1.1 	A bill for an act
1.2 	relating to state government; making changes to health and human services 
1.3 	programs; amending continuing care, agency management, children and family 
1.4 	services, and health care; awarding housing access grants; requiring studies and 
1.5 	reports; making supplemental appropriations; reducing certain appropriations; 
1.6 	making forecast adjustments; clarifying appropriations and transfers;amending 
1.7 	Minnesota Statutes 2006, sections 13.461, by adding a subdivision; 256.01, by 
1.8 	adding a subdivision; 256.741, subdivisions 2, 2a, 3; 256.969, subdivisions 2b, 
1.9 	20; 256B.0571, subdivisions 8, 9; 256B.0621, subdivisions 2, 6, 10; 256B.0924, 
1.10 	subdivisions 4, 6; 256B.19, subdivision 1d; 256B.431, subdivision 23; 256B.69, 
1.11 	subdivisions 5a, 6, by adding subdivisions; 256B.692, subdivision 2, by adding 
1.12 	a subdivision; 256D.44, subdivisions 2, 5; 256L.12, subdivision 9; 518A.50; 
1.13 	518A.53, subdivision 5; Minnesota Statutes 2007 Supplement, sections 256.741, 
1.14 	subdivision 1; 256B.0625, subdivision 20; 256B.0631, subdivisions 1, 3; 
1.15 	256B.199; 256B.434, subdivision 19; 256J.621; Laws 2007, chapter 147, article 
1.16 	2, section 21; article 19, section 3, subdivision 1; proposing coding for new 
1.17 	law in Minnesota Statutes, chapter 256B; repealing Minnesota Statutes 2006, 
1.18 	sections 256.741, subdivision 15; 256J.24, subdivision 6; Minnesota Statutes 
1.19 	2007 Supplement, section 256.969, subdivision 27.
1.20 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.21 	ARTICLE 1
1.22 	CONTINUING CARE

1.23 	Section 1. Minnesota Statutes 2006, section 256B.0621, subdivision 2, is amended to 
1.24 	read:
1.25 		Subd. 2.Targeted case management; definitions. For purposes of subdivisions 3 
1.26 	to 10, the following terms have the meanings given them:
1.27 	(1) "home care service recipients" means those individuals receiving the following 
1.28 	services under sections 256B.0651 to 256B.0656: skilled nursing visits, home health aide 
1.29 	visits, private duty nursing, personal care assistants, or therapies provided through a 
1.30 	home health agency;
2.1 	(2) "home care targeted case management" means the provision of targeted case 
2.2 	management services for the purpose of assisting home care service recipients to gain 
2.3 	access to needed services and supports so that they may remain in the community;
2.4 	(3) "institutions" means hospitals, consistent with Code of Federal Regulations, title 
2.5 	42, section 440.10; regional treatment center inpatient services, consistent with section 
2.6 	245.474; nursing facilities; and intermediate care facilities for persons with developmental 
2.7 	disabilities;
2.8 	(4) "relocation targeted case management" includes the provision of both county 
2.9 	targeted case management and public or private vendor service coordination services 
2.10 	for the purpose of assisting recipients to gain access to needed services and supports if 
2.11 	they choose to move from an institution to the community. Relocation targeted case 
2.12 	management may be provided during the lesser of:
2.13 	(i) the last 180 consecutive days of an eligible recipient's institutional stay; or
2.14 	(ii) the limits and conditions which apply to federal Medicaid funding for this 
2.15 	service; and
2.16 	(5) "targeted case management" means case management services provided to help 
2.17 	recipients gain access to needed medical, social, educational, and other services and 
2.18 	supports.

2.19 	Sec. 2. Minnesota Statutes 2006, section 256B.0621, subdivision 6, is amended to read:
2.20 		Subd. 6.Eligible services. (a) Services eligible for medical assistance 
2.21 	reimbursement as targeted case management include:
2.22 	(1) assessment of the recipient's need for targeted case management services and 
2.23 	for persons choosing to relocate, the county must provide service coordination provider 
2.24 	options at the first contact and upon request;
2.25 	(2) development, completion, and regular review of a written individual service 
2.26 	plan, which is based upon the assessment of the recipient's needs and choices, and which 
2.27 	will ensure access to medical, social, educational, and other related services and supports;
2.28 	(3) routine contact or communication with the recipient, recipient's family, primary 
2.29 	caregiver, legal representative, substitute care provider, service providers, or other relevant 
2.30 	persons identified as necessary to the development or implementation of the goals of the 
2.31 	individual service plan;
2.32 	(4) coordinating referrals for, and the provision of, case management services for 
2.33 	the recipient with appropriate service providers, consistent with section 1902(a)(23) of 
2.34 	the Social Security Act;
3.1 	(5) coordinating and monitoring the overall service delivery and engaging in 
3.2 	advocacy as needed to ensure quality of services, appropriateness, and continued need;
3.3 	(6) completing and maintaining necessary documentation that supports and verifies 
3.4 	the activities in this subdivision;
3.5 	(7) assisting individuals in order to access needed services, including travel to 
3.6 	conduct a visit with the recipient or other relevant person necessary to develop or 
3.7 	implement the goals of the individual service plan; and
3.8 	(8) coordinating with the institution discharge planner in the 180-day period before 
3.9 	the recipient's discharge.
3.10 	(b) Relocation targeted county case management includes services under paragraph 
3.11 	(a), clauses (1), (2), and (4). Relocation service coordination includes services under 
3.12 	paragraph (a), clauses (3) and (5) to (8). Home care targeted case management includes 
3.13 	services under paragraph (a), clauses (1) to (8).

3.14 	Sec. 3. Minnesota Statutes 2006, section 256B.0621, subdivision 10, is amended to 
3.15 	read:
3.16 		Subd. 10.Payment rates. The commissioner shall set payment rates for targeted 
3.17 	case management under this subdivision. Case managers may bill according to the 
3.18 	following criteria:
3.19 	(1) for relocation targeted case management, case managers may bill for direct case 
3.20 	management activities, including face-to-face and telephone contacts, in the lesser of:
3.21 	(i) 180 days preceding an eligible recipient's discharge from an institution; or
3.22 	(ii) the limits and conditions which apply to federal Medicaid funding for this 
3.23 	service;
3.24 	(2) for home care targeted case management, case managers may bill for direct case 
3.25 	management activities, including face-to-face and telephone contacts; and
3.26 	(3) billings for targeted case management services under this subdivision shall not 
3.27 	duplicate payments made under other program authorities for the same purpose.

3.28 	Sec. 4. Minnesota Statutes 2007 Supplement, section 256B.0625, subdivision 20, 
3.29 	is amended to read:
3.30 		Subd. 20.Mental health case management. (a) To the extent authorized by rule 
3.31 	of the state agency, medical assistance covers case management services to persons with 
3.32 	serious and persistent mental illness and children with severe emotional disturbance. 
3.33 	Services provided under this section must meet the relevant standards in sections 245.461
4.1 	to 245.4887, the Comprehensive Adult and Children's Mental Health Acts, Minnesota 
4.2 	Rules, parts 9520.0900 to 9520.0926, and 9505.0322, excluding subpart 10. 
4.3 	(b) Entities meeting program standards set out in rules governing family community 
4.4 	support services as defined in section 245.4871, subdivision 17, are eligible for medical 
4.5 	assistance reimbursement for case management services for children with severe 
4.6 	emotional disturbance when these services meet the program standards in Minnesota 
4.7 	Rules, parts 9520.0900 to 9520.0926 and 9505.0322, excluding subparts 6 and 10. 
4.8 	(c) Medical assistance and MinnesotaCare payment for mental health case 
4.9 	management shall be made on a monthly basis. In order to receive payment for an eligible 
4.10 	child, the provider must document at least a face-to-face contact with the child, the child's 
4.11 	parents, or the child's legal representative. To receive payment for an eligible adult, the 
4.12 	provider must document:
4.13 	(1) at least a face-to-face contact with the adult or the adult's legal representative; or
4.14 	(2) at least a telephone contact with the adult or the adult's legal representative and 
4.15 	document a face-to-face contact with the adult or the adult's legal representative within 
4.16 	the preceding two months.
4.17 	(d) Payment for mental health case management provided by county or state staff 
4.18 	shall be based on the monthly rate methodology under section 256B.094, subdivision 6, 
4.19 	paragraph (b), with separate rates calculated for child welfare and mental health, and 
4.20 	within mental health, separate rates for children and adults. 
4.21 	(e) Payment for mental health case management provided by Indian health services 
4.22 	or by agencies operated by Indian tribes may be made according to this section or other 
4.23 	relevant federally approved rate setting methodology.
4.24 	(f) Payment for mental health case management provided by vendors who contract 
4.25 	with a county or Indian tribe shall be based on a monthly rate negotiated by the host county 
4.26 	or tribe. The negotiated rate must not exceed the rate charged by the vendor for the same 
4.27 	service to other payers. If the service is provided by a team of contracted vendors, the 
4.28 	county or tribe may negotiate a team rate with a vendor who is a member of the team. The 
4.29 	team shall determine how to distribute the rate among its members. No reimbursement 
4.30 	received by contracted vendors shall be returned to the county or tribe, except to reimburse 
4.31 	the county or tribe for advance funding provided by the county or tribe to the vendor.
4.32 	(g) If the service is provided by a team which includes contracted vendors, tribal 
4.33 	staff, and county or state staff, the costs for county or state staff participation in the team 
4.34 	shall be included in the rate for county-provided services. In this case, the contracted 
4.35 	vendor, the tribal agency, and the county may each receive separate payment for services 
4.36 	provided by each entity in the same month. In order to prevent duplication of services, 
5.1 	each entity must document, in the recipient's file, the need for team case management and 
5.2 	a description of the roles of the team members.
5.3 	(h) Notwithstanding section 256B.19, subdivision 1, the nonfederal share of costs 
5.4 	for mental health case management shall be provided by the recipient's county of 
5.5 	responsibility, as defined in sections 256G.01 to 256G.12, from sources other than federal 
5.6 	funds or funds used to match other federal funds. If the service is provided by a tribal 
5.7 	agency, the nonfederal share, if any, shall be provided by the recipient's tribe. When this 
5.8 	service is paid by the state without a federal share through fee-for-service, 50 percent of 
5.9 	the cost shall be provided by the recipient's county of responsibility.
5.10 	(i) Notwithstanding any administrative rule to the contrary, prepaid medical 
5.11 	assistance, general assistance medical care, and MinnesotaCare include mental health case 
5.12 	management. When the service is provided through prepaid capitation, the nonfederal 
5.13 	share is paid by the state and the county pays no share.
5.14 	(j) The commissioner may suspend, reduce, or terminate the reimbursement to a 
5.15 	provider that does not meet the reporting or other requirements of this section. The county 
5.16 	of responsibility, as defined in sections 256G.01 to 256G.12, or, if applicable, the tribal 
5.17 	agency, is responsible for any federal disallowances. The county or tribe may share this 
5.18 	responsibility with its contracted vendors. 
5.19 	(k) The commissioner shall set aside a portion of the federal funds earned for county 
5.20 	expenditures under this section to repay the special revenue maximization account under 
5.21 	section 256.01, subdivision 2, clause (15). The repayment is limited to: 
5.22 	(1) the costs of developing and implementing this section; and
5.23 	(2) programming the information systems.
5.24 	(l) Payments to counties and tribal agencies for case management expenditures 
5.25 	under this section shall only be made from federal earnings from services provided 
5.26 	under this section. When this service is paid by the state without a federal share through 
5.27 	fee-for-service, 50 percent of the cost shall be provided by the state. Payments to 
5.28 	county-contracted vendors shall include the federal earnings, the state share, and the 
5.29 	county share.
5.30 	(m) Case management services under this subdivision do not include therapy, 
5.31 	treatment, legal, or outreach services.
5.32 	(n) If the recipient is a resident of a nursing facility, intermediate care facility, or 
5.33 	hospital, and the recipient's institutional care is paid by medical assistance, payment for 
5.34 	case management services under this subdivision is limited to the lesser of:
5.35 	(1) the last 180 days of the recipient's residency in that facility and may not exceed 
5.36 	more than six months in a calendar year; or
6.1 	(2) the limits and conditions which apply to federal Medicaid funding for this service.
6.2 	(o) Payment for case management services under this subdivision shall not duplicate 
6.3 	payments made under other program authorities for the same purpose.

6.4 	Sec. 5. [256B.0658] HOUSING ACCESS GRANTS.
6.5 	The commissioner of human services shall award through a competitive process 
6.6 	contracts for grants to public and private agencies to support and assist individuals eligible 
6.7 	for publicly funded home and community-based services, including state plan home care, 
6.8 	to access housing. Grants may be awarded to agencies that may include, but are not limited 
6.9 	to, the following supports: assessment to assure suitability of housing, accompanying an 
6.10 	individual to look at housing, filling out applications and rental agreements, meeting 
6.11 	with landlords, helping with Section 8 or other program applications, helping to develop 
6.12 	a budget, obtaining furniture and household goods, if necessary, and assisting with any 
6.13 	problems that may arise with housing.

6.14 	Sec. 6. Minnesota Statutes 2006, section 256B.0924, subdivision 4, is amended to read:
6.15 		Subd. 4.Targeted case management service activities. (a) For persons with 
6.16 	developmental disabilities, targeted case management services must meet the provisions 
6.17 	of section 256B.092. 
6.18 	(b) For persons not eligible as a person with a developmental disability, targeted 
6.19 	case management service activities include:
6.20 	(1) an assessment of the person's need for targeted case management services;
6.21 	(2) the development of a written personal service plan;
6.22 	(3) a regular review and revision of the written personal service plan with the 
6.23 	recipient and the recipient's legal representative, and others as identified by the recipient, 
6.24 	to ensure access to necessary services and supports identified in the plan;
6.25 	(4) effective communication with the recipient and the recipient's legal representative 
6.26 	and others identified by the recipient;
6.27 	(5) coordination of referrals for needed services with qualified providers;
6.28 	(6) coordination and monitoring of the overall service delivery to ensure the quality 
6.29 	and effectiveness of services;
6.30 	(7) assistance to the recipient and the recipient's legal representative to help make 
6.31 	an informed choice of services;
6.32 	(8) advocating on behalf of the recipient when service barriers are encountered or 
6.33 	referring the recipient and the recipient's legal representative to an independent advocate;
7.1 	(9) monitoring and evaluating services identified in the personal service plan to 
7.2 	ensure personal outcomes are met and to ensure satisfaction with services and service 
7.3 	delivery;
7.4 	(10) conducting face-to-face monitoring with the recipient at least twice a year;
7.5 	(11) completing and maintaining necessary documentation that supports and verifies 
7.6 	the activities in this section;
7.7 	(12) coordinating with the medical assistance facility discharge planner in the 
7.8 	180-day period prior to the recipient's discharge into the community; and
7.9 	(13) a personal service plan developed and reviewed at least annually with the 
7.10 	recipient and the recipient's legal representative. The personal service plan must be revised 
7.11 	when there is a change in the recipient's status. The personal service plan must identify:
7.12 	(i) the desired personal short and long-term outcomes;
7.13 	(ii) the recipient's preferences for services and supports, including development of 
7.14 	a person-centered plan if requested; and
7.15 	(iii) formal and informal services and supports based on areas of assessment, such 
7.16 	as: social, health, mental health, residence, family, educational and vocational, safety, 
7.17 	legal, self-determination, financial, and chemical health as determined by the recipient and 
7.18 	the recipient's legal representative and the recipient's support network.

7.19 	Sec. 7. Minnesota Statutes 2006, section 256B.0924, subdivision 6, is amended to read:
7.20 		Subd. 6.Payment for targeted case management. (a) Medical assistance and 
7.21 	MinnesotaCare payment for targeted case management shall be made on a monthly basis. 
7.22 	In order to receive payment for an eligible adult, the provider must document at least one 
7.23 	contact per month and not more than two consecutive months without a face-to-face 
7.24 	contact with the adult or the adult's legal representative, family, primary caregiver, or 
7.25 	other relevant persons identified as necessary to the development or implementation 
7.26 	of the goals of the personal service plan.
7.27 	(b) Payment for targeted case management provided by county staff under this 
7.28 	subdivision shall be based on the monthly rate methodology under section 256B.094, 
7.29 	subdivision 6, paragraph (b), calculated as one combined average rate together with 
7.30 	adult mental health case management under section 256B.0625, subdivision 20, except 
7.31 	for calendar year 2002. In calendar year 2002, the rate for case management under this 
7.32 	section shall be the same as the rate for adult mental health case management in effect 
7.33 	as of December 31, 2001. Billing and payment must identify the recipient's primary 
7.34 	population group to allow tracking of revenues. 
8.1 	(c) Payment for targeted case management provided by county-contracted vendors 
8.2 	shall be based on a monthly rate negotiated by the host county. The negotiated rate must 
8.3 	not exceed the rate charged by the vendor for the same service to other payers. If the 
8.4 	service is provided by a team of contracted vendors, the county may negotiate a team rate 
8.5 	with a vendor who is a member of the team. The team shall determine how to distribute 
8.6 	the rate among its members. No reimbursement received by contracted vendors shall be 
8.7 	returned to the county, except to reimburse the county for advance funding provided by 
8.8 	the county to the vendor.
8.9 	(d) If the service is provided by a team that includes contracted vendors and county 
8.10 	staff, the costs for county staff participation on the team shall be included in the rate for 
8.11 	county-provided services. In this case, the contracted vendor and the county may each 
8.12 	receive separate payment for services provided by each entity in the same month. In 
8.13 	order to prevent duplication of services, the county must document, in the recipient's file, 
8.14 	the need for team targeted case management and a description of the different roles of 
8.15 	the team members.
8.16 	(e) Notwithstanding section 256B.19, subdivision 1, the nonfederal share of costs 
8.17 	for targeted case management shall be provided by the recipient's county of responsibility, 
8.18 	as defined in sections 256G.01 to 256G.12, from sources other than federal funds or 
8.19 	funds used to match other federal funds. 
8.20 	(f) The commissioner may suspend, reduce, or terminate reimbursement to a 
8.21 	provider that does not meet the reporting or other requirements of this section. The county 
8.22 	of responsibility, as defined in sections 256G.01 to 256G.12, is responsible for any federal 
8.23 	disallowances. The county may share this responsibility with its contracted vendors. 
8.24 	(g) The commissioner shall set aside five percent of the federal funds received under 
8.25 	this section for use in reimbursing the state for costs of developing and implementing 
8.26 	this section.
8.27 	(h) Payments to counties for targeted case management expenditures under this 
8.28 	section shall only be made from federal earnings from services provided under this 
8.29 	section. Payments to contracted vendors shall include both the federal earnings and the 
8.30 	county share.
8.31 	(i) Notwithstanding section 256B.041, county payments for the cost of case 
8.32 	management services provided by county staff shall not be made to the commissioner of 
8.33 	finance. For the purposes of targeted case management services provided by county staff 
8.34 	under this section, the centralized disbursement of payments to counties under section 
8.35 	256B.041 consists only of federal earnings from services provided under this section. 
9.1 	(j) If the recipient is a resident of a nursing facility, intermediate care facility, or 
9.2 	hospital, and the recipient's institutional care is paid by medical assistance, payment for 
9.3 	targeted case management services under this subdivision is limited to the lesser of:
9.4 	(1) the last 180 days of the recipient's residency in that facility and may not exceed 
9.5 	more than six months in a calendar year; or
9.6 	(2) the limits and conditions which apply to federal Medicaid funding for this service.
9.7 	(k) Payment for targeted case management services under this subdivision shall not 
9.8 	duplicate payments made under other program authorities for the same purpose.
9.9 	(l) Any growth in targeted case management services and cost increases under this 
9.10 	section shall be the responsibility of the counties.

9.11 	Sec. 8. Minnesota Statutes 2006, section 256B.19, subdivision 1d, is amended to read:
9.12 		Subd. 1d.Portion of nonfederal share to be paid by certain counties. (a) 
9.13 	In addition to the percentage contribution paid by a county under subdivision 1, the 
9.14 	governmental units designated in this subdivision shall be responsible for an additional 
9.15 	portion of the nonfederal share of medical assistance cost. For purposes of this 
9.16 	subdivision, "designated governmental unit" means the counties of Becker, Beltrami, 
9.17 	Clearwater, Cook, Dodge, Hubbard, Itasca, Lake, Pennington, Pipestone, Ramsey, St. 
9.18 	Louis, Steele, Todd, Traverse, and Wadena.
9.19 	(b) Beginning in 1994, each of the governmental units designated in this subdivision 
9.20 	shall transfer before noon on May 31 to the state Medicaid agency an amount equal to the 
9.21 	number of licensed beds in any nursing home owned and operated by the county on that 
9.22 	date, with the county named as licensee, multiplied by $5,723. If two or more counties own 
9.23 	and operate a nursing home, the payment shall be prorated. These sums shall be part of the 
9.24 	designated governmental unit's portion of the nonfederal share of medical assistance costs.
9.25 	(c) Beginning in 2002, in addition to any transfer under paragraph (b), each of the 
9.26 	governmental units designated in this subdivision shall transfer before noon on May 31 
9.27 	to the state Medicaid agency an amount equal to the number of licensed beds in any 
9.28 	nursing home owned and operated by the county on that date, with the county named as 
9.29 	licensee, multiplied by $10,784. The provisions of paragraph (b) apply to transfers under 
9.30 	this paragraph.
9.31 	(d) Beginning in 2003, in addition to any transfer under paragraphs (b) and (c), each 
9.32 	of the governmental units designated in this subdivision shall transfer before noon on May 
9.33 	31 to the state Medicaid agency an amount equal to the number of licensed beds in any 
9.34 	nursing home owned and operated by the county on that date, with the county named as 
10.1 	licensee, multiplied by $2,230. The provisions of paragraph (b) apply to transfers under 
10.2 	this paragraph.
10.3 	(e) (d) The commissioner may reduce the intergovernmental transfers under 
10.4 	paragraphs paragraph (c) and (d) based on the commissioner's determination of the 
10.5 	payment rate in section 256B.431, subdivision 23, paragraphs (c), and (d), and (e). Any 
10.6 	adjustments must be made on a per-bed basis and must result in an amount equivalent to 
10.7 	the total amount resulting from the rate adjustment in section 256B.431, subdivision 23, 
10.8 	paragraphs (c), and (d), and (e). 

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

10.10 	Sec. 9. Minnesota Statutes 2006, section 256B.431, subdivision 23, is amended to read:
10.11 		Subd. 23.County nursing home payment adjustments. (a) Beginning in 1994, 
10.12 	the commissioner shall pay a nursing home payment adjustment on May 31 after noon 
10.13 	to a county in which is located a nursing home that, on that date, was county-owned and 
10.14 	operated, with the county named as licensee by the commissioner of health, and had over 
10.15 	40 beds and medical assistance occupancy in excess of 50 percent during the reporting 
10.16 	year ending September 30, 1991. The adjustment shall be an amount equal to $16 per 
10.17 	calendar day multiplied by the number of beds licensed in the facility on that date.
10.18 	(b) Payments under paragraph (a) are excluded from medical assistance per diem 
10.19 	rate calculations. These payments are required notwithstanding any rule prohibiting 
10.20 	medical assistance payments from exceeding payments from private pay residents. A 
10.21 	facility receiving a payment under paragraph (a) may not increase charges to private pay 
10.22 	residents by an amount equivalent to the per diem amount payments under paragraph (a) 
10.23 	would equal if converted to a per diem.
10.24 	(c) Beginning in 2002, in addition to any payment under paragraph (a), the 
10.25 	commissioner shall pay to a nursing facility described in paragraph (a) an adjustment in 
10.26 	an amount equal to $29.55 per calendar day multiplied by the number of beds licensed 
10.27 	in the facility on that date. The provisions of paragraphs (a) and (b) apply to payments 
10.28 	under this paragraph.
10.29 	(d) Beginning in 2003, in addition to any payment under paragraphs (a) and (c), the 
10.30 	commissioner shall pay to a nursing facility described in paragraph (a) an adjustment in 
10.31 	an amount equal to $6.11 per calendar day multiplied by the number of beds licensed in 
10.32 	the facility on that date. The provisions of paragraphs (a) and (b) apply to payments 
10.33 	under this paragraph.
10.34 	(e) (d) The commissioner may reduce payments under paragraphs paragraph (c) and 
10.35 	(d) based on the commissioner's determination of Medicare upper payment limits. Any 
11.1 	adjustments must be proportional to adjustments made under section  256B.19, subdivision 
11.2 	1d, paragraph (e) (d). 

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

11.4 	Sec. 10. Minnesota Statutes 2007 Supplement, section 256B.434, subdivision 19, 
11.5 	is amended to read:
11.6 		Subd. 19.Nursing facility rate increases beginning October 1, 2007, and 
11.7 	October 1, 2008.  (a) For the rate year beginning October 1, 2007, the commissioner 
11.8 	shall make available to each nursing facility reimbursed under this section operating 
11.9 	payment rate adjustments equal to 1.87 percent of the operating payment rates in effect 
11.10 	on September 30, 2007. For the rate year beginning October 1, 2008, the commissioner 
11.11 	shall make available to each nursing facility reimbursed under this section, operating 
11.12 	payment rate adjustments equal to 2.0 percent of the operating payment rates in effect 
11.13 	on September 30, 2008.
11.14 	(b) Seventy-five percent of the money resulting from the rate adjustment under 
11.15 	paragraph (a) must be used for increases in compensation-related costs for employees 
11.16 	directly employed by the nursing facility on or after the effective date of the rate 
11.17 	adjustment, except:
11.18 	(1) the administrator;
11.19 	(2) persons employed in the central office of a corporation that has an ownership 
11.20 	interest in the nursing facility or exercises control over the nursing facility; and 
11.21 	(3) persons paid by the nursing facility under a management contract.
11.22 	(c) Two-thirds of the money available under paragraph (b) must be used for wage 
11.23 	increases for all employees directly employed by the nursing facility on or after the 
11.24 	effective date of the rate adjustment, except those listed in paragraph (b), clauses (1) to 
11.25 	(3). The wage adjustment that employees receive under this paragraph must be paid as 
11.26 	an equal hourly percentage wage increase for all eligible employees. All wage increases 
11.27 	under this paragraph must be effective on the same date. Only costs associated with the 
11.28 	portion of the equal hourly percentage wage increase that goes to all employees shall 
11.29 	qualify under this paragraph. Costs associated with wage increases in excess of the 
11.30 	amount of the equal hourly percentage wage increase provided to all employees shall be 
11.31 	allowed only for meeting the requirements in paragraph (b). This paragraph shall not 
11.32 	apply to employees covered by a collective bargaining agreement.
11.33 	(d) The commissioner shall allow as compensation-related costs all costs for:
11.34 	(1) wages and salaries;
12.1 	(2) FICA taxes, Medicare taxes, state and federal unemployment taxes, and workers' 
12.2 	compensation;
12.3 	(3) the employer's share of health and dental insurance, life insurance, disability 
12.4 	insurance, long-term care insurance, uniform allowance, and pensions; and
12.5 	(4) other benefits provided, subject to the approval of the commissioner.
12.6 	(e) The portion of the rate adjustment under paragraph (a) that is not subject to the 
12.7 	requirements in paragraphs (b) and (c) shall be provided to nursing facilities effective 
12.8 	October 1, 2007, or October 1, 2008, as applicable.
12.9 	(f) Nursing facilities may apply for the portion of the rate adjustment under 
12.10 	paragraph (a) that is subject to the requirements in paragraphs (b) and (c). The application 
12.11 	must be submitted to the commissioner within six months of the effective date of the 
12.12 	rate adjustment, and the nursing facility must provide additional information required 
12.13 	by the commissioner within nine months of the effective date of the rate adjustment. 
12.14 	The commissioner must respond to all applications within three weeks of receipt. 
12.15 	The commissioner may waive the deadlines in this paragraph under extraordinary 
12.16 	circumstances, to be determined at the sole discretion of the commissioner. The 
12.17 	application must contain:
12.18 	(1) an estimate of the amounts of money that must be used as specified in paragraphs 
12.19 	(b) and (c);
12.20 	(2) a detailed distribution plan specifying the allowable compensation-related and 
12.21 	wage increases the nursing facility will implement to use the funds available in clause (1);
12.22 	(3) a description of how the nursing facility will notify eligible employees of 
12.23 	the contents of the approved application, which must provide for giving each eligible 
12.24 	employee a copy of the approved application, excluding the information required in clause 
12.25 	(1), or posting a copy of the approved application, excluding the information required in 
12.26 	clause (1), for a period of at least six weeks in an area of the nursing facility to which all 
12.27 	eligible employees have access; and
12.28 	(4) instructions for employees who believe they have not received the 
12.29 	compensation-related or wage increases specified in clause (2), as approved by the 
12.30 	commissioner, and which must include a mailing address, e-mail address, and the 
12.31 	telephone number that may be used by the employee to contact the commissioner or the 
12.32 	commissioner's representative.
12.33 	(g) The commissioner shall ensure that cost increases in distribution plans under 
12.34 	paragraph (f), clause (2), that may be included in approved applications, comply with the 
12.35 	following requirements:
13.1 	(1) costs to be incurred during the applicable rate year resulting from wage and 
13.2 	salary increases effective after October 1, 2006, and prior to the first day of the nursing 
13.3 	facility's payroll period that includes October 1, 2007 of each year, shall be allowed if they 
13.4 	were not used in the prior year's application;
13.5 	(2) a portion of the costs resulting from tenure-related wage or salary increases 
13.6 	may be considered to be allowable wage increases, according to formulas that the 
13.7 	commissioner shall provide, where employee retention is above the average statewide 
13.8 	rate of retention of direct care employees;
13.9 	(3) the annualized amount of increases in costs for the employer's share of health 
13.10 	and dental insurance, life insurance, disability insurance, and workers' compensation 
13.11 	shall be allowable compensation-related increases if they are effective on or after April 
13.12 	1, 2007, of the year in which the rate adjustments are effective and prior to April 1, 2008
13.13 	of the following year; and 
13.14 	(4) for nursing facilities in which employees are represented by an exclusive 
13.15 	bargaining representative, the commissioner shall approve the application only upon 
13.16 	receipt of a letter of acceptance of the distribution plan, in regard to members of the 
13.17 	bargaining unit, signed by the exclusive bargaining agent and dated after May 25, 2007. 
13.18 	Upon receipt of the letter of acceptance, the commissioner shall deem all requirements of 
13.19 	this section as having been met in regard to the members of the bargaining unit.
13.20 	(h) The commissioner shall review applications received under paragraph (f) and 
13.21 	shall provide the portion of the rate adjustment under paragraphs (b) and (c) if the 
13.22 	requirements of this subdivision have been met. The rate adjustment shall be effective 
13.23 	October 1. Notwithstanding paragraph (a), if the approved application distributes less 
13.24 	money than is available, the amount of the rate adjustment shall be reduced so that the 
13.25 	amount of money made available is equal to the amount to be distributed.

13.26 	Sec. 11. Minnesota Statutes 2006, section 256B.69, subdivision 6, is amended to read:
13.27 		Subd. 6.Service delivery. (a) Each demonstration provider shall be responsible for 
13.28 	the health care coordination for eligible individuals. Demonstration providers:
13.29 	(1) shall authorize and arrange for the provision of all needed health services 
13.30 	including but not limited to the full range of services listed in sections 256B.02, 
13.31 	subdivision 8, and 256B.0625 in order to ensure appropriate health care is delivered to 
13.32 	enrollees. Notwithstanding section 256B.0621, demonstration providers that provide 
13.33 	nursing home and community-based services under this section shall provide relocation 
13.34 	service coordination to enrolled persons age 65 and over; 
14.1 	(2) shall accept the prospective, per capita payment from the commissioner in return 
14.2 	for the provision of comprehensive and coordinated health care services for eligible 
14.3 	individuals enrolled in the program;
14.4 	(3) may contract with other health care and social service practitioners to provide 
14.5 	services to enrollees; and
14.6 	(4) shall institute recipient grievance procedures according to the method established 
14.7 	by the project, utilizing applicable requirements of chapter 62D. Disputes not resolved 
14.8 	through this process shall be appealable to the commissioner as provided in subdivision 11.
14.9 	(b) Demonstration providers must comply with the standards for claims settlement 
14.10 	under section 72A.201, subdivisions 4, 5, 7, and 8, when contracting with other health 
14.11 	care and social service practitioners to provide services to enrollees. A demonstration 
14.12 	provider must pay a clean claim, as defined in Code of Federal Regulations, title 42, 
14.13 	section 447.45(b), within 30 business days of the date of acceptance of the claim. 

14.14 	Sec. 12. Minnesota Statutes 2006, section 256D.44, subdivision 2, is amended to read:
14.15 		Subd. 2.Standard of assistance for persons eligible for medical assistance 
14.16 	waivers or at risk of placement in a group residential housing facility. The state 
14.17 	standard of assistance for a person who: (1) is eligible for a medical assistance home and 
14.18 	community-based services waiver or a person who; (2) has been determined by the local 
14.19 	agency to meet the plan requirements for placement in a group residential housing facility 
14.20 	under section 256I.04, subdivision 1a,; or (3) is eligible for a shelter needy payment 
14.21 	under subdivision 5, paragraph (f); is the standard established in subdivision 3, paragraph 
14.22 	(a) or (b). 

14.23 	EFFECTIVE DATE. This section is effective January 1, 2009.

14.24 	Sec. 13. Minnesota Statutes 2006, section 256D.44, subdivision 5, is amended to read:
14.25 		Subd. 5.Special needs. In addition to the state standards of assistance established in 
14.26 	subdivisions 1 to 4, payments are allowed for the following special needs of recipients of 
14.27 	Minnesota supplemental aid who are not residents of a nursing home, a regional treatment 
14.28 	center, or a group residential housing facility.
14.29 	(a) The county agency shall pay a monthly allowance for medically prescribed 
14.30 	diets if the cost of those additional dietary needs cannot be met through some other 
14.31 	maintenance benefit. The need for special diets or dietary items must be prescribed by 
14.32 	a licensed physician. Costs for special diets shall be determined as percentages of the 
14.33 	allotment for a one-person household under the thrifty food plan as defined by the United 
15.1 	States Department of Agriculture. The types of diets and the percentages of the thrifty 
15.2 	food plan that are covered are as follows:
15.3 	(1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;
15.4 	(2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent 
15.5 	of thrifty food plan;
15.6 	(3) controlled protein diet, less than 40 grams and requires special products, 125 
15.7 	percent of thrifty food plan;
15.8 	(4) low cholesterol diet, 25 percent of thrifty food plan;
15.9 	(5) high residue diet, 20 percent of thrifty food plan;
15.10 	(6) pregnancy and lactation diet, 35 percent of thrifty food plan;
15.11 	(7) gluten-free diet, 25 percent of thrifty food plan;
15.12 	(8) lactose-free diet, 25 percent of thrifty food plan;
15.13 	(9) antidumping diet, 15 percent of thrifty food plan;
15.14 	(10) hypoglycemic diet, 15 percent of thrifty food plan; or
15.15 	(11) ketogenic diet, 25 percent of thrifty food plan.
15.16 	(b) Payment for nonrecurring special needs must be allowed for necessary home 
15.17 	repairs or necessary repairs or replacement of household furniture and appliances using 
15.18 	the payment standard of the AFDC program in effect on July 16, 1996, for these expenses, 
15.19 	as long as other funding sources are not available.
15.20 	(c) A fee for guardian or conservator service is allowed at a reasonable rate 
15.21 	negotiated by the county or approved by the court. This rate shall not exceed five percent 
15.22 	of the assistance unit's gross monthly income up to a maximum of $100 per month. If the 
15.23 	guardian or conservator is a member of the county agency staff, no fee is allowed.
15.24 	(d) The county agency shall continue to pay a monthly allowance of $68 for 
15.25 	restaurant meals for a person who was receiving a restaurant meal allowance on June 1, 
15.26 	1990, and who eats two or more meals in a restaurant daily. The allowance must continue 
15.27 	until the person has not received Minnesota supplemental aid for one full calendar month 
15.28 	or until the person's living arrangement changes and the person no longer meets the criteria 
15.29 	for the restaurant meal allowance, whichever occurs first.
15.30 	(e) A fee of ten percent of the recipient's gross income or $25, whichever is less, 
15.31 	is allowed for representative payee services provided by an agency that meets the 
15.32 	requirements under SSI regulations to charge a fee for representative payee services. This 
15.33 	special need is available to all recipients of Minnesota supplemental aid regardless of 
15.34 	their living arrangement.
15.35 	(f) (1) Notwithstanding the language in this subdivision, an amount equal to the 
15.36 	maximum allotment authorized by the federal Food Stamp Program for a single individual 
16.1 	which is in effect on the first day of January July of the previous each year will be added to 
16.2 	the standards of assistance established in subdivisions 1 to 4 for individuals adults under 
16.3 	the age of 65 who qualify as shelter needy and are: (i) relocating from an institution, or an 
16.4 	adult mental health residential treatment program under section 256B.0622, and who are 
16.5 	shelter needy; (ii) eligible for the self-directed supports option as defined under section 
16.6 	256B.0657, subdivision 2; or (iii) home and community-based waiver recipients living in 
16.7 	their own home or rented or leased apartment which is not owned, operated, or controlled 
16.8 	by a provider of service not related by blood or marriage.
16.9 	(2) Notwithstanding subdivision 3, paragraph (c), an individual eligible for the 
16.10 	shelter needy benefit under this paragraph is considered a household of one. An eligible 
16.11 	individual who receives this benefit prior to age 65 may continue to receive the benefit 
16.12 	after the age of 65.
16.13 	(3) "Shelter needy" means that the assistance unit incurs monthly shelter costs that 
16.14 	exceed 40 percent of the assistance unit's gross income before the application of this 
16.15 	special needs standard. "Gross income" for the purposes of this section is the applicant's or 
16.16 	recipient's income as defined in section 256D.35, subdivision 10, or the standard specified 
16.17 	in subdivision 3, paragraph (a) or (b), whichever is greater. A recipient of a federal or 
16.18 	state housing subsidy, that limits shelter costs to a percentage of gross income, shall not be 
16.19 	considered shelter needy for purposes of this paragraph.

16.20 	EFFECTIVE DATE. This section is effective January 1, 2009.

16.21 	ARTICLE 2
16.22 	AGENCY MANAGEMENT

16.23 	Section 1. Minnesota Statutes 2006, section 13.461, is amended by adding a 
16.24 	subdivision to read:
16.25 		Subd. 24a.Managed care plans. Data provided to the commissioner of human 
16.26 	services by managed care plans relating to contracts and provider payment rates are 
16.27 	classified under section 256B.69, subdivision 9b.

16.28 	Sec. 2. Minnesota Statutes 2006, section 256.01, is amended by adding a subdivision 
16.29 	to read:
16.30 		Subd. 27.Automation and coordination for state health care programs. (a) For 
16.31 	purposes of this subdivision, "state health care program" means the medical assistance, 
16.32 	MinnesotaCare, or general assistance medical care programs.
17.1 	(b) By July 1, 2010, the commissioner shall improve coordination between state 
17.2 	health care programs and social service programs including but not limited to WIC, 
17.3 	free and reduced-price school lunch programs, and food stamps, and shall develop and 
17.4 	use automated systems to identify persons served by social service programs who may 
17.5 	be eligible for, but are not enrolled in, a state health care program. The system must 
17.6 	also permit enrollees to renew state health care program enrollment through these social 
17.7 	services programs. By January 15, 2010, the commissioner shall, as necessary, identify 
17.8 	and recommend to the legislature statutory changes to state health care and social service 
17.9 	programs necessary to improve coordination and automation of outreach and enrollment 
17.10 	efforts, and report estimated local and state costs of implementation and evaluate funding 
17.11 	alternatives, including possible federal reimbursement.
17.12 	(c) By January 15, 2010, the commissioner shall establish and implement an 
17.13 	automated process to send out state health care program renewal forms in the most 
17.14 	common foreign languages to those state health care program enrollees who request 
17.15 	renewal forms in those foreign languages. The commissioner, as part of the initial 
17.16 	enrollment process, shall inform applicants of the availability of this option.
17.17 	(d) Beginning July 1, 2010, the commissioner, county social service agencies, and 
17.18 	health care providers shall update state health care program enrollee addresses and related 
17.19 	contact information at the time of each enrollee contact. The commissioner shall report 
17.20 	the costs of automatically updating contact information across programs to health care 
17.21 	providers and county agencies.

17.22 	Sec. 3. Minnesota Statutes 2006, section 256B.69, subdivision 5a, is amended to read:
17.23 		Subd. 5a.Managed care contracts. (a) Managed care contracts under this section 
17.24 	and sections 256L.12 and 256D.03, shall be entered into or renewed on a calendar year 
17.25 	basis beginning January 1, 1996. Managed care contracts which were in effect on June 
17.26 	30, 1995, and set to renew on July 1, 1995, shall be renewed for the period July 1, 1995 
17.27 	through December 31, 1995 at the same terms that were in effect on June 30, 1995. The 
17.28 	commissioner may issue separate contracts with requirements specific to services to 
17.29 	medical assistance recipients age 65 and older. 
17.30 	(b) A prepaid health plan providing covered health services for eligible persons 
17.31 	pursuant to chapters 256B, 256D, and 256L, is responsible for complying with the terms 
17.32 	of its contract with the commissioner. Requirements applicable to managed care programs 
17.33 	under chapters 256B, 256D, and 256L, established after the effective date of a contract 
17.34 	with the commissioner take effect when the contract is next issued or renewed.
18.1 	(c) Effective for services rendered on or after January 1, 2003, the commissioner 
18.2 	shall withhold five percent of managed care plan payments under this section for the 
18.3 	prepaid medical assistance and general assistance medical care programs pending 
18.4 	completion of performance targets. Each performance target must be quantifiable, 
18.5 	objective, measurable, and reasonably attainable, except in the case of a performance 
18.6 	target based on a federal or state law or rule. Criteria for assessment of each performance 
18.7 	target must be outlined in writing prior to the contract effective date. The managed 
18.8 	care plan must demonstrate, to the commissioner's satisfaction, that the data submitted 
18.9 	regarding attainment of the performance target is accurate. The commissioner shall 
18.10 	periodically change the administrative measures used as performance targets in order 
18.11 	to improve plan performance across a broader range of administrative services. The 
18.12 	performance targets must include measurement of plan efforts to contain spending 
18.13 	on health care services and administrative activities. The commissioner may adopt 
18.14 	plan-specific performance targets that take into account factors affecting only one plan, 
18.15 	including characteristics of the plan's enrollee population. The withheld funds must be 
18.16 	returned no sooner than July of the following year if performance targets in the contract 
18.17 	are achieved. The commissioner may exclude special demonstration projects under 
18.18 	subdivision 23. A managed care plan or a county-based purchasing plan under section 
18.19 	256B.692 may include as admitted assets under section 62D.044 any amount withheld 
18.20 	under this paragraph that is reasonably expected to be returned. 

18.21 	Sec. 4. Minnesota Statutes 2006, section 256B.69, is amended by adding a subdivision 
18.22 	to read:
18.23 		Subd. 5i.Administrative expenses. (a) Managed care plan and county-based 
18.24 	purchasing plan administrative costs for a prepaid health plan provided under this section 
18.25 	or section 256B.692 must not exceed by more than five percent that prepaid health plan's 
18.26 	or county-based purchasing plan's actual calculated administrative spending for the 
18.27 	previous calendar year as a percentage of total revenue. The penalty for exceeding this 
18.28 	limit must be the amount of administrative spending in excess of 105 percent of the actual 
18.29 	calculated amount. The commissioner may waive this penalty if the excess administrative 
18.30 	spending is the result of unexpected shifts in enrollment or member needs or new program 
18.31 	requirements.
18.32 	(b) Capitated rate payments for administrative costs must be reduced to exclude 
18.33 	onetime or sporadic expenditures in the prior year unless the managed care plan certifies 
18.34 	that the expenditure will recur during the contract year. The commissioner shall verify 
19.1 	these certifications on an annual basis and recoup any payments made for onetime or 
19.2 	sporadic expenditures that did not occur in the prior year.
19.3 	(c) Expenses under section 62D.12, subdivision 9a, clause (4), are not allowable 
19.4 	administrative expenses for rate-setting purposes under this section, unless approved by 
19.5 	the commissioner.

19.6 	Sec. 5. Minnesota Statutes 2006, section 256B.69, is amended by adding a subdivision 
19.7 	to read:
19.8 		Subd. 5j.Treatment of investment earnings. Capitation rates shall treat investment 
19.9 	income and interest earnings as income to the same extent that investment-related 
19.10 	expenses are treated as administrative expenditures.

19.11 	Sec. 6. Minnesota Statutes 2006, section 256B.69, is amended by adding a subdivision 
19.12 	to read:
19.13 		Subd. 9a.Administrative expense reporting. Each managed care plan and 
19.14 	county-based purchasing plan must provide to the commissioner detailed information on 
19.15 	administrative spending, including:
19.16 	(1) itemized lists of costs for claims processing and provider network management;
19.17 	(2) detailed reports of costs for contracts with providers and third-party 
19.18 	administrators;
19.19 	(3) a detailed analysis of administrative spending for each Minnesota health care 
19.20 	program;
19.21 	(4) a detailed analysis of the provider's allocation of administrative expenses among 
19.22 	its public and commercial lines of business;
19.23 	(5) a detailed analysis of administrative costs by service category; and 
19.24 	(6) a detailed analysis of onetime and sporadic expenditures included in the 
19.25 	administrative spending category.

19.26 	Sec. 7. Minnesota Statutes 2006, section 256B.69, is amended by adding a subdivision 
19.27 	to read:
19.28 		Subd. 9b.Reporting of subcontracts and provider payment rates. (a) Each 
19.29 	managed care plan and county-based purchasing plan must provide to the commissioner:
19.30 	(1) detailed information on contracts with health care providers; and
19.31 	(2) detailed information on reimbursement rates paid by the managed care plan 
19.32 	to providers under contract with the plan.
20.1 	(b) Data provided to the commissioner under this subdivision are nonpublic data as 
20.2 	defined in section 13.02.

20.3 	Sec. 8. Minnesota Statutes 2006, section 256B.692, subdivision 2, is amended to read:
20.4 		Subd. 2.Duties of commissioner of health. (a) Notwithstanding chapters 62D 
20.5 	and 62N, a county that elects to purchase medical assistance and general assistance 
20.6 	medical care in return for a fixed sum without regard to the frequency or extent of services 
20.7 	furnished to any particular enrollee is not required to obtain a certificate of authority 
20.8 	under chapter 62D or 62N. The county board of commissioners is the governing body of 
20.9 	a county-based purchasing program. In a multicounty arrangement, the governing body 
20.10 	is a joint powers board established under section 471.59.
20.11 	(b) A county that elects to purchase medical assistance and general assistance 
20.12 	medical care services under this section must satisfy the commissioner of health that the 
20.13 	requirements for assurance of consumer protection, provider protection, and, effective 
20.14 	January 1, 2010, fiscal solvency of chapter 62D, applicable to health maintenance 
20.15 	organizations, or chapter 62N, applicable to community integrated service networks, will 
20.16 	be met. according to the following schedule:
20.17 	(1) for a county-based purchasing plan approved on or before June 30, 2008, the 
20.18 	plan must have in reserve:
20.19 	(i) at least 50 percent of the minimum amount required under chapter 62D as 
20.20 	of January 1, 2010;
20.21 	(ii) at least 75 percent of the minimum amount required under chapter 62D as of 
20.22 	January 1, 2011;
20.23 	(iii) at least 87.5 percent of the minimum amount required under chapter 62D as 
20.24 	of January 1, 2012; and 
20.25 	(iv) at least 100 percent of the minimum amount required under chapter 62D as 
20.26 	of January 1, 2013; and 
20.27 	(2) for a county-based purchasing plan first approved after June 30, 2008, the plan 
20.28 	must have in reserve:
20.29 	(i) at least 50 percent of the minimum amount required under chapter 62D at the 
20.30 	time the plan begins enrolling enrollees;
20.31 	(ii) at least 75 percent of the minimum amount required under chapter 62D after 
20.32 	the first full calendar year;
20.33 	(iii) at least 87.5 percent of the minimum amount required under chapter 62D after 
20.34 	the second full calendar year; and 
21.1 	(iv) at least 100 percent of the minimum amount required under chapter 62D after 
21.2 	the third full calendar year.
21.3 	(c) Until a plan is required to have reserves equaling at least 100 percent of the 
21.4 	minimum amount required under chapter 62D, the plan may demonstrate its ability to 
21.5 	cover any losses by satisfying the requirements of chapter 62N. A county county-based 
21.6 	purchasing plan  must also assure the commissioner of health that the requirements of 
21.7 	sections 62J.041; 62J.48; 62J.71 to 62J.73; 62M.01 to 62M.16; all applicable provisions 
21.8 	of chapter 62Q, including sections 62Q.075; 62Q.1055; 62Q.106; 62Q.12; 62Q.135; 
21.9 	62Q.14; 62Q.145; 62Q.19; 62Q.23, paragraph (c); 62Q.43; 62Q.47; 62Q.50; 62Q.52 to 
21.10 	62Q.56; 62Q.58; 62Q.68 to 62Q.72; and 72A.201 will be met.
21.11 	(d) All enforcement and rulemaking powers available under chapters 62D, 62J, 
21.12 	62M, 62N, and 62Q are hereby granted to the commissioner of health with respect to 
21.13 	counties that purchase medical assistance and general assistance medical care services 
21.14 	under this section.
21.15 	(e) The commissioner, in consultation with county government, shall develop 
21.16 	administrative and financial reporting requirements for county-based purchasing programs 
21.17 	relating to sections 62D.041, 62D.042, 62D.045, 62D.08, 62N.28, 62N.29, and 62N.31, 
21.18 	and other sections as necessary, that are specific to county administrative, accounting, and 
21.19 	reporting systems and consistent with other statutory requirements of counties.

21.20 	Sec. 9. Minnesota Statutes 2006, section 256B.692, is amended by adding a 
21.21 	subdivision to read:
21.22 		Subd. 4a.Expenditure of revenues. (a) A county that has elected to participate 
21.23 	in a county-based purchasing plan under this section shall use any excess revenues over 
21.24 	expenses that are received by the county and are not needed for capital reserves under 
21.25 	subdivision 2, to increase payments to providers, or to repay county investments or 
21.26 	contributions to the county-based purchasing plan, for prevention, early intervention, and 
21.27 	health care programs, services, or activities.
21.28 	(b) A county-based purchasing plan under this section is subject to the unreasonable 
21.29 	expense provisions of section 62D.19.

21.30 	Sec. 10. Minnesota Statutes 2006, section 256L.12, subdivision 9, is amended to read:
21.31 		Subd. 9.Rate setting; performance withholds. (a) Rates will be prospective, 
21.32 	per capita, where possible. The commissioner may allow health plans to arrange for 
21.33 	inpatient hospital services on a risk or nonrisk basis. The commissioner shall consult with 
21.34 	an independent actuary to determine appropriate rates.
22.1 	(b) For services rendered on or after January 1, 2003, to December 31, 2003, the 
22.2 	commissioner shall withhold .5 percent of managed care plan payments under this section 
22.3 	pending completion of performance targets. The withheld funds must be returned no 
22.4 	sooner than July 1 and no later than July 31 of the following year if performance targets 
22.5 	in the contract are achieved. A managed care plan may include as admitted assets under 
22.6 	section 62D.044 any amount withheld under this paragraph that is reasonably expected 
22.7 	to be returned. 
22.8 	(c) For services rendered on or after January 1, 2004, the commissioner shall 
22.9 	withhold five percent of managed care plan payments under this section pending 
22.10 	completion of performance targets. Each performance target must be quantifiable, 
22.11 	objective, measurable, and reasonably attainable, except in the case of a performance target 
22.12 	based on a federal or state law or rule. Criteria for assessment of each performance target 
22.13 	must be outlined in writing prior to the contract effective date.  The managed care plan 
22.14 	must demonstrate, to the commissioner's satisfaction, that the data submitted regarding 
22.15 	attainment of the performance target is accurate. The commissioner shall periodically 
22.16 	change the administrative measures used as performance targets in order to improve plan 
22.17 	performance across a broader range of administrative services. The performance targets 
22.18 	must include measurement of plan efforts to contain spending on health care services and 
22.19 	administrative activities. The commissioner may adopt plan-specific performance targets 
22.20 	that take into account factors affecting only one plan, such as characteristics of the plan's 
22.21 	enrollee population. The withheld funds must be returned no sooner than July 1 and no 
22.22 	later than July 31 of the following calendar year if performance targets in the contract are 
22.23 	achieved. A managed care plan or a county-based purchasing plan under section 256B.692
22.24 	may include as admitted assets under section 62D.044 any amount withheld under this 
22.25 	paragraph that is reasonably expected to be returned. 

22.26 	Sec. 11. REPORT ON FINANCIAL MANAGEMENT OF HEALTH CARE 
22.27 	PROGRAMS.
 22.28 	The commissioner of human services shall report to the legislature under Minnesota 
22.29 	Statutes, section 3.195, by January 15, 2009, with the following information regarding 
22.30 	financial management of health care programs:
22.31 	(1) a status report on implementation of the cost containment strategies identified in 
22.32 	the 2005 "Strategies for Savings" report. The report must include:
22.33 	(i) information on progress made towards implementation of cost-saving strategies;
22.34 	(ii) an explanation of why certain strategies were not implemented; and 
23.1 	(iii) where appropriate, alternative strategies to those recommended in 2005 for 
23.2 	containing public health care program costs;
23.3 	(2) a description of and, to the extent possible, an explanation of recent differences 
23.4 	between the health plan net revenue targets established by the commissioner for health 
23.5 	plans participating in public health care programs and the actual net revenue realized by 
23.6 	the plans from public programs;
23.7 	(3) the adequacy of public health care programs for fee-for-service rates, including 
23.8 	an identification of service areas or geographical regions where enrollees have difficulty 
23.9 	accessing providers as the result of inadequate provider payments. This report must 
23.10 	include recommendations to increase rates as needed to eliminate identified access 
23.11 	problems; and 
23.12 	(4) a progress report on implementation of Minnesota Statutes, section 256B.76, 
23.13 	paragraph (e), requiring payments for physician and professional services to be based 
23.14 	on Medicare relative value units, and an estimated completion date for implementation 
23.15 	of this payment system.

23.16 	Sec. 12. HEALTH PLAN AND COUNTY-BASED PURCHASING PLAN 
23.17 	REQUIREMENTS.
 23.18 	(a) The commissioner of health shall develop and report to the legislature under 
23.19 	Minnesota Statutes, section 3.195, by January 15, 2009, guidelines to ensure that health 
23.20 	plans, and county-based purchasing plans where applicable, have consistent procedures 
23.21 	for allocating administrative expenses and investment income across their commercial and 
23.22 	public lines of business and across individual public programs. The guidelines shall be 
23.23 	consistent with generally accepted accounting principles and principles from the National 
23.24 	Association of Insurance Commissioners. The guidelines shall not have the effect of 
23.25 	changing allocation for Medicare-related programs as permitted by federal law and the 
23.26 	Centers for Medicare and Medicaid Services.
23.27 	(b) The commissioner of health, in cooperation with the commissioners of commerce 
23.28 	and human services, shall develop and report to the legislature under Minnesota Statutes, 
23.29 	section 3.195, by January 15, 2009, detailed standards and procedures for examining 
23.30 	the reasonableness of health plan and county-based purchasing plan administrative 
23.31 	expenditures for publicly funded programs. These standards and procedures must include 
23.32 	a process for detailed examinations of individual programs and functional areas.
23.33 	(c) The commissioner of health shall develop and report to the legislature under 
23.34 	Minnesota Statutes, section 3.195, by January 15, 2009, a more efficient method for a 
23.35 	health plan, and a county-based purchasing plan where appropriate, to demonstrate to the 
24.1 	commissioner that providers in the plan's network have appropriate credentials. The 
24.2 	commissioner shall review issues regarding:
24.3 	(1) the duplicate review of credentials at a health care provider by multiple health 
24.4 	plans;
24.5 	(2) the review of the credentials of all staff of a health care provider when only 
24.6 	limited staff will be in the plan network; and
24.7 	(3) other duplicative credentialing issues.

24.8 	Sec. 13. OMBUDSMAN FOR MANAGED CARE STUDY.
 24.9 	The commissioner of human services, in cooperation with the ombudsman for 
24.10 	managed care, shall study and report to the legislature under Minnesota Statutes, 
24.11 	section 3.195, by January 15, 2009, with recommendations on whether the duties of the 
24.12 	ombudsman should be expanded to include advocating on behalf of public health care 
24.13 	programs fee-for-service enrollees. The report must include:
24.14 	(1) a comparison of recourses available to managed care clients versus 
24.15 	fee-for-service clients when service problems occur; and 
24.16 	(2) an estimate of any net cost increase from this change in the ombudsman's duties, 
24.17 	taking into account any reduction in the commissioner's duties.

24.18 	Sec. 14. REPORTING MANAGED CARE PERFORMANCE DATA.
 24.19 	The commissioner of human services, in cooperation with the commissioner of 
24.20 	health, shall report to the legislature under Minnesota Statutes, section 3.195, by January 
24.21 	15, 2009, with recommendations on the adoption of a single method to compute and 
24.22 	publicly report managed health care performance measures in order to avoid confusion 
24.23 	about the plans' performance levels. The study must include recommendations regarding 
24.24 	coordinated use by the two agencies of the following data sources:
24.25 	(1) Healthcare Effectiveness Data and Information Set (HEDIS) from managed 
24.26 	care organizations;
24.27 	(2) data that health plans submit to claim reimbursement for health care procedures; 
24.28 	and 
24.29 	(3) data collected from medical record reviews of randomly selected individuals.

24.30 	Sec. 15. PUBLIC DENTAL COVERAGE PROGRAM STUDY.
 24.31 	(a) The commissioner of human services shall undertake a study to determine 
24.32 	whether alternative approaches to offering dental coverage to public programs enrollees 
24.33 	would result in:
25.1 	(1) improved access to dental care;
25.2 	(2) cost savings to providers and the department; and
25.3 	(3) improved quality and outcomes of care. 
25.4 	Alternatives considered must include moving to a single dental plan administrator, 
25.5 	retaining the current model, and other innovative approaches. Issues relating to chronic 
25.6 	disease management, medical and dental interface, plan payment approaches, and provider 
25.7 	payment should also be addressed. The report must make a recommendation on whether 
25.8 	to alter the current approach to contracting for dental services, and include a detailed 
25.9 	plan on how to implement any changes. The commissioner shall consult with dentists, 
25.10 	safety net dental providers, dental plans, health plans and county-based purchasing 
25.11 	organizations, patients and advocates, and other interested parties in developing their 
25.12 	findings and recommendations. 
25.13 	(b) By December 15, 2008, the commissioner of human services shall report findings 
25.14 	and recommendations to the chairs of the house of representatives and senate committees 
25.15 	having jurisdiction over health and human services policy and finance.

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

25.17 	Sec. 16. WORK GROUP; TARGETED CASE MANAGEMENT.
 25.18 	(a) The commissioner of human services shall convene a work group and seek 
25.19 	information from counties, juvenile court staff, guardians ad litem, and mental health and 
25.20 	child welfare advocates on the impact of federal regulations that cut funding for targeted 
25.21 	case management services and the child support administrative collection system. The 
25.22 	work group shall consider the impact these cuts will have on child protection, mental 
25.23 	health, and housing relocation services.
25.24 	(b) The commissioner shall issue a report from the work group summarizing the 
25.25 	impact of the federal budget cuts on persons eligible for targeted case management 
25.26 	services and the impact on county budgets. This report shall include budget and policy 
25.27 	strategies to restore service levels to that of the year prior to the effective date of the 
25.28 	federal regulations. A preliminary report shall be issued on December 15, 2008.

25.29 	ARTICLE 3
25.30 	CHILDREN AND FAMILY SERVICES

25.31 	Section 1. Minnesota Statutes 2007 Supplement, section 256.741, subdivision 1, 
25.32 	is amended to read:
26.1 		Subdivision 1.Public assistance Definitions. (a) The term "direct support" as used 
26.2 	in this chapter and chapters 257, 518, 518A, and 518C refers to an assigned support 
26.3 	payment from an obligor which is paid directly to a recipient of TANF or MFIP public 
26.4 	assistance.
26.5 	(b) The term "public assistance" as used in this chapter and chapters 257, 518, 518A, 
26.6 	and 518C, includes any form of assistance provided under the AFDC program formerly 
26.7 	codified in sections 256.72 to 256.87, MFIP and MFIP-R formerly codified under chapter 
26.8 	256, MFIP under chapter 256J, work first program formerly codified under chapter 256K; 
26.9 	child care assistance provided through the child care fund under chapter 119B; any form 
26.10 	of medical assistance under chapter 256B; MinnesotaCare under chapter 256L; and foster 
26.11 	care as provided under title IV-E of the Social Security Act. 
26.12 	(c) The term "child support agency" as used in this section refers to the public 
26.13 	authority responsible for child support enforcement.
26.14 	(d) The term "public assistance agency" as used in this section refers to a public 
26.15 	authority providing public assistance to an individual.
26.16 	(e) The terms "child support" and "arrears" as used in this section have the meanings 
26.17 	provided in section 518A.26.
26.18 	(f) The term "maintenance" as used in this section has the meaning provided in 
26.19 	section 518.003.

26.20 	Sec. 2. Minnesota Statutes 2006, section 256.741, subdivision 2, is amended to read:
26.21 		Subd. 2.Assignment of support and maintenance rights. (a) An individual 
26.22 	receiving public assistance in the form of assistance under any of the following programs: 
26.23 	the AFDC program formerly codified in sections 256.72 to 256.87, MFIP under chapter 
26.24 	256J, MFIP-R and MFIP formerly codified under chapter 256, or work first program 
26.25 	formerly codified under chapter 256K is considered to have assigned to the state at the 
26.26 	time of application all rights to child support and maintenance from any other person the 
26.27 	applicant or recipient may have in the individual's own behalf or in the behalf of any other 
26.28 	family member for whom application for public assistance is made. An assistance unit is 
26.29 	ineligible for the Minnesota family investment program unless the caregiver assigns all 
26.30 	rights to child support and spousal maintenance benefits according to this section. 
26.31 	(1) AnThe assignment made according to this section is effective as to:
26.32 	(i) any current child support and current spousal maintenance; and.
26.33 	(ii) any accrued child support and spousal maintenance arrears.
26.34 	(2) An assignment made after September 30, 1997, is effective as to:
26.35 	(i) any current child support and current spousal maintenance;
27.1 	(ii) any accrued child support and spousal maintenance arrears collected before 
27.2 	October 1, 2000, or the date the individual terminates assistance, whichever is later; and
27.3 	(iii) any accrued child support and spousal maintenance arrears collected under 
27.4 	federal tax intercept.
27.5 	(2) Any child support or maintenance arrears that accrue while an individual is 
27.6 	receiving public assistance in the form of assistance under any of the programs listed in 
27.7 	this paragraph are permanently assigned to the state.
27.8 	(3) The assignment of current child support and current maintenance ends on the 
27.9 	date the individual ceases to receive or is no longer eligible to receive public assistance 
27.10 	under any of the programs listed in this paragraph.
27.11 	(b) An individual receiving public assistance in the form of medical assistance, 
27.12 	including MinnesotaCare, is considered to have assigned to the state at the time of 
27.13 	application all rights to medical support from any other person the individual may have 
27.14 	in the individual's own behalf or in the behalf of any other family member for whom 
27.15 	medical assistance is provided.
27.16 	(1) An assignment made after September 30, 1997, is effective as to any medical 
27.17 	support accruing after the date of medical assistance or MinnesotaCare eligibility.
27.18 	(2) Any medical support arrears that accrue while an individual is receiving public 
27.19 	assistance in the form of medical assistance, including MinnesotaCare, are permanently 
27.20 	assigned to the state.
27.21 	(3) The assignment of current medical support ends on the date the individual ceases 
27.22 	to receive or is no longer eligible to receive public assistance in the form of medical 
27.23 	assistance or MinnesotaCare.
27.24 	(c) An individual receiving public assistance in the form of child care assistance 
27.25 	under the child care fund pursuant to chapter 119B is considered to have assigned to the 
27.26 	state at the time of application all rights to child care support from any other person the 
27.27 	individual may have in the individual's own behalf or in the behalf of any other family 
27.28 	member for whom child care assistance is provided.
27.29 	An(1) The assignment made according to this paragraph is effective as to:
27.30 	(1) any current child care support and any child care support arrears assigned and 
27.31 	accruing after July 1, 1997, that are collected before October 1, 2000; and.
27.32 	(2) any accrued child care support arrears collected under federal tax intercept. Any 
27.33 	child care support arrears that accrue while an individual is receiving public assistance in 
27.34 	the form of child care assistance under the child care fund in chapter 119B are permanently 
27.35 	assigned to the state.
28.1 	(3) The assignment of current child care support ends on the date the individual 
28.2 	ceases to receive or is no longer eligible to receive public assistance in the form of child 
28.3 	care assistance under the child care fund under chapter 119B.

28.4 	Sec. 3. Minