 
268.32 	in county-based purchasing according to section 256B.692, and a children's mental health 
268.33 	collaborative under contract to provide medical assistance for individuals enrolled in 
269.1 	the prepaid medical assistance and MinnesotaCare programs under sections 245.493 to 
269.2 	245.495.

269.3 	Sec. 4. Minnesota Statutes 2008, section 246.51, is amended by adding a subdivision 
269.4 	to read:
269.5 		Subd. 1a.Clients in state-operated community-based programs; determination.
 269.6 	For clients admitted to a state-operated community-based program, the commissioner shall 
269.7 	make an investigation to determine the available health plan coverage for services being 
269.8 	provided. If the health plan coverage requires a co-pay or deductible, or if there is no 
269.9 	available health plan coverage, the commission shall make an investigation as necessary 
269.10 	to determine, and as circumstances require redetermine, what part of the noncovered 
269.11 	cost of care, if any, the client is able to pay. If the client is unable to pay the uncovered 
269.12 	cost of care, the commissioner shall make a determination as to the ability of the client's 
269.13 	relatives to pay. The client and relatives shall provide the commissioner documents and 
269.14 	proof necessary to determine their ability to pay. Failure to provide the commissioner with 
269.15 	sufficient information to determine ability to pay may make the client or relatives liable 
269.16 	for the full cost of care until the time when sufficient information is provided. If it is 
269.17 	determined that the responsible party does not have the ability to pay, the commissioner 
269.18 	shall waive payment of the portion that exceeds ability to pay under the determination.

269.19 	Sec. 5. Minnesota Statutes 2008, section 246.51, is amended by adding a subdivision 
269.20 	to read:
269.21 		Subd. 1b.Clients served by regional treatment centers or nursing homes; 
269.22 	determination.  For clients served in regional treatment centers or nursing homes operated 
269.23 	by state-operated services, the commissioner shall make investigation as necessary to 
269.24 	determine, and as circumstances require redetermine, what part of the cost of care, if any, 
269.25 	the client is able to pay. If the client is unable to pay the full cost of care, the commissioner 
269.26 	shall determine whether the client's relatives have the ability to pay. The client and 
269.27 	relatives shall provide the commissioner documents and proof necessary to determine their 
269.28 	ability to pay. Failure to provide the commissioner with sufficient information to determine 
269.29 	ability to pay may make the client or relatives liable for the full cost of care until the time 
269.30 	when sufficient information is provided. No parent shall be liable for the cost of care given 
269.31 	a client at a regional treatment center after the client has reached the age of 18 years.

269.32 	Sec. 6. Minnesota Statutes 2008, section 246.511, is amended to read:
269.33 	246.511 RELATIVE RESPONSIBILITY.
270.1 	Except for chemical dependency services paid for with funds provided under chapter 
270.2 	254B, a client's relatives shall not, pursuant to the commissioner's authority under section 
270.3 	246.51, be ordered to pay more than ten percent of the cost ofthe following: (1) for 
270.4 	services provided in a community-based service, the noncovered cost of care as determined 
270.5 	under the ability to pay determination; and (2) for services provided at a regional treatment 
270.6 	center operated by state-operated services, 20 percent of the cost of care, unless they 
270.7 	reside outside the state. Parents of children in state facilities shall have their responsibility 
270.8 	to pay determined according to section 252.27, subdivision 2, or in rules adopted under 
270.9 	chapter 254B if the cost of care is paid under chapter 254B. The commissioner may 
270.10 	accept voluntary payments in excess of ten 20 percent. The commissioner may require 
270.11 	full payment of the full per capita cost of care in state facilities for clients whose parent, 
270.12 	parents, spouse, guardian, or conservator do not reside in Minnesota.  

270.13 	Sec. 7. Minnesota Statutes 2008, section 246.52, is amended to read:
270.14 	246.52 PAYMENT FOR CARE; ORDER; ACTION.
270.15 	The commissioner shall issue an order to the client or the guardian of the estate, if 
270.16 	there be one, and relatives determined able to pay requiring them to pay monthly to the 
270.17 	state of Minnesota the amounts so determined the total of which shall not exceed the full 
270.18 	cost of care. Such order shall specifically state the commissioner's determination and shall 
270.19 	be conclusive unless appealed from as herein provided. When a client or relative fails to 
270.20 	pay the amount due hereunder the attorney general, upon request of the commissioner, 
270.21 	may institute, or direct the appropriate county attorney to institute, civil action to recover 
270.22 	such amount.

270.23 	Sec. 8. Minnesota Statutes 2008, section 246B.01, is amended by adding a subdivision 
270.24 	to read:
270.25 		Subd. 1a. Client. "Client" means a person who is admitted to the Minnesota sex 
270.26 	offender program or subject to a court hold order under section 253B.185 for the purpose 
270.27 	of assessment, diagnosis, care, treatment, supervision, or other services provided by the 
270.28 	Minnesota sex offender program.

270.29 	Sec. 9. Minnesota Statutes 2008, section 246B.01, is amended by adding a subdivision 
270.30 	to read:
270.31 		Subd. 1b.Client's county. "Client's county" means the county of the client's 
270.32 	legal settlement for poor relief purposes at the time of commitment. If the client has no 
270.33 	legal settlement for poor relief in this state, it means the county of commitment, except 
271.1 	that when a client with no legal settlement for poor relief is committed while serving a 
271.2 	sentence at a penal institution, it means the county from which the client was sentenced.

271.3 	Sec. 10. Minnesota Statutes 2008, section 246B.01, is amended by adding a 
271.4 	subdivision to read:
271.5 		Subd. 2a.Cost of care. "Cost of care" means the commissioner's charge for housing 
271.6 	and treatment services provided to any person admitted to the Minnesota sex offender 
271.7 	program.
271.8 	For purposes of this subdivision, "charge for housing and treatment services" means 
271.9 	the cost of services, treatment, maintenance, bonds issued for capital improvements, 
271.10 	depreciation of buildings and equipment, and indirect costs related to the operation of 
271.11 	state facilities. The commissioner may determine the charge for services on an anticipated 
271.12 	average per diem basis as an all-inclusive charge per facility.

271.13 	Sec. 11. Minnesota Statutes 2008, section 246B.01, is amended by adding a subdivision 
271.14 	to read:
271.15 		Subd. 2b.Local social services agency. "Local social services agency" means the 
271.16 	local social services agency of the client's county as defined in subdivision 1b and of the 
271.17 	county of commitment, and any other local social services agency possessing information 
271.18 	regarding, or requested by the commissioner to investigate, the financial circumstances 
271.19 	of a client.

271.20 	Sec. 12. [246B.07] PAYMENT FOR CARE AND TREATMENT: 
271.21 	DETERMINATION.
271.22 		Subdivision 1.Procedures. The commissioner shall make investigation as 
271.23 	necessary to determine, and as circumstances require redetermine, what part of the cost of 
271.24 	care, if any, the client is able to pay. The client shall provide the commissioner documents 
271.25 	and proof necessary to determine the ability to pay. Failure to provide the commissioner 
271.26 	with sufficient information to determine ability to pay may make the client liable for the 
271.27 	full cost of care until the time when sufficient information is provided.
271.28 		Subd. 2.Rules. The commissioner shall adopt, pursuant to the Administrative 
271.29 	Procedure Act, rules establishing uniform standards for determination of client liability 
271.30 	for care provided by the Minnesota sex offender program. These rules shall have the 
271.31 	force and effect of law.
271.32 		Subd. 3.Applicability. The commissioner may recover, under sections 246B.07 to 
271.33 	246B.10, the cost of any care provided by the Minnesota sex offender program.

272.1 	Sec. 13. [246B.08] PAYMENT FOR CARE; ORDER; ACTION.
272.2 	The commissioner shall issue an order to the client or the guardian of the estate, if 
272.3 	there is one, requiring them to pay to the state the amounts so determined, the total of which 
272.4 	shall not exceed the full cost of care. The order shall specifically state the commissioner's 
272.5 	determination and must be conclusive, unless appealed. When a client fails to pay the 
272.6 	amount due, the attorney general, upon request of the commissioner, may institute, or 
272.7 	direct the appropriate county attorney to institute, civil action to recover the amount.

272.8 	Sec. 14. [246B.09] CLAIM AGAINST ESTATE OF DECEASED CLIENT.
272.9 		Subdivision 1.Client's estate. Upon the death of a client, or a former client, the 
272.10 	total cost of care given the client, less the amount actually paid toward the cost of care by 
272.11 	the client, shall be filed by the commissioner as a claim against the estate of the client 
272.12 	with the court having jurisdiction to probate the estate and all proceeds collected by the 
272.13 	state in the case shall be divided between the state and county in proportion to the cost 
272.14 	of care each has borne.
272.15 		Subd. 2.Preferred status. An estate claim in subdivision 1 shall be considered an 
272.16 	expense of the last illness for purposes of section 524.3-805.
272.17 	If the commissioner of human services determines that the property or estate of a 
272.18 	client is not more than needed to care for and maintain the spouse and minor or dependent 
272.19 	children of a deceased client, the commissioner has the power to compromise the claim of 
272.20 	the state in a manner deemed just and proper.
272.21 		Subd. 3.Exception from statute of limitations. Any statute of limitations that 
272.22 	limits the commissioner in recovering the cost of care obligation incurred by a client or 
272.23 	former client must not apply to any claim against an estate made under this section to 
272.24 	recover cost of care.

272.25 	Sec. 15. [246B.10] LIABILITY OF COUNTY; REIMBURSEMENT.
272.26 	The client's county shall pay to the state a portion of the cost of care provided in 
272.27 	the Minnesota sex offender program to a client legally settled in that county. A county's 
272.28 	payment shall be made from the county's own sources of revenue and payments shall 
272.29 	equal ten percent of the cost of care, as determined by the commissioner, for each day or 
272.30 	portion of a day, that the client spends at the facility. If payments received by the state 
272.31 	under sections 246.50 to 246.53 exceed 90 percent of the cost of care, the county shall 
272.32 	be responsible for paying the state only the remaining amount. The county shall not be 
272.33 	entitled to reimbursement from the client, the client's estate, or from the client's relatives, 
272.34 	except as provided in section 246B.07.

273.1 	Sec. 16.  REPEALER.
 273.2 	Minnesota Statutes 2008, sections 246.51, subdivision 1; and 246.53, subdivision 
273.3 	3, are repealed.

273.4 	ARTICLE 11
273.5 	DEPARTMENT OF HEALTH

273.6 	Section 1. Minnesota Statutes 2008, section 103I.208, subdivision 2, is amended to 
273.7 	read:
273.8 		Subd. 2.Permit fee. The permit fee to be paid by a property owner is:
273.9 	(1) for a water supply well that is not in use under a maintenance permit, $175 
273.10 	annually;
273.11 	(2) for construction of a monitoring well, $215, which includes the state core 
273.12 	function fee;
273.13 	(3) for a monitoring well that is unsealed under a maintenance permit, $175 annually;
273.14 	(4) for a monitoring well owned by a federal agency, state agency, or local unit of 
273.15 	government that is unsealed under a maintenance permit, $50 annually. "Local unit of 
273.16 	government" means a statutory or home rule charter city, town, county, or soil and water 
273.17 	conservation district, watershed district, and organization formed for the joint exercise 
273.18 	of powers under section 471.59, a board of health or community health board, or other 
273.19 	special purpose district or authority with local jurisdiction in water and related land 
273.20 	resources management;
273.21 	(5) for monitoring wells used as a leak detection device at a single motor fuel retail 
273.22 	outlet, a single petroleum bulk storage site excluding tank farms, or a single agricultural 
273.23 	chemical facility site, the construction permit fee is $215, which includes the state core 
273.24 	function fee, per site regardless of the number of wells constructed on the site, and 
273.25 	the annual fee for a maintenance permit for unsealed monitoring wells is $175 per site 
273.26 	regardless of the number of monitoring wells located on site;
273.27 	(5) (6) for a groundwater thermal exchange device, in addition to the notification fee 
273.28 	for water supply wells, $215, which includes the state core function fee;
273.29 	(6) (7) for a vertical heat exchanger with less than ten tons of heating/cooling 
273.30 	capacity, $215;
273.31 	(8) for a vertical heat exchanger with ten to 50 tons of heating/cooling capacity, $425;
273.32 	(9) for a vertical heat exchanger with greater than 50 tons of heating/cooling 
273.33 	capacity, $650;
273.34 	(7) (10) for a dewatering well that is unsealed under a maintenance permit, $175 
273.35 	annually for each dewatering well, except a dewatering project comprising more than five 
274.1 	dewatering wells shall be issued a single permit for $875 annually for dewatering wells 
274.2 	recorded on the permit; and
274.3 	(8) (11) for an elevator boring, $215 for each boring.

274.4 	Sec. 2. Minnesota Statutes 2008, section 144.121, subdivision 1a, is amended to read:
274.5 		Subd. 1a.Fees for ionizing radiation-producing equipment. (a) A facility with 
274.6 	ionizing radiation-producing equipment must pay an annual initial or annual renewal 
274.7 	registration fee consisting of a base facility fee of $66 $100 and an additional fee for 
274.8 	each radiation source, as follows:

274.9	(1)
	medical or veterinary equipment
		$
	53100
	
274.10	(2)
	dental x-ray equipment
		$
	3340
	
274.11	(3)
	accelerator
		$
	66
	
274.12	(4)
	radiation therapy equipment
		$
	66
	
274.13
274.14	(5)(3)
	x-ray equipment not used on 
humans or animals
		$
	53100
	
274.15
274.16
274.17	(6)(4)
	devices with sources of ionizing 
radiation not used on humans or 
animals
		$
	53100
	
274.18 	(b) A facility with radiation therapy and accelerator equipment must pay an annual 
274.19 	registration fee of $500. A facility with an industrial accelerator must pay an annual 
274.20 	registration fee of $150.
274.21 	(c) Electron microscopy equipment is exempt from the registration fee requirements 
274.22 	of this section.

274.23 	Sec. 3. Minnesota Statutes 2008, section 144.121, subdivision 1b, is amended to read:
274.24 		Subd. 1b.Penalty fee for late registration. Applications for initial or renewal 
274.25 	registrations submitted to the commissioner after the time specified by the commissioner 
274.26 	shall be accompanied by a penalty fee of $20 an amount equal to 25 percent of the fee 
274.27 	due in addition to the fees prescribed in subdivision 1a.

274.28 	Sec. 4. Minnesota Statutes 2008, section 144.122, is amended to read:
274.29 	144.122 LICENSE, PERMIT, AND SURVEY FEES.
274.30 	(a) The state commissioner of health, by rule, may prescribe procedures and fees 
274.31 	for filing with the commissioner as prescribed by statute and for the issuance of original 
274.32 	and renewal permits, licenses, registrations, and certifications issued under authority of 
274.33 	the commissioner. The expiration dates of the various licenses, permits, registrations, 
274.34 	and certifications as prescribed by the rules shall be plainly marked thereon. Fees may 
274.35 	include application and examination fees and a penalty fee for renewal applications 
275.1 	submitted after the expiration date of the previously issued permit, license, registration, 
275.2 	and certification. The commissioner may also prescribe, by rule, reduced fees for permits, 
275.3 	licenses, registrations, and certifications when the application therefor is submitted 
275.4 	during the last three months of the permit, license, registration, or certification period. 
275.5 	Fees proposed to be prescribed in the rules shall be first approved by the Department of 
275.6 	Finance. All fees proposed to be prescribed in rules shall be reasonable. The fees shall be 
275.7 	in an amount so that the total fees collected by the commissioner will, where practical, 
275.8 	approximate the cost to the commissioner in administering the program. All fees collected 
275.9 	shall be deposited in the state treasury and credited to the state government special revenue 
275.10 	fund unless otherwise specifically appropriated by law for specific purposes.
275.11 	(b) The commissioner may charge a fee for voluntary certification of medical 
275.12 	laboratories and environmental laboratories, and for environmental and medical laboratory 
275.13 	services provided by the department, without complying with paragraph (a) or chapter 14. 
275.14 	Fees charged for environment and medical laboratory services provided by the department 
275.15 	must be approximately equal to the costs of providing the services.
275.16 	(c) The commissioner may develop a schedule of fees for diagnostic evaluations 
275.17 	conducted at clinics held by the services for children with disabilities program. All 
275.18 	receipts generated by the program are annually appropriated to the commissioner for use 
275.19 	in the maternal and child health program.
275.20 	(d) The commissioner shall set license fees for hospitals and nursing homes that are 
275.21 	not boarding care homes at the following levels:

275.22
275.23
275.24
275.25	Joint Commission on Accreditation of 
Healthcare Organizations (JCAHO) and 
American Osteopathic Association (AOA) 
hospitals
	$7,555$7,655 plus $13$16 per bed
	
275.26	Non-JCAHO and non-AOA hospitals
	$5,180$5,280 plus $247$250 per bed
	
275.27	Nursing home
	$183 plus $91 per bed
	
275.28 	The commissioner shall set license fees for outpatient surgical centers, boarding care 
275.29 	homes, and supervised living facilities at the following levels:

275.30	Outpatient surgical centers
	$3,349$3,712
	
275.31	Boarding care homes
	$183 plus $91 per bed
	
275.32	Supervised living facilities
	$183 plus $91 per bed.
	
275.33 	(e) Unless prohibited by federal law, the commissioner of health shall charge 
275.34 	applicants the following fees to cover the cost of any initial certification surveys required 
275.35 	to determine a provider's eligibility to participate in the Medicare or Medicaid program:

275.36	Prospective payment surveys for hospitals
	$
	900
	
275.37	Swing bed surveys for nursing homes
	$
	1,200
	
276.1	Psychiatric hospitals
	$
	1,400
	
276.2	Rural health facilities
	$
	1,100
	
276.3	Portable x-ray providers
	$
	500
	
276.4	Home health agencies
	$
	1,800
	
276.5	Outpatient therapy agencies
	$
	800
	
276.6	End stage renal dialysis providers
	$
	2,100
	
276.7	Independent therapists
	$
	800
	
276.8	Comprehensive rehabilitation outpatient facilities
	$
	1,200
	
276.9	Hospice providers
	$
	1,700
	
276.10	Ambulatory surgical providers
	$
	1,800
	
276.11	Hospitals
	$
	4,200
	
276.12
276.13
276.14	Other provider categories or additional
resurveys required to complete initial
certification
	Actual surveyor costs: average 
surveyor cost x number of hours 
for the survey process.
	
276.15 	These fees shall be submitted at the time of the application for federal certification 
276.16 	and shall not be refunded. All fees collected after the date that the imposition of fees is not 
276.17 	prohibited by federal law shall be deposited in the state treasury and credited to the state 
276.18 	government special revenue fund.

276.19 	Sec. 5. Minnesota Statutes 2008, section 144.1222, subdivision 1a, is amended to read:
276.20 		Subd. 1a. Fees. All plans and specifications for public pool and spa construction, 
276.21 	installation, or alteration or requests for a variance that are submitted to the commissioner 
276.22 	according to Minnesota Rules, part 4717.3975, shall be accompanied by the appropriate 
276.23 	fees. All public pool construction plans submitted for review after January 1, 2009, 
276.24 	must be certified by a professional engineer registered in the state of Minnesota. If the 
276.25 	commissioner determines, upon review of the plans, that inadequate fees were paid, the 
276.26 	necessary additional fees shall be paid before plan approval. For purposes of determining 
276.27 	fees, a project is defined as a proposal to construct or install a public pool, spa, special 
276.28 	purpose pool, or wading pool and all associated water treatment equipment and drains, 
276.29 	gutters, decks, water recreation features, spray pads, and those design and safety features 
276.30 	that are within five feet of any pool or spa. The commissioner shall charge the following 
276.31 	fees for plan review and inspection of public pools and spas and for requests for variance 
276.32 	from the public pool and spa rules: 
276.33 	(1) each pool, $800 $1,500; 
276.34 	(2) each spa pool, $500 $800; 
276.35 	(3) each slide, $400 $600; 
276.36 	(4) projects valued at $250,000 or more, the greater of the sum of the fees in clauses 
276.37 	(1), (2), and (3) or 0.5 percent of the documented estimated project cost to a maximum 
276.38 	fee of $10,000 $15,000; 
277.1 	(5) alterations to an existing pool without changing the size or configuration of 
277.2 	the pool, $400 $600; 
277.3 	(6) removal or replacement of pool disinfection equipment only, $75 $100; and 
277.4 	(7) request for variance from the public pool and spa rules, $500. 

277.5 	Sec. 6. Minnesota Statutes 2008, section 144.226, subdivision 4, is amended to read:
277.6 		Subd. 4.Vital records surcharge. (a) In addition to any fee prescribed under 
277.7 	subdivision 1, there is a nonrefundable surcharge of $2 for each certified and noncertified 
277.8 	birth, stillbirth, or death record, and for a certification that the record cannot be found. 
277.9 	The local or state registrar shall forward this amount to the commissioner of finance to 
277.10 	be deposited into the state government special revenue fund. This surcharge shall not be 
277.11 	charged under those circumstances in which no fee for a birth, stillbirth, or death record is 
277.12 	permitted under subdivision 1, paragraph (a).
277.13 	(b) Effective August 1, 2005, to June 30, 2009, the surcharge in paragraph (a) shall 
277.14 	be is $4.

277.15 	Sec. 7. Minnesota Statutes 2008, section 144.72, subdivision 1, is amended to read:
277.16 		Subdivision 1.Permits License required. The state commissioner of health is 
277.17 	authorized to issue permits for the operation of youth camps which are required to obtain 
277.18 	the permits a license according to chapter 157.

277.19 	Sec. 8. Minnesota Statutes 2008, section 144.72, subdivision 3, is amended to read:
277.20 		Subd. 3.Issuance of permits license. If the commissioner should determine from 
277.21 	the application that the health and safety of the persons using the camp will be properly 
277.22 	safeguarded, the commissioner may, prior to actual inspection of the camp, issue the 
277.23 	permit license in writing. No fee shall be charged for the permit. The permit license shall 
277.24 	be posted in a conspicuous place on the premises occupied by the camp.

277.25 	Sec. 9. Minnesota Statutes 2008, section 144.9501, is amended by adding a subdivision 
277.26 	to read:
277.27 		Subd. 8a.Disclosure pamphlet. "Disclosure pamphlet" means the EPA pamphlet 
277.28 	titled "Renovate Right: Important Lead Hazard Information for Families, Child Care 
277.29 	Providers and Schools" developed under section 406(a) of the Toxic Substance Control 
277.30 	Act.

278.1 	Sec. 10. Minnesota Statutes 2008, section 144.9501, subdivision 22b, is amended to 
278.2 	read:
278.3 		Subd. 22b.Lead sampling technician. "Lead sampling technician" means an 
278.4 	individual who performs clearance inspections for nonabatement or nonorder lead hazard 
278.5 	reduction renovation sites, and lead dust sampling in other settings, or visual assessment 
278.6 	for deteriorated paint for nonabatement sites, and who is registered with the commissioner 
278.7 	under section 144.9505. 

278.8 	Sec. 11. Minnesota Statutes 2008, section 144.9501, subdivision 26a, is amended to 
278.9 	read:
278.10 		Subd. 26a.Regulated lead work. (a) "Regulated lead work" means:
278.11 	(1) abatement;
278.12 	(2) interim controls;
278.13 	(3) a clearance inspection;
278.14 	(4) a lead hazard screen;
278.15 	(5) a lead inspection;
278.16 	(6) a lead risk assessment;
278.17 	(7) lead project designer services;
278.18 	(8) lead sampling technician services; or
278.19 	(9) swab team services.;
278.20 	(10) renovation activities; or
278.21 	(11) activities performed to comply with lead orders issued by a board of health.
278.22 	(b) Regulated lead work does not include abatement, interim controls, swab team 
278.23 	services, or renovation activities that disturb painted surfaces that total no more than:
278.24 	(1) activities such as remodeling, renovation, installation, rehabilitation, or 
278.25 	landscaping activities, the primary intent of which is to remodel, repair, or restore a 
278.26 	structure or dwelling, rather than to permanently eliminate lead hazards, even though these 
278.27 	activities may incidentally result in a reduction in lead hazards; or
278.28 	(2) interim control activities that are not performed as a result of a lead order and 
278.29 	that do not disturb painted surfaces that total more than:
278.30 	(i) (1) 20 square feet (two square meters) on exterior surfaces; or
278.31 	(ii) (2)two six square feet (0.2 0.6 square meters) in an interior room; or.
278.32 	(iii) ten percent of the total surface area on an interior or exterior type of component 
278.33 	with a small surface area.

279.1 	Sec. 12. Minnesota Statutes 2008, section 144.9501, is amended by adding a 
279.2 	subdivision to read:
279.3 		Subd. 26b.Renovation. "Renovation" means the modification of any affected 
279.4 	property that results in the disturbance of painted surfaces, unless that activity is performed 
279.5 	as an abatement. A renovation performed for the purpose of converting a building or part 
279.6 	of a building into an affected property is a renovation under this subdivision.

279.7 	Sec. 13. Minnesota Statutes 2008, section 144.9505, subdivision 1g, is amended to 
279.8 	read:
279.9 		Subd. 1g.Certified lead firm. A person within the state intending to directly 
279.10 	perform or cause to be performed through subcontracting or similar delegation any 
279.11 	regulated lead work shall first obtain certification from the commissioner A person who 
279.12 	employs individuals to perform regulated lead work outside of the person's property must 
279.13 	obtain certification as a lead firm. The certificate must be in writing, contain an expiration 
279.14 	date, be signed by the commissioner, and give the name and address of the person to 
279.15 	whom it is issued. The certification fee is $100, is nonrefundable, and must be submitted 
279.16 	with each application. The certificate or a copy of the certificate must be readily available 
279.17 	at the worksite for review by the contracting entity, the commissioner, and other public 
279.18 	health officials charged with the health, safety, and welfare of the state's citizens.

279.19 	Sec. 14. Minnesota Statutes 2008, section 144.9505, subdivision 4, is amended to read:
279.20 		Subd. 4.Notice of regulated lead work. (a) At least five working days before 
279.21 	starting work at each regulated lead worksite, the person performing the regulated lead 
279.22 	work shall give written notice to the commissioner and the appropriate board of health.
279.23 	(b) This provision does not apply to lead hazard screen, lead inspection, lead risk 
279.24 	assessment, lead sampling technician, renovation, or lead project design activities.

279.25 	Sec. 15. Minnesota Statutes 2008, section 144.9508, subdivision 2, is amended to read:
279.26 		Subd. 2.Regulated lead work standards and methods. (a) The commissioner 
279.27 	shall adopt rules establishing regulated lead work standards and methods in accordance 
279.28 	with the provisions of this section, for lead in paint, dust, drinking water, and soil in 
279.29 	a manner that protects public health and the environment for all residences, including 
279.30 	residences also used for a commercial purpose, child care facilities, playgrounds, and 
279.31 	schools.
279.32 	(b) In the rules required by this section, the commissioner shall require lead hazard 
279.33 	reduction of intact paint only if the commissioner finds that the intact paint is on a 
280.1 	chewable or lead-dust producing surface that is a known source of actual lead exposure to 
280.2 	a specific individual. The commissioner shall prohibit methods that disperse lead dust into 
280.3 	the air that could accumulate to a level that would exceed the lead dust standard specified 
280.4 	under this section. The commissioner shall work cooperatively with the commissioner 
280.5 	of administration to determine which lead hazard reduction methods adopted under this 
280.6 	section may be used for lead-safe practices including prohibited practices, preparation, 
280.7 	disposal, and cleanup. The commissioner shall work cooperatively with the commissioner 
280.8 	of the Pollution Control Agency to develop disposal procedures. In adopting rules under 
280.9 	this section, the commissioner shall require the best available technology for regulated 
280.10 	lead work methods, paint stabilization, and repainting.
280.11 	(c) The commissioner of health shall adopt regulated lead work standards and 
280.12 	methods for lead in bare soil in a manner to protect public health and the environment. 
280.13 	The commissioner shall adopt a maximum standard of 100 parts of lead per million in 
280.14 	bare soil. The commissioner shall set a soil replacement standard not to exceed 25 parts 
280.15 	of lead per million. Soil lead hazard reduction methods shall focus on erosion control 
280.16 	and covering of bare soil.
280.17 	(d) The commissioner shall adopt regulated lead work standards and methods for 
280.18 	lead in dust in a manner to protect the public health and environment. Dust standards 
280.19 	shall use a weight of lead per area measure and include dust on the floor, on the window 
280.20 	sills, and on window wells. Lead hazard reduction methods for dust shall focus on dust 
280.21 	removal and other practices which minimize the formation of lead dust from paint, soil, or 
280.22 	other sources.
280.23 	(e) The commissioner shall adopt lead hazard reduction standards and methods for 
280.24 	lead in drinking water both at the tap and public water supply system or private well 
280.25 	in a manner to protect the public health and the environment. The commissioner may 
280.26 	adopt the rules for controlling lead in drinking water as contained in Code of Federal 
280.27 	Regulations, title 40, part 141. Drinking water lead hazard reduction methods may include 
280.28 	an educational approach of minimizing lead exposure from lead in drinking water.
280.29 	(f) The commissioner of the Pollution Control Agency shall adopt rules to ensure that 
280.30 	removal of exterior lead-based coatings from residences and steel structures by abrasive 
280.31 	blasting methods is conducted in a manner that protects health and the environment.
280.32 	(g) All regulated lead work standards shall provide reasonable margins of safety that 
280.33 	are consistent with more than a summary review of scientific evidence and an emphasis on 
280.34 	overprotection rather than underprotection when the scientific evidence is ambiguous.
280.35 	(h) No unit of local government shall have an ordinance or regulation governing 
280.36 	regulated lead work standards or methods for lead in paint, dust, drinking water, or soil 
281.1 	that require a different regulated lead work standard or method than the standards or 
281.2 	methods established under this section.
281.3 	(i) Notwithstanding paragraph (h), the commissioner may approve the use by a unit 
281.4 	of local government of an innovative lead hazard reduction method which is consistent 
281.5 	in approach with methods established under this section.
281.6 	(j) The commissioner shall adopt rules for issuing lead orders required under section 
281.7 	144.9504, rules for notification of abatement or interim control activities requirements, 
281.8 	and other rules necessary to implement sections 144.9501 to 144.9512. 
281.9 	(k) The commissioners shall adopt rules consistent with section 402(c)(3) of the 
281.10 	Toxic Substances Control Act to ensure that renovation is a pre-1978 affected property 
281.11 	where a child or pregnant female resides is conducted in a manner that protects health 
281.12 	and the environment.
281.13 	(l) The commissioner shall adopt rules consistent with sections 406(a) and 406(b) of 
281.14 	the Toxic Substances Control Act.

281.15 	Sec. 16. Minnesota Statutes 2008, section 144.9508, subdivision 3, is amended to read:
281.16 		Subd. 3.Licensure and certification. The commissioner shall adopt rules to 
281.17 	license lead supervisors, lead workers, lead project designers, lead inspectors, and lead 
281.18 	risk assessors, and lead sampling technicians. The commissioner shall also adopt rules 
281.19 	requiring certification of firms that perform regulated lead work and rules requiring 
281.20 	registration of lead sampling technicians. The commissioner shall require periodic renewal 
281.21 	of licenses, and certificates, and registrations and shall establish the renewal periods.

281.22 	Sec. 17. Minnesota Statutes 2008, section 144.9508, subdivision 4, is amended to read:
281.23 		Subd. 4.Lead training course. The commissioner shall establish by rule 
281.24 	requirements for training course providers and the renewal period for each lead-related 
281.25 	training course required for certification or licensure. The commissioner shall establish 
281.26 	criteria in rules for the content and presentation of training courses intended to qualify 
281.27 	trainees for licensure under subdivision 3. The commissioner shall establish criteria 
281.28 	in rules for the content and presentation of training courses for lead interim control 
281.29 	workers renovation and lead sampling technicians. Training course permit fees shall be 
281.30 	nonrefundable and must be submitted with each application in the amount of $500 for an 
281.31 	initial training course, $250 for renewal of a permit for an initial training course, $250 for 
281.32 	a refresher training course, and $125 for renewal of a permit of a refresher training course.

281.33 	Sec. 18. Minnesota Statutes 2008, section 144.97, subdivision 2, is amended to read:
282.1 		Subd. 2.Certification Accreditation. "Certification" means written 
282.2 	acknowledgment of a laboratory's demonstrated capability to perform tests for a specific 
282.3 	purpose "Accreditation" means written acknowledgment that a laboratory has the 
282.4 	policies, procedures, equipment, and practices to produce reliable data in the analysis of 
282.5 	environmental samples.

282.6 	EFFECTIVE DATE. This section is effective July 1, 2009.

282.7 	Sec. 19. Minnesota Statutes 2008, section 144.97, subdivision 4, is amended to read:
282.8 		Subd. 4.ContractCommercial laboratory. "Contract Commercial laboratory" 
282.9 	means a laboratory that performs tests on samples on a contract or fee-for-service basis.

282.10 	EFFECTIVE DATE. This section is effective July 1, 2009.

282.11 	Sec. 20. Minnesota Statutes 2008, section 144.97, is amended by adding a subdivision 
282.12 	to read:
282.13 		Subd. 5a.Field of testing. "Field of testing" means the combination of analyte, 
282.14 	method, matrix, and test category for which a laboratory may hold accreditation.

282.15 	EFFECTIVE DATE. This section is effective July 1, 2009.

282.16 	Sec. 21. Minnesota Statutes 2008, section 144.97, subdivision 6, is amended to read:
282.17 		Subd. 6.Laboratory. "Laboratory" means the state, a person, corporation, or other 
282.18 	entity, including governmental, that examines, analyzes, or tests samples in a specified 
282.19 	physical location.

282.20 	EFFECTIVE DATE. This section is effective July 1, 2009.

282.21 	Sec. 22. Minnesota Statutes 2008, section 144.97, is amended by adding a subdivision 
282.22 	to read:
282.23 		Subd. 8.Test category. "Test category" means the combination of program and 
282.24 	category as provided by section 144.98, subdivisions 3, paragraph (b), clauses (1) to (10), 
282.25 	and 3a, paragraph (a), clauses (1) to (5).

282.26 	EFFECTIVE DATE. This section is effective July 1, 2009.

282.27 	Sec. 23. Minnesota Statutes 2008, section 144.98, subdivision 1, is amended to read:
282.28 		Subdivision 1.Authorization. The commissioner of health may certify shall 
282.29 	accredit environmental laboratories that test environmental samples according to national 
283.1 	standards developed using a consensus process as established by Circular A-119, 
283.2 	published by the United States Office of Management and Budget.

283.3 	EFFECTIVE DATE. This section is effective July 1, 2009.

283.4 	Sec. 24. Minnesota Statutes 2008, section 144.98, subdivision 2, is amended to read:
283.5 		Subd. 2.Rules and standards. The commissioner may adopt rules to implement 
283.6 	this section, including: carry out the commissioner's responsibilities under the national 
283.7 	standards specified in subdivisions 1 and 2a.
283.8 	(1) procedures, requirements, and fee adjustments for laboratory certification, 
283.9 	including provisional status and recertification;
283.10 	(2) standards and fees for certificate approval, suspension, and revocation;
283.11 	(3) standards for environmental samples;
283.12 	(4) analysis methods that assure reliable test results;
283.13 	(5) laboratory quality assurance, including internal quality control, proficiency 
283.14 	testing, and personnel training; and
283.15 	(6) criteria for recognition of certification programs of other states and the federal 
283.16 	government.

283.17 	EFFECTIVE DATE. This section is effective July 1, 2009.

283.18 	Sec. 25. Minnesota Statutes 2008, section 144.98, is amended by adding a subdivision 
283.19 	to read:
283.20 		Subd. 2a.Standards. The commissioner shall accredit laboratories according to 
283.21 	the most current environmental laboratory accreditation standards under subdivision 1 
283.22 	and as accepted by the accreditation bodies recognized by the National Environmental 
283.23 	Laboratory Accreditation Program, NELAP, of the NELAC Institute.

283.24 	EFFECTIVE DATE. This section is effective July 1, 2009.

283.25 	Sec. 26. Minnesota Statutes 2008, section 144.98, subdivision 3, is amended to read:
283.26 		Subd. 3.Annual fees. (a) An application for certification accreditation under 
283.27 	subdivision 1 6 must be accompanied by the biennial fee annual fees specified in this 
283.28 	subdivision. The fees are for annual fees include:
283.29 	(1) base certification accreditation fee, $1,600 $1,500;
283.30 	(2) sample preparation techniques fees fee, $100 $200 per technique; and
283.31 	(3) an administrative fee for laboratories located outside this state, $3,750; and
283.32 	(4) test category certification fees:.

284.1
284.2	Test Category
	Certification 
Fee
	
284.3	Clean water program bacteriology
	$800
	
284.4	Safe drinking water program bacteriology
	$800
	
284.5	Clean water program inorganic chemistry
	$800
	
284.6	Safe drinking water program inorganic chemistry
	$800
	
284.7	Clean water program chemistry metals
	$1,200
	
284.8	Safe drinking water program chemistry metals
	$1,200
	
284.9	Resource conservation and recovery program chemistry metals
	$1,200
	
284.10	Clean water program volatile organic compounds
	$1,500
	
284.11	Safe drinking water program volatile organic compounds
	$1,500
	
284.12	Resource conservation and recovery program volatile organic compounds
	$1,500
	
284.13	Underground storage tank program volatile organic compounds
	$1,500
	
284.14	Clean water program other organic compounds
	$1,500
	
284.15	Safe drinking water program other organic compounds
	$1,500
	
284.16	Resource conservation and recovery program other organic compounds
	$1,500
	
284.17	Clean water program radiochemistry
	$2,500
	
284.18	Safe drinking water program radiochemistry
	$2,500
	
284.19	Resource conservation and recovery program agricultural contaminants
	$2,500
	
284.20	Resource conservation and recovery program emerging contaminants
	$2,500
	
284.21 	(b) Laboratories located outside of this state that require an on-site inspection shall be 
284.22 	assessed an additional $3,750 fee. For the programs in subdivision 3a, the commissioner 
284.23 	may accredit laboratories for fields of testing under the categories listed in clauses (1) to 
284.24 	(10) upon completion of the application requirements provided by subdivision 6 and 
284.25 	receipt of the fees for each category under each program that accreditation is requested. 
284.26 	The categories offered and related fees include:
284.27 	(1) microbiology, $450;
284.28 	(2) inorganics, $450;
284.29 	(3) metals, $1,000;
284.30 	(4) volatile organics, $1,300;
284.31 	(5) other organics, $1,300;
284.32 	(6) radiochemistry, $1,500;
284.33 	(7) emerging contaminants, $1,500;
284.34 	(8) agricultural contaminants, $1,250;
284.35 	(9) toxicity (bioassay), $1,000; and
284.36 	(10) physical characterization, $250.
284.37 	(c) The total biennial certification annual fee includes the base fee, the sample 
284.38 	preparation techniques fees, the test category fees per program, and, when applicable, the 
284.39 	on-site inspection fee an administrative fee for out-of-state laboratories.
285.1 	(d) Fees must be set so that the total fees support the laboratory certification program. 
285.2 	Direct costs of the certification service include program administration, inspections, the 
285.3 	agency's general support costs, and attorney general costs attributable to the fee function.
285.4 	(e) A change fee shall be assessed if a laboratory requests additional analytes 
285.5 	or methods at any time other than when applying for or renewing its certification. The 
285.6 	change fee is equal to the test category certification fee for the analyte.
285.7 	(f) A variance fee shall be assessed if a laboratory requests and is granted a variance 
285.8 	from a rule adopted under this section. The variance fee is $500 per variance.
285.9 	(g) Refunds or credits shall not be made for analytes or methods requested but 
285.10 	not approved.
285.11 	(h) Certification of a laboratory shall not be awarded until all fees are paid.

285.12 	Sec. 27. Minnesota Statutes 2008, section 144.98, is amended by adding a subdivision 
285.13 	to read:
285.14 		Subd. 3a.Available programs, categories, and analytes. (a) The commissioner 
285.15 	shall accredit laboratories that test samples under the following programs:
285.16 	(1) the clean water program, such as compliance monitoring under the federal Clean 
285.17 	Water Act, and ambient monitoring of surface and ground water, or analysis of biological 
285.18 	tissue;
285.19 	(2) the safe drinking water program, including compliance monitoring under the 
285.20 	federal Safe Drinking Water Act, and the state requirements for monitoring private wells;
285.21 	(3) the resource conservation and recovery program, including federal and state 
285.22 	requirements for monitoring solid and hazardous wastes, biological tissue, leachates, and 
285.23 	ground water monitoring wells not intended as drinking water sources;
285.24 	(4) the underground storage tank program; and
285.25 	(5) the clean air program, including air and emissions testing under the federal Clean 
285.26 	Air Act, and state and federal requirements for vapor intrusion monitoring.
285.27 	(b) The commissioner shall maintain and publish a list of analytes available for 
285.28 	accreditation. The list must be reviewed at least once every six months and the changes 
285.29 	published in the State Register and posted on the program's Web site. The commissioner 
285.30 	shall publish the notification of changes and review comments on the changes no less than 
285.31 	30 days from the date the list is published.

285.32 	Sec. 28. Minnesota Statutes 2008, section 144.98, is amended by adding a subdivision 
285.33 	to read:
286.1 		Subd. 3b.Additional fees. (a) Laboratories located outside of this state that require 
286.2 	an on-site assessment more frequent than once every two years must pay an additional 
286.3 	assessed fee of $3,000 per assessment for each additional on-site assessment conducted. 
286.4 	The laboratory must pay the fee within 15 business days of receiving the commissioner's 
286.5 	notification that an on-site assessment is required. The commissioner may conduct 
286.6 	additional on-site assessments to determine a laboratory's continued compliance with 
286.7 	the standards provided in subdivision 2a.
286.8 	(b) A late fee of $200 shall be added to the annual fee for accredited laboratories 
286.9 	submitting renewal applications to the commissioner after November 1.
286.10 	(c) A change fee shall be assessed if a laboratory requests additional fields of testing 
286.11 	at any time other than when initially applying for or renewing its accreditation. A change 
286.12 	fee does not apply for applications to add fields of testing for new analytes in response 
286.13 	to the published notice under subdivision 3a, paragraph (b), if the laboratory holds valid 
286.14 	accreditation for the changed test category and applies for additional analytes within the 
286.15 	same test category. The change fee is equal to the applicable test category fee for the 
286.16 	field of testing requested.  An application that requests accreditation of multiple fields of 
286.17 	testing within a test category requires a single payment of the applicable test category fee 
286.18 	per application submitted.
286.19 	(d) A variance fee shall be assessed if a laboratory requests a variance from a 
286.20 	standard provided in subdivision 2a. The variance fee is $500 per variance.
286.21 	(e) The commissioner shall assess a fee for changes to laboratory information 
286.22 	regarding ownership, name, address, or personnel. Laboratories must submit changes 
286.23 	through the application process under subdivision 6. The information update fee is $250 
286.24 	per application.
286.25 	(f) Fees must be set so that the total fees support the laboratory accreditation 
286.26 	program.  Direct costs of the accreditation service include program administration, 
286.27 	assessments, the agency's general support costs, and attorney general costs attributable 
286.28 	to the fee function.

286.29 	Sec. 29. Minnesota Statutes 2008, section 144.98, is amended by adding a subdivision 
286.30 	to read:
286.31 		Subd. 3c.Refunds and nonpayment. Refunds or credits shall not be made for 
286.32 	applications received but not approved. Accreditation of a laboratory shall not be awarded 
286.33 	until all fees are paid.

287.1 	Sec. 30. Minnesota Statutes 2008, section 144.98, is amended by adding a subdivision 
287.2 	to read:
287.3 		Subd. 6.Application. (a) Laboratories seeking accreditation must apply on a form 
287.4 	provided by the commissioner, include the laboratory's procedures and quality manual, 
287.5 	and pay the applicable fees.
287.6 	(b) Laboratories may be fixed-base or mobile. The commissioner shall accredit 
287.7 	mobile laboratories individually and require a vehicle identification number, license 
287.8 	plate number, or other uniquely identifying information in addition to the application 
287.9 	requirements of paragraph (a).
287.10 	(c) Laboratories maintained on separate properties, even though operated under the 
287.11 	same management or ownership, must apply separately. Laboratories with more than one 
287.12 	building on the same or adjoining properties do not need to submit a separate application.
287.13 	(d) The commissioner may accredit laboratories located out-of-state. Accreditation 
287.14 	for out-of-state laboratories may be obtained directly from the commissioner following 
287.15 	the requirements in paragraph (a), or out-of-state laboratories may be accredited through 
287.16 	a reciprocal agreement if the laboratory:
287.17 	(1) is accredited by a NELAP-recognized accreditation body for those fields of 
287.18 	testing in which the laboratory requests accreditation from the commissioner;
287.19 	(2) submits an application and documentation according to this subdivision; and
287.20 	(3) submits a current copy of the laboratory's unexpired accreditation from a 
287.21 	NELAP-recognized accreditation body showing the fields of accreditation for which the 
287.22 	laboratory is currently accredited.
287.23 	(e) Under the conflict of interest determinations provided in section 43A.38, 
287.24 	subdivision 6, clause (a), the commissioner shall not accredit governmental laboratories 
287.25 	operated by agencies of the executive branch of the state. If accreditation is required, 
287.26 	laboratories operated by agencies of the executive branch of the state must apply for 
287.27 	accreditation through any other NELAP-recognized accreditation body.

287.28 	EFFECTIVE DATE. This section is effective July 1, 2009.

287.29 	Sec. 31. Minnesota Statutes 2008, section 144.98, is amended by adding a subdivision 
287.30 	to read:
287.31 		Subd. 6a.Implementation and effective date. All laboratories must comply with 
287.32 	standards under this section by July 1, 2009. Fees under subdivisions 3 and 3b apply to 
287.33 	applications received and accreditations issued after June 30, 2009. Accreditations issued 
287.34 	on or after June 30, 2009, shall expire upon their current expiration date.

288.1 	Sec. 32. Minnesota Statutes 2008, section 144.98, is amended by adding a subdivision 
288.2 	to read:
288.3 		Subd. 7.Initial accreditation and annual accreditation renewal. (a) The 
288.4 	commissioner shall issue or renew accreditation after receipt of the completed application 
288.5 	and documentation required in this section, provided the laboratory maintains compliance 
288.6 	with the standards specified in subdivision 2a, and attests to the compliance on the 
288.7 	application form.
288.8 	(b) The commissioner shall prorate the fees in subdivision 3 for laboratories 
288.9 	applying for accreditation after December 31. The fees are prorated on a quarterly basis 
288.10 	beginning with the quarter in which the commissioner receives the completed application 
288.11 	from the laboratory.
288.12 	(c) Applications for renewal of accreditation must be received by November 1 and 
288.13 	no earlier than October 1 of each year. The commissioner shall send annual renewal 
288.14 	notices to laboratories 90 days before expiration. Failure to receive a renewal notice does 
288.15 	not exempt laboratories from meeting the annual November 1 renewal date.
288.16 	(d) The commissioner shall issue all accreditations for the calendar year for which 
288.17 	the application is made, and the accreditation shall expire on December 31 of that year.
288.18 	(e) The accreditation of any laboratory that fails to submit a renewal application 
288.19 	and fees to the commissioner expires automatically on December 31 without notice or 
288.20 	further proceeding. Any person who operates a laboratory as accredited after expiration of 
288.21 	accreditation or without having submitted an application and paid the fees is in violation 
288.22 	of the provisions of this section and is subject to enforcement action under sections 
288.23 	144.989 to 144.993, the Health Enforcement Consolidation Act. A laboratory with expired 
288.24 	accreditation may reapply under subdivision 6.

288.25 	EFFECTIVE DATE. This section is effective July 1, 2009.

288.26 	Sec. 33. Minnesota Statutes 2008, section 144.99, subdivision 1, is amended to read:
288.27 		Subdivision 1.Remedies available. The provisions of chapters 103I and 157 and 
288.28 	sections 115.71 to 115.77; 144.12, subdivision 1, paragraphs (1), (2), (5), (6), (10), (12), 
288.29 	(13), (14), and (15); 144.1201 to 144.1204; 144.121; 144.1222; 144.35; 144.381 to 
288.30 	144.385; 144.411 to 144.417; 144.495; 144.71 to 144.74; 144.9501 to 144.9512; 144.992; 
288.31 	144.97 to 144.98; 326.70 to 326.785; 327.10 to 327.131; and 327.14 to 327.28 and all 
288.32 	rules, orders, stipulation agreements, settlements, compliance agreements, licenses, 
288.33 	registrations, certificates, and permits adopted or issued by the department or under any 
288.34 	other law now in force or later enacted for the preservation of public health may, in 
288.35 	addition to provisions in other statutes, be enforced under this section. 

289.1 	EFFECTIVE DATE. This section is effective July 1, 2009.

289.2 	Sec. 34. Minnesota Statutes 2008, section 148.6445, is amended by adding a 
289.3 	subdivision to read:
289.4 		Subd. 2a.Duplicate license fee. The fee for a duplicate license is $25.

289.5 	Sec. 35. Minnesota Statutes 2008, section 153A.17, is amended to read:
289.6 	153A.17 EXPENSES; FEES.
289.7 	The expenses for administering the certification requirements including the 
289.8 	complaint handling system for hearing aid dispensers in sections 153A.14 and 153A.15
289.9 	and the Consumer Information Center under section 153A.18 must be paid from initial 
289.10 	application and examination fees, renewal fees, penalties, and fines. All fees are 
289.11 	nonrefundable. The initial and annual renewal certificate application fee is $350 $700, 
289.12 	the examination fee is $250 $500 for the written portion and $250 $500 for the practical 
289.13 	portion each time one or the other is taken, and. For persons meeting the requirements of 
289.14 	section 148.515, subdivision 2, the fee for the practical portion of the hearing instrument 
289.15 	dispensing examination is $250 each time it is taken. The trainee application fee is 
289.16 	$200. Effective July 1, 2009, a surcharge of $550 shall be paid at the time of certification 
289.17 	application or renewal until June 30, 2011, to recover the commissioner's accumulated 
289.18 	direct expenditures for administering the requirements of this chapter. The penalty fee for 
289.19 	late submission of a renewal application is $200. The fee for verification of certification 
289.20 	to other jurisdictions or entities is $25. All fees, penalties, and fines received must be 
289.21 	deposited in the state government special revenue fund. The commissioner may prorate 
289.22 	the certification fee for new applicants based on the number of quarters remaining in 
289.23 	the annual certification period.  

289.24 	Sec. 36. Minnesota Statutes 2008, section 157.15, is amended by adding a subdivision 
289.25 	to read:
289.26 		Subd. 20.Youth camp. "Youth camp" has the meaning given in section 144.71, 
289.27 	subdivision 2.

289.28 	Sec. 37. Minnesota Statutes 2008, section 157.16, is amended to read:
289.29 	157.16 LICENSES REQUIRED; FEES. 
289.30 		Subdivision 1. License required annually. A license is required annually for every 
289.31 	person, firm, or corporation engaged in the business of conducting a food and beverage 
289.32 	service establishment, youth camp, hotel, motel, lodging establishment, public pool, or 
290.1 	resort. Any person wishing to operate a place of business licensed in this section shall 
290.2 	first make application, pay the required fee specified in this section, and receive approval 
290.3 	for operation, including plan review approval. Seasonal and temporary food stands and
290.4 	Special event food stands are not required to submit plans. Nonprofit organizations 
290.5 	operating a special event food stand with multiple locations at an annual one-day event 
290.6 	shall be issued only one license. Application shall be made on forms provided by the 
290.7 	commissioner and shall require the applicant to state the full name and address of the 
290.8 	owner of the building, structure, or enclosure, the lessee and manager of the food and 
290.9 	beverage service establishment, hotel, motel, lodging establishment, public pool, or resort; 
290.10 	the name under which the business is to be conducted; and any other information as may 
290.11 	be required by the commissioner to complete the application for license. 
290.12 		Subd. 2. License renewal. Initial and renewal licenses for all food and beverage 
290.13 	service establishments, youth camps, hotels, motels, lodging establishments, public pools, 
290.14 	and resorts shall be issued for the calendar year for which application is made and shall 
290.15 	expire on December 31 of such year on an annual basis. Any person who operates a place 
290.16 	of business after the expiration date of a license or without having submitted an application 
290.17 	and paid the fee shall be deemed to have violated the provisions of this chapter and shall 
290.18 	be subject to enforcement action, as provided in the Health Enforcement Consolidation 
290.19 	Act, sections 144.989 to 144.993. In addition, a penalty of $50 $60 shall be added to the 
290.20 	total of the license fee for any food and beverage service establishment operating without 
290.21 	a license as a mobile food unit, a seasonal temporary or seasonal permanent food stand, or 
290.22 	a special event food stand, and a penalty of $100 $120 shall be added to the total of the 
290.23 	license fee for all restaurants, food carts, hotels, motels, lodging establishments, youth 
290.24 	camps, public pools, and resorts operating without a license for a period of up to 30 days. 
290.25 	A late fee of $300 $360 shall be added to the license fee for establishments operating more 
290.26 	than 30 days without a license. 
290.27 		Subd. 2a. Food manager certification. An applicant for certification or certification 
290.28 	renewal as a food manager must submit to the commissioner a $28 $35 nonrefundable 
290.29 	certification fee payable to the Department of Health. The commissioner shall issue a 
290.30 	duplicate certificate to replace a lost, destroyed, or mutilated certificate if the applicant 
290.31 	submits a completed application on a form provided by the commissioner for a duplicate 
290.32 	certificate and pays $20 to the department for the cost of duplication.
290.33 		Subd. 3. Establishment fees; definitions. (a) The following fees are required 
290.34 	for food and beverage service establishments, youth camps, hotels, motels, lodging 
290.35 	establishments, public pools, and resorts licensed under this chapter. Food and beverage 
290.36 	service establishments must pay the highest applicable fee under paragraph (d), clause 
291.1 	(1), (2), (3), or (4), and establishments serving alcohol must pay the highest applicable 
291.2 	fee under paragraph (d), clause (6) or (7). The license fee for new operators previously 
291.3 	licensed under this chapter for the same calendar year is one-half of the appropriate annual 
291.4 	license fee, plus any penalty that may be required. The license fee for operators opening 
291.5 	on or after October 1 is one-half of the appropriate annual license fee, plus any penalty 
291.6 	that may be required. 
291.7 	(b) All food and beverage service establishments, except special event food stands, 
291.8 	and all hotels, motels, lodging establishments, public pools, and resorts shall pay an 
291.9 	annual base fee of $150. 
291.10 	(c) A special event food stand shall pay a flat fee of $40 $50 annually. "Special event 
291.11 	food stand" means a fee category where food is prepared or served in conjunction with 
291.12 	celebrations, county fairs, or special events from a special event food stand as defined 
291.13 	in section 157.15. 
291.14 	(d) In addition to the base fee in paragraph (b), each food and beverage service 
291.15 	establishment, other than a special event food stand, and each hotel, motel, lodging 
291.16 	establishment, public pool, and resort shall pay an additional annual fee for each fee 
291.17 	category, additional food service, or required additional inspection specified in this 
291.18 	paragraph: 
291.19 	(1) Limited food menu selection, $50 $60. "Limited food menu selection" means a 
291.20 	fee category that provides one or more of the following: 
291.21 	(i) prepackaged food that receives heat treatment and is served in the package; 
291.22 	(ii) frozen pizza that is heated and served; 
291.23 	(iii) a continental breakfast such as rolls, coffee, juice, milk, and cold cereal; 
291.24 	(iv) soft drinks, coffee, or nonalcoholic beverages; or 
291.25 	(v) cleaning for eating, drinking, or cooking utensils, when the only food served 
291.26 	is prepared off site. 
291.27 	(2) Small establishment, including boarding establishments, $100 $120. "Small 
291.28 	establishment" means a fee category that has no salad bar and meets one or more of 
291.29 	the following: 
291.30 	(i) possesses food service equipment that consists of no more than a deep fat fryer, a 
291.31 	grill, two hot holding containers, and one or more microwave ovens; 
291.32 	(ii) serves dipped ice cream or soft serve frozen desserts; 
291.33 	(iii) serves breakfast in an owner-occupied bed and breakfast establishment; 
291.34 	(iv) is a boarding establishment; or 
291.35 	(v) meets the equipment criteria in clause (3), item (i) or (ii), and has a maximum 
291.36 	patron seating capacity of not more than 50. 
292.1 	(3) Medium establishment, $260 $310. "Medium establishment" means a fee 
292.2 	category that meets one or more of the following: 
292.3 	(i) possesses food service equipment that includes a range, oven, steam table, salad 
292.4 	bar, or salad preparation area; 
292.5 	(ii) possesses food service equipment that includes more than one deep fat fryer, 
292.6 	one grill, or two hot holding containers; or 
292.7 	(iii) is an establishment where food is prepared at one location and served at one or 
292.8 	more separate locations. 
292.9 	Establishments meeting criteria in clause (2), item (v), are not included in this fee 
292.10 	category. 
292.11 	(4) Large establishment, $460 $540. "Large establishment" means either: 
292.12 	(i) a fee category that (A) meets the criteria in clause (3), items (i) or (ii), for a 
292.13 	medium establishment, (B) seats more than 175 people, and (C) offers the full menu 
292.14 	selection an average of five or more days a week during the weeks of operation; or 
292.15 	(ii) a fee category that (A) meets the criteria in clause (3), item (iii), for a medium 
292.16 	establishment, and (B) prepares and serves 500 or more meals per day. 
292.17 	(5) Other food and beverage service, including food carts, mobile food units, 
292.18 	seasonal temporary food stands, and seasonal permanent food stands, $50 $60. 
292.19 	(6) Beer or wine table service, $50 $60. "Beer or wine table service" means a fee 
292.20 	category where the only alcoholic beverage service is beer or wine, served to customers 
292.21 	seated at tables. 
292.22 	(7) Alcoholic beverage service, other than beer or wine table service, $135 $165. 
292.23 	"Alcohol beverage service, other than beer or wine table service" means a fee 
292.24 	category where alcoholic mixed drinks are served or where beer or wine are served from 
292.25 	a bar. 
292.26 	(8) Lodging per sleeping accommodation unit, $8 $10, including hotels, motels, 
292.27 	lodging establishments, and resorts, up to a maximum of $800 $1,000. "Lodging per 
292.28 	sleeping accommodation unit" means a fee category including the number of guest rooms, 
292.29 	cottages, or other rental units of a hotel, motel, lodging establishment, or resort; or the 
292.30 	number of beds in a dormitory. 
292.31 	(9) First public pool, $180 $325; each additional public pool, $100 $175. "Public 
292.32 	pool" means a fee category that has the meaning given in section 144.1222, subdivision 4. 
292.33 	(10) First spa, $110 $175; each additional spa, $50 $100. "Spa pool" means a fee 
292.34 	category that has the meaning given in Minnesota Rules, part 4717.0250, subpart 9. 
292.35 	(11) Private sewer or water, $50 $60. "Individual private water" means a fee 
292.36 	category with a water supply other than a community public water supply as defined in 
293.1 	Minnesota Rules, chapter 4720. "Individual private sewer" means a fee category with an 
293.2 	individual sewage treatment system which uses subsurface treatment and disposal. 
293.3 	(12) Additional food service, $130 $150. "Additional food service" means a location 
293.4 	at a food service establishment, other than the primary food preparation and service area, 
293.5 	used to prepare or serve food to the public. 
293.6 	(13) Additional inspection fee, $300 $360. "Additional inspection fee" means a 
293.7 	fee to conduct the second inspection each year for elementary and secondary education 
293.8 	facility school lunch programs when required by the Richard B. Russell National School 
293.9 	Lunch Act. 
293.10 	(e) A fee of $350 for review of the construction plans must accompany the initial 
293.11 	license application for restaurants, hotels, motels, lodging establishments, or resorts with 
293.12 	five or more sleeping units., seasonal food stands, and mobile food units. The fee for 
293.13 	this construction plan review is as follows:

293.14	Service Area
	Type
	Fee
	
293.15	Food
	limited food menu
	$275
	
293.16		small establishment
	$400
	
293.17		medium establishment
	$450
	
293.18		large food establishment
	$500
	
293.19		additional food service
	$150
	
293.20	Transient food service
	food cart
	$250
	
293.21		seasonal permanent food stand
	$250
	
293.22		seasonal temporary food stand
	$250
	
293.23		mobile food unit
	$350
	
293.24	Alcohol
	beer or wine table service
	$150
	
293.25		alcohol service from bar
	$250
	
293.26	Lodging
	< 25 rooms
	$375
	
293.27		≥ 25 to < 100 rooms
	$400
	
293.28		≥ 100 rooms
	$500

293.29		< five cabins
	$350
	
293.30		≥ five to < ten cabins
	$400
	
293.31		≥ ten cabins
	$450
	
293.32 	(f) When existing food and beverage service establishments, hotels, motels, lodging 
293.33 	establishments, or resorts, seasonal food stands, and mobile food units are extensively 
293.34 	remodeled, a fee of $250 must be submitted with the remodeling plans. A fee of $250 
293.35 	must be submitted for new construction or remodeling for a restaurant with a limited food 
293.36 	menu selection, a seasonal permanent food stand, a mobile food unit, or a food cart, or for 
293.37 	a hotel, motel, resort, or lodging establishment addition of less than five sleeping units.
293.38 	The fee for this construction plan review is as follows:

294.1	Service Area
	Type
	Fee
	
294.2	Food
	limited food menu
	$250
	
294.3		small establishment
	$300
	
294.4		medium establishment
	$350
	
294.5		large food establishment
	$400
	
294.6		additional food service
	$150
	
294.7	Transient food service
	food cart
	$250
	
294.8		seasonal permanent food stand
	$250
	
294.9		seasonal temporary food stand
	$250
	
294.10		mobile food unit
	$250
	
294.11	Alcohol
	beer or wine table service
	$150
	
294.12		alcohol service from bar
	$250
	
294.13	Lodging
	< 25 rooms
	$250
	
294.14		≥ 25 to < 100 rooms
	$300
	
294.15		≥ 100 rooms
	$450

294.16		< five cabins
	$250
	
294.17		≥ five to < ten cabins
	$350
	
294.18		≥ ten cabins
	$400
	
294.19 	(g) Seasonal temporary food stands and Special event food stands are not required to 
294.20 	submit construction or remodeling plans for review. 
294.21 	(h) Youth camp fee, $500.
294.22 		Subd. 3a. Statewide hospitality fee. Every person, firm, or corporation that 
294.23 	operates a licensed boarding establishment, food and beverage service establishment, 
294.24 	seasonal temporary or permanent food stand, special event food stand, mobile food unit, 
294.25 	food cart, resort, hotel, motel, or lodging establishment in Minnesota must submit to the 
294.26 	commissioner a $35 annual statewide hospitality fee for each licensed activity. The fee 
294.27 	for establishments licensed by the Department of Health is required at the same time the 
294.28 	licensure fee is due. For establishments licensed by local governments, the fee is due by 
294.29 	July 1 of each year. 
294.30 		Subd. 4. Posting requirements. Every food and beverage service establishment,
294.31 	youth camp, hotel, motel, lodging establishment, public pool, or resort must have the 
294.32 	license posted in a conspicuous place at the establishment. Mobile food units, food carts, 
294.33 	and seasonal temporary food stands shall be issued decals with the initial license and each 
294.34 	calendar year with license renewals. The current license year decal must be placed on the 
294.35 	unit or stand in a location determined by the commissioner. Decals are not transferable.

294.36 	Sec. 38. Minnesota Statutes 2008, section 157.22, is amended to read:
294.37 	157.22 EXEMPTIONS.
295.1 	This chapter shall not be construed to does not apply to:
295.2 	(1) interstate carriers under the supervision of the United States Department of 
295.3 	Health and Human Services;
295.4 	(2) any building constructed and primarily used for religious worship;
295.5 	(3) any building owned, operated, and used by a college or university in accordance 
295.6 	with health regulations promulgated by the college or university under chapter 14;
295.7 	(4) any person, firm, or corporation whose principal mode of business is licensed 
295.8 	under sections 28A.04 and 28A.05, is exempt at that premises from licensure as a food 
295.9 	or beverage establishment; provided that the holding of any license pursuant to sections 
295.10 	28A.04 and 28A.05 shall not exempt any person, firm, or corporation from the applicable 
295.11 	provisions of this chapter or the rules of the state commissioner of health relating to 
295.12 	food and beverage service establishments;  
295.13 	(5) family day care homes and group family day care homes governed by sections 
295.14 	245A.01 to 245A.16;  
295.15 	(6) nonprofit senior citizen centers for the sale of home-baked goods;
295.16 	(7) fraternal or patriotic organizations that are tax exempt under section 501(c)(3), 
295.17 	501(c)(4), 501(c)(6), 501(c)(7), 501(c)(10), or 501(c)(19) of the Internal Revenue Code of 
295.18 	1986, or organizations related to or affiliated with such fraternal or patriotic organizations. 
295.19 	Such organizations may organize events at which home-prepared food is donated by 
295.20 	organization members for sale at the events, provided:
295.21 	(i) the event is not a circus, carnival, or fair;
295.22 	(ii) the organization controls the admission of persons to the event, the event agenda, 
295.23 	or both; and
295.24 	(iii) the organization's licensed kitchen is not used in any manner for the event;
295.25 	(8) food not prepared at an establishment and brought in by individuals attending a 
295.26 	potluck event for consumption at the potluck event. An organization sponsoring a potluck 
295.27 	event under this clause may advertise the potluck event to the public through any means. 
295.28 	Individuals who are not members of an organization sponsoring a potluck event under this 
295.29 	clause may attend the potluck event and consume the food at the event. Licensed food 
295.30 	establishments other than schools cannot be sponsors of potluck events. A school may 
295.31 	sponsor and hold potluck events in areas of the school other than the school's kitchen, 
295.32 	provided that the school's kitchen is not used in any manner for the potluck event. For 
295.33 	purposes of this clause, "school" means a public school as defined in section 120A.05, 
295.34 	subdivisions 9, 11, 13, and 17, or a nonpublic school, church, or religious organization 
295.35 	at which a child is provided with instruction in compliance with sections 120A.22 and 
296.1 	120A.24. Potluck event food shall not be brought into a licensed food establishment 
296.2 	kitchen; and
296.3 	(9) a home school in which a child is provided instruction at home.; and
296.4 	(10) concession stands operated in conjunction with school-sponsored events on 
296.5 	school property are exempt from the 21-day restriction.

296.6 	Sec. 39. Minnesota Statutes 2008, section 327.14, is amended by adding a subdivision 
296.7 	to read:
296.8 		Subd. 9.Special event recreational camping area. "Special event recreational 
296.9 	camping area" means a recreational camping area which operates no more than two times 
296.10 	annually and for no more than 14 consecutive days.

296.11 	Sec. 40. Minnesota Statutes 2008, section 327.15, is amended to read:
296.12 	327.15 LICENSE REQUIRED; RENEWAL; PLANS FOR EXPANSIONFEES.
296.13 		Subdivision 1.License required; plan review.  No person, firm or corporation shall 
296.14 	establish, maintain, conduct or operate a manufactured home park or recreational camping 
296.15 	area within this state without first obtaining a an annual license therefor from the state 
296.16 	Department of Health. Any person wishing to obtain a license shall first make application, 
296.17 	pay the required fee specified in this section, and receive approval for operation, including 
296.18 	plan review approval. Application shall be made on forms provided by the commissioner 
296.19 	and shall require the applicant to state the full name and address of the owner of the 
296.20 	manufactured home park or recreational camping area, the name under which the business 
296.21 	is to be conducted, and any other information as may be required by the commissioner 
296.22 	to complete the application for license. Any person, firm, or corporation desiring to 
296.23 	operate either a manufactured home park or a recreational camping area on the same site 
296.24 	in connection with the other, need only obtain one license. A license shall expire and be 
296.25 	renewed as prescribed by the commissioner pursuant to section 144.122. The license shall 
296.26 	state the number of manufactured home sites and recreational camping sites allowed 
296.27 	according to state commissioner of health approval. No renewal license shall be issued if 
296.28 	the number of sites specified in the application exceeds those of the original application
296.29 	The number of licensed sites shall not be increased unless the plans for expansion or 
296.30 	the construction for expansion are submitted and the expansion first approved by the 
296.31 	Department of Health. Any manufactured home park or recreational camping area located 
296.32 	in more than one municipality shall be dealt with as two separate manufactured home 
296.33 	parks or camping areas. The license shall be conspicuously displayed in the office of the 
297.1 	manufactured home park or camping area. The license is not transferable as to person 
297.2 	or place. 
297.3 		Subd. 2.License renewal. Initial and renewal licenses for all manufactured home 
297.4 	parks and recreational camping areas shall be issued annually and shall have an expiration 
297.5 	date included on the license. Any person who operates a manufactured home park or 
297.6 	recreational camping area after the expiration date of a license or without having submitted 
297.7 	an application and paid the fee shall be deemed to have violated the provisions of this 
297.8 	chapter and shall be subject to enforcement action, as provided in the Health Enforcement 
297.9 	Consolidation Act, sections 144.989 to 144.993. In addition, a penalty of $120 shall 
297.10 	be added to the total of the license fee for any manufactured home park or recreational 
297.11 	camping area operating without a license for a period of up to 30 days. A late fee of $360 
297.12 	shall be added to the license fee for any manufactured home park or recreational camping 
297.13 	area operating more than 30 days without a license.
297.14 		Subd. 3.Fees, manufactured home parks and recreational camping areas. (a) 
297.15 	The following fees are required for manufactured home parks and recreational camping 
297.16 	areas licensed under this chapter. Recreational camping areas and manufactured home 
297.17 	parks must pay the highest applicable fee under paragraph (c). The license fee for new 
297.18 	operators of a manufactured home park or recreational camping area previously licensed 
297.19 	under this chapter for the same calendar year is one-half of the appropriate annual license 
297.20 	fee, plus any penalty that may be required. The license fee for operators opening on 
297.21 	or after October 1 is one-half of the appropriate annual license fee, plus any penalty 
297.22 	that may be required.
297.23 	(b) All manufactured home parks and recreational camping areas, except special 
297.24 	event recreational camping areas, shall pay an annual base fee of $150 plus $4 for each 
297.25 	licensed site, except that any operator of a manufactured home park or recreational 
297.26 	camping area who is licensed under section 157.16 for the same location shall not be 
297.27 	required to pay the base fee.
297.28 	(c) In addition to the fee in paragraph (b), each manufactured home park or 
297.29 	recreational camping area shall pay an additional annual fee for each fee category 
297.30 	specified in this paragraph:
297.31 	(1) Manufactured home parks and recreational camping areas with public swimming 
297.32 	pools and spas shall pay the appropriate fees specified in section 157.16.
297.33 	(2) Individual private sewer or water, $60. "Individual private water" means a fee 
297.34 	category with a water supply other than a community public water supply as defined in 
297.35 	Minnesota Rules, chapter 4720. "Individual private sewer" means a fee category with an 
297.36 	individual sewage treatment system which uses subsurface treatment and disposal.
298.1 	(d) The following fees must accompany a plan review application for initial 
298.2 	construction of a manufactured home park or recreational camping area:
298.3 	(1) for initial construction of less than 25 sites, $375;
298.4 	(2) for initial construction of 25 to less than 100 sites, $400; and
298.5 	(3) for initial construction of 100 or more sites, $500.
298.6 	(e) The following fees must accompany a plan review application when an existing 
298.7 	manufactured home park or recreational camping area is expanded:
298.8 	(1) for expansion of less than 25 sites, $250;
298.9 	(2) for expansion of 25 and less than 100 sites, $300; and
298.10 	(3) for expansion of 100 or more sites, $450.
298.11 		Subd. 4.Fees, special event recreational camping areas. (a) The following fees 
298.12 	are required for special event recreational camping areas licensed under this chapter.
298.13 	(b) All special event recreational camping areas shall pay an annual fee of $150 plus 
298.14 	$1 for each licensed site.
298.15 	(c) A special event recreational camping area shall pay a late fee of $360 for failing 
298.16 	to obtain a license prior to operating.
298.17 	(d) The following fees must accompany a plan review application for initial 
298.18 	construction of a special event recreational camping area:
298.19 	(1) for initial construction of less than 25 special event recreational camping sites, 
298.20 	$375;
298.21 	(2) for initial construction of 25 to less than 100 sites, $400; and
298.22 	(3) for initial construction of 100 or more sites, $500.
298.23 	(e) The following fees must accompany a plan review application for expansion of a 
298.24 	special event recreational camping area:
298.25 	(1) for expansion of less than 25 sites, $250;
298.26 	(2) for expansion of 25 and less than 100 sites, $300; and
298.27 	(3) for expansion of 100 or more sites, $450.

298.28 	Sec. 41. Minnesota Statutes 2008, section 327.16, is amended to read:
298.29 	327.16 LICENSE PLAN REVIEW APPLICATION.
298.30 		Subdivision 1.Made to state Department of Health. The plan review application 
298.31 	for license to operate and maintain a manufactured home park or recreational camping 
298.32 	area shall be made to the state Department of Health, at such office and in such manner 
298.33 	as may be prescribed by that department.
299.1 		Subd. 2.Contents. The applicant for a primary license or annual license shall make 
299.2 	application in writing plan review application shall be made upon a form provided by the 
299.3 	state Department of Health setting forth:
299.4 	(1) The full name and address of the applicant or applicants, or names and addresses 
299.5 	of the partners if the applicant is a partnership, or the names and addresses of the officers 
299.6 	if the applicant is a corporation.
299.7 	(2) A legal description of the site, lot, field, or tract of land upon which the applicant 
299.8 	proposes to operate and maintain a manufactured home park or recreational camping area.
299.9 	(3) The proposed and existing facilities on and about the site, lot, field, or tract of 
299.10 	land for the proposed construction or alteration and maintaining of a sanitary community 
299.11 	building for toilets, urinals, sinks, wash basins, slop-sinks, showers, drains, laundry 
299.12 	facilities, source of water supply, sewage, garbage and waste disposal; except that no 
299.13 	toilet facilities shall be required in any manufactured home park which permits only 
299.14 	manufactured homes equipped with toilet facilities discharging to water carried sewage 
299.15 	disposal systems; and method of fire and storm protection.
299.16 	(4) The proposed method of lighting the structures and site, lot, field, or tract of land 
299.17 	upon which the manufactured home park or recreational camping area is to be located.
299.18 	(5) The calendar months of the year which the applicant will operate the 
299.19 	manufactured home park or recreational camping area.
299.20 	(6) Plans and drawings for new construction or alteration, including buildings, wells, 
299.21 	plumbing and sewage disposal systems.
299.22 		Subd. 3.Fees; Approval. The application for the primary license plan review shall 
299.23 	be submitted with all plans and specifications enumerated in subdivision 2, and payment 
299.24 	of a fee in an amount prescribed by the state commissioner of health pursuant to section 
299.25 	144.122 and shall be accompanied by an approved zoning permit from the municipality or 
299.26 	county wherein the park is to be located, or a statement from the municipality or county 
299.27 	that it does not require an approved zoning permit. The fee for the annual license shall be 
299.28 	in an amount prescribed by the state commissioner of health pursuant to section 144.122. 
299.29 	All license fees paid to the commissioner of health shall be turned over to the state 
299.30 	treasury. The fee submitted for the primary license plan review shall be retained by the 
299.31 	state even though the proposed project is not approved and a license is denied. 
299.32 	When construction has been completed in accordance with approved plans and 
299.33 	specifications the state commissioner of health shall promptly cause the manufactured 
299.34 	home park or recreational camping area and appurtenances thereto to be inspected. When 
299.35 	the inspection and report has been made and the state commissioner of health finds that 
299.36 	all requirements of sections 327.10, 327.11, 327.14 to 327.28, and such conditions of 
300.1 	health and safety as the state commissioner of health may require, have been met by 
300.2 	the applicant, the state commissioner of health shall forthwith issue the primary license 
300.3 	in the name of the state. 
300.4 		Subd. 4.Sanitary facilities Compliance with current state law. During the 
300.5 	pendency of the application for such primary license any change in the sanitary or safety 
300.6 	facilities of the intended manufactured home park or recreational camping area shall be 
300.7 	immediately reported in writing to the state Department of Health through the office 
300.8 	through which the application was made. If no objection is made by the state Department 
300.9 	of Health to such change in such sanitary or safety facilities within 60 days of the date 
300.10 	such change is reported, it shall be deemed to have the approval of the state Department of 
300.11 	Health. Any manufactured home park or recreational camping area must be constructed 
300.12 	and operated according to all applicable state electrical, fire, plumbing, and building codes.
300.13 		Subd. 5.Permit. When the plans and specifications have been approved, the state 
300.14 	Department of Health shall issue an approval report permitting the applicant to construct 
300.15 	or make alterations upon a manufactured home park or recreational camping area and the 
300.16 	appurtenances thereto according to the plans and specifications presented.
300.17 	Such approval does not relieve the applicant from securing building permits in 
300.18 	municipalities that require permits or from complying with any other municipal ordinance 
300.19 	or ordinances, applicable thereto, not in conflict with this statute.
300.20 		Subd. 6.Denial of construction. If the application to construct or make alterations 
300.21 	upon a manufactured home park or recreational camping area and the appurtenances 
300.22 	thereto or a primary license to operate and maintain the same is denied by the state 
300.23 	commissioner of health, the commissioner shall so state in writing giving the reason 
300.24 	or reasons for denying the application. If the objections can be corrected the applicant 
300.25 	may amend the application and resubmit it for approval, and if denied the applicant may 
300.26 	appeal from the decision of the state commissioner of health as provided in section 
300.27 	144.99, subdivision 10. 

300.28 	Sec. 42. Minnesota Statutes 2008, section 327.20, subdivision 1, is amended to read:
300.29 		Subdivision 1.Rules. No domestic animals or house pets of occupants of 
300.30 	manufactured home parks or recreational camping areas shall be allowed to run at large, 
300.31 	or commit any nuisances within the limits of a manufactured home park or recreational 
300.32 	camping area. Each manufactured home park or recreational camping area licensed under 
300.33 	the provisions of sections 327.10, 327.11, and327.14 to 327.28 shall, among other things, 
300.34 	provide for the following, in the manner hereinafter specified: 
301.1 	(1) A responsible attendant or caretaker shall be in charge of every manufactured 
301.2 	home park or recreational camping area at all times, who shall maintain the park or 
301.3 	area, and its facilities and equipment in a clean, orderly and sanitary condition. In any 
301.4 	manufactured home park containing more than 50 lots, the attendant, caretaker, or other 
301.5 	responsible park employee, shall be readily available at all times in case of emergency.
301.6 	(2) All manufactured home parks shall be well drained and be located so that the 
301.7 	drainage of the park area will not endanger any water supply. No wastewater from 
301.8 	manufactured homes or recreational camping vehicles shall be deposited on the surface of 
301.9 	the ground. All sewage and other water carried wastes shall be discharged into a municipal 
301.10 	sewage system whenever available. When a municipal sewage system is not available, a 
301.11 	sewage disposal system acceptable to the state commissioner of health shall be provided.
301.12 	(3) No manufactured home shall be located closer than three feet to the side lot lines 
301.13 	of a manufactured home park, if the abutting property is improved property, or closer than 
301.14 	ten feet to a public street or alley. Each individual site shall abut or face on a driveway 
301.15 	or clear unoccupied space of not less than 16 feet in width, which space shall have 
301.16 	unobstructed access to a public highway or alley. There shall be an open space of at least 
301.17 	ten feet between the sides of adjacent manufactured homes including their attachments 
301.18 	and at least three feet between manufactured homes when parked end to end. The space 
301.19 	between manufactured homes may be used for the parking of motor vehicles and other 
301.20 	property, if the vehicle or other property is parked at least ten feet from the nearest 
301.21 	adjacent manufactured home position. The requirements of this paragraph shall not apply 
301.22 	to recreational camping areas and variances may be granted by the state commissioner 
301.23 	of health in manufactured home parks when the variance is applied for in writing and in 
301.24 	the opinion of the commissioner the variance will not endanger the health, safety, and 
301.25 	welfare of manufactured home park occupants.
301.26 	(4) An adequate supply of water of safe, sanitary quality shall be furnished at each 
301.27 	manufactured home park or recreational camping area. The source of the water supply 
301.28 	shall first be approved by the state Department of Health.
301.29 	(5) All plumbing shall be installed in accordance with the rules of the state 
301.30 	commissioner of labor and industry and the provisions of the Minnesota Plumbing Code.
301.31 	(6) In the case of a manufactured home park with less than ten manufactured homes, 
301.32 	a plan for the sheltering or the safe evacuation to a safe place of shelter of the residents of 
301.33 	the park in times of severe weather conditions, such as tornadoes, high winds, and floods. 
301.34 	The shelter or evacuation plan shall be developed with the assistance and approval of 
301.35 	the municipality where the park is located and shall be posted at conspicuous locations 
301.36 	throughout the park. The park owner shall provide each resident with a copy of the 
302.1 	approved shelter or evacuation plan, as provided by section 327C.01, subdivision 1c. 
302.2 	Nothing in this paragraph requires the Department of Health to review or approve any 
302.3 	shelter or evacuation plan developed by a park. Failure of a municipality to approve a plan 
302.4 	submitted by a park shall not be grounds for action against the park by the Department of 
302.5 	Health if the park has made a good faith effort to develop the plan and obtain municipal 
302.6 	approval. 
302.7 	(7) A manufactured home park with ten or more manufactured homes, licensed prior 
302.8 	to March 1, 1988, shall provide a safe place of shelter for park residents or a plan for the 
302.9 	evacuation of park residents to a safe place of shelter within a reasonable distance of the 
302.10 	park for use by park residents in times of severe weather, including tornadoes and high 
302.11 	winds. The shelter or evacuation plan must be approved by the municipality by March 1, 
302.12 	1989. The municipality may require the park owner to construct a shelter if it determines 
302.13 	that a safe place of shelter is not available within a reasonable distance from the park. A 
302.14 	copy of the municipal approval and the plan shall be submitted by the park owner to the 
302.15 	Department of Health. The park owner shall provide each resident with a copy of the 
302.16 	approved shelter or evacuation plan, as provided by section 327C.01, subdivision 1c. 
302.17 	(8) A manufactured home park with ten or more manufactured homes, receiving 
302.18 	a primary an initial license after March 1, 1988, must provide the type of shelter required 
302.19 	by section 327.205, except that for manufactured home parks established as temporary, 
302.20 	emergency housing in a disaster area declared by the President of the United States or 
302.21 	the governor, an approved evacuation plan may be provided in lieu of a shelter for a 
302.22 	period not exceeding 18 months. 
302.23 	(9) For the purposes of this subdivision, "park owner" and "resident" have the 
302.24 	meaning meanings given them in section 327C.01. 

302.25 	Sec. 43. Minnesota Statutes 2008, section 327.20, is amended by adding a subdivision 
302.26 	to read:
302.27 		Subd. 4.Special event recreational camping areas. Each special event camping 
302.28 	area licensed under sections 327.10, 327.11, and 327.14 to 327.28 is subject to this section.
302.29 	(1) Recreational camping vehicles and tents, including attachments, must be 
302.30 	separated from each other and other structures by at least seven feet.
302.31 	(2) A minimum area of 300 square feet per site must be provided and the total 
302.32 	number of sites must not exceed one site for every 300 square feet of usable land area.
302.33 	(3) Each site must abut or face a driveway or clear unoccupied space of at least 16 
302.34 	feet in width, which space must have unobstructed access to a public roadway.
303.1 	(4) If no approved on-site water supply system is available, hauled water may be 
303.2 	used, provided that persons using hauled water comply with Minnesota Rules, parts 
303.3 	4720.4000 to 4720.4600.
303.4 	(5) Nonburied sewer lines may be permitted provided they are of approved materials, 
303.5 	watertight, and properly maintained.
303.6 	(6) If a sanitary dumping station is not provided on-site, arrangements must be 
303.7 	made with a licensed sewage pumper to service recreational camping vehicle holding 
303.8 	tanks as needed.
303.9 	(7) Toilet facilities must be provided consisting of toilets connected to an approved 
303.10 	sewage disposal system, portable toilets, or approved, properly constructed privies.
303.11 	(8) Toilets must be provided in the ratio of one toilet for each sex for each 150 sites.
303.12 	(9) Toilets must be not more than 400 feet from any site.
303.13 	(10) If a central building or buildings are provided with running water, then toilets 
303.14 	and hand-washing lavatories must be provided in the building or buildings that meet the 
303.15 	requirements of this subdivision.
303.16 	(11) Showers, if provided, must be provided in the ratio of one shower for each sex 
303.17 	for each 250 sites. Showerheads must be provided, where running water is available, for 
303.18 	each camping event exceeding two nights.
303.19 	(12) Central toilet and shower buildings, if provided, must be constructed with 
303.20 	adequate heating, ventilation, and lighting, and floors of impervious material sloped 
303.21 	to drain. Walls must be of a washable material. Permanent facilities must meet the 
303.22 	requirements of the Americans with Disabilities Act.
303.23 	(13) An adequate number of durable, covered, watertight containers must be 
303.24 	provided for all garbage and refuse. Garbage and refuse must be collected as often as 
303.25 	necessary to prevent nuisance conditions.
303.26 	(14) Campgrounds must be located in areas free of poison ivy or other noxious 
303.27 	weeds considered detrimental to health. Sites must not be located in areas of tall grass or 
303.28 	weeds and sites must be adequately drained.
303.29 	(15) Campsites for recreational vehicles may not be located on inclines of greater 
303.30 	than eight percent grade or one inch drop per lineal foot.
303.31 	(16) A responsible attendant or caretaker must be available on-site at all times during 
303.32 	the operation of any special event recreational camping area that has 50 or more sites.

303.33 	Sec. 44.  REPEALER.
 303.34 	(a) Minnesota Statutes 2008, sections 62U.08; 103I.112; 144.9501, subdivision 17b; 
303.35 	and 327.14, subdivisions 5 and 6, are repealed.
304.1 	(b) Minnesota Rules, part 4626.2015, subpart 9, is repealed.

304.2 	ARTICLE 12
304.3 	TECHNICAL

304.4 	Section 1. Minnesota Statutes 2008, section 125A.744, subdivision 3, is amended to 
304.5 	read:
304.6 		Subd. 3.Implementation. Consistent with section 256B.0625, subdivision 26, 
304.7 	school districts may enroll as medical assistance providers or subcontractors and bill 
304.8 	the Department of Human Services under the medical assistance fee for service claims 
304.9 	processing system for special education services which are covered services under chapter 
304.10 	256B, which are provided in the school setting for a medical assistance recipient, and for 
304.11 	whom the district has secured informed consent consistent with section 13.05, subdivision 
304.12 	4, paragraph (d), and section 256B.77, subdivision 2, paragraph (p), to bill for each type 
304.13 	of covered service. School districts shall be reimbursed by the commissioner of human 
304.14 	services for the federal share of individual education plan health-related services that 
304.15 	qualify for reimbursement by medical assistance, minus up to five percent retained by the 
304.16 	commissioner of human services for administrative costs, not to exceed $350,000 per 
304.17 	fiscal year. The commissioner may withhold up to five percent of each payment to a 
304.18 	school district. Following the end of each fiscal year, the commissioner shall settle up with 
304.19 	each school district in order to ensure that collections from each district for departmental 
304.20 	administrative costs are made on a pro rata basis according to federal earnings for these 
304.21 	services in each district. A school district is not eligible to enroll as a home care provider 
304.22 	or a personal care provider organization for purposes of billing home care services under 
304.23 	sections 256B.0651and 256B.0653 to 256B.0656and 256B.0659 until the commissioner 
304.24 	of human services issues a bulletin instructing county public health nurses on how to 
304.25 	assess for the needs of eligible recipients during school hours. To use private duty nursing 
304.26 	services or personal care services at school, the recipient or responsible party must provide 
304.27 	written authorization in the care plan identifying the chosen provider and the daily amount 
304.28 	of services to be used at school.

304.29 	Sec. 2. Minnesota Statutes 2008, section 144A.46, subdivision 1, is amended to read:
304.30 		Subdivision 1. License required. (a) A home care provider may not operate in the 
304.31 	state without a current license issued by the commissioner of health. A home care provider 
304.32 	may hold a separate license for each class of home care licensure. 
304.33 	(b) Within ten days after receiving an application for a license, the commissioner 
304.34 	shall acknowledge receipt of the application in writing. The acknowledgment must 
305.1 	indicate whether the application appears to be complete or whether additional information 
305.2 	is required before the application will be considered complete. Within 90 days after 
305.3 	receiving a complete application, the commissioner shall either grant or deny the license. 
305.4 	If an applicant is not granted or denied a license within 90 days after submitting a 
305.5 	complete application, the license must be deemed granted. An applicant whose license has 
305.6 	been deemed granted must provide written notice to the commissioner before providing a 
305.7 	home care service. 
305.8 	(c) Each application for a home care provider license, or for a renewal of a license, 
305.9 	shall be accompanied by a fee to be set by the commissioner under section 144.122. 
305.10 	(d) The commissioner of health, in consultation with the commissioner of human 
305.11 	services, shall provide recommendations to the legislature by February 15, 2009, for 
305.12 	provider standards for personal care assistant services as described in section 256B.0655
305.13 	256B.0659. 

305.14 	Sec. 3. Minnesota Statutes 2008, section 176.011, subdivision 9, is amended to read:
305.15 		Subd. 9. Employee. "Employee" means any person who performs services for 
305.16 	another for hire including the following: 
305.17 	(1) an alien; 
305.18 	(2) a minor; 
305.19 	(3) a sheriff, deputy sheriff, police officer, firefighter, county highway engineer, and 
305.20 	peace officer while engaged in the enforcement of peace or in the pursuit or capture of a 
305.21 	person charged with or suspected of crime; 
305.22 	(4) a person requested or commanded to aid an officer in arresting or retaking a 
305.23 	person who has escaped from lawful custody, or in executing legal process, in which 
305.24 	cases, for purposes of calculating compensation under this chapter, the daily wage of the 
305.25 	person shall be the prevailing wage for similar services performed by paid employees; 
305.26 	(5) a county assessor; 
305.27 	(6) an elected or appointed official of the state, or of a county, city, town, school 
305.28 	district, or governmental subdivision in the state. An officer of a political subdivision 
305.29 	elected or appointed for a regular term of office, or to complete the unexpired portion of a 
305.30 	regular term, shall be included only after the governing body of the political subdivision 
305.31 	has adopted an ordinance or resolution to that effect; 
305.32 	(7) an executive officer of a corporation, except those executive officers excluded 
305.33 	by section 176.041; 
305.34 	(8) a voluntary uncompensated worker, other than an inmate, rendering services in 
305.35 	state institutions under the commissioners of human services and corrections similar to 
306.1 	those of officers and employees of the institutions, and whose services have been accepted 
306.2 	or contracted for by the commissioner of human services or corrections as authorized by 
306.3 	law. In the event of injury or death of the worker, the daily wage of the worker, for the 
306.4 	purpose of calculating compensation under this chapter, shall be the usual wage paid at 
306.5 	the time of the injury or death for similar services in institutions where the services are 
306.6 	performed by paid employees; 
306.7 	(9) a voluntary uncompensated worker engaged in emergency management as 
306.8 	defined in section 12.03, subdivision 4, who is: 
306.9 	(i) registered with the state or any political subdivision of it, according to the 
306.10 	procedures set forth in the state or political subdivision emergency operations plan; and 
306.11 	(ii) acting under the direction and control of, and within the scope of duties approved 
306.12 	by, the state or political subdivision. 
306.13 	The daily wage of the worker, for the purpose of calculating compensation under this 
306.14 	chapter, shall be the usual wage paid at the time of the injury or death for similar services 
306.15 	performed by paid employees; 
306.16 	(10) a voluntary uncompensated worker participating in a program established by a 
306.17 	local social services agency. For purposes of this clause, "local social services agency" 
306.18 	means any agency established under section 393.01. In the event of injury or death of the 
306.19 	worker, the wage of the worker, for the purpose of calculating compensation under this 
306.20 	chapter, shall be the usual wage paid in the county at the time of the injury or death for 
306.21 	similar services performed by paid employees working a normal day and week; 
306.22 	(11) a voluntary uncompensated worker accepted by the commissioner of natural 
306.23 	resources who is rendering services as a volunteer pursuant to section 84.089. The daily 
306.24 	wage of the worker for the purpose of calculating compensation under this chapter, shall 
306.25 	be the usual wage paid at the time of injury or death for similar services performed by 
306.26 	paid employees; 
306.27 	(12) a voluntary uncompensated worker in the building and construction industry 
306.28 	who renders services for joint labor-management nonprofit community service projects. 
306.29 	The daily wage of the worker for the purpose of calculating compensation under this 
306.30 	chapter shall be the usual wage paid at the time of injury or death for similar services 
306.31 	performed by paid employees; 
306.32 	(13) a member of the military forces, as defined in section 190.05, while in state 
306.33 	active service, as defined in section 190.05, subdivision 5a. The daily wage of the member 
306.34 	for the purpose of calculating compensation under this chapter shall be based on the 
306.35 	member's usual earnings in civil life. If there is no evidence of previous occupation or 
307.1 	earning, the trier of fact shall consider the member's earnings as a member of the military 
307.2 	forces; 
307.3 	(14) a voluntary uncompensated worker, accepted by the director of the Minnesota 
307.4 	Historical Society, rendering services as a volunteer, pursuant to chapter 138. The daily 
307.5 	wage of the worker, for the purposes of calculating compensation under this chapter, 
307.6 	shall be the usual wage paid at the time of injury or death for similar services performed 
307.7 	by paid employees; 
307.8 	(15) a voluntary uncompensated worker, other than a student, who renders services 
307.9 	at the Minnesota State Academy for the Deaf or the Minnesota State Academy for the 
307.10 	Blind, and whose services have been accepted or contracted for by the commissioner of 
307.11 	education, as authorized by law. In the event of injury or death of the worker, the daily 
307.12 	wage of the worker, for the purpose of calculating compensation under this chapter, shall 
307.13 	be the usual wage paid at the time of the injury or death for similar services performed in 
307.14 	institutions by paid employees; 
307.15 	(16) a voluntary uncompensated worker, other than a resident of the veterans home, 
307.16 	who renders services at a Minnesota veterans home, and whose services have been 
307.17 	accepted or contracted for by the commissioner of veterans affairs, as authorized by law. 
307.18 	In the event of injury or death of the worker, the daily wage of the worker, for the purpose 
307.19 	of calculating compensation under this chapter, shall be the usual wage paid at the time of 
307.20 	the injury or death for similar services performed in institutions by paid employees; 
307.21 	(17) a worker performing services under section 256B.0655256B.0659 for a 
307.22 	recipient in the home of the recipient or in the community under section 256B.0625, 
307.23 	subdivision 19a, who is paid from government funds through a fiscal intermediary under 
307.24 	section 256B.0655, subdivision 7 256B.0659, subdivision 33. For purposes of maintaining 
307.25 	workers' compensation insurance, the employer of the worker is as designated in law 
307.26 	by the commissioner of the Department of Human Services, notwithstanding any other 
307.27 	law to the contrary;
307.28 	(18) students enrolled in and regularly attending the Medical School of the 
307.29 	University of Minnesota in the graduate school program or the postgraduate program. The 
307.30 	students shall not be considered employees for any other purpose. In the event of the 
307.31 	student's injury or death, the weekly wage of the student for the purpose of calculating 
307.32 	compensation under this chapter, shall be the annualized educational stipend awarded to 
307.33 	the student, divided by 52 weeks. The institution in which the student is enrolled shall 
307.34 	be considered the "employer" for the limited purpose of determining responsibility for 
307.35 	paying benefits under this chapter; 
308.1 	(19) a faculty member of the University of Minnesota employed for an academic 
308.2 	year is also an employee for the period between that academic year and the succeeding 
308.3 	academic year if: 
308.4 	(a) the member has a contract or reasonable assurance of a contract from the 
308.5 	University of Minnesota for the succeeding academic year; and 
308.6 	(b) the personal injury for which compensation is sought arises out of and in the 
308.7 	course of activities related to the faculty member's employment by the University of 
308.8 	Minnesota; 
308.9 	(20) a worker who performs volunteer ambulance driver or attendant services is an 
308.10 	employee of the political subdivision, nonprofit hospital, nonprofit corporation, or other 
308.11 	entity for which the worker performs the services. The daily wage of the worker for the 
308.12 	purpose of calculating compensation under this chapter shall be the usual wage paid at the 
308.13 	time of injury or death for similar services performed by paid employees; 
308.14 	(21) a voluntary uncompensated worker, accepted by the commissioner of 
308.15 	administration, rendering services as a volunteer at the Department of Administration. In 
308.16 	the event of injury or death of the worker, the daily wage of the worker, for the purpose of 
308.17 	calculating compensation under this chapter, shall be the usual wage paid at the time of the 
308.18 	injury or death for similar services performed in institutions by paid employees; 
308.19 	(22) a voluntary uncompensated worker rendering service directly to the Pollution 
308.20 	Control Agency. The daily wage of the worker for the purpose of calculating compensation 
308.21 	payable under this chapter is the usual going wage paid at the time of injury or death for 
308.22 	similar services if the services are performed by paid employees; 
308.23 	(23) a voluntary uncompensated worker while volunteering services as a first 
308.24 	responder or as a member of a law enforcement assistance organization while acting 
308.25 	under the supervision and authority of a political subdivision. The daily wage of the 
308.26 	worker for the purpose of calculating compensation payable under this chapter is the 
308.27 	usual going wage paid at the time of injury or death for similar services if the services 
308.28 	are performed by paid employees; 
308.29 	(24) a voluntary uncompensated member of the civil air patrol rendering service on 
308.30 	the request and under the authority of the state or any of its political subdivisions. The 
308.31 	daily wage of the member for the purposes of calculating compensation payable under this 
308.32 	chapter is the usual going wage paid at the time of injury or death for similar services if 
308.33 	the services are performed by paid employees; and 
308.34 	(25) a Minnesota Responds Medical Reserve Corps volunteer, as provided in 
308.35 	sections 145A.04 and 145A.06, responding at the request of or engaged in training 
308.36 	conducted by the commissioner of health. The daily wage of the volunteer for the purposes 
309.1 	of calculating compensation payable under this chapter is established in section 145A.06. 
309.2 	A person who qualifies under this clause and who may also qualify under another clause 
309.3 	of this subdivision shall receive benefits in accordance with this clause. 
309.4 	If it is difficult to determine the daily wage as provided in this subdivision, the trier 
309.5 	of fact may determine the wage upon which the compensation is payable. 

309.6 	Sec. 4. Minnesota Statutes 2008, section 245C.03, subdivision 2, is amended to read:
309.7 		Subd. 2.Personal care provider organizations. The commissioner shall conduct 
309.8 	background studies on any individual required under sections 256B.0651and 256B.0653
309.9 	to 256B.0656and 256B.0659 to have a background study completed under this chapter.

309.10 	Sec. 5. Minnesota Statutes 2008, section 245C.04, subdivision 3, is amended to read:
309.11 		Subd. 3.Personal care provider organizations. (a) The commissioner shall 
309.12 	conduct a background study of an individual required to be studied under section 245C.03, 
309.13 	subdivision 2, at least upon application for initial enrollment under sections 256B.0651
309.14 	and 256B.0653 to 256B.0656 and 256B.0659.
309.15 	(b) Organizations required to initiate background studies under sections 256B.0651
309.16 	and 256B.0653 to 256B.0656and 256B.0659 for individuals described in section 245C.03, 
309.17 	subdivision 2, must submit a completed background study form to the commissioner 
309.18 	before those individuals begin a position allowing direct contact with persons served 
309.19 	by the organization.

309.20 	Sec. 6. Minnesota Statutes 2008, section 245C.10, subdivision 3, is amended to read:
309.21 		Subd. 3.Personal care provider organizations. The commissioner shall recover 
309.22 	the cost of background studies initiated by a personal care provider organization under 
309.23 	sections 256B.0651and 256B.0653 to 256B.0656and 256B.0659 through a fee of no 
309.24 	more than $20 per study charged to the organization responsible for submitting the 
309.25 	background study form. The fees collected under this subdivision are appropriated to the 
309.26 	commissioner for the purpose of conducting background studies.

309.27 	Sec. 7. Minnesota Statutes 2008, section 256B.04, subdivision 16, is amended to read:
309.28 		Subd. 16. Personal care services. (a) Notwithstanding any contrary language in 
309.29 	this paragraph, the commissioner of human services and the commissioner of health shall 
309.30 	jointly promulgate rules to be applied to the licensure of personal care services provided 
309.31 	under the medical assistance program. The rules shall consider standards for personal care 
309.32 	services that are based on the World Institute on Disability's recommendations regarding 
310.1 	personal care services. These rules shall at a minimum consider the standards and 
310.2 	requirements adopted by the commissioner of health under section 144A.45, which the 
310.3 	commissioner of human services determines are applicable to the provision of personal 
310.4 	care services, in addition to other standards or modifications which the commissioner of 
310.5 	human services determines are appropriate. 
310.6 	The commissioner of human services shall establish an advisory group including 
310.7 	personal care consumers and providers to provide advice regarding which standards or 
310.8 	modifications should be adopted. The advisory group membership must include not less 
310.9 	than 15 members, of which at least 60 percent must be consumers of personal care services 
310.10 	and representatives of recipients with various disabilities and diagnoses and ages. At least 
310.11 	51 percent of the members of the advisory group must be recipients of personal care. 
310.12 	The commissioner of human services may contract with the commissioner of health 
310.13 	to enforce the jointly promulgated licensure rules for personal care service providers. 
310.14 	Prior to final promulgation of the joint rule the commissioner of human services 
310.15 	shall report preliminary findings along with any comments of the advisory group and a 
310.16 	plan for monitoring and enforcement by the Department of Health to the legislature by 
310.17 	February 15, 1992. 
310.18 	Limits on the extent of personal care services that may be provided to an individual 
310.19 	must be based on the cost-effectiveness of the services in relation to the costs of inpatient 
310.20 	hospital care, nursing home care, and other available types of care. The rules must 
310.21 	provide, at a minimum: 
310.22 	(1) that agencies be selected to contract with or employ and train staff to provide and 
310.23 	supervise the provision of personal care services; 
310.24 	(2) that agencies employ or contract with a qualified applicant that a qualified 
310.25 	recipient proposes to the agency as the recipient's choice of assistant; 
310.26 	(3) that agencies bill the medical assistance program for a personal care service 
310.27 	by a personal care assistant and supervision by a qualified professional supervising the 
310.28 	personal care assistant unless the recipient selects the fiscal agent option under section 
310.29 	256B.0655, subdivision 7 256B.0659, subdivision 33; 
310.30 	(4) that agencies establish a grievance mechanism; and 
310.31 	(5) that agencies have a quality assurance program. 
310.32 	(b) The commissioner may waive the requirement for the provision of personal care 
310.33 	services through an agency in a particular county, when there are less than two agencies 
310.34 	providing services in that county and shall waive the requirement for personal care 
310.35 	assistants required to join an agency for the first time during 1993 when personal care 
310.36 	services are provided under a relative hardship waiver under Minnesota Statutes 1992, 
311.1 	section 256B.0627, subdivision 4, paragraph (b), clause (7), and at least two agencies 
311.2 	providing personal care services have refused to employ or contract with the independent 
311.3 	personal care assistant. 

311.4 	Sec. 8. Minnesota Statutes 2008, section 256B.055, subdivision 12, is amended to read:
311.5 		Subd. 12. Disabled children. (a) A person is eligible for medical assistance if the 
311.6 	person is under age 19 and qualifies as a disabled individual under United States Code, 
311.7 	title 42, section 1382c(a), and would be eligible for medical assistance under the state 
311.8 	plan if residing in a medical institution, and the child requires a level of care provided in 
311.9 	a hospital, nursing facility, or intermediate care facility for persons with developmental 
311.10 	disabilities, for whom home care is appropriate, provided that the cost to medical 
311.11 	assistance under this section is not more than the amount that medical assistance would pay 
311.12 	for if the child resides in an institution. After the child is determined to be eligible under 
311.13 	this section, the commissioner shall review the child's disability under United States Code, 
311.14 	title 42, section 1382c(a) and level of care defined under this section no more often than 
311.15 	annually and may elect, based on the recommendation of health care professionals under 
311.16 	contract with the state medical review team, to extend the review of disability and level of 
311.17 	care up to a maximum of four years. The commissioner's decision on the frequency of 
311.18 	continuing review of disability and level of care is not subject to administrative appeal 
311.19 	under section 256.045. The county agency shall send a notice of disability review to the 
311.20 	enrollee six months prior to the date the recertification of disability is due. Nothing in this 
311.21 	subdivision shall be construed as affecting other redeterminations of medical assistance 
311.22 	eligibility under this chapter and annual cost-effective reviews under this section. 
311.23 	(b) For purposes of this subdivision, "hospital" means an institution as defined 
311.24 	in section 144.696, subdivision 3, 144.55, subdivision 3, or Minnesota Rules, part 
311.25 	4640.3600, and licensed pursuant to sections 144.50 to 144.58. For purposes of this 
311.26 	subdivision, a child requires a level of care provided in a hospital if the child is determined 
311.27 	by the commissioner to need an extensive array of health services, including mental health 
311.28 	services, for an undetermined period of time, whose health condition requires frequent 
311.29 	monitoring and treatment by a health care professional or by a person supervised by a 
311.30 	health care professional, who would reside in a hospital or require frequent hospitalization 
311.31 	if these services were not provided, and the daily care needs are more complex than 
311.32 	a nursing facility level of care. 
311.33 	A child with serious emotional disturbance requires a level of care provided in a 
311.34 	hospital if the commissioner determines that the individual requires 24-hour supervision 
311.35 	because the person exhibits recurrent or frequent suicidal or homicidal ideation or 
312.1 	behavior, recurrent or frequent psychosomatic disorders or somatopsychic disorders that 
312.2 	may become life threatening, recurrent or frequent severe socially unacceptable behavior 
312.3 	associated with psychiatric disorder, ongoing and chronic psychosis or severe, ongoing 
312.4 	and chronic developmental problems requiring continuous skilled observation, or severe 
312.5 	disabling symptoms for which office-centered outpatient treatment is not adequate, and 
312.6 	which overall severely impact the individual's ability to function. 
312.7 	(c) For purposes of this subdivision, "nursing facility" means a facility which 
312.8 	provides nursing care as defined in section 144A.01, subdivision 5, licensed pursuant to 
312.9 	sections 144A.02 to 144A.10, which is appropriate if a person is in active restorative 
312.10 	treatment; is in need of special treatments provided or supervised by a licensed nurse; or 
312.11 	has unpredictable episodes of active disease processes requiring immediate judgment 
312.12 	by a licensed nurse. For purposes of this subdivision, a child requires the level of care 
312.13 	provided in a nursing facility if the child is determined by the commissioner to meet 
312.14 	the requirements of the preadmission screening assessment document under section 
312.15 	256B.0911 and the home care independent rating document under section 256B.0655, 
312.16 	subdivision 4, clause (3) 256B.0659, adjusted to address age-appropriate standards for 
312.17 	children age 18 and under, pursuant to section 256B.0655, subdivision 3 256B.0659. 
312.18 	(d) For purposes of this subdivision, "intermediate care facility for persons with 
312.19 	developmental disabilities" or "ICF/MR" means a program licensed to provide services to 
312.20 	persons with developmental disabilities under section 252.28, and chapter 245A, and a 
312.21 	physical plant licensed as a supervised living facility under chapter 144, which together 
312.22 	are certified by the Minnesota Department of Health as meeting the standards in Code of 
312.23 	Federal Regulations, title 42, part 483, for an intermediate care facility which provides 
312.24 	services for persons with developmental disabilities who require 24-hour supervision 
312.25 	and active treatment for medical, behavioral, or habilitation needs. For purposes of this 
312.26 	subdivision, a child requires a level of care provided in an ICF/MR if the commissioner 
312.27 	finds that the child has a developmental disability in accordance with section 256B.092, 
312.28 	is in need of a 24-hour plan of care and active treatment similar to persons with 
312.29 	developmental disabilities, and there is a reasonable indication that the child will need 
312.30 	ICF/MR services. 
312.31 	(e) For purposes of this subdivision, a person requires the level of care provided 
312.32 	in a nursing facility if the person requires 24-hour monitoring or supervision and a plan 
312.33 	of mental health treatment because of specific symptoms or functional impairments 
312.34 	associated with a serious mental illness or disorder diagnosis, which meet severity criteria 
312.35 	for mental health established by the commissioner and published in March 1997 as 
313.1 	the Minnesota Mental Health Level of Care for Children and Adolescents with Severe 
313.2 	Emotional Disorders. 
313.3 	(f) The determination of the level of care needed by the child shall be made by 
313.4 	the commissioner based on information supplied to the commissioner by the parent or 
313.5 	guardian, the child's physician or physicians, and other professionals as requested by the 
313.6 	commissioner. The commissioner shall establish a screening team to conduct the level of 
313.7 	care determinations according to this subdivision. 
313.8 	(g) If a child meets the conditions in paragraph (b), (c), (d), or (e), the commissioner 
313.9 	must assess the case to determine whether: 
313.10 	(1) the child qualifies as a disabled individual under United States Code, title 42, 
313.11 	section 1382c(a), and would be eligible for medical assistance if residing in a medical 
313.12 	institution; and 
313.13 	(2) the cost of medical assistance services for the child, if eligible under this 
313.14 	subdivision, would not be more than the cost to medical assistance if the child resides in a 
313.15 	medical institution to be determined as follows: 
313.16 	(i) for a child who requires a level of care provided in an ICF/MR, the cost of 
313.17 	care for the child in an institution shall be determined using the average payment rate 
313.18 	established for the regional treatment centers that are certified as ICF's/MR; 
313.19 	(ii) for a child who requires a level of care provided in an inpatient hospital setting 
313.20 	according to paragraph (b), cost-effectiveness shall be determined according to Minnesota 
313.21 	Rules, part 9505.3520, items F and G; and 
313.22 	(iii) for a child who requires a level of care provided in a nursing facility according 
313.23 	to paragraph (c) or (e), cost-effectiveness shall be determined according to Minnesota 
313.24 	Rules, part 9505.3040, except that the nursing facility average rate shall be adjusted to 
313.25 	reflect rates which would be paid for children under age 16. The commissioner may 
313.26 	authorize an amount up to the amount medical assistance would pay for a child referred to 
313.27 	the commissioner by the preadmission screening team under section 256B.0911. 
313.28 	(h) Children eligible for medical assistance services under section 256B.055, 
313.29 	subdivision 12, as of June 30, 1995, must be screened according to the criteria in this 
313.30 	subdivision prior to January 1, 1996. Children found to be ineligible may not be removed 
313.31 	from the program until January 1, 1996. 

313.32 	Sec. 9. Minnesota Statutes 2008, section 256B.0621, subdivision 2, is amended to read:
313.33 		Subd. 2.Targeted case management; definitions. For purposes of subdivisions 3 
313.34 	to 10, the following terms have the meanings given them:
314.1 	(1) "home care service recipients" means those individuals receiving the following 
314.2 	services under sections 256B.0651 to 256B.0656 and 256B.0659: skilled nursing visits, 
314.3 	home health aide visits, private duty nursing, personal care assistants, or therapies 
314.4 	provided through a home health agency;
314.5 	(2) "home care targeted case management" means the provision of targeted case 
314.6 	management services for the purpose of assisting home care service recipients to gain 
314.7 	access to needed services and supports so that they may remain in the community;
314.8 	(3) "institutions" means hospitals, consistent with Code of Federal Regulations, title 
314.9 	42, section 440.10; regional treatment center inpatient services, consistent with section 
314.10 	245.474; nursing facilities; and intermediate care facilities for persons with developmental 
314.11 	disabilities;
314.12 	(4) "relocation targeted case management" includes the provision of both county 
314.13 	targeted case management and public or private vendor service coordination services 
314.14 	for the purpose of assisting recipients to gain access to needed services and supports if 
314.15 	they choose to move from an institution to the community. Relocation targeted case 
314.16 	management may be provided during the lesser of:
314.17 	(i) the last 180 consecutive days of an eligible recipient's institutional stay; or
314.18 	(ii) the limits and conditions which apply to federal Medicaid funding for this 
314.19 	service; and
314.20 	(5) "targeted case management" means case management services provided to help 
314.21 	recipients gain access to needed medical, social, educational, and other services and 
314.22 	supports.

314.23 	Sec. 10. Minnesota Statutes 2008, section 256B.0625, subdivision 19a, is amended to 
314.24 	read:
314.25 		Subd. 19a.Personal care assistant services. Medical assistance covers personal 
314.26 	care assistant services in a recipient's home. To qualify for personal care assistant services, 
314.27 	recipients or responsible parties must be able to identify the recipient's needs, direct and 
314.28 	evaluate task accomplishment, and provide for health and safety. Approved hours may be 
314.29 	used outside the home when normal life activities take them outside the home. To use 
314.30 	personal care assistant services at school, the recipient or responsible party must provide 
314.31 	written authorization in the care plan identifying the chosen provider and the daily amount 
314.32 	of services to be used at school. Total hours for services, whether actually performed 
314.33 	inside or outside the recipient's home, cannot exceed that which is otherwise allowed for 
314.34 	personal care assistant services in an in-home setting according to sections 256B.0651and 
314.35 	256B.0653 to 256B.0656 and 256B.0659. Medical assistance does not cover personal care 
315.1 	assistant services for residents of a hospital, nursing facility, intermediate care facility, 
315.2 	health care facility licensed by the commissioner of health, or unless a resident who is 
315.3 	otherwise eligible is on leave from the facility and the facility either pays for the personal 
315.4 	care assistant services or forgoes the facility per diem for the leave days that personal care 
315.5 	assistant services are used. All personal care assistant services must be provided according 
315.6 	to sections 256B.0651and 256B.0653 to 256B.0656 and 256B.0659. Personal care 
315.7 	assistant services may not be reimbursed if the personal care assistant is the spouse or legal 
315.8 	guardian of the recipient or the parent of a recipient under age 18, or the responsible party 
315.9 	or the foster care provider of a recipient who cannot direct the recipient's own care unless, 
315.10 	in the case of a foster care provider, a county or state case manager visits the recipient as 
315.11 	needed, but not less than every six months, to monitor the health and safety of the recipient 
315.12 	and to ensure the goals of the care plan are met. Parents of adult recipients, adult children 
315.13 	of the recipient or adult siblings of the recipient may be reimbursed for personal care 
315.14 	assistant services, if they are granted a waiver under sections 256B.0651and 256B.0653
315.15 	to 256B.0656 and 256B.0659. Notwithstanding the provisions of section 256B.0655, 
315.16 	subdivision 2, paragraph (b), clause (4) 256B.0659, the noncorporate legal guardian or 
315.17 	conservator of an adult, who is not the responsible party and not the personal care provider 
315.18 	organization, may be granted a hardship waiver under sections 256B.0651and 256B.0653
315.19 	to 256B.0656 and 256B.0659, to be reimbursed to provide personal care assistant services 
315.20 	to the recipient, and shall not be considered to have a service provider interest for purposes 
315.21 	of participation on the screening team under section 256B.092, subdivision 7.

315.22 	Sec. 11. Minnesota Statutes 2008, section 256B.0651, subdivision 13, is amended to 
315.23 	read:
315.24 		Subd. 13.Recovery of excessive payments. The commissioner shall seek 
315.25 	monetary recovery from providers of payments made for services which exceed the 
315.26 	limits established in this section and sections 256B.0653256B.0652 to 256B.0656 and 
315.27 	256B.0659. This subdivision does not apply to services provided to a recipient at the 
315.28 	previously authorized level pending an appeal under section 256.045, subdivision 10.

315.29 	Sec. 12. Minnesota Statutes 2008, section 256B.0652, subdivision 3, is amended to 
315.30 	read:
315.31 		Subd. 3.Assessment and prior authorization process. Effective January 1, 1996, 
315.32 	for purposes of providing informed choice, coordinating of local planning decisions, and 
315.33 	streamlining administrative requirements, the assessment and prior authorization process 
315.34 	for persons receiving both home care and home and community-based waivered services 
316.1 	for persons with developmental disabilities shall meet the requirements of sections 
316.2 	256B.0651and 256B.0653 to 256B.0656and 256B.0659 with the following exceptions:
316.3 	(a) Upon request for home care services and subsequent assessment by the public 
316.4 	health nurse under sections 256B.0651and 256B.0653 to 256B.0656 and 256B.0659, 
316.5 	the public health nurse shall participate in the screening process, as appropriate, and, 
316.6 	if home care services are determined to be necessary, participate in the development 
316.7 	of a service plan coordinating the need for home care and home and community-based 
316.8 	waivered services with the assigned county case manager, the recipient of services, and 
316.9 	the recipient's legal representative, if any.
316.10 	(b) The public health nurse shall give prior authorization for home care services 
316.11 	to the extent that home care services are:
316.12 	(1) medically necessary;
316.13 	(2) chosen by the recipient and their legal representative, if any, from the array of 
316.14 	home care and home and community-based waivered services available;
316.15 	(3) coordinated with other services to be received by the recipient as described 
316.16 	in the service plan; and
316.17 	(4) provided within the county's reimbursement limits for home care and home and 
316.18 	community-based waivered services for persons with developmental disabilities.
316.19 	(c) If the public health agency is or may be the provider of home care services to the 
316.20 	recipient, the public health agency shall provide the commissioner of human services with 
316.21 	a written plan that specifies how the assessment and prior authorization process will be 
316.22 	held separate and distinct from the provision of services.

316.23 	Sec. 13. Minnesota Statutes 2008, section 256B.0657, subdivision 2, is amended to 
316.24 	read:
316.25 		Subd. 2.Eligibility. (a) The self-directed supports option is available to a person 
316.26 	who:
316.27 	(1) is a recipient of medical assistance as determined under sections 256B.055, 
316.28 	256B.056, and 256B.057, subdivision 9;
316.29 	(2) is eligible for personal care assistant services under section 256B.0655
316.30 	256B.0659;
316.31 	(3) lives in the person's own apartment or home, which is not owned, operated, or 
316.32 	controlled by a provider of services not related by blood or marriage;
316.33 	(4) has the ability to hire, fire, supervise, establish staff compensation for, and 
316.34 	manage the individuals providing services, and to choose and obtain items, related 
316.35 	services, and supports as described in the participant's plan. If the recipient is not able to 
317.1 	carry out these functions but has a legal guardian or parent to carry them out, the guardian 
317.2 	or parent may fulfill these functions on behalf of the recipient; and
317.3 	(5) has not been excluded or disenrolled by the commissioner.
317.4 	(b) The commissioner may disenroll or exclude recipients, including guardians and 
317.5 	parents, under the following circumstances:
317.6 	(1) recipients who have been restricted by the Primary Care Utilization Review 
317.7 	Committee may be excluded for a specified time period; 
317.8 	(2) recipients who exit the self-directed supports option during the recipient's 
317.9 	service plan year shall not access the self-directed supports option for the remainder of 
317.10 	that service plan year; and
317.11 	(3) when the department determines that the recipient cannot manage recipient 
317.12 	responsibilities under the program.

317.13 	Sec. 14. Minnesota Statutes 2008, section 256B.0657, subdivision 6, is amended to 
317.14 	read:
317.15 		Subd. 6.Services covered. (a) Services covered under the self-directed supports 
317.16 	option include:
317.17 	(1) personal care assistant services under section 256B.0655 256B.0659; and 
317.18 	(2) items, related services, and supports, including assistive technology, that increase 
317.19 	independence or substitute for human assistance to the extent expenditures would 
317.20 	otherwise be used for human assistance.
317.21 	(b) Items, supports, and related services purchased under this option shall not be 
317.22 	considered home care services for the purposes of section 144A.43.

317.23 	Sec. 15. Minnesota Statutes 2008, section 256B.0657, subdivision 8, is amended to 
317.24 	read:
317.25 		Subd. 8.Self-directed budget requirements. The budget for the provision of the 
317.26 	self-directed service option shall be equal to the greater of either:
317.27 	(1) the annual amount of personal care assistant services under section 256B.0655
317.28 	256B.0659 that the recipient has used in the most recent 12-month period; or 
317.29 	(2) the amount determined using the consumer support grant methodology under 
317.30 	section 256.476, subdivision 11, except that the budget amount shall include the federal 
317.31 	and nonfederal share of the average service costs.

317.32 	Sec. 16. Minnesota Statutes 2008, section 256B.49, subdivision 17, is amended to read:
318.1 		Subd. 17.Cost of services and supports. (a) The commissioner shall ensure 
318.2 	that the average per capita expenditures estimated in any fiscal year for home and 
318.3 	community-based waiver recipients does not exceed the average per capita expenditures 
318.4 	that would have been made to provide institutional services for recipients in the absence 
318.5 	of the waiver.
318.6 	(b) The commissioner shall implement on January 1, 2002, one or more aggregate, 
318.7 	need-based methods for allocating to local agencies the home and community-based 
318.8 	waivered service resources available to support recipients with disabilities in need of 
318.9 	the level of care provided in a nursing facility or a hospital. The commissioner shall 
318.10 	allocate resources to single counties and county partnerships in a manner that reflects 
318.11 	consideration of:
318.12 	(1) an incentive-based payment process for achieving outcomes;
318.13 	(2) the need for a state-level risk pool;
318.14 	(3) the need for retention of management responsibility at the state agency level; and
318.15 	(4) a phase-in strategy as appropriate.
318.16 	(c) Until the allocation methods described in paragraph (b) are implemented, the 
318.17 	annual allowable reimbursement level of home and community-based waiver services 
318.18 	shall be the greater of:
318.19 	(1) the statewide average payment amount which the recipient is assigned under the 
318.20 	waiver reimbursement system in place on June 30, 2001, modified by the percentage of 
318.21 	any provider rate increase appropriated for home and community-based services; or
318.22 	(2) an amount approved by the commissioner based on the recipient's extraordinary 
318.23 	needs that cannot be met within the current allowable reimbursement level. The 
318.24 	increased reimbursement level must be necessary to allow the recipient to be discharged 
318.25 	from an institution or to prevent imminent placement in an institution. The additional 
318.26 	reimbursement may be used to secure environmental modifications; assistive technology 
318.27 	and equipment; and increased costs for supervision, training, and support services 
318.28 	necessary to address the recipient's extraordinary needs. The commissioner may approve 
318.29 	an increased reimbursement level for up to one year of the recipient's relocation from an 
318.30 	institution or up to six months of a determination that a current waiver recipient is at 
318.31 	imminent risk of being placed in an institution.
318.32 	(d) Beginning July 1, 2001, medically necessary private duty nursing services 
318.33 	will be authorized under this section as complex and regular care according to sections 
318.34 	256B.0651and 256B.0653 to 256B.0656 and 256B.0659. The rate established by the 
318.35 	commissioner for registered nurse or licensed practical nurse services under any home and 
318.36 	community-based waiver as of January 1, 2001, shall not be reduced.

319.1 	Sec. 17. Minnesota Statutes 2008, section 256B.501, subdivision 4a, is amended to 
319.2 	read:
319.3 		Subd. 4a.Inclusion of home care costs in waiver rates. The commissioner 
319.4 	shall adjust the limits of the established average daily reimbursement rates for waivered 
319.5 	services to include the cost of home care services that may be provided to waivered 
319.6 	services recipients. This adjustment must be used to maintain or increase services and 
319.7 	shall not be used by county agencies for inflation increases for waivered services vendors. 
319.8 	Home care services referenced in this section are those listed in section 256B.0651, 
319.9 	subdivision 2. The average daily reimbursement rates established in accordance with 
319.10 	the provisions of this subdivision apply only to the combined average, daily costs of 
319.11 	waivered and home care services and do not change home care limitations under sections 
319.12 	256B.0651and 256B.0653 to 256B.0656 and 256B.0659. Waivered services recipients 
319.13 	receiving home care as of June 30, 1992, shall not have the amount of their services 
319.14 	reduced as a result of this section.

319.15 	Sec. 18. Minnesota Statutes 2008, section 256G.02, subdivision 6, is amended to read:
319.16 		Subd. 6.Excluded time. "Excluded time" means:
319.17 	(a) any period an applicant spends in a hospital, sanitarium, nursing home, shelter 
319.18 	other than an emergency shelter, halfway house, foster home, semi-independent living 
319.19 	domicile or services program, residential facility offering care, board and lodging facility 
319.20 	or other institution for the hospitalization or care of human beings, as defined in section 
319.21 	144.50, 144A.01, or 245A.02, subdivision 14; maternity home, battered women's shelter, 
319.22 	or correctional facility; or any facility based on an emergency hold under sections 
319.23 	253B.05, subdivisions 1 and 2, and 253B.07, subdivision 6;
319.24 	(b) any period an applicant spends on a placement basis in a training and habilitation 
319.25 	program, including a rehabilitation facility or work or employment program as defined 
319.26 	in section 268A.01; or receiving personal care assistant services pursuant to section 
319.27 	256B.0655, subdivision 2 256B.0659; semi-independent living services provided under 
319.28 	section 252.275, and Minnesota Rules, parts 9525.0500 to 9525.0660; day training and 
319.29 	habilitation programs and assisted living services; and
319.30 	(c) any placement for a person with an indeterminate commitment, including 
319.31 	independent living.

319.32 	Sec. 19. Minnesota Statutes 2008, section 256I.05, subdivision 1a, is amended to read:
319.33 		Subd. 1a.Supplementary service rates. (a) Subject to the provisions of section 
319.34 	256I.04, subdivision 3, the county agency may negotiate a payment not to exceed $426.37 
320.1 	for other services necessary to provide room and board provided by the group residence 
320.2 	if the residence is licensed by or registered by the Department of Health, or licensed by 
320.3 	the Department of Human Services to provide services in addition to room and board, 
320.4 	and if the provider of services is not also concurrently receiving funding for services for 
320.5 	a recipient under a home and community-based waiver under title XIX of the Social 
320.6 	Security Act; or funding from the medical assistance program under section 256B.0655, 
320.7 	subdivision 2 256B.0659, for personal care services for residents in the setting; or residing 
320.8 	in a setting which receives funding under Minnesota Rules, parts 9535.2000 to 9535.3000. 
320.9 	If funding is available for other necessary services through a home and community-based 
320.10 	waiver, or personal care services under section 256B.0655, subdivision 2 256B.0659, 
320.11 	then the GRH rate is limited to the rate set in subdivision 1. Unless otherwise provided 
320.12 	in law, in no case may the supplementary service rate exceed $426.37. The registration 
320.13 	and licensure requirement does not apply to establishments which are exempt from state 
320.14 	licensure because they are located on Indian reservations and for which the tribe has 
320.15 	prescribed health and safety requirements. Service payments under this section may be 
320.16 	prohibited under rules to prevent the supplanting of federal funds with state funds. The 
320.17 	commissioner shall pursue the feasibility of obtaining the approval of the Secretary of 
320.18 	Health and Human Services to provide home and community-based waiver services under 
320.19 	title XIX of the Social Security Act for residents who are not eligible for an existing home 
320.20 	and community-based waiver due to a primary diagnosis of mental illness or chemical 
320.21 	dependency and shall apply for a waiver if it is determined to be cost-effective.
320.22 	(b) The commissioner is authorized to make cost-neutral transfers from the GRH 
320.23 	fund for beds under this section to other funding programs administered by the department 
320.24 	after consultation with the county or counties in which the affected beds are located. 
320.25 	The commissioner may also make cost-neutral transfers from the GRH fund to county 
320.26 	human service agencies for beds permanently removed from the GRH census under a plan 
320.27 	submitted by the county agency and approved by the commissioner. The commissioner 
320.28 	shall report the amount of any transfers under this provision annually to the legislature.
320.29 	(c) The provisions of paragraph (b) do not apply to a facility that has its 
320.30 	reimbursement rate established under section 256B.431, subdivision 4, paragraph (c).

320.31 	Sec. 20. Minnesota Statutes 2008, section 256J.45, subdivision 3, is amended to read:
320.32 		Subd. 3.Good cause exemptions for not attending orientation. (a) The county 
320.33 	agency shall not impose the sanction under section 256J.46 if it determines that the 
320.34 	participant has good cause for failing to attend orientation. Good cause exists when:
320.35 	(1) appropriate child care is not available;
321.1 	(2) the participant is ill or injured;
321.2 	(3) a family member is ill and needs care by the participant that prevents the 
321.3 	participant from attending orientation. For a caregiver with a child or adult in the 
321.4 	household who meets the disability or medical criteria for home care services under 
321.5 	section 256B.0655, subdivision 1c 256B.0659, or a home and community-based waiver 
321.6 	services program under chapter 256B, or meets the criteria for severe emotional 
321.7 	disturbance under section 245.4871, subdivision 6, or for serious and persistent mental 
321.8 	illness under section 245.462, subdivision 20, paragraph (c), good cause also exists when 
321.9 	an interruption in the provision of those services occurs which prevents the participant 
321.10 	from attending orientation;
321.11 	(4) the caregiver is unable to secure necessary transportation;
321.12 	(5) the caregiver is in an emergency situation that prevents orientation attendance;
321.13 	(6) the orientation conflicts with the caregiver's work, training, or school schedule; or
321.14 	(7) the caregiver documents other verifiable impediments to orientation attendance 
321.15 	beyond the caregiver's control.
321.16 	(b) Counties must work with clients to provide child care and transportation 
321.17 	necessary to ensure a caregiver has every opportunity to attend orientation.

321.18 	Sec. 21. Minnesota Statutes 2008, section 604A.33, subdivision 1, is amended to read:
321.19 		Subdivision 1.Application. This section applies to residential treatment programs 
321.20 	for children or group homes for children licensed under chapter 245A, residential 
321.21 	services and programs for juveniles licensed under section 241.021, providers licensed 
321.22 	pursuant to sections 144A.01 to 144A.33 or sections 144A.43 to  144A.47, personal care 
321.23 	provider organizations under section 256B.0655, subdivision 1g 256B.0659, providers 
321.24 	of day training and habilitation services under sections 252.40 to 252.46, board and 
321.25 	lodging facilities licensed under chapter 157, intermediate care facilities for persons with 
321.26 	developmental disabilities, and other facilities licensed to provide residential services to 
321.27 	persons with developmental disabilities.

321.28 	Sec. 22. Minnesota Statutes 2008, section 609.232, subdivision 11, is amended to read:
321.29 		Subd. 11.Vulnerable adult. "Vulnerable adult" means any person 18 years of 
321.30 	age or older who:
321.31 	(1) is a resident inpatient of a facility;
321.32 	(2) receives services at or from a facility required to be licensed to serve adults 
321.33 	under sections 245A.01 to 245A.15, except that a person receiving outpatient services for 
321.34 	treatment of chemical dependency or mental illness, or one who is committed as a sexual 
322.1 	psychopathic personality or as a sexually dangerous person under chapter 253B, is not 
322.2 	considered a vulnerable adult unless the person meets the requirements of clause (4);
322.3 	(3) receives services from a home care provider required to be licensed under section 
322.4 	144A.46; or from a person or organization that exclusively offers, provides, or arranges 
322.5 	for personal care assistant services under the medical assistance program as authorized 
322.6 	under sections 256B.04, subdivision 16, 256B.0625, subdivision 19a, 256B.0651, and 
322.7 	256B.0653 to 256B.0656 and 256B.0659; or
322.8 	(4) regardless of residence or whether any type of service is received, possesses a 
322.9 	physical or mental infirmity or other physical, mental, or emotional dysfunction:
322.10 	(i) that impairs the individual's ability to provide adequately for the individual's 
322.11 	own care without assistance, including the provision of food, shelter, clothing, health 
322.12 	care, or supervision; and
322.13 	(ii) because of the dysfunction or infirmity and the need for assistance, the individual 
322.14 	has an impaired ability to protect the individual from maltreatment.

322.15 	Sec. 23. Minnesota Statutes 2008, section 626.5572, subdivision 6, is amended to read:
322.16 		Subd. 6.Facility. (a) "Facility" means a hospital or other entity required to be 
322.17 	licensed under sections 144.50 to 144.58; a nursing home required to be licensed to 
322.18 	serve adults under section 144A.02; a residential or nonresidential facility required to 
322.19 	be licensed to serve adults under sections 245A.01 to 245A.16; a home care provider 
322.20 	licensed or required to be licensed under section 144A.46; a hospice provider licensed 
322.21 	under sections 144A.75 to 144A.755; or a person or organization that exclusively offers, 
322.22 	provides, or arranges for personal care assistant services under the medical assistance 
322.23 	program as authorized under sections 256B.04, subdivision 16, 256B.0625, subdivision 
322.24 	19a, 256B.0651, and 256B.0653 to 256B.0656, and 256B.0659.
322.25 	(b) For home care providers and personal care attendants, the term "facility" refers 
322.26 	to the provider or person or organization that exclusively offers, provides, or arranges for 
322.27 	personal care services, and does not refer to the client's home or other location at which 
322.28 	services are rendered.

322.29 	Sec. 24. Minnesota Statutes 2008, section 626.5572, subdivision 21, is amended to 
322.30 	read:
322.31 		Subd. 21. Vulnerable adult. "Vulnerable adult" means any person 18 years of 
322.32 	age or older who: 
322.33 	(1) is a resident or inpatient of a facility; 
323.1 	(2) receives services at or from a facility required to be licensed to serve adults 
323.2 	under sections 245A.01 to 245A.15, except that a person receiving outpatient services for 
323.3 	treatment of chemical dependency or mental illness, or one who is served in the Minnesota 
323.4 	sex offender program on a court-hold order for commitment, or is committed as a sexual 
323.5 	psychopathic personality or as a sexually dangerous person under chapter 253B, is not 
323.6 	considered a vulnerable adult unless the person meets the requirements of clause (4); 
323.7 	(3) receives services from a home care provider required to be licensed under section 
323.8 	144A.46; or from a person or organization that exclusively offers, provides, or arranges 
323.9 	for personal care assistant services under the medical assistance program as authorized 
323.10 	under sections 256B.04, subdivision 16, 256B.0625, subdivision 19a, 256B.0651, and
323.11 	256B.0653 to 256B.0656, and 256B.0659; or 
323.12 	(4) regardless of residence or whether any type of service is received, possesses a 
323.13 	physical or mental infirmity or other physical, mental, or emotional dysfunction: 
323.14 	(i) that impairs the individual's ability to provide adequately for the individual's 
323.15 	own care without assistance, including the provision of food, shelter, clothing, health 
323.16 	care, or supervision; and 
323.17 	(ii) because of the dysfunction or infirmity and the need for assistance, the individual 
323.18 	has an impaired ability to protect the individual from maltreatment. 

323.19 	ARTICLE 13
323.20 	CHEMICAL AND MENTAL HEALTH

323.21 	Section 1. Minnesota Statutes 2008, section 245.4885, subdivision 1, is amended to 
323.22 	read:
323.23 		Subdivision 1.Admission criteria. The county board shall, (a) Prior to admission, 
323.24 	except in the case of emergency admission, determine the needed level of care for all 
323.25 	children referred for treatment of severe emotional disturbance in a treatment foster care 
323.26 	setting, residential treatment facility, or informally admitted to a regional treatment center
323.27 	shall undergo an assessment to determine the appropriate level of care if public funds are 
323.28 	used to pay for the services. The county board shall also determine the needed level of 
323.29 	care for all children admitted to an acute care hospital for treatment of severe emotional 
323.30 	disturbance if public funds other than reimbursement under chapters 256B and 256D 
323.31 	are used to pay for the services.
323.32 	(b) The county board shall determine the appropriate level of care when 
323.33 	county-controlled funds are used to pay for the services. When the child is enrolled in 
323.34 	a prepaid health program under section 256B.69, the enrolled child's contracted health 
323.35 	plan must determine the appropriate level of care. When the child is an Indian tribal 
324.1 	member seeking placement through the tribe in a tribally operated or contracted facility, 
324.2 	the tribe must determine the appropriate level of care. When more than one entity bears 
324.3 	responsibility for coverage, the entities shall coordinate level of care determination 
324.4 	activities to the extent possible.
324.5 	(c) The level of care determination shall determine whether the proposed treatment:
324.6 	(1) is necessary;
324.7 	(2) is appropriate to the child's individual treatment needs;
324.8 	(3) cannot be effectively provided in the child's home; and
324.9 	(4) provides a length of stay as short as possible consistent with the individual 
324.10 	child's need.
324.11 	(d) When a level of care determination is conducted, the county board responsible 
324.12 	entity may not determine that referral or admission to a treatment foster care setting, or
324.13 	residential treatment facility, or acute care hospital is not appropriate solely because 
324.14 	services were not first provided to the child in a less restrictive setting and the child failed 
324.15 	to make progress toward or meet treatment goals in the less restrictive setting. The level 
324.16 	of care determination must be based on a diagnostic assessment that includes a functional 
324.17 	assessment which evaluates family, school, and community living situations; and an 
324.18 	assessment of the child's need for care out of the home using a validated tool which 
324.19 	assesses a child's functional status and assigns an appropriate level of care. The validated 
324.20 	tool must be approved by the commissioner of human services. If a diagnostic assessment 
324.21 	including a functional assessment has been completed by a mental health professional 
324.22 	within the past 180 days, a new diagnostic assessment need not be completed unless in the 
324.23 	opinion of the current treating mental health professional the child's mental health status 
324.24 	has changed markedly since the assessment was completed. The child's parent shall be 
324.25 	notified if an assessment will not be completed and of the reasons. A copy of the notice 
324.26 	shall be placed in the child's file. Recommendations developed as part of the level of care 
324.27 	determination process shall include specific community services needed by the child and, 
324.28 	if appropriate, the child's family, and shall indicate whether or not these services are 
324.29 	available and accessible to the child and family.
324.30 	During the level of care determination process, the child, child's family, or child's 
324.31 	legal representative, as appropriate, must be informed of the child's eligibility for case 
324.32 	management services and family community support services and that an individual 
324.33 	family community support plan is being developed by the case manager, if assigned.
324.34 	The level of care determination shall comply with section 260C.212. Wherever 
324.35 	possible, The parent shall be consulted in the process, unless clinically inappropriate
324.36 	detrimental to the child.
325.1 	The level of care determination, and placement decision, and recommendations for 
325.2 	mental health services must be documented in the child's record.
325.3 	An alternate review process may be approved by the commissioner if the county 
325.4 	board demonstrates that an alternate review process has been established by the county 
325.5 	board and the times of review, persons responsible for the review, and review criteria are 
325.6 	comparable to the standards in clauses (1) to (4).

325.7 	Sec. 2. Minnesota Statutes 2008, section 254A.02, is amended by adding a subdivision 
325.8 	to read:
325.9 		Subd. 8a.Placing authority. "Placing authority" means a county, prepaid health 
325.10 	plan, or tribal governing board governed by Minnesota Rules, parts 9530.6600 to 
325.11 	9530.6655.

325.12 	Sec. 3. [254A.081] GRANTS FOR DETOXIFICATION SERVICES.
325.13 	(a) Effective January 1, 2011, funds appropriated for alcohol and drug abuse services 
325.14 	from the children's and community services act grants under section 256M.40 must be 
325.15 	allocated to counties for detoxification services as defined in section 254A.08.
325.16 	(b) Funds must be allocated in proportion to the percent of state population at or 
325.17 	below 100 percent of the federal poverty guideline residing in each county.
325.18 	(c) Upon receipt of county expenditure reports for January to June of each year, the 
325.19 	commissioner shall pay each county based on the county's actual expenditures to date plus 
325.20 	projected expenditures for the remainder of the calendar year up to the total amount of 
325.21 	the allocation.
325.22 	(d) By January 31, 2012, and each year thereafter, counties shall report actual 
325.23 	expenditures for detoxification services for the prior year. The commissioner shall 
325.24 	reallocate unexpended funds to counties that expended more than their allocation, based 
325.25 	on the percent of state population at or below 100 percent of the federal poverty guideline 
325.26 	residing in each eligible county.

325.27 	Sec. 4. Minnesota Statutes 2008, section 254A.16, is amended by adding a subdivision 
325.28 	to read:
325.29 		Subd. 6.Monitoring. The commissioner shall gather and placing authorities shall 
325.30 	provide information to measure compliance with Minnesota Rules, parts 9530.6600 to 
325.31 	9530.6655. The commissioner shall specify the format for data collection to facilitate 
325.32 	tracking, aggregating, and using the information.

326.1 	Sec. 5. Minnesota Statutes 2008, section 254B.03, subdivision 3, is amended to read:
326.2 		Subd. 3.Local agencies to pay state for county share.  Local agencies shall pay 
326.3 	the state for the county share of the services authorized by the local agency, except when 
326.4 	the payment is made according to section 254B.09, subdivision 8.

326.5 	Sec. 6. [254B.11] MAXIMUM RATES.
326.6 	The commissioner shall publish maximum rates for vendors of the consolidated 
326.7 	chemical dependency treatment fund by July 1 of each year for implementation the 
326.8 	following January 1. Rates for calendar year 2010 must not exceed 185 percent of the 
326.9 	average rate on January 1, 2009, for each group of vendors with similar attributes. Unless 
326.10 	a new rate methodology is developed under section 254B.12, rates for services provided on 
326.11 	and after July 1, 2011, must not exceed 160 percent of the average rate on January 1, 2009, 
326.12 	for each group of vendors with similar attributes. Payment for services provided by Indian 
326.13 	Health Services or by agencies operated by Indian tribes for medical assistance-eligible 
326.14 	individuals must be governed by the applicable federal rate methodology.

326.15 	Sec. 7. [254B.12] RATE METHODOLOGY.
326.16 	(a) The commissioner shall, with broad-based stakeholder input, develop a 
326.17 	recommendation and present a report to the 2011 legislature, including proposed 
326.18 	legislation for a new rate methodology for the consolidated chemical dependency 
326.19 	treatment fund. The new methodology must replace county-negotiated rates with a 
326.20 	uniform statewide methodology that must include:
326.21 	(1) a graduated reimbursement scale based on the patients' level of acuity and 
326.22 	complexity; and
326.23 	(2) beginning July 1, 2011, retroactive quality incentive payments up to four percent 
326.24 	of each provider's prior-year approved chemical dependency fund claims.
326.25 	(b) The quality incentive payments under paragraph (a), clause (2), must be based on 
326.26 	each provider's performance in the prior year relating to certain program criteria, based on 
326.27 	best practices in addiction treatment. The quality incentive criteria under paragraph (a), 
326.28 	clause (2), may include program completion rates, national outcome measures, program 
326.29 	innovations, lack of licensing violations, and other measures to be determined by the 
326.30 	commissioner.

326.31 	Sec. 8. Minnesota Statutes 2008, section 256B.0625, subdivision 41, is amended to 
326.32 	read:
327.1 		Subd. 41.Residential services for children with severe emotional disturbance.
 327.2 	Medical assistance covers rehabilitative services in accordance with section 256B.0945
327.3 	that are provided by a county through a residential facility under contract with a county or 
327.4 	Indian tribe, for children who have been diagnosed with severe emotional disturbance and 
327.5 	have been determined to require the level of care provided in a residential facility.

327.6 	Sec. 9. Minnesota Statutes 2008, section 256B.0625, subdivision 47, is amended to 
327.7 	read:
327.8 		Subd. 47.Treatment foster care services. Effective July 1, 2007 2011, and subject 
327.9 	to federal approval, medical assistance covers treatment foster care services according to 
327.10 	section 256B.0946.

327.11 	Sec. 10. Minnesota Statutes 2008, section 256B.0944, is amended by adding a 
327.12 	subdivision to read:
327.13 		Subd. 4a.Alternative provider standards. If a provider entity demonstrates that, 
327.14 	due to geographic or other barriers, it is not feasible to provide mobile crisis intervention 
327.15 	services 24 hours a day, seven days a week, according to the standards in subdivision 4, 
327.16 	paragraph (b), clause (1), the commissioner may approve a crisis response provider based 
327.17 	on an alternative plan proposed by a provider entity. The alternative plan must:
327.18 	(1) result in increased access and a reduction in disparities in the availability of 
327.19 	crisis services; and
327.20 	(2) provide mobile services outside of the usual nine-to-five office hours and on 
327.21 	weekends and holidays.

327.22 	Sec. 11. Minnesota Statutes 2008, section 256B.0945, subdivision 4, is amended to 
327.23 	read:
327.24 		Subd. 4.Payment rates. (a) Notwithstanding sections 256B.19 and 256B.041, 
327.25 	payments to counties for residential services provided by a residential facility shall only 
327.26 	be made of federal earnings for services provided under this section, and the nonfederal 
327.27 	share of costs for services provided under this section shall be paid by the county from 
327.28 	sources other than federal funds or funds used to match other federal funds. Payment to 
327.29 	counties for services provided according to this section shall be a proportion of the per 
327.30 	day contract rate that relates to rehabilitative mental health services and shall not include 
327.31 	payment for costs or services that are billed to the IV-E program as room and board. 
327.32 	(b) Per diem rates paid to providers under this section by prepaid plans shall be the 
327.33 	proportion of the per-day contract rate that relates to rehabilitative mental health services 
328.1 	and shall not include payment for group foster care costs or services that are billed to the 
328.2 	county of financial responsibility.
328.3 	(c) (b) The commissioner shall set aside a portion not to exceed five percent of the 
328.4 	federal funds earned for county expenditures under this section to cover the state costs of 
328.5 	administering this section. Any unexpended funds from the set-aside shall be distributed 
328.6 	to the counties in proportion to their earnings under this section.
328.7 	(c) The payment rate negotiated and paid to a provider by prepaid health plans 
328.8 	under section 256B.69 for services under this section must be supplemented by the 
328.9 	commissioner from state appropriations to cover the nontreatment costs at a rate equal to 
328.10 	the portion of the county negotiated per diem attributable to nontreatment service costs for 
328.11 	that provider as determined by the commissioner of human services.
328.12 	(d) Payment for mental health rehabilitative services provided under this section by 
328.13 	or under contract with an Indian tribe or tribal organization or by agencies operated by or 
328.14 	under contract with an Indian tribe or tribal organization may be made according to section 
328.15 	256B.0625, subdivision 34, or other relevant federally approved rate setting methodology.

328.16 	Sec. 12. Minnesota Statutes 2008, section 256B.0947, subdivision 1, is amended to 
328.17 	read:
328.18 		Subdivision 1.Scope. Subject to federal approval Effective May 1, 2010, medical 
328.19 	assistance covers medically necessary, intensive nonresidential rehabilitative mental 
328.20 	health services as defined in subdivision 2, for recipients as defined in subdivision 3, when 
328.21 	the services are provided by an entity meeting the standards in this section.

328.22 	Sec. 13. Minnesota Statutes 2008, section 256B.761, is amended to read:
328.23 	256B.761 REIMBURSEMENT FOR MENTAL HEALTH SERVICES.
328.24 	(a) Effective for services rendered on or after July 1, 2001, payment for medication 
328.25 	management provided to psychiatric patients, outpatient mental health services, day 
328.26 	treatment services, home-based mental health services, and family community support 
328.27 	services shall be paid at the lower of (1) submitted charges, or (2) 75.6 percent of the 
328.28 	50th percentile of 1999 charges.
328.29 	(b) Effective July 1, 2001, the medical assistance rates for outpatient mental health 
328.30 	services provided by an entity that operates: (1) a Medicare-certified comprehensive 
328.31 	outpatient rehabilitation facility; and (2) a facility that was certified prior to January 1, 
328.32 	1993, with at least 33 percent of the clients receiving rehabilitation services in the most 
328.33 	recent calendar year who are medical assistance recipients, will be increased by 38 percent, 
329.1 	when those services are provided within the comprehensive outpatient rehabilitation 
329.2 	facility and provided to residents of nursing facilities owned by the entity.
329.3 	(c) Effective January 1, 2010, the rate for partial hospitalization for children is 
329.4 	increased to equal the rate for partial hospitalization for adults.

329.5 	Sec. 14. MENTAL HEALTH PORTION OF CHILDREN'S AND COMMUNITY 
329.6 	SERVICES ACT GRANTS.
 329.7 	The commissioner of human services shall consult with stakeholders to develop a 
329.8 	recommendation to the 2010 legislative session regarding administration of the mental 
329.9 	health services portion of those funds to be allocated to mental health starting January 1, 
329.10 	2011, from the children's and community services act grants under Minnesota Statutes, 
329.11 	section 256M.40. The recommendation must include:
329.12 	(1) an effective and efficient process to administer these funds together with other 
329.13 	mental health services funding;
329.14 	(2) identification of the priorities and services to be funded;
329.15 	(3) a reporting and monitoring methodology that is efficient and ensures 
329.16 	accountability; and
329.17 	(4) a funding allocation method.

329.18 	ARTICLE 14
329.19 	HEALTH-RELATED FEES

329.20 	Section 1. Minnesota Statutes 2008, section 148.108, is amended to read:
329.21 	148.108 FEES.
329.22 		Subdivision 1.Fees. In addition to the fees established in Minnesota Rules, chapter 
329.23 	2500, and according to sections 148.05, 148.06, 148.07, and 148.10, subdivisions 2 and 3, 
329.24 	the board is authorized to charge the fees in this section.
329.25 		Subd. 2.Annual renewal of inactive acupuncture registration License and 
329.26 	registration fees. The annual renewal of an inactive acupuncture registration fee is $25.
329.27 	License and registration fees are as follows:
329.28 	(1) for a license application fee, $300;
329.29 	(2) for a license active renewal fee, $220;
329.30 	(3) for a license inactive renewal fee, $165;
329.31 	(4) for an acupuncture initial registration fee, $125;
329.32 	(5) for an acupuncture active registration renewal fee, $75;
329.33 	(6) for an acupuncture registration reinstatement fee, $50;
329.34 	(7) for an acupuncture inactive registration renewal fee, $25;
330.1 	(8) for an animal chiropractic registration fee, $125;
330.2 	(9) for an animal chiropractic active registration renewal fee, $75; and
330.3 	(10) for an animal chiropractic inactive registration renewal fee, $25.
330.4 		Subd. 3.Acupuncture reinstatement. The acupuncture reinstatement fee is $50.

330.5 	Sec. 2. Minnesota Statutes 2008, section 148D.180, subdivision 1, is amended to read:
330.6 		Subdivision 1.Application fees. Application fees for licensure are as follows:
330.7 	(1) for a licensed social worker, $45;
330.8 	(2) for a licensed graduate social worker, $45;
330.9 	(3) for a licensed independent social worker, $90 $45;
330.10 	(4) for a licensed independent clinical social worker, $90 $45;
330.11 	(5) for a temporary license, $50; and
330.12 	(6) for a licensure by endorsement, $150 $85.
330.13 	The fee for criminal background checks is the fee charged by the Bureau of Criminal 
330.14 	Apprehension. The criminal background check fee must be included with the application 
330.15 	fee as required pursuant to section 148D.055.

330.16 	Sec. 3. Minnesota Statutes 2008, section 148D.180, subdivision 2, is amended to read:
330.17 		Subd. 2.License fees. License fees are as follows:
330.18 	(1) for a licensed social worker, $115.20 $81;
330.19 	(2) for a licensed graduate social worker, $201.60 $144;
330.20 	(3) for a licensed independent social worker, $302.40 $216;
330.21 	(4) for a licensed independent clinical social worker, $331.20 $238.50;
330.22 	(5) for an emeritus license, $43.20; and
330.23 	(6) for a temporary leave fee, the same as the renewal fee specified in subdivision 3.
330.24 	If the licensee's initial license term is less or more than 24 months, the required 
330.25 	license fees must be prorated proportionately.

330.26 	Sec. 4. Minnesota Statutes 2008, section 148D.180, subdivision 3, is amended to read:
330.27 		Subd. 3.Renewal fees. Renewal fees for licensure are as follows:
330.28 	(1) for a licensed social worker, $115.20 $81;
330.29 	(2) for a licensed graduate social worker, $201.60 $144;
330.30 	(3) for a licensed independent social worker, $302.40 $216; and
330.31 	(4) for a licensed independent clinical social worker, $331.20 $238.50.

330.32 	Sec. 5. Minnesota Statutes 2008, section 148D.180, subdivision 5, is amended to read:
331.1 		Subd. 5.Late fees. Late fees are as follows:
331.2 	(1) renewal late fee, one-half one-fourth of the renewal fee specified in subdivision 
331.3 	3; and
331.4 	(2) supervision plan late fee, $40.

331.5 	Sec. 6. Minnesota Statutes 2008, section 148E.180, subdivision 1, is amended to read:
331.6 		Subdivision 1.Application fees. Application fees for licensure are as follows:
331.7 	(1) for a licensed social worker, $45;
331.8 	(2) for a licensed graduate social worker, $45;
331.9 	(3) for a licensed independent social worker, $90 $45;
331.10 	(4) for a licensed independent clinical social worker, $90 $45;
331.11 	(5) for a temporary license, $50; and
331.12 	(6) for a licensure by endorsement, $150 $85.
331.13 	The fee for criminal background checks is the fee charged by the Bureau of Criminal 
331.14 	Apprehension. The criminal background check fee must be included with the application 
331.15 	fee as required according to section 148E.055.

331.16 	Sec. 7. Minnesota Statutes 2008, section 148E.180, subdivision 2, is amended to read:
331.17 		Subd. 2.License fees. License fees are as follows:
331.18 	(1) for a licensed social worker, $115.20 $81;
331.19 	(2) for a licensed graduate social worker, $201.60 $144;
331.20 	(3) for a licensed independent social worker, $302.40 $216;
331.21 	(4) for a licensed independent clinical social worker, $331.20 $238.50;
331.22 	(5) for an emeritus license, $43.20; and
331.23 	(6) for a temporary leave fee, the same as the renewal fee specified in subdivision 3.
331.24 	If the licensee's initial license term is less or more than 24 months, the required 
331.25 	license fees must be prorated proportionately.

331.26 	Sec. 8. Minnesota Statutes 2008, section 148E.180, subdivision 3, is amended to read:
331.27 		Subd. 3.Renewal fees. Renewal fees for licensure are as follows:
331.28 	(1) for a licensed social worker, $115.20 $81;
331.29 	(2) for a licensed graduate social worker, $201.60 $144;
331.30 	(3) for a licensed independent social worker, $302.40 $216; and
331.31 	(4) for a licensed independent clinical social worker, $331.20 $238.50.

331.32 	Sec. 9. Minnesota Statutes 2008, section 148E.180, subdivision 5, is amended to read:
332.1 		Subd. 5.Late fees. Late fees are as follows:
332.2 	(1) renewal late fee, one-half one-fourth of the renewal fee specified in subdivision 
332.3 	3; and
332.4 	(2) supervision plan late fee, $40.

332.5 	Sec. 10. [156.011] LICENSE, APPLICATION, AND EXAMINATION FEES.
332.6 		Subdivision 1.Application fee. A person applying for a license to practice 
332.7 	veterinary medicine in Minnesota or applying for a permit to take the national veterinary 
332.8 	medical examination must pay a $60 nonrefundable application fee to the board. Persons 
332.9 	submitting concurrent applications for licensure and a national examination permit shall 
332.10 	pay only one application fee.
332.11 		Subd. 2.Examination fees. (a) An applicant for veterinary licensure in Minnesota 
332.12 	must successfully pass the Minnesota Veterinary Jurisprudence Examination. The fee for 
332.13 	this examination is $60, payable to the board.
332.14 	(b) An applicant participating in the national veterinary licensing examination must 
332.15 	complete a separate application for the national examination and submit the application 
332.16 	to the board for approval. Payment for the national examination must be made by the 
332.17 	applicant to the national board examination committee.

332.18 	Sec. 11. [156.012] INITIAL AND RENEWAL FEE.
332.19 		Subdivision 1.Required for licensure. A person now licensed to practice 
332.20 	veterinary medicine in this state, or who becomes licensed by the Board of Veterinary 
332.21 	Medicine to engage in the practice, shall pay an initial fee or a biennial license renewal 
332.22 	fee if the person wishes to practice veterinary medicine in the coming two-year period 
332.23 	or remain licensed as a veterinarian. A licensure period begins on March 1 and expires 
332.24 	the last day of February two years later. A licensee with an even-numbered license shall 
332.25 	renew by March 1 of even-numbered years and a licensee with an odd-numbered license 
332.26 	shall renew by March 1 of odd-numbered years.
332.27 		Subd. 2.Amount. The initial licensure fee and the biennial renewal fee is $280 
332.28 	and must be paid to the executive director of the board. By January 1 of the first year 
332.29 	for which the biennial renewal fee is due, the board shall issue a renewal application to 
332.30 	a current licensee to the last address maintained in the board file. Failure to receive this 
332.31 	notice does not relieve the licensee of the obligation to pay renewal fees so that they are 
332.32 	received by the board on or before the renewal date of March 1.
332.33 	Initial licenses issued after the start of the licensure renewal period are valid only 
332.34 	until the end of the period.
333.1 		Subd. 3.Date due. A licensee must apply for a renewal license on or before March 
333.2 	1 of the first year of the biennial license renewal period. A renewal license is valid 
333.3 	from March 1 through the last day of February of the last year of the two-year license 
333.4 	renewal period. An application postmarked no later than the last day of February must be 
333.5 	considered to have been received on March 1.
333.6 		Subd. 4.Late renewal penalty. An applicant for renewal must pay a late renewal 
333.7 	penalty of $140 in addition to the renewal fee if the application for renewal is received 
333.8 	after March 1 of the licensure renewal period. A renewed license issued after March 1 of 
333.9 	the licensure renewal period is valid only to the end of the period regardless of when the 
333.10 	renewal fee is received.
333.11 		Subd. 5.Reinstatement fee. An applicant for license renewal whose license 
333.12 	has previously been suspended by official board action for nonrenewal must pay a 
333.13 	reinstatement fee of $60 in addition to the $280 renewal fee and the $140 late renewal 
333.14 	penalty.
333.15 		Subd. 6.Penalty for failure to pay. Within 30 days after the renewal date, a 
333.16 	licensee who has not renewed the license must be notified by letter sent to the last known 
333.17 	address of the licensee in the file of the board that the renewal is overdue and that failure 
333.18 	to pay the current fee and current late fee within 60 days after the renewal date will result 
333.19 	in suspension of the license. A second notice must be sent by registered or certified mail at 
333.20 	least seven days before a board meeting occurring 60 days or more after the renewal date 
333.21 	to a licensee who has not paid the renewal fee and late fee.
333.22 		Subd. 7.Suspension. The board, by means of a roll call vote, shall suspend the 
333.23 	license of a licensee whose license renewal is at least 60 days overdue and to whom 
333.24 	notification has been sent as provided in subpart 5. Failure of a licensee to receive 
333.25 	notification is not grounds for later challenge by the licensee of the suspension. The 
333.26 	former licensee must be notified by registered or certified letter within seven days of the 
333.27 	board action. The suspended status placed on a license may be removed only on payment 
333.28 	of renewal fees and late penalty fees for each licensure period or part of a period that the 
333.29 	license was not renewed. A licensee who fails to renew a license for five years or more 
333.30 	must meet the criteria of section 156.071, for relicensure.
333.31 		Subd. 8.Inactive license. (a) A person holding a current active license to practice 
333.32 	veterinary medicine in Minnesota may, at the time of the person's next biennial license 
333.33 	renewal date, renew the license as an inactive license at one-half the renewal fee of an 
333.34 	active license. The license may be continued in an inactive status by renewal on a biennial 
333.35 	basis at one-half the regular license fee.
334.1 	(b) A person holding an inactive license is not permitted to practice veterinary 
334.2 	medicine in Minnesota and remains under the disciplinary authority of the board.
334.3 	(c) A person may convert a current inactive license to an active license upon 
334.4 	application to and approval by the board. The application must include:
334.5 	(1) documentation of licensure in good standing and of having met continuing 
334.6 	education requirements of current state of practice, or documentation of having met 
334.7 	Minnesota continuing education requirements retroactive to the date of licensure 
334.8 	inactivation;
334.9 	(2) certification by the applicant that the applicant is not currently under disciplinary 
334.10 	orders or investigation for acts that could result in disciplinary action in any other 
334.11 	jurisdiction; and
334.12 	(3) payment of a fee equal to the full difference between an inactive and active 
334.13 	license if converting during the first year of the biennial license cycle or payment of a fee 
334.14 	equal to one-half the difference between an inactive and an active license if converting 
334.15 	during the second year of the license cycle.
334.16 	(d) Deadline for renewal of an inactive license is March 1 of the first year of the 
334.17 	biennial license renewal period. A late renewal penalty of one-half the inactive renewal 
334.18 	fee must be paid if renewal is received after March 1.

334.19 	Sec. 12. Minnesota Statutes 2008, section 156.015, is amended to read:
334.20 	156.015 MISCELLANEOUS FEES.
334.21 		Subdivision 1.Verification of licensure. The board may charge a fee of $25 per 
334.22 	license verification to a licensee for verification of licensure status provided to other 
334.23 	veterinary licensing boards.
334.24 		Subd. 2.Continuing education review. The board may charge a fee of $50 per 
334.25 	submission to a sponsor for review and approval of individual continuing education 
334.26 	seminars, courses, wet labs, and lectures. This fee does not apply to continuing education 
334.27 	sponsors that already meet the criteria for preapproval under Minnesota Rules, part 
334.28 	9100.1000, subpart 3, item A.
334.29 		Subd. 3.Temporary license fee. A person meeting the requirements for issuance 
334.30 	of a temporary permit to practice veterinary medicine under section 156.073, pending 
334.31 	examination, who desires a temporary permit shall pay a fee of $60 to the board.
334.32 		Subd. 4.Duplicate license. A person requesting issuance of a duplicate or 
334.33 	replacement license shall pay a fee of $15 to the board.
334.34 		Subd. 5.Mailing examination and reference materials. An applicant who resides 
334.35 	outside the Twin Cities metropolitan area may request to take the Minnesota Veterinary 
335.1 	Jurisprudence Examination by mail. The fee for mailing the examination and reference 
335.2 	materials is $15.

335.3 	Sec. 13.  REPEALER.
 335.4 	(a) Minnesota Rules, parts 9100.0400, subparts 1 and 3; 9100.0500; and 9100.0600,
335.5 	are repealed.
335.6 	(b) Minnesota Statutes 2008, section 148D.180, subdivision 8, is repealed.

335.7 	ARTICLE 15
335.8 	CORRECTIONAL STATE EMPLOYEES RETIREMENT PLAN - I

335.9 	Section 1. Minnesota Statutes 2008, section 352.90, is amended to read:
335.10 	352.90 POLICY.
335.11 	It is the policy of the legislature to provide special retirement benefits for and special 
335.12 	contributions by certain correctional employees who may be required to retire at an early 
335.13 	age because they lose the mental or physical capacity required to maintain the safety, 
335.14 	security, discipline, and custody of inmates at state correctional facilities or, of patients at 
335.15 	the Minnesota Security Hospital, or of patients in the Minnesota sex offender program, or 
335.16 	of patients in the Minnesota extended treatment options program.

335.17 	Sec. 2. Minnesota Statutes 2008, section 352.91, subdivision 1, is amended to read:
335.18 		Subdivision 1.Qualifying jobs. "Covered correctional service" means service 
335.19 	performed by a state employee, as defined in section 352.01, who is employed at a state 
335.20 	correctional facility, the Minnesota Security Hospital, or the Minnesota sex offender 
335.21 	program as: 
335.22 	(1) a corrections officer 1;
335.23 	(2) a corrections officer 2;
335.24 	(3) a corrections officer 3;
335.25 	(4) a corrections officer supervisor;
335.26 	(5) (4) a corrections lieutenant;
335.27 	(6) (5) a corrections captain;
335.28 	(7) (6) a security counselor; 
335.29 	(8) (7) a security counselor lead; or
335.30 	(9) (8) a corrections canine officer.;
335.31 	(9) group supervisor; or
335.32 	(10) group supervisor assistant.

336.1 	Sec. 3. Minnesota Statutes 2008, section 352.91, subdivision 3h, is amended to read:
336.2 		Subd. 3h.Employment occupation name changes. (a) If the occupational title of a 
336.3 	state employee covered by the Minnesota correctional employees retirement plan changes 
336.4 	from the applicable title listed in subdivision 1, 2, 2a, 3c, 3d, 3e, 3f, or 3g, qualification for 
336.5 	coverage by the correctional state employees retirement plan continues until the July 1 
336.6 	next following the title change if the commissioner of finance certifies to the executive 
336.7 	director of the Minnesota State Retirement System and to the executive director of the 
336.8 	Legislative Commission on Pensions and Retirement that the duties, requirements, and 
336.9 	responsibilities of the new occupational title are substantially identical to the duties, 
336.10 	requirements, and responsibilities of the prior occupational title.
336.11 	(b) If the commissioner of finance does not certify a new occupational title under 
336.12 	paragraph (a), eligibility for future correctional state employees retirement coverage 
336.13 	terminates as of the start of the first payroll period next following the effective date of the 
336.14 	occupational title change.
336.15 	(c) For consideration by the Legislative Commission on Pensions and Retirement 
336.16 	during the legislative session next following an occupational title change involving a state 
336.17 	employee in covered correctional service, the commissioner of finance shall submit the 
336.18 	applicable draft proposed legislation reflecting the occupational title change covered 
336.19 	by this section.

336.20 	Sec. 4.  REPEALER.
 336.21 	Minnesota Statutes 2008, section 352.91, subdivisions 2, 2a, 3c, 3d, 3e, 3f, 3g, 3i, 
336.22 	4a, 4b, and 5, are repealed.

336.23 	Sec. 5. EFFECTIVE DATE.
 336.24 	Sections 1 to 4 are effective July 1, 2009.

336.25 	ARTICLE 16
336.26 	CORRECTIONAL STATE EMPLOYEES RETIREMENT PLAN - II

336.27 	Section 1. Minnesota Statutes 2008, section 352.72, subdivision 1, is amended to read:
336.28 		Subdivision 1.Entitlement to annuity. (a) Except as provided in paragraph (b), any 
336.29 	person who has been an employee covered by a retirement system listed in paragraph (b)
336.30 	(c) is entitled when qualified to an annuity from each fund if total allowable service in all 
336.31 	funds or in any two of these funds totals three or more years.
336.32 	(b) If the combination of retirement plans includes the correctional state employees 
336.33 	retirement plan of the Minnesota State Retirement System, no retirement annuity is 
337.1 	payable from the correctional state employees retirement plan unless the person has credit 
337.2 	for at least ten years of covered correctional service under section 352.91, although any 
337.3 	covered correctional service may be used to establish eligibility for an annuity from 
337.4 	another retirement plan and a service credit transfer under section 352.93, subdivision 
337.5 	4a, may be elected.
337.6 	(c) This section applies to the Minnesota State Retirement System, the Public 
337.7 	Employees Retirement Association including the Public Employees Retirement 
337.8 	Association police and fire fund, the Teachers Retirement Association, the State Patrol 
337.9 	Retirement Association, or any other public employee retirement system in the state with 
337.10 	a similar provision, except as noted in paragraph (c) (d).
337.11 	(c)(d) This section does not apply to other funds providing benefits for police 
337.12 	officers or firefighters under chapter 423A, 423B, or 424A.
337.13 	(d)(e) No portion of the allowable service upon which the retirement annuity from 
337.14 	one fund is based shall be again used in the computation for benefits from another fund. 
337.15 	No refund may have been taken from any one of these funds since service entitling the 
337.16 	employee to coverage under the system or the employee's membership in any of the 
337.17 	associations last terminated. The annuity from each fund must be determined by the 
337.18 	appropriate provisions of the law except that the requirement that a person must have at 
337.19 	least three years allowable service in the respective system or association does not apply 
337.20 	for the purposes of this section if the combined service in two or more of these funds 
337.21 	equals three or more years.

337.22 	Sec. 2. Minnesota Statutes 2008, section 352.93, subdivision 1, is amended to read:
337.23 		Subdivision 1.Basis of annuity; when to apply. After separation from state 
337.24 	service, an employee covered under section 352.91 who has reached age 55 years and 
337.25 	has credit for at least threeten years of covered correctional service or a combination 
337.26 	of covered correctional service and general employees state retirement plan service is 
337.27 	entitled upon application to a retirement annuity under this section, based only on covered 
337.28 	correctional employees' service. Application may be made no earlier than 60 days before 
337.29 	the date the employee is eligible to retire by reason of both age and service requirements.

337.30 	Sec. 3. Minnesota Statutes 2008, section 352.93, subdivision 2a, is amended to read:
337.31 		Subd. 2a.Early retirement. Any covered correctional employee who becomes at 
337.32 	least 50 years old and who has at least threeten years of allowablecovered correctional 
337.33 	service is entitled upon application to a reduced retirement annuity equal to the annuity 
338.1 	calculated under subdivision 2, reduced by two-tenths of one percent for each month that 
338.2 	the correctional employee is under age 55 at the time of retirement.

338.3 	Sec. 4. Minnesota Statutes 2008, section 352.93, subdivision 4, is amended to read:
338.4 		Subd. 4.Employee with regular and correctional service. A former employee 
338.5 	who has both regular and correctional service shall, if the employee has at least ten years 
338.6 	of covered correctional service and is otherwise qualified, receive an annuity based on 
338.7 	both periods of service under applicable sections of law but no period of service shall be 
338.8 	used more than once in calculating the annuity.

338.9 	Sec. 5. Minnesota Statutes 2008, section 352.93, is amended by adding a subdivision 
338.10 	to read:
338.11 		Subd. 4a.Service credit transfer and partial refund in certain instances. An 
338.12 	employee covered under section 352.91 who has reached the age of 55 years and who has 
338.13 	credit for less than ten years of covered correctional service may, upon written application, 
338.14 	have that covered correctional service credited as allowable service credit in the general 
338.15 	state employees retirement plan and used to calculate a retirement annuity under sections 
338.16 	352.115 and 352.116, and receive, 30 days following retirement, a refund of that portion 
338.17 	of employee contributions during covered correctional service under section 352.92, 
338.18 	subdivision 1, that exceeds the employee contributions required under the general state 
338.19 	employees retirement plan under section 352.04, subdivision 2, for the same period, plus 
338.20 	annual compound interest on the partial refund amount from the date of each contribution 
338.21 	until the date of refund payment at the rate of six percent.

338.22 	Sec. 6. Minnesota Statutes 2008, section 356.30, subdivision 1, is amended to read:
338.23 		Subdivision 1. Eligibility; computation of annuity. (a) Notwithstanding any 
338.24 	provisions of the laws governing the retirement plans enumerated in subdivision 3, a 
338.25 	person who has met the qualifications of paragraph (b) may elect to receive a retirement 
338.26 	annuity from each enumerated retirement plan, other than the correctional state employees 
338.27 	retirement plan of the Minnesota State Retirement System, in which the person has at least 
338.28 	one-half year of allowable service, based on the allowable service in each plan, subject to 
338.29 	the provisions of paragraph (c). 
338.30 	(b) A person may receive, upon retirement, a retirement annuity from each 
338.31 	enumerated retirement plan, other than the correctional state employees retirement plan of 
338.32 	the Minnesota State Retirement System, in which the person has at least one-half year of 
338.33 	allowable service, and augmentation of a deferred annuity calculated at the appropriate 
339.1 	rate under the laws governing each public pension plan or fund named in subdivision 3, 
339.2 	based on the date of the person's initial entry into public employment from the date the 
339.3 	person terminated all public service if: 
339.4 	(1) the person has allowable service totaling an amount that allows the person to 
339.5 	receive an annuity in any two or more of the enumerated plans; and 
339.6 	(2) the person has not begun to receive an annuity from any enumerated plan or the 
339.7 	person has made application for benefits from each applicable plan and the effective 
339.8 	dates of the retirement annuity with each plan under which the person chooses to receive 
339.9 	an annuity are within a one-year period. 
339.10 	(c) The retirement annuity from each plan must be based upon the allowable service, 
339.11 	accrual rates, and average salary in the applicable plan except as further specified or 
339.12 	modified in the following clauses: 
339.13 	(1) the laws governing annuities must be the law in effect on the date of termination 
339.14 	from the last period of public service under a covered retirement plan with which the 
339.15 	person earned a minimum of one-half year of allowable service credit during that 
339.16 	employment; 
339.17 	(2) the "average salary" on which the annuity from each covered plan in which 
339.18 	the employee has credit in a formula plan must be based on the employee's highest five 
339.19 	successive years of covered salary during the entire service in covered plans; 
339.20 	(3) the accrual rates to be used by each plan must be those percentages prescribed by 
339.21 	each plan's formula as continued for the respective years of allowable service from one 
339.22 	plan to the next, recognizing all previous allowable service with the other covered plans; 
339.23 	(4) the allowable service in all the plans must be combined in determining eligibility 
339.24 	for and the application of each plan's provisions in respect to reduction in the annuity 
339.25 	amount for retirement prior to normal retirement age; and
339.26 	(5) the annuity amount payable for any allowable service under a nonformula plan 
339.27 	of a covered plan must not be affected, but such service and covered salary must be used 
339.28 	in the above calculation.; and
339.29 	(6) for a person who was a member of the correctional state employees retirement 
339.30 	plan, the person must have at least ten years of covered correctional service under section 
339.31 	352.91 in order to receive a retirement annuity from that plan, but may apply for a service 
339.32 	credit transfer and partial refund under section 352.93, subdivision 4a.
339.33 	(d) This section does not apply to any person whose final termination from the last 
339.34 	public service under a covered plan was before May 1, 1975. 
339.35 	(e) For the purpose of computing annuities under this section, the accrual rates 
339.36 	used by any covered plan, except the public employees police and fire plan, the judges 
340.1 	retirement fund, and the State Patrol retirement plan, must not exceed the percent specified 
340.2 	in section 356.315, subdivision 4, per year of service for any year of service or fraction 
340.3 	thereof. The formula percentage used by the judges retirement fund must not exceed the 
340.4 	percentage rate specified in section 356.315, subdivision 8, per year of service for any 
340.5 	year of service or fraction thereof. The accrual rate used by the public employees police 
340.6 	and fire plan and the State Patrol retirement plan must not exceed the percentage rate 
340.7 	specified in section 356.315, subdivision 6, per year of service for any year of service or 
340.8 	fraction thereof. The accrual rate or rates used by the legislators retirement plan must not 
340.9 	exceed 2.5 percent, but this limit does not apply to the adjustment provided under section 
340.10 	3A.02, subdivision 1, paragraph (c). 
340.11 	(f) Any period of time for which a person has credit in more than one of the covered 
340.12 	plans must be used only once for the purpose of determining total allowable service. 
340.13 	(g) If the period of duplicated service credit is more than one-half year, or the person 
340.14 	has credit for more than one-half year, with each of the plans, each plan must apply its 
340.15 	formula to a prorated service credit for the period of duplicated service based on a fraction 
340.16 	of the salary on which deductions were paid to that fund for the period divided by the total 
340.17 	salary on which deductions were paid to all plans for the period. 
340.18 	(h) If the period of duplicated service credit is less than one-half year, or when 
340.19 	added to other service credit with that plan is less than one-half year, the service credit 
340.20 	must be ignored and a refund of contributions made to the person in accord with that 
340.21 	plan's refund provisions. 

340.22 	Sec. 7. EFFECTIVE DATE.
 340.23 	Sections 1 to 6 are effective July 1, 2009.

340.24 	ARTICLE 17
340.25 	HEALTH AND HUMAN SERVICES APPROPRIATIONS

340.26	Section 1.  SUMMARY OF APPROPRIATIONS.
 	
340.27 	The amounts shown in this section summarize direct appropriations by fund made 
340.28 	in this article.

340.29			2010
		2011
		Total
	
340.30	General
	$
	5,311,561,000
	$
	5,544,392,000
	$
	10,855,953,000
	
340.31
340.32	State Government Special 
Revenue
		60,719,000
		60,532,000
		121,251,000
	
340.33	Health Care Access
		372,976,000
		118,764,000
		491,740,000
	
340.34	Federal TANF
		281,030,000
		274,912,000
		555,942,000
	
340.35	Lottery Prize
		1,665,000
		1,665,000
		3,330,000
	
341.1	Clean Water
		1,250,000
		2,500,000
		3,750,000
	
341.2	Total
	$
	6,029,201,000
	$
	6,002,765,000
	$
	12,031,966,000

341.3	Sec. 2. HEALTH AND HUMAN SERVICES APPROPRIATION.
 	
341.4 	The sums shown in the columns marked "Appropriations" are appropriated to the 
341.5 	agencies and for the purposes specified in this article. The appropriations are from the 
341.6 	general fund, or another named fund, and are available for the fiscal years indicated 
341.7 	for each purpose. The figures "2010" and "2011" used in this article mean that the 
341.8 	appropriations listed under them are available for the fiscal year ending June 30, 2010, or 
341.9 	June 30, 2011, respectively. "The first year" is fiscal year 2010. "The second year" is fiscal 
341.10 	year 2011. "The biennium" is fiscal years 2010 and 2011. Appropriations for the fiscal 
341.11 	year ending June 30, 2009, are effective the day following final enactment.

341.12				APPROPRIATIONS
	
341.13				Available for the Year
	
341.14				Ending June 30
	
341.15					2010
		2011

341.16	Sec. 3. HUMAN SERVICES

341.17	Subdivision 1.Total Appropriation
 	$
	5,861,298,000
	$
	5,840,623,000

341.18	Appropriations by Fund
	
341.19		2010
	2011
	
341.20	General
	5,237,520,000
	5,475,544,000
	
341.21
341.22	State Government 
Special Revenue
	565,000
	565,000
	
341.23	Health Care Access
	352,251,000
	99,670,000
	
341.24	Federal TANF
	269,297,000
	263,179,000
	
341.25	Lottery Prize
	1,665,000
	1,665,000
	
341.26 	Receipts for Systems Projects.
341.27 	Appropriations and federal receipts for 
341.28 	information systems projects for MAXIS, 
341.29 	PRISM, MMIS, and SSIS must be deposited 
341.30 	in the state system account authorized in 
341.31 	Minnesota Statutes, section 256.014. Money 
341.32 	appropriated for computer projects approved 
341.33 	by the Minnesota Office of Enterprise 
341.34 	Technology, funded by the legislature, and 
341.35 	approved by the commissioner of finance, 
341.36 	may be transferred from one project to 
342.1 	another and from development to operations 
342.2 	as the commissioner of human services 
342.3 	considers necessary. Any unexpended 
342.4 	balance in the appropriation for these 
342.5 	projects does not cancel but is available for 
342.6 	ongoing development and operations.
342.7 	Nonfederal Share Transfers. The 
342.8 	nonfederal share of activities for which 
342.9 	federal administrative reimbursement is 
342.10 	appropriated to the commissioner may be 
342.11 	transferred to the special revenue fund.
342.12 	TANF Maintenance of Effort.
342.13 	(a) In order to meet the basic maintenance 
342.14 	of effort (MOE) requirements of the TANF 
342.15 	block grant specified under Code of Federal 
342.16 	Regulations, title 45, section 263.1, the 
342.17 	commissioner may only report nonfederal 
342.18 	money expended for allowable activities 
342.19 	listed in the following clauses as TANF/MOE 
342.20 	expenditures:
342.21 	(1) MFIP cash, diversionary work program, 
342.22 	and food assistance benefits under Minnesota 
342.23 	Statutes, chapter 256J;
342.24 	(2) the child care assistance programs 
342.25 	under Minnesota Statutes, sections 119B.03 
342.26 	and 119B.05, and county child care 
342.27 	administrative costs under Minnesota 
342.28 	Statutes, section 119B.15;
342.29 	(3) state and county MFIP administrative 
342.30 	costs under Minnesota Statutes, chapters 
342.31 	256J and 256K;
342.32 	(4) state, county, and tribal MFIP 
342.33 	employment services under Minnesota 
342.34 	Statutes, chapters 256J and 256K;
343.1 	(5) expenditures made on behalf of 
343.2 	noncitizen MFIP recipients who qualify 
343.3 	for the medical assistance without federal 
343.4 	financial participation program under 
343.5 	Minnesota Statutes, section 256B.06, 
343.6 	subdivision 4, paragraphs (d), (e), and (j); 
343.7 	and
343.8 	(6) qualifying working family credit 
343.9 	expenditures under Minnesota Statutes, 
343.10 	section 290.0671.
343.11 	(b) The commissioner shall ensure that 
343.12 	sufficient qualified nonfederal expenditures 
343.13 	are made each year to meet the state's 
343.14 	TANF/MOE requirements. For the activities 
343.15 	listed in paragraph (a), clauses (2) to 
343.16 	(6), the commissioner may only report 
343.17 	expenditures that are excluded from the 
343.18 	definition of assistance under Code of 
343.19 	Federal Regulations, title 45, section 260.31.
343.20 	(c) For fiscal years beginning with state 
343.21 	fiscal year 2003, the commissioner shall 
343.22 	ensure that the maintenance of effort used 
343.23 	by the commissioner of finance for the 
343.24 	February and November forecasts required 
343.25 	under Minnesota Statutes, section 16A.103, 
343.26 	contains expenditures under paragraph (a), 
343.27 	clause (1), equal to at least 16 percent of 
343.28 	the total required under Code of Federal 
343.29 	Regulations, title 45, section 263.1.
343.30 	(d) For the federal fiscal year beginning 
343.31 	October 1, 2007, the commissioner may not 
343.32 	claim an amount of TANF/MOE in excess of 
343.33 	the 75 percent standard in Code of Federal 
343.34 	Regulations, title 45, section 263.1(a)(2), 
343.35 	except:
344.1 	(1) to the extent necessary to meet the 80 
344.2 	percent standard under Code of Federal 
344.3 	Regulations, title 45, section 263.1(a)(1), 
344.4 	if it is determined by the commissioner 
344.5 	that the state will not meet the TANF work 
344.6 	participation target rate for the current year;
344.7 	(2) to provide any additional amounts 
344.8 	under Code of Federal Regulations, title 45, 
344.9 	section 264.5, that relate to replacement of 
344.10 	TANF funds due to the operation of TANF 
344.11 	penalties; and
344.12 	(3) to provide any additional amounts that 
344.13 	may contribute to avoiding or reducing 
344.14 	TANF work participation penalties through 
344.15 	the operation of the excess MOE provisions 
344.16 	of Code of Federal Regulations, title 45, 
344.17 	section 261.43(a)(2).
344.18 	For the purposes of clauses (1) to (3), 
344.19 	the commissioner may supplement the 
344.20 	MOE claim with working family credit 
344.21 	expenditures to the extent such expenditures 
344.22 	or other qualified expenditures are otherwise 
344.23 	available after considering the expenditures 
344.24 	allowed in this section.
344.25 	(e) Minnesota Statutes, section 256.011, 
344.26 	subdivision 3, which requires that federal 
344.27 	grants or aids secured or obtained under that 
344.28 	subdivision be used to reduce any direct 
344.29 	appropriations provided by law, do not apply 
344.30 	if the grants or aids are federal TANF funds.
344.31 	(f) Notwithstanding any contrary provision 
344.32 	in this article, this provision expires June 30, 
344.33 	2013.
344.34 	Working Family Credit Expenditures as 
344.35 	TANF/MOE. The commissioner may claim 
345.1 	as TANF/MOE up to $6,707,000 per year for 
345.2 	fiscal year 2010 through fiscal year 2011.
345.3 	Working Family Credit Expenditures 
345.4 	to be Claimed for TANF/MOE. The 
345.5 	commissioner may count the following 
345.6 	amounts of working family credit expenditure 
345.7 	as TANF/MOE:
345.8 	(1) fiscal year 2010, $42,079,000;
345.9 	(2) fiscal year 2011, $61,494,000;
345.10 	(3) fiscal year 2012, $44,236,000; and
345.11 	(4) fiscal year 2013, $46,952,000.
345.12 	Notwithstanding any contrary provision in 
345.13 	this article, this rider expires June 30, 2013.
345.14 	TANF Transfer to Federal Child Care 
345.15 	and Development Fund. The following 
345.16 	TANF fund amounts are appropriated to the 
345.17 	commissioner for the purposes of MFIP and 
345.18 	transition year child care under Minnesota 
345.19 	Statutes, section 119B.05:
345.20 	(1) fiscal year 2010, $9,415,000;
345.21 	(2) fiscal year 2011, $24,568,000;
345.22 	(3) fiscal year 2012, $26,866,000; and
345.23 	(4) fiscal year 2013, $29,664,000.
345.24 	The commissioner shall authorize the 
345.25 	transfer of sufficient TANF funds to the 
345.26 	federal child care and development fund to 
345.27 	meet this appropriation and shall ensure that 
345.28 	all transferred funds are expended according 
345.29 	to federal child care and development fund 
345.30 	regulations.
345.31 	Child Care and Development Fund 
345.32 	Unexpended Balance. (a) The commissioner 
345.33 	shall determine the unexpended balance of 
346.1 	the federal Child Care and Development 
346.2 	Fund (CCDF) for the basic sliding fee child 
346.3 	care program by February 28, 2009. The 
346.4 	balance must first be used to fund programs 
346.5 	described in paragraph (b) and the remainder 
346.6 	must be available for the basic sliding fee 
346.7 	child care under Minnesota Statutes, section 
346.8 	119B.03.
346.9 	(b) Notwithstanding Minnesota Statutes, 
346.10 	section 119B.03, subdivision 5b, and 
346.11 	Minnesota Rules, part 3400.0060, subpart 
346.12 	4, the commissioner shall expend up to 
346.13 	$763,000 in fiscal year 2010 and up to 
346.14 	$760,000 in fiscal year 2011 to continue the 
346.15 	school readiness service agreements pilot 
346.16 	under Minnesota Statutes, section 119B.231. 
346.17 	The commissioner shall expend up to 
346.18 	$990,000 in fiscal year 2011 to support the 
346.19 	Parent Aware pilot. The commissioner shall 
346.20 	ensure that all child care and development 
346.21 	funds are expended according to the 
346.22 	federal Child Care and Development Fund 
346.23 	regulations.
346.24 	Food Stamps Employment and Training.
346.25 	Notwithstanding Minnesota Statutes, sections 
346.26 	256J.626 and 256D.051, subdivisions 1a, 6b, 
346.27 	and 6c, federal food stamps employment and 
346.28 	training funds received as reimbursement of 
346.29 	MFIP consolidated fund grant expenditures 
346.30 	and child care assistance program 
346.31 	expenditures for two-parent families must be 
346.32 	deposited in the general fund. The amount of 
346.33 	funds must be limited to $3,400,000 in fiscal 
346.34 	year 2010 and $4,400,000 in fiscal years 
346.35 	2011 through 2013, contingent on approval 
346.36 	by the federal Food and Nutrition Service. 
347.1 	Consistent with the receipt of these federal 
347.2 	funds, the commissioner may adjust the 
347.3 	level of working family credit expenditures 
347.4 	claimed as TANF maintenance of effort. 
347.5 	Notwithstanding any contrary provision in 
347.6 	this article, this rider expires June 30, 2013.

347.7	Subd. 2.Agency Management
 					
347.8 	The amounts that may be spent from the 
347.9 	appropriation for each purpose are as follows:

347.10	(a) Financial Operations

347.11	Appropriations by Fund
	
347.12	General
	3,380,000
	3,908,000
	
347.13	Health Care Access
	1,241,000
	1,016,000
	
347.14	Federal TANF
	122,000
	122,000

347.15	(b) Legal and Regulatory Operations

347.16	Appropriations by Fund
	
347.17	General
	13,690,000
	13,470,000
	
347.18
347.19	State Government 
Special Revenue
	440,000
	440,000
	
347.20	Health Care Access
	943,000
	943,000
	
347.21	Federal TANF
	100,000
	100,000
	
347.22 	Base Adjustment. The general fund base 
347.23 	is decreased $4,550,000 in fiscal year 2012 
347.24 	and $4,550,000 in fiscal year 2013. The state 
347.25 	government special revenue fund base is 
347.26 	increased $4,500,000 in fiscal year 2012 and 
347.27 	$4,500,000 in fiscal year 2013.

347.28	(c) Management Operations

347.29	Appropriations by Fund
	
347.30	General
	4,715,000
	4,715,000
	
347.31	Health Care Access
	242,000
	242,000

347.32	(d) Information Technology Operations

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

348.1
348.2	Subd. 3.Revenue and Pass-Through Revenue 
Expenditures
 		75,161,000
		91,656,000
	
348.3 	This appropriation is from the federal TANF 
348.4 	fund.

348.5
348.6	Subd. 4.Children and Economic Assistance 
Grants
 					
348.7 	The amounts that may be spent from this 
348.8 	appropriation for each purpose are as follows:

348.9	(a) MFIP/DWP Grants

348.10	Appropriations by Fund
	
348.11	General
	67,984,000
	75,077,000
	
348.12	Federal TANF
	82,257,000
	71,494,000

348.13	(b) Support Services Grants

348.14	Appropriations by Fund
	
348.15	General
	8,715,000
	8,715,000
	
348.16	Federal TANF
	110,961,000
	99,111,000
	
348.17 	MFIP Consolidated Fund. The MFIP 
348.18 	consolidated fund TANF appropriation is 
348.19 	reduced by $2,750,000 in fiscal year 2010 
348.20 	and $5,500,000 in fiscal year 2011.

348.21	(c) MFIP Child Care Assistance Grants
		52,219,000
		37,204,000

348.22
348.23	(d) Basic Sliding Fee Child Care Assistance 
Grants
		42,855,000
		42,330,000
	
348.24 	Base Adjustment. The general fund base is 
348.25 	increased by $5,000 in fiscal year 2012 and 
348.26 	$7,000 in fiscal year 2013.

348.27	(e) Child Care Development Grants
		1,389,000
		1,340,000
	
348.28 	Child Care Program Integrity Funds for 
348.29 	State Fraud Program. Child care program 
348.30 	integrity grants are reduced to $49,000 in 
348.31 	fiscal year 2010 and $0 in fiscal year 2011 
348.32 	for the purpose of funding state assumption 
348.33 	of the county fraud prevention investigation 
348.34 	function.

349.1	(f) Child Support Enforcement Grants
		3,705,000
		3,705,000

349.2	(g) Children's Services Grants

349.3	Appropriations by Fund
	
349.4	General
	50,590,000
	54,879,000
	
349.5	Federal TANF
	200,000
	200,000
	
349.6 	Base Adjustment. The general fund base is 
349.7 	increased by $4,625,000 in fiscal year 2012 
349.8 	and $7,192,000 in fiscal year 2013.
349.9 	Privatized Adoption Grants. Federal 
349.10 	reimbursement for privatized adoption grant 
349.11 	and foster care recruitment grant expenditures 
349.12 	is appropriated to the commissioner for 
349.13 	adoption grants and foster care and adoption 
349.14 	administrative purposes.
349.15 	Adoption Assistance Incentive Grants.
349.16 	Federal funds available during fiscal year 
349.17 	2010 and fiscal year 2011 for the adoption 
349.18 	incentive grants are appropriated to the 
349.19 	commissioner for these purposes.
349.20 	Adoption Assistance, Relative Custody 
349.21 	Assistance, and Northstar Care for 
349.22 	Children. The commissioner may transfer 
349.23 	unencumbered appropriation balances 
349.24 	for adoption assistance, relative custody 
349.25 	assistance, and Northstar care for children 
349.26 	between fiscal years and between programs.

349.27	(h) Children and Community Services Grants
		67,604,000
		67,463,000
	
349.28 	Targeted Case Management Temporary 
349.29 	Funding Adjustment. The commissioner 
349.30 	shall recover from each county and tribe 
349.31 	receiving a targeted case management 
349.32 	temporary funding payment in fiscal year 
349.33 	2008 an amount equal to that payment. The 
349.34 	commissioner shall recover one-half of the 
350.1 	funds by February 1, 2010, and the remainder 
350.2 	by February 1, 2011. At the commissioner's 
350.3 	discretion and at the request of a county 
350.4 	or tribe, the commissioner may revise 
350.5 	the payment schedule, but full payment 
350.6 	must not be delayed beyond May 1, 2011. 
350.7 	The commissioner may use the recovery 
350.8 	procedure under Minnesota Statutes, section 
350.9 	256.017, to recover the funds. Recovered 
350.10 	funds must be deposited into the general 
350.11 	fund.
350.12 	CCSA Distribution. Beginning July 1, 2011, 
350.13 	the general fund base must be distributed 
350.14 	among program categories according to the 
350.15 	following percentages: Children's Services, 
350.16 	56.5 percent; Mental Health and Chemical 
350.17 	Dependency 28.0 percent; and Adult and 
350.18 	Disability 15.5 percent. The commissioner 
350.19 	shall transfer funds from this appropriation 
350.20 	to implement this distribution.
350.21 	Children and Communities Services Act 
350.22 	Distribution of County Social Services 
350.23 	Block Grant (SSBG) Funds. Beginning 
350.24 	January 1, 2011, the federal SSBG funds 
350.25 	available for grants for the calendar year will 
350.26 	be distributed among programs according 
350.27 	to the following percentages: children's 
350.28 	services, 51.8 percent; mental health and 
350.29 	chemical dependency, 28.9 percent; and 
350.30 	adult and disability, 19.3 percent. Funds 
350.31 	transferred from the TANF block grant 
350.32 	to SSBG shall be considered part of the 
350.33 	distribution to the children's services 
350.34 	program.

350.35	(i) General Assistance Grants
		49,301,000
		49,723,000
	
351.1 	General Assistance Standard. The 
351.2 	commissioner shall set the monthly standard 
351.3 	of assistance for general assistance units 
351.4 	consisting of an adult recipient who is 
351.5 	childless and unmarried or living apart 
351.6 	from parents or a legal guardian at $203. 
351.7 	The commissioner may reduce this amount 
351.8 	according to Laws 1997, chapter 85, article 
351.9 	3, section 54.
351.10 	Combining Emergency Assistance for 
351.11 	MSA and GA. The amount appropriated 
351.12 	for emergency general assistance funds is 
351.13 	limited to no more than $8,989,812 in fiscal 
351.14 	year 2010 and $8,989,812 in fiscal year 2011. 
351.15 	Funds to counties must be allocated by the 
351.16 	commissioner using the allocation method 
351.17 	specified in Minnesota Statutes, section 
351.18 	256D.06.

351.19	(j) Minnesota Supplemental Aid Grants
		31,774,000
		32,757,000

351.20	(k) Group Residential Housing Grants
		105,229,000
		107,268,000

351.21	(l) Children's Mental Health Grants
		16,885,000
		16,882,000
	
351.22 	Funding Usage. Up to 75 percent of a fiscal 
351.23 	year's appropriation for children's mental 
351.24 	health grants may be used to fund allocations 
351.25 	in that portion of the fiscal year ending 
351.26 	December 31.

351.27
351.28	(m) Other Children and Economic Assistance 
Grants
		14,818,000
		13,865,000
	
351.29 	Fraud Prevention Grants for State Fraud 
351.30 	Program. Fraud prevention investigation 
351.31 	grants are reduced to $463,000 in fiscal 
351.32 	year 2010 and $0 in fiscal year 2011 for 
351.33 	the purposes of funding state assumption of 
351.34 	the county fraud prevention investigation 
351.35 	function.

352.1
352.2	Subd. 5.Children and Economic Assistance 
Management
 					
352.3 	The amounts that may be spent from the 
352.4 	appropriation for each purpose are as follows:

352.5
352.6	(a) Children and Economic Assistance 
Administration

352.7	Appropriations by Fund
	
352.8	General
	11,950,000
	12,844,000
	
352.9	Federal TANF
	496,000
	496,000

352.10
352.11	(b) Children and Economic Assistance 
Operations

352.12	Appropriations by Fund
	
352.13	General
	34,263,000
	33,423,000
	
352.14	Health Care Access
	361,000
	361,000
	
352.15 	State Assumption of County Fraud 
352.16 	Prevention Program. Of the amounts 
352.17 	appropriated, $1,682,000 in fiscal year 
352.18 	2010 and $2,536,000 in fiscal year 2011 is 
352.19 	available to fund state assumption of county 
352.20 	fraud prevention programs.
352.21 	Financial Institution Data Match and 
352.22 	Payment of Fees. The commissioner is 
352.23 	authorized to allocate up to $310,000 each 
352.24 	year in fiscal years 2010 and 2011 from the 
352.25 	PRISM special revenue account to make 
352.26 	payments to financial institutions in exchange 
352.27 	for performing data matches between account 
352.28 	information held by financial institutions 
352.29 	and the public authority's database of child 
352.30 	support obligors as authorized by Minnesota 
352.31 	Statutes, section 13B.06, subdivision 7.

352.32	Subd. 6.Basic Health Care Grants
 					
352.33 	The amounts that may be spent from this 
352.34 	appropriation for each purpose are as follows:

352.35	(a) MinnesotaCare Grants
		320,717,000
		69,978,000
	
353.1 	This appropriation is from the health care 
353.2 	access fund.

353.3
353.4	(b) MA Basic Health Care Grants - Families 
and Children
		979,255,000
		1,027,604,000
	
353.5 	Medical Education Research Costs 
353.6 	(MERC). (1) Of these funds, the 
353.7 	commissioner of human services shall 
353.8 	transfer $38,000,000 in fiscal year 2010 to 
353.9 	the medical education research fund. These 
353.10 	funds must restore the fiscal year 2009 
353.11 	unallotment of the transfers under Minnesota 
353.12 	Statutes, section 256B.69, subdivision 5c, 
353.13 	paragraph (a), for the July 1, 2008, through 
353.14 	June 30, 2009, period.
353.15 	(2) In fiscal year 2010, the commissioner 
353.16 	of human services shall reduce the amount 
353.17 	transferred to the medical education 
353.18 	research fund under Minnesota Statutes, 
353.19 	section 256B.69, subdivision 5c, paragraph 
353.20 	(a), for the July 1, 2009, through June 
353.21 	30, 2010, period by $28,000,000. The 
353.22 	commissioner shall first reduce the transfers 
353.23 	under Minnesota Statutes, section 256B.69, 
353.24 	subdivision 5c, paragraph (a), clauses (2), (3), 
353.25 	and (4), and second, proportionally reduce 
353.26 	the transfers under Minnesota Statutes, 
353.27 	section 256B.69, subdivision 5c, paragraph 
353.28 	(a), clause (1), to meet the $28,000,000 
353.29 	reduction.

353.30
353.31	(c) MA Basic Health Care Grants - Elderly and 
Disabled
		1,156,525,000
		1,251,736,000
	
353.32 	Minnesota Disability Health Options.
353.33 	The monthly enrollment of home and 
353.34 	community-based services recipients, 
353.35 	including personal care assistance and 
353.36 	private duty nurse recipients, in the 
354.1 	Minnesota disability health options program 
354.2 	shall not exceed 1,043 in calendar year 2009, 
354.3 	1,201 in calendar year 2010, and 1,402 in 
354.4 	calendar year 2011.
354.5 	Hospital Fee-for-Service Payment Delay.
354.6 	Payments from the Medicaid Management 
354.7 	Information System that would otherwise 
354.8 	have been made for inpatient hospital 
354.9 	services for Minnesota health care program 
354.10 	enrollees must be delayed as follows: (1) 
354.11 	for fiscal year 2010, the payments for the 
354.12 	month of June must be included in the 
354.13 	first payments in fiscal year 2011; and (2) 
354.14 	for fiscal year 2011, the payments in the 
354.15 	month of June must be included in the first 
354.16 	payment of fiscal year 2012. The provisions 
354.17 	of Minnesota Statutes, section 16A.124, do 
354.18 	not apply to these delayed payments.
354.19 	Nonhospital Fee-for-Service Payment 
354.20 	Delay. Payments from the Medicaid 
354.21 	Management Information System that would 
354.22 	otherwise have been made for nonhospital 
354.23 	acute care services for Minnesota health 
354.24 	care program enrollees must be delayed 
354.25 	as follows: (1) the last payment for fiscal 
354.26 	year 2010 must be included in the first 
354.27 	payment for fiscal year 2011; and (2) the 
354.28 	last payment for fiscal year 2011 must be 
354.29 	included in the first payment for fiscal year 
354.30 	2012. This payment delay must not include 
354.31 	nursing facilities, intermediate care facilities 
354.32 	for developmental disabilities, home and 
354.33 	community-based services, prepaid health 
354.34 	plans, personal care provider organizations, 
354.35 	and home health agencies. The provisions of 
355.1 	Minnesota Statutes, section 16A.124, do not 
355.2 	apply to these delayed payments.

355.3	(d) General Assistance Medical Care Grants
		333,074,000
		362,264,000

355.4	(e) Other Health Care Grants
					
355.5	Appropriations by Fund
					
355.6	General
	205,000
	205,000
					
355.7	Health Care Access
	900,000
	150,000

355.8	Subd. 7.Health Care Management
 					
355.9 	The amounts that may be spent from the 
355.10 	appropriation for each purpose are as follows:

355.11	(a) Health Care Administration
					
355.12	Appropriations by Fund
					
355.13	General
	5,274,000
	5,235,000
					
355.14	Health Care Access
	789,000
	746,000
					
355.15 	Base Adjustment. The health care access 
355.16 	fund base is increased by $183,000 in fiscal 
355.17 	year 2012.

355.18	(b) Health Care Operations
					
355.19	Appropriations by Fund
					
355.20	General
	19,685,000
	18,830,000
					
355.21	Health Care Access
	21,452,000
	20,616,000
					
355.22 	Base Adjustment. The health care access 
355.23 	fund base is decreased by $667,000 in fiscal 
355.24 	year 2012 and $1,170,000 in fiscal year 
355.25 	2013. The general fund base is decreased by 
355.26 	$278,000 in fiscal year 2012 and $278,000 in 
355.27 	fiscal year 2013.

355.28	Subd. 8.Continuing Care Grants
 					
355.29 	The amounts that may be spent from the 
355.30 	appropriation for each purpose are as follows:

355.31	(a) Aging and Adult Services Grants
		14,532,000
		19,703,000
	
355.32 	Base Adjustment. The general fund base is 
355.33 	increased by $1,181,000 in fiscal year 2012 
355.34 	and $2,093,000 in fiscal year 2013.
356.1 	Information and Assistance 
356.2 	Reimbursement. Federal administrative 
356.3 	reimbursement obtained from information 
356.4 	and assistance services provided by the 
356.5 	Senior LinkAge or Disability Linkage lines 
356.6 	to people who are identified as eligible for 
356.7 	medical assistance shall be appropriated to 
356.8 	the commissioner for this activity.
356.9 	Community Service Development Grant 
356.10 	Reduction. Funding for community service 
356.11 	development grants must be reduced by 
356.12 	$240,000 per year for fiscal years 2010 and 
356.13 	2011. This reduction shall not adjust the base 
356.14 	appropriation.

356.15	(b) Alternative Care Grants
		50,507,000
		45,269,000
	
356.16 	Base Adjustment. The general fund base is 
356.17 	decreased by $681,000 in fiscal year 2012 
356.18 	and $1,078,000 in fiscal year 2013.
356.19 	Alternative Care Transfer. Any money 
356.20 	allocated to the alternative care program that 
356.21 	is not spent for the purposes indicated does 
356.22 	not cancel but must be transferred to the 
356.23 	medical assistance account.

356.24
356.25	(c) Medical Assistance Grants; Long-Term 
Care Facilities.
		475,969,000
		476,918,000

356.26
356.27	(d) Medical Assistance Long-Term Care 
Waivers and Home Care Grants
		1,100,137,000
		1,155,618,000
	
356.28 	Manage Growth in TBI and CADI 
356.29 	Waivers. During the fiscal years beginning 
356.30 	on July 1, 2009, and July 1, 2010, the 
356.31 	commissioner shall allocate money for home 
356.32 	and community-based waiver programs 
356.33 	under Minnesota Statutes, section 256B.49, 
356.34 	to ensure a reduction in state spending that is 
356.35 	equivalent to limiting the caseload growth of 
357.1 	the TBI waiver to 12.5 allocations per month 
357.2 	each year of the biennium and the CADI 
357.3 	waiver to 95 allocations per month each year 
357.4 	of the biennium. Limits do not apply: (1) 
357.5 	when there is an approved plan for nursing 
357.6 	facility bed closures for individuals under 
357.7 	age 65 who require relocation due to the 
357.8 	bed closure; (2) to fiscal year 2009 waiver 
357.9 	allocations delayed due to unallotment; or (3) 
357.10 	to transfers authorized by the commissioner 
357.11 	from the personal care assistance program 
357.12 	of individuals having a home care rating 
357.13 	of "CS," "MT," or "HL." Priorities for the 
357.14 	allocation of funds must be for individuals 
357.15 	anticipated to be discharged from institutional 
357.16 	settings or who are at imminent risk of a 
357.17 	placement in an institutional setting.
357.18 	Manage Growth in DD Waiver. The 
357.19 	commissioner shall manage the growth in 
357.20 	the DD waiver by limiting the allocations 
357.21 	included in the February 2009 forecast to 15 
357.22 	additional diversion allocations each month 
357.23 	for the calendar years that begin on January 
357.24 	1, 2010, and January 1, 2011. Additional 
357.25 	allocations must be made available for 
357.26 	transfers authorized by the commissioner 
357.27 	from the personal care program of individuals 
357.28 	having a home care rating of "CS," "MT," 
357.29 	or "HL."
357.30 	Adjustment to Lead Agency Waiver 
357.31 	allocations. Prior to the availability of the 
357.32 	alternative license defined in Minnesota 
357.33 	Statutes, section 245A.11, subdivision 8, 
357.34 	the commissioner shall reduce lead agency 
357.35 	waiver allocations for the purposes of 
358.1 	implementing a moratorium on corporate 
358.2 	foster care.

358.3	(e) Mental Health Grants

358.4	Appropriations by Fund
	
358.5	General
	76,989,000
	78,456,000
	
358.6	Health Care Access
	750,000
	750,000
	
358.7	Lottery Prize
	1,508,000
	1,508,000
	
358.8 	Funding Usage. Up to 75 percent of a fiscal 
358.9 	year's appropriation for children's mental 
358.10 	health grants may be used to fund allocations 
358.11 	in that portion of the fiscal year ending 
358.12 	December 31.

358.13	(f) Deaf and Hard-of-Hearing Grants
		1,924,000
		1,909,000

358.14	(g) Chemical Dependency Entitlement Grants
		112,316,000
		121,295,000
	
358.15 	Payments for Substance Abuse Treatment.
358.16 	For services provided in fiscal years 2010 
358.17 	and 2011, county-negotiated rates and 
358.18 	provider claims to the consolidated chemical 
358.19 	dependency fund must not exceed rates 
358.20 	charged for services in excess of those 
358.21 	in effect on January 1, 2009. If statutes 
358.22 	authorize a cost-of-living adjustment 
358.23 	during fiscal years 2010 and 2011, then 
358.24 	notwithstanding any law to the contrary, 
358.25 	fiscal years 2010 and 2011 rates must 
358.26 	not exceed those in effect on January 2, 
358.27 	2009, plus any authorized cost-of-living 
358.28 	adjustments.

358.29
358.30	(h) Chemical Dependency Nonentitlement 
Grants
		1,383,000
		1,036,000

358.31	(i) Other Continuing Care Grants
		18,168,000
		12,300,000
	
358.32 	Base Adjustment. The general fund base is 
358.33 	decreased $1,142,000 in fiscal year 2012 and 
358.34 	$2,146,000 in fiscal year 2013.
359.1 	Technology Grants. $650,000 in fiscal 
359.2 	year 2010 and $1,000,000 in fiscal year 
359.3 	2011 are for technology grants, case 
359.4 	consultation, evaluation, and consumer 
359.5 	information grants related to developing and 
359.6 	supporting alternatives to shift-staff foster 
359.7 	care residential service models.

359.8	Subd. 9.Continuing Care Management

359.9	Appropriations by Fund
	
359.10	General
	25,036,000
	25,079,000
	
359.11
359.12	State Government 
Special Revenue
	125,000
	125,000
	
359.13	Lottery Prize
	157,000
	157,000
	
359.14 	The general fund base is decreased 
359.15 	$2,900,000 in fiscal year 2012 and 
359.16 	$2,900,000 in fiscal year 2013.

359.17	Subd. 10.State-Operated Services
 		257,399,000
		264,442,000
	
359.18 	The amounts that may be spent from the 
359.19 	appropriation for each purpose are as follows:
359.20 	Transfer Authority Related to 
359.21 	State-Operated Services. Money 
359.22 	appropriated to finance state-operated 
359.23 	services may be transferred between the 
359.24 	fiscal years of the biennium with the approval 
359.25 	of the commissioner of finance.
359.26 	County Past Due Receivables. The 
359.27 	commissioner is authorized to withhold 
359.28 	county federal administrative reimbursement 
359.29 	when the county of financial responsibility 
359.30 	for cost-of-care payments due the state 
359.31 	under Minnesota Statutes, section 246.54 
359.32 	or 253B.045, is 90 days past due. The 
359.33 	commissioner shall deposit the withheld 
359.34 	federal administrative earnings for the county 
359.35 	into the general fund to settle the claims with 
360.1 	the county of financial responsibility. The 
360.2 	process for withholding funds is governed by 
360.3 	Minnesota Statutes, section 256.017.

360.4	(a) Adult Mental Health Services
		110,216,000
		114,953,000
	
360.5 	Appropriation Limitation. No part of 
360.6 	the appropriation in this article to the 
360.7 	commissioner for mental health treatment 
360.8 	services provided by state-operated services 
360.9 	shall be used for the Minnesota sex offender 
360.10 	program.
360.11 	Community Behavioral Health Hospitals.
360.12 	Under Minnesota Statutes, section 246.51, 
360.13 	subdivision 1, a determination order for the 
360.14 	clients served in a community behavioral 
360.15 	health hospital operated by the commissioner 
360.16 	of human services is only required when 
360.17 	a client's third-party coverage has been 
360.18 	exhausted.

360.19
360.20
360.21	(b) Minnesota Security 
Hospital and METO 
Services
				82,918,000
		82,652,000
	
360.22 	Minnesota Security Hospital.  For the 
360.23 	purposes of enhancing the safety of 
360.24 	the public, improving supervision, and 
360.25 	enhancing community-based mental health 
360.26 	treatment, state-operated services may 
360.27 	establish additional community capacity 
360.28 	for providing treatment and supervision 
360.29 	of clients who have been ordered into a 
360.30 	less restrictive alternative of care from the 
360.31 	state-operated services transitional services 
360.32 	program consistent with Minnesota Statutes, 
360.33 	section 246.014.

360.34	(c) Minnesota Sex Offender Services
		64,265,000
		66,837,000

361.1	Sec. 4. COMMISSIONER OF HEALTH

361.2	Subdivision 1.Total Appropriation
 	$
	147,432,000
	$
	141,858,000

361.3	Appropriations by Fund
	
361.4		2010
	2011
	
361.5	General
	68,309,000
	63,116,000
	
361.6
361.7	State Government 
Special Revenue
	45,415,000
	45,415,000
	
361.8	Health Care Access
	20,725,000
	19,094,000
	
361.9	Federal TANF
	11,733,000
	11,733,000
	
361.10	Clean Water
	1,250,000
	2,500,000

361.11	Subd. 2.Community and Family Health

361.12	Appropriations by Fund
	
361.13	General
	43,430,000
	38,237,000
	
361.14
361.15	State Government 
Special Revenue
	1,033,000
	1,033,000
	
361.16	Health Care Access
	7,642,000
	7,719,000
	
361.17	Federal TANF
	11,733,000
	11,733,000
	
361.18 	Funding Usage. Up to 75 percent of the 
361.19 	fiscal year 2012 appropriation for local public 
361.20 	health grants may be used to fund calendar 
361.21 	year 2011 allocations for this program. The 
361.22 	general fund reduction of $5,193,000 in 
361.23 	fiscal year 2011 for local public health grants 
361.24 	is onetime and the base funding for local 
361.25 	public health grants for fiscal year 2012 is 
361.26 	increased by $5,193,000.
361.27 	Statewide Health Improvement Programs.
361.28 	Of the health care access fund appropriation, 
361.29 	$6,000,000 per fiscal year is for the statewide 
361.30 	health improvement program. Up to ten 
361.31 	percent of the funding may be used for 
361.32 	administrative purposes. Base funding for 
361.33 	this program expires June 30, 2013.
361.34 	TANF Appropriations. (1) $1,156,000 of 
361.35 	the TANF funds are appropriated each year to 
361.36 	the commissioner for family planning grants 
361.37 	under Minnesota Statutes, section 145.925.
362.1 	(2) $3,579,000 of the TANF funds are 
362.2 	appropriated each year to the commissioner 
362.3 	for home visiting and nutritional services 
362.4 	listed under Minnesota Statutes, section 
362.5 	145.882, subdivision 7, clauses (6) and (7). 
362.6 	Funds must be distributed to community 
362.7 	health boards according to Minnesota 
362.8 	Statutes, section 145A.131, subdivision 1.
362.9 	(3) $2,000,000 of the TANF funds are 
362.10 	appropriated each year to the commissioner 
362.11 	for decreasing racial and ethnic disparities 
362.12 	in infant mortality rates under Minnesota 
362.13 	Statutes, section 145.928, subdivision 7.
362.14 	(4) $4,998,000 of the TANF funds are 
362.15 	appropriated each year to the commissioner 
362.16 	for the family home visiting grant program 
362.17 	according to Minnesota Statutes, section 
362.18 	145A.17. $4,000,000 of the funding must 
362.19 	be distributed to community health boards 
362.20 	according to Minnesota Statutes, section 
362.21 	145A.131, subdivision 1. $998,000 of 
362.22 	the funding must be distributed to tribal 
362.23 	governments based on Minnesota Statutes, 
362.24 	section 145A.14, subdivision 2a. The 
362.25 	commissioner may use five percent of 
362.26 	the funds appropriated each fiscal year to 
362.27 	conduct the ongoing evaluations required 
362.28 	under Minnesota Statutes, section 145A.17, 
362.29 	subdivision 7, and may use ten percent of 
362.30 	the funds appropriated each fiscal year to 
362.31 	provide training and technical assistance as 
362.32 	required under Minnesota Statutes, section 
362.33 	145A.17, subdivisions 4 and 5.
362.34 	TANF Carryforward. Any unexpended 
362.35 	balance of the TANF appropriation in the 
363.1 	first year of the biennium does not cancel but 
363.2 	is available for the second year.

363.3	Subd. 3.Policy Quality and Compliance

363.4	Appropriations by Fund
	
363.5	General
	7,593,000
	7,593,000
	
363.6
363.7	State Government 
Special Revenue
	14,173,000
	14,173,000
	
363.8	Health Care Access
	13,083,000
	11,375,000
	
363.9 	MERC Federal Compliance.
363.10 	Notwithstanding Laws 2008, chapter 
363.11 	363, article 18, section 4, subdivision 3, the 
363.12 	base level funding for the commissioner to 
363.13 	distribute to the Mayo Clinic for transitional 
363.14 	funding while federal compliance changes 
363.15 	are made to the medical education and 
363.16 	research cost funding distribution formula 
363.17 	shall be $0 for fiscal years 2010 and 2011.
363.18 	Value-Based Insurance Designs. The 
363.19 	commissioner of health, in consultation 
363.20 	with the commissioner of human services, 
363.21 	commerce, and Minnesota management 
363.22 	and budget, shall study and report to the 
363.23 	legislature on value-based insurance designs 
363.24 	that vary enrollee cost-sharing based on 
363.25 	clinical or cost-effectiveness of services. 
363.26 	In performing this study, the commissioner 
363.27 	shall consult with and seek input from 
363.28 	health plans, health care providers, and 
363.29 	employers. The commissioner shall report to 
363.30 	the legislature by January 15, 2010.
363.31 	Base Adjustment. The general fund base 
363.32 	is $8,593,000 for each of fiscal years 2012 
363.33 	and 2013. The health care access fund 
363.34 	base is $10,775,000 in fiscal year 2012 and 
363.35 	$7,641,000 in fiscal year 2013.

364.1	Subd. 4.Health Protection

364.2	Appropriations by Fund
	
364.3	General
	9,930,000
	9,930,000
	
364.4
364.5	State Government 
Special Revenue
	30,209,000
	30,209,000
	
364.6	Clean Water
	1,250,000
	2,500,000
	
364.7 	Clean Water Act Funding. Of the 
364.8 	appropriations from the clean water fund, 
364.9 	$805,000 in fiscal year 2010 and $1,610,000 
364.10 	in fiscal year 2012 are for protection of 
364.11 	drinking water sources and $445,000 in fiscal 
364.12 	year 2010 and $890,000 in fiscal year 2011 
364.13 	are for addressing public health concerns 
364.14 	related to contaminants found in Minnesota 
364.15 	drinking water for which no health-based 
364.16 	drinking water standard exists.

364.17	Subd. 5.Administrative Support Services
 		7,356,000
		7,356,000

364.18	Sec. 5. HEALTH RELATED BOARDS

364.19	Subdivision 1.Total Appropriation 
 	$
	14,035,000
	$
	13,848,000
	
364.20 	This appropriation is from the state 
364.21 	government special revenue fund.
364.22 	The amounts that may be spent for each 
364.23 	purpose are specified in the following 
364.24 	subdivisions.

364.25	Subd. 2.Board of Chiropractic Examiners
 		447,000
		447,000

364.26	Subd. 3.Board of Dentistry
 		1,009,000
		1,009,000

364.27
364.28	Subd. 4.Board of Dietetic and Nutrition 
Practice
 		105,000
		105,000

364.29
364.30	Subd. 5.Board of Marriage and Family 
Therapy
 		137,000
		137,000

364.31	Subd. 6.Board of Medical Practice
 		3,682,000
		3,682,000

364.32	Subd. 7.Board of Nursing
 		3,287,000
		3,289,000

365.1
365.2	Subd. 8.Board of Nursing Home 
Administrators
 		1,212,000
		1,023,000
	
365.3 	Administrative Services Unit - Operating 
365.4 	Costs. Of this appropriation, $524,000 
365.5 	in fiscal year 2010 and $526,000 in 
365.6 	fiscal year 2011 are for operating costs 
365.7 	of the administrative services unit. The 
365.8 	administrative services unit may receive 
365.9 	and expend reimbursements for services 
365.10 	performed by other agencies.
365.11 	Administrative Services Unit - Retirement 
365.12 	Costs. Of this appropriation in fiscal year 
365.13 	2010, $201,000 is for onetime retirement 
365.14 	costs in the health-related boards. This 
365.15 	funding may be transferred to the health 
365.16 	boards incurring those costs for their 
365.17 	payment. These funds are available either 
365.18 	year of the biennium.
365.19 	Administrative Services Unit - Volunteer 
365.20 	Health Care Provider Program. Of this 
365.21 	appropriation, $79,000 in fiscal year 2010 
365.22 	and $89,000 in fiscal year 2011 are to pay 
365.23 	for medical professional liability coverage 
365.24 	required under Minnesota Statutes, section 
365.25 	214.40.
365.26 	Administrative Services Unit - Contested 
365.27 	Cases and Other Legal Proceedings. Of 
365.28 	this appropriation, $200,000 in fiscal year 
365.29 	2010 and $200,000 in fiscal year 2011 
365.30 	are for costs of contested case hearings 
365.31 	and other unanticipated costs of legal 
365.32 	proceedings involving health-related 
365.33 	boards funded under this section. Upon 
365.34 	certification of a health-related board to the 
365.35 	administrative services unit that the costs 
366.1 	will be incurred and that there is insufficient 
366.2 	money available to pay for the costs out of 
366.3 	money currently available to that board, the 
366.4 	administrative services unit is authorized 
366.5 	to transfer money from this appropriation 
366.6 	to the board for payment of those costs 
366.7 	with the approval of the commissioner of 
366.8 	finance. This appropriation does not cancel. 
366.9 	Any unencumbered and unspent balances 
366.10 	remain available for these expenditures in 
366.11 	subsequent fiscal years.

366.12	Subd. 9.Board of Optometry
 		101,000
		101,000

366.13	Subd. 10.Board of Pharmacy
 		1,388,000
		1,388,000

366.14	Subd. 11.Board of Physical Therapy
 		295,000
		295,000

366.15	Subd. 12.Board of Podiatry
 		56,000
		56,000

366.16	Subd. 13.Board of Psychology
 		806,000
		806,000

366.17	Subd. 14.Board of Social Work
 		921,000
		921,000

366.18	Subd. 15.Board of Veterinary Medicine
 		195,000
		195,000

366.19
366.20	Subd. 16.Board of Behavioral Health and 
Therapy
 		394,000
		394,000

366.21
366.22	Sec. 6. EMERGENCY MEDICAL SERVICES 
BOARD
 	$
	3,992,000
	$
	3,992,000

366.23	Appropriations by Fund
	
366.24		2010
	2011
	
366.25	General
	3,288,000
	3,288,000
	
366.26
366.27	State Government 
Special Revenue
	704,000
	704,000
	
366.28 	Longevity Award and Incentive Program.
366.29 	Of the general fund appropriation, $700,000 
366.30 	in fiscal year 2010 and $700,000 in fiscal 
366.31 	year 2011 are to the board for the ambulance 
366.32 	service personnel longevity award and 
366.33 	incentive program, under Minnesota Statutes, 
366.34 	section 144E.40.
367.1 	Health Professional Services Program.
367.2 	$704,000 in fiscal year 2010 and $704,000 in 
367.3 	fiscal year 2011 from the state government 
367.4 	special revenue fund are for the health 
367.5 	professional services program.

367.6	Sec. 7. COUNCIL ON DISABILITY
 	$
	524,000
	$
	524,000

367.7
367.8
367.9	Sec. 8. OMBUDSMAN FOR MENTAL 
HEALTH AND DEVELOPMENTAL 
DISABILITIES
 	$
	1,655,000
	$
	1,655,000

367.10	Sec. 9. OMBUDSPERSON FOR FAMILIES
 	$
	265,000
	$
	265,000

367.11 	Sec. 10. Minnesota Statutes 2008, section 16A.725, subdivision 3, is amended to read:
367.12 		Subd. 3.Fund reimbursements. (a) Each fiscal year, the commissioner of finance 
367.13 	shall first transfer from the health impact fund to the general fund an amount sufficient 
367.14 	to offset the general fund cost of the certified expenditures under subdivision 2 or the 
367.15 	balance of the fund, whichever is less.
367.16 	(b) If any balance remains in the health impact fund after the transfer in paragraph 
367.17 	(a), the commissioner of finance shall transfer to the health care access fund the amount 
367.18 	sufficient to offset the health care access fund cost of the certified expenditures in 
367.19 	subdivision 2, or the balance of the fund, whichever is less.

367.20 	Sec. 11. Minnesota Statutes 2008, section 144.1501, subdivision 2, is amended to read:
367.21 		Subd. 2. Creation of account. (a) A health professional education loan forgiveness 
367.22 	program account is established in the general fund. The commissioner of health shall use 
367.23 	money from the account to establish a loan forgiveness program: 
367.24 	(1) for medical residents agreeing to practice in designated rural areas or underserved 
367.25 	urban communities or specializing in the area of pediatric psychiatry; 
367.26 	(2) for midlevel practitioners agreeing to practice in designated rural areas or to 
367.27 	teach at least 12 credit hours, or 720 hours  per year  in the nursing field in a postsecondary 
367.28 	program at the undergraduate level or the equivalent at the graduate level; 
367.29 	(3) for nurses who agree to practice in a Minnesota nursing home or intermediate 
367.30 	care facility for persons with developmental disability or to teach at least 12 credit hours, 
367.31 	or 720 hours per year in the nursing field in a postsecondary program at the undergraduate 
367.32 	level or the equivalent at the graduate level; 
368.1 	(4) for other health care technicians agreeing to teach at least 12 credit hours, or 720 
368.2 	hours  per year  in their designated field in a postsecondary program at the undergraduate 
368.3 	level or the equivalent at the graduate level. The commissioner, in consultation with 
368.4 	the Healthcare Education-Industry Partnership, shall determine the health care fields 
368.5 	where the need is the greatest, including, but not limited to, respiratory therapy, clinical 
368.6 	laboratory technology, radiologic technology, and surgical technology; 
368.7 	(5) for pharmacists who agree to practice in designated rural areas; and 
368.8 	(6) for dentists agreeing to deliver at least 25 percent of the dentist's yearly patient 
368.9 	encounters to state public program enrollees or patients receiving sliding fee schedule 
368.10 	discounts through a formal sliding fee schedule meeting the standards established by 
368.11 	the United States Department of Health and Human Services under Code of Federal 
368.12 	Regulations, title 42, section 51, chapter 303. 
368.13 	(b) Appropriations made to the account do not cancel and are available until 
368.14 	expended, except that at the end of each biennium, any remaining balance in the account 
368.15 	that is not committed by contract and not needed to fulfill existing commitments shall 
368.16 	cancel to the general fund. 

368.17 	Sec. 12. Minnesota Statutes 2008, section 144.1501, subdivision 5, is amended to read:
368.18 		Subd. 5.Penalty for nonfulfillment. If a participant does not fulfill the required 
368.19 	minimum commitment of service according to subdivision 3, the commissioner of health 
368.20 	shall collect from the participant the total amount paid to the participant under the loan 
368.21 	forgiveness program plus interest at a rate established according to section 270C.40. The 
368.22 	commissioner shall deposit the money collected in the health care accessgeneral fund 
368.23 	to be credited to the health professional education loan forgiveness program account 
368.24 	established in subdivision 2. The commissioner shall allow waivers of all or part of the 
368.25 	money owed the commissioner as a result of a nonfulfillment penalty if emergency 
368.26 	circumstances prevented fulfillment of the minimum service commitment.

368.27 	Sec. 13. Minnesota Statutes 2008, section 145.986, subdivision 5, is amended to read:
368.28 		Subd. 5.Report. The commissioner shall submit a biennial report to the legislature 
368.29 	on the statewide health improvement program funded under this section. These reports 
368.30 	must include information on grant recipients, activities that were conducted using grant 
368.31 	funds, evaluation data, and outcome measures, if available. In addition, the commissioner 
368.32 	shall provide recommendations on future areas of focus for health improvement. These 
368.33 	reports are due by January 15 of every other year, beginning in 2010. In the report due 
368.34 	on January 15, 2010, the commissioner shall include recommendations on a sustainable 
369.1 	funding source for the statewide health improvement program other than the health care 
369.2 	access fund.

369.3 	Sec. 14. [256.0191] RECEIPTS FOR SYSTEMS PROJECTS.
369.4 	Appropriations and federal receipts for information systems projects for MAXIS, 
369.5 	PRISM, MMIS, and SSIS must be deposited in the state system account authorized 
369.6 	in section 256.014. Money appropriated for computer projects approved by the 
369.7 	Minnesota Office of Enterprise Technology, funded by the legislature, and approved by 
369.8 	the commissioner of finance, may be transferred from one project to another and from 
369.9 	development to operations as the commissioner of human services considers necessary. 
369.10 	Any unexpended balance in the appropriation for these projects does not cancel but is 
369.11 	available for ongoing development and operations.

369.12 	Sec. 15. Minnesota Statutes 2008, section 295.58, is amended to read:
369.13 	295.58 DEPOSIT OF REVENUES AND PAYMENT OF REFUNDS.
369.14 	The commissioner shall deposit all revenues, including penalties and interest, 
369.15 	derived from the taxes imposed by sections 295.50 to 295.57 and from the insurance 
369.16 	premiums tax imposed by section 297I.05, subdivision 5, on health maintenance 
369.17 	organizations, community integrated service networks, and nonprofit health service plan 
369.18 	corporations in the health care accessgeneral fund. There is annually appropriated from 
369.19 	the health care accessgeneral fund to the commissioner of revenue the amount necessary 
369.20 	to make refunds under this chapter.  

369.21 	Sec. 16. Minnesota Statutes 2008, section 297I.05, subdivision 5, is amended to read:
369.22 		Subd. 5.Health maintenance organizations, nonprofit health service plan 
369.23 	corporations, and community integrated service networks. (a) A tax is imposed on 
369.24 	health maintenance organizations, community integrated service networks, and nonprofit 
369.25 	health care service plan corporations. The rate of tax is equal to one percent of gross 
369.26 	premiums less return premiums on all direct business received by the organization, 
369.27 	network, or corporation or its agents in Minnesota, in cash or otherwise, in the calendar 
369.28 	year.
369.29 	(b) The commissioner shall deposit all revenues, including penalties and interest, 
369.30 	collected under this chapter from health maintenance organizations, community integrated 
369.31 	service networks, and nonprofit health service plan corporations in the health care access
369.32 	general fund. Refunds of overpayments of tax imposed by this subdivision must be paid 
369.33 	from the health care accessgeneral fund. There is annually appropriated from the health 
370.1 	care accessgeneral fund to the commissioner the amount necessary to make any refunds 
370.2 	of the tax imposed under this subdivision.

370.3 	Sec. 17. Laws 2003, First Special Session chapter 14, article 13C, section 2, subdivision 
370.4 	1, as amended by Laws 2004, chapter 272, article 2, section 2, is amended to read:

370.5	Subdivision 1.Total Appropriation 
 	$
	3,848,049,000
	$
	4,135,780,000

370.6	Summary by Fund
	
370.7	General
	3,301,811,000 
	3,561,055,000
	
370.8	State Government
	534,000
	534,000
	
370.9370.10
	Special Revenue 
Health Care Access
	273,723,000
	302,272,000
	
370.11	Federal TANF
	270,425,000
	270,363,000
	
370.12	Lottery Cash Flow
	1,556,000
	1,556,000
	
370.13 	FEDERAL CONTINGENCY 
370.14 	APPROPRIATION. (a) Federal Medicaid 
370.15 	funds made available under title IV of 
370.16 	the federal Jobs and Growth Tax Relief 
370.17 	Reconciliation Act of 2003 are appropriated 
370.18 	to the commissioner of human services 
370.19 	for use in the state's medical assistance 
370.20 	and MinnesotaCare programs. The 
370.21 	commissioners of human services and 
370.22 	finance shall report to the legislative advisory 
370.23 	committee on the additional federal Medicaid 
370.24 	matching funds that will be available to the 
370.25 	state.
370.26 	(b) Because of the availability of these funds, 
370.27 	the following policies shall become effective:
370.28 	(1) medical assistance and MinnesotaCare 
370.29 	eligibility and local financial participation 
370.30 	changes provided for in this act may be 
370.31 	implemented prior to September 2, 2003, or 
370.32 	may be delayed as necessary to maximize 
370.33 	the use of federal funds received under 
370.34 	title IV of the Jobs and Growth Tax Relief 
370.35 	Reconciliation Act of 2003;
371.1 	(2) the aggregate cap on the services 
371.2 	identified in Minnesota Statutes, section 
371.3 	256L.035, paragraph (a), clause (3), shall 
371.4 	be increased from $2,000 to $5,000. This 
371.5 	increase shall expire at the end of fiscal year 
371.6 	2007. Funds may be transferred from the 
371.7 	general fund to the health care access fund as 
371.8 	necessary to implement this provision; and
371.9 	(3) the following payment shifts shall not be 
371.10 	implemented:
371.11 	(i) MFIP payment shift found in subdivision 
371.12 	11;
371.13 	(ii) the county payment shift found in 
371.14 	subdivision 1; and
371.15 	(iii) the delay in medical assistance 
371.16 	and general assistance medical care 
371.17 	fee-for-service payments found in 
371.18 	subdivision 6.
371.19 	(c) Notwithstanding section 14, paragraphs 
371.20 	(a) and (b) shall expire June 30, 2007.
371.21 	RECEIPTS FOR SYSTEMS PROJECTS.
371.22 	Appropriations and federal receipts for 
371.23 	information system projects for MAXIS, 
371.24 	PRISM, MMIS, and SSIS must be deposited 
371.25 	in the state system account authorized in 
371.26 	Minnesota Statutes, section 256.014. Money 
371.27 	appropriated for computer projects approved 
371.28 	by the Minnesota office of technology, 
371.29 	funded by the legislature, and approved 
371.30 	by the commissioner of finance may be 
371.31 	transferred from one project to another 
371.32 	and from development to operations as the 
371.33 	commissioner of human services considers 
371.34 	necessary. Any unexpended balance in 
371.35 	the appropriation for these projects does 
372.1 	not cancel but is available for ongoing 
372.2 	development and operations.
372.3 	GIFTS. Notwithstanding Minnesota 
372.4 	Statutes, chapter 7, the commissioner may 
372.5 	accept on behalf of the state additional 
372.6 	funding from sources other than state funds 
372.7 	for the purpose of financing the cost of 
372.8 	assistance program grants or nongrant 
372.9 	administration. All additional funding is 
372.10 	appropriated to the commissioner for use as 
372.11 	designated by the grantor of funding.
372.12 	SYSTEMS CONTINUITY. In the event of 
372.13 	disruption of technical systems or computer 
372.14 	operations, the commissioner may use 
372.15 	available grant appropriations to ensure 
372.16 	continuity of payments for maintaining the 
372.17 	health, safety, and well-being of clients 
372.18 	served by programs administered by the 
372.19 	department of human services. Grant funds 
372.20 	must be used in a manner consistent with the 
372.21 	original intent of the appropriation.
372.22 	NONFEDERAL SHARE TRANSFERS.
372.23 	The nonfederal share of activities for which 
372.24 	federal administrative reimbursement is 
372.25 	appropriated to the commissioner may be 
372.26 	transferred to the special revenue fund.
372.27 	TANF FUNDS APPROPRIATED TO 
372.28 	OTHER ENTITIES. Any expenditures 
372.29 	from the TANF block grant shall be expended 
372.30 	in accordance with the requirements and 
372.31 	limitations of part A of title IV of the 
372.32 	Social Security Act, as amended, and any 
372.33 	other applicable federal requirement or 
372.34 	limitation. Prior to any expenditure of these 
372.35 	funds, the commissioner shall assure that 
373.1 	funds are expended in compliance with the 
373.2 	requirements and limitations of federal law 
373.3 	and that any reporting requirements of federal 
373.4 	law are met. It shall be the responsibility 
373.5 	of any entity to which these funds are 
373.6 	appropriated to implement a memorandum 
373.7 	of understanding with the commissioner 
373.8 	that provides the necessary assurance of 
373.9 	compliance prior to any expenditure of funds. 
373.10 	The commissioner shall receipt TANF funds 
373.11 	appropriated to other state agencies and 
373.12 	coordinate all related interagency accounting 
373.13 	transactions necessary to implement these 
373.14 	appropriations. Unexpended TANF funds 
373.15 	appropriated to any state, local, or nonprofit 
373.16 	entity cancel at the end of the state fiscal 
373.17 	year unless appropriating language permits 
373.18 	otherwise.
373.19 	TANF FUNDS TRANSFERRED TO 
373.20 	OTHER FEDERAL GRANTS. The 
373.21 	commissioner must authorize transfers 
373.22 	from TANF to other federal block grants so 
373.23 	that funds are available to meet the annual 
373.24 	expenditure needs as appropriated. Transfers 
373.25 	may be authorized prior to the expenditure 
373.26 	year with the agreement of the receiving 
373.27 	entity. Transferred funds must be expended 
373.28 	in the year for which the funds were 
373.29 	appropriated unless appropriation language 
373.30 	permits otherwise. In accelerating transfer 
373.31 	authorizations, the commissioner must aim to 
373.32 	preserve the future potential transfer capacity 
373.33 	from TANF to other block grants.
373.34 	TANF MAINTENANCE OF EFFORT.
373.35 	(a) In order to meet the basic maintenance 
373.36 	of effort (MOE) requirements of the TANF 
374.1 	block grant specified under Code of Federal 
374.2 	Regulations, title 45, section 263.1, the 
374.3 	commissioner may only report nonfederal 
374.4 	money expended for allowable activities 
374.5 	listed in the following clauses as TANF/MOE 
374.6 	expenditures:
374.7 	(1) MFIP cash, diversionary work program, 
374.8 	and food assistance benefits under Minnesota 
374.9 	Statutes, chapter 256J;
374.10 	(2) the child care assistance programs 
374.11 	under Minnesota Statutes, sections 119B.03
374.12 	and 119B.05, and county child care 
374.13 	administrative costs under Minnesota 
374.14 	Statutes, section 119B.15;
374.15 	(3) state and county MFIP administrative 
374.16 	costs under Minnesota Statutes, chapters 
374.17 	256J and 256K;
374.18 	(4) state, county, and tribal MFIP 
374.19 	employment services under Minnesota 
374.20 	Statutes, chapters 256J and 256K;
374.21 	(5) expenditures made on behalf of 
374.22 	noncitizen MFIP recipients who qualify 
374.23 	for the medical assistance without federal 
374.24 	financial participation program under 
374.25 	Minnesota Statutes, section 256B.06, 
374.26 	subdivision 4, paragraphs (d), (e), and (j); 
374.27 	and
374.28 	(6) qualifying working family credit 
374.29 	expenditures under Minnesota Statutes, 
374.30 	section 290.0671.
374.31 	(b) The commissioner shall ensure that 
374.32 	sufficient qualified nonfederal expenditures 
374.33 	are made each year to meet the state's 
374.34 	TANF/MOE requirements. For the activities 
375.1 	listed in paragraph (a), clauses (2) to 
375.2 	(6), the commissioner may only report 
375.3 	expenditures that are excluded from the 
375.4 	definition of assistance under Code of 
375.5 	Federal Regulations, title 45, section 260.31.
375.6 	(c) By August 31 of each year, the 
375.7 	commissioner shall make a preliminary 
375.8 	calculation to determine the likelihood 
375.9 	that the state will meet its annual federal 
375.10 	work participation requirement under Code 
375.11 	of Federal Regulations, title 45, sections 
375.12 	261.21 and 261.23, after adjustment for any 
375.13 	caseload reduction credit under Code of 
375.14 	Federal Regulations, title 45, section 261.41. 
375.15 	If the commissioner determines that the 
375.16 	state will meet its federal work participation 
375.17 	rate for the federal fiscal year ending that 
375.18 	September, the commissioner may reduce the 
375.19 	expenditure under paragraph (a), clause (1), 
375.20 	to the extent allowed under Code of Federal 
375.21 	Regulations, title 45, section 263.1(a)(2).
375.22 	(d) For fiscal years beginning with state 
375.23 	fiscal year 2003, the commissioner shall 
375.24 	assure that the maintenance of effort used 
375.25 	by the commissioner of finance for the 
375.26 	February and November forecasts required 
375.27 	under Minnesota Statutes, section 16A.103, 
375.28 	contains expenditures under paragraph (a), 
375.29 	clause (1), equal to at least 25 percent of 
375.30 	the total required under Code of Federal 
375.31 	Regulations, title 45, section 263.1.
375.32 	(e) If nonfederal expenditures for the 
375.33 	programs and purposes listed in paragraph 
375.34 	(a) are insufficient to meet the state's 
375.35 	TANF/MOE requirements, the commissioner 
376.1 	shall recommend additional allowable 
376.2 	sources of nonfederal expenditures to the 
376.3 	legislature, if the legislature is or will be in 
376.4 	session to take action to specify additional 
376.5 	sources of nonfederal expenditures for 
376.6 	TANF/MOE before a federal penalty is 
376.7 	imposed. The commissioner shall otherwise 
376.8 	provide notice to the legislative commission 
376.9 	on planning and fiscal policy under paragraph 
376.10 	(g).
376.11 	(f) If the commissioner uses authority 
376.12 	granted under section 11, or similar authority 
376.13 	granted by a subsequent legislature, to 
376.14 	meet the state's TANF/MOE requirement 
376.15 	in a reporting period, the commissioner 
376.16 	shall inform the chairs of the appropriate 
376.17 	legislative committees about all transfers 
376.18 	made under that authority for this purpose.
376.19 	(g) If the commissioner determines that 
376.20 	nonfederal expenditures under paragraph 
376.21 	(a) are insufficient to meet TANF/MOE 
376.22 	expenditure requirements, and if the 
376.23 	legislature is not or will not be in 
376.24 	session to take timely action to avoid a 
376.25 	federal penalty, the commissioner may 
376.26 	report nonfederal expenditures from 
376.27 	other allowable sources as TANF/MOE 
376.28 	expenditures after the requirements of this 
376.29 	paragraph are met. The commissioner 
376.30 	may report nonfederal expenditures 
376.31 	in addition to those specified under 
376.32 	paragraph (a) as nonfederal TANF/MOE 
376.33 	expenditures, but only ten days after the 
376.34 	commissioner of finance has first submitted 
376.35 	the commissioner's recommendations for 
376.36 	additional allowable sources of nonfederal 
377.1 	TANF/MOE expenditures to the members of 
377.2 	the legislative commission on planning and 
377.3 	fiscal policy for their review.
377.4 	(h) The commissioner of finance shall not 
377.5 	incorporate any changes in federal TANF 
377.6 	expenditures or nonfederal expenditures for 
377.7 	TANF/MOE that may result from reporting 
377.8 	additional allowable sources of nonfederal 
377.9 	TANF/MOE expenditures under the interim 
377.10 	procedures in paragraph (g) into the February 
377.11 	or November forecasts required under 
377.12 	Minnesota Statutes, section 16A.103, unless 
377.13 	the commissioner of finance has approved 
377.14 	the additional sources of expenditures under 
377.15 	paragraph (g).
377.16 	(i) Minnesota Statutes, section 256.011, 
377.17 	subdivision 3, which requires that federal 
377.18 	grants or aids secured or obtained under that 
377.19 	subdivision be used to reduce any direct 
377.20 	appropriations provided by law, do not apply 
377.21 	if the grants or aids are federal TANF funds.
377.22 	(j) Notwithstanding section 14, paragraph 
377.23 	(a), clauses (1) to (6), and paragraphs (b) to 
377.24 	(j) expire June 30, 2007.
377.25 	WORKING FAMILY CREDIT 
377.26 	EXPENDITURES AS TANF MOE.
377.27 	The commissioner may claim as TANF 
377.28 	maintenance of effort up to the following 
377.29 	amounts of working family credit 
377.30 	expenditures for the following fiscal years:
377.31 	(1) fiscal year 2004, $7,013,000;
377.32 	(2) fiscal year 2005, $25,133,000;
377.33 	(3) fiscal year 2006, $6,942,000; and
377.34 	(4) fiscal year 2007, $6,707,000.
378.1 	FISCAL YEAR 2003 APPROPRIATIONS 
378.2 	CARRYFORWARD. Effective the day 
378.3 	following final enactment, notwithstanding 
378.4 	Minnesota Statutes, section 16A.28, or any 
378.5 	other law to the contrary, state agencies and 
378.6 	constitutional offices may carry forward 
378.7 	unexpended and unencumbered nongrant 
378.8 	operating balances from fiscal year 2003 
378.9 	general fund appropriations into fiscal year 
378.10 	2004 to offset general budget reductions.
378.11 	TRANSFER OF GRANT BALANCES.
378.12 	Effective the day following final enactment, 
378.13 	the commissioner of human services, 
378.14 	with the approval of the commissioner of 
378.15 	finance and after notification of the chair 
378.16 	of the senate health, human services and 
378.17 	corrections budget division and the chair 
378.18 	of the house of representatives health 
378.19 	and human services finance committee, 
378.20 	may transfer unencumbered appropriation 
378.21 	balances for the biennium ending June 30, 
378.22 	2003, in fiscal year 2003 among the MFIP, 
378.23 	MFIP child care assistance under Minnesota 
378.24 	Statutes, section 119B.05, general assistance, 
378.25 	general assistance medical care, medical 
378.26 	assistance, Minnesota supplemental aid, 
378.27 	and group residential housing programs, 
378.28 	and the entitlement portion of the chemical 
378.29 	dependency consolidated treatment fund, and 
378.30 	between fiscal years of the biennium.
378.31 	TANF APPROPRIATION 
378.32 	CANCELLATION. Notwithstanding 
378.33 	the provisions of Laws 2000, chapter 488, 
378.34 	article 1, section 16, any prior appropriations 
378.35 	of TANF funds to the department of trade and 
378.36 	economic development or to the job skills 
379.1 	partnership board or any transfers of TANF 
379.2 	funds from another agency to the department 
379.3 	of trade and economic development or to the 
379.4 	job skills partnership board are not available 
379.5 	until expended, and if unobligated as of June 
379.6 	30, 2003, these appropriations or transfers 
379.7 	shall cancel to the TANF fund.
379.8 	SHIFT COUNTY PAYMENT. The 
379.9 	commissioner shall make up to 100 percent 
379.10 	of the calendar year 2005 payments to 
379.11 	counties for developmental disabilities 
379.12 	semi-independent living services grants, 
379.13 	developmental disabilities family support 
379.14 	grants, and adult mental health grants from 
379.15 	fiscal year 2006 appropriations. This is a 
379.16 	onetime payment shift. Calendar year 2006 
379.17 	and future payments for these grants are not 
379.18 	affected by this shift. This provision expires 
379.19 	June 30, 2006.
379.20 	CAPITATION RATE INCREASE. Of 
379.21 	the health care access fund appropriations 
379.22 	to the University of Minnesota in the 
379.23 	higher education omnibus appropriation 
379.24 	bill, $2,157,000 in fiscal year 2004 and 
379.25 	$2,157,000 in fiscal year 2005 are to be used 
379.26 	to increase the capitation payments under
379.27 	for fiscal years beginning on July 1, 2003, 
379.28 	and thereafter, $2,157,000 each year must be 
379.29 	transferred to the commissioner for purposes 
379.30 	of Minnesota Statutes, section 256B.69. 
379.31 	Notwithstanding the provisions of section 
379.32 	14, this provision shall not expire.

379.33 	EFFECTIVE DATE. This section is effective retroactively from July 1, 2003.

379.34 	Sec. 18. TRANSFERS.
 380.1 		Subdivision 1.Grants. The commissioner of human services, with the approval 
380.2 	of the commissioner of finance, and after notification of the chairs of the relevant senate 
380.3 	budget division and house of representatives finance division committee, may transfer 
380.4 	unencumbered appropriation balances for the biennium ending June 30, 2011, within 
380.5 	fiscal years among the MFIP, general assistance, general assistance medical care, medical 
380.6 	assistance, MinnesotaCare, MFIP child care assistance under Minnesota Statutes, section 
380.7 	119B.05, Minnesota supplemental aid, and group residential housing programs, and the 
380.8 	entitlement portion of the chemical dependency consolidated treatment fund, and between 
380.9 	fiscal years of the biennium.
380.10 		Subd. 2.Administration. Positions, salary money, and nonsalary administrative 
380.11 	money may be transferred within the Departments of Human Services and Health as the 
380.12 	commissioners consider necessary, with the advance approval of the commissioner of 
380.13 	finance. The commissioner shall inform the chairs of the relevant house and senate health 
380.14 	committees quarterly about transfers made under this provision.

380.15 	Sec. 19. 2007 AND 2008 APPROPRIATION AMENDMENTS.
 380.16 	(a) The base for the integrated service projects authorized under Laws 2007, chapter 
380.17 	147, article 19, section 3, subdivision 4, paragraph (b), as amended by Laws 2008, chapter 
380.18 	363, article 18, section 7, paragraph (b), is $1,250,000 in fiscal year 2010 and $0 in fiscal 
380.19 	year 2011. This paragraph is effective retroactively from July 1, 2008.
380.20 	(b) Notwithstanding Laws 2007, chapter 147, article 19, section 3, subdivision 4, 
380.21 	paragraph (g), as amended by Laws 2008, chapter 363, article 18, section 7, the TANF 
380.22 	fund base for the Children's Mental Health Pilots is $0 in fiscal year 2011. This paragraph 
380.23 	is effective retroactively from July 1, 2008.
380.24 	(c) Notwithstanding Laws 2007, chapter 147, article 19, section 3, subdivision 
380.25 	4, paragraph (g), as amended by Laws 2008, chapter 363, article 18, section 7, the 
380.26 	appropriations for grants for programs serving young parents do not become part of the 
380.27 	agency's base. This paragraph is effective retroactively from July 1, 2008.
380.28 	(d) Notwithstanding Laws 2007, chapter 147, article 19, section 3, subdivision 
380.29 	4, paragraph (k), as amended by Laws 2008, chapter 363, article 18, section 7, the 
380.30 	appropriation for People Incorporated does not become part of the agency's base. This 
380.31 	paragraph is effective retroactively from July 1, 2008.
380.32 	(e) The appropriation for patient incentive programs under Laws 2007, chapter 147, 
380.33 	article 19, section 3, subdivision 6, paragraph (e), is canceled. This paragraph is effective 
380.34 	retroactively from July 1, 2007.
381.1 	(f) The onetime general fund base reduction for Child Care Development Grants 
381.2 	under Laws 2008, chapter 363, article 18, section 3, subdivision 4, paragraph (d), is 
381.3 	increased by $4,000. This paragraph is effective retroactively from July 1, 2008.
381.4 	(g) The base for Children Services Grants under Laws 2008, chapter 363, article 18, 
381.5 	section 3, subdivision 4, paragraph (e), is decreased $1,000 in each year of the fiscal year 
381.6 	2010 and 2011 biennium. This paragraph is effective retroactively from July 1, 2008.
381.7 	(h) Notwithstanding Laws 2008, chapter 363, article 18, section 3, subdivision 4, the 
381.8 	general fund base adjustment for Children and Community Services Grants under Laws 
381.9 	2008, chapter 363, article 18, section 3, subdivision 4, paragraph (f), is increased by 
381.10 	$98,000 each year of fiscal years 2010 and 2011. This paragraph is effective retroactively 
381.11 	from July 1, 2008.
381.12 	(i) The base for Other Continuing Care Grants under Laws 2008, chapter 363, article 
381.13 	18, section 3, subdivision 6, paragraph (h), is decreased by $10,000 in fiscal year 2010. 
381.14 	This paragraph is effective retroactively from July 1, 2008.
381.15 	(j) The appropriation for the Community-Based Health Care Demonstration Project 
381.16 	under Minnesota Statutes, section 62Q.80, subdivision 1a, authorized under Laws 2007, 
381.17 	chapter 147, article 19, section 3, subdivision 6, paragraph (e), is canceled. This paragraph 
381.18 	is effective retroactively from July 1, 2007.
381.19 	(k) The appropriation for Section 125 Employer Incentives in Laws 2008, chapter 
381.20 	358, article 5, section 4, subdivision 3, is reduced by $800,000. This paragraph is effective 
381.21 	retroactively from July 1, 2008.

381.22 	Sec. 20. HEALTH CARE ACCESS FUND RESOURCES AND 
381.23 	APPROPRIATIONS.
 381.24 	Effective July 1, 2009, all health care access fund resources and agency 
381.25 	appropriations become general fund resources and agency appropriations.

381.26 	Sec. 21. INDIRECT COSTS NOT TO FUND PROGRAMS.
 381.27 	The commissioners of health and human services shall not use indirect cost 
381.28 	allocations to pay for the operational costs of any program for which they are responsible.

381.29 	Sec. 22. EXPIRATION OF UNCODIFIED LANGUAGE.
 381.30 	All uncodified language contained in this article expires on June 30, 2011, unless a 
381.31 	different expiration date is explicit.

381.32 	Sec. 23.  REPEALER.
 382.1 	(a) Minnesota Statutes 2008, section 16A.724, is repealed.
382.2 	(b) Minnesota Statutes 2008, section 62U.10, subdivision 4, is repealed.
382.3 	(c) Minnesota Statutes 2008, section 256L.02, subdivision 3, is repealed.
382.4 	(d) Minnesota Statutes 2008, section 295.581, is repealed.

382.5 	Sec. 24. EFFECTIVE DATE.
 382.6 	The provisions in this article are effective July 1, 2009, unless a different effective 
382.7 	date is specified.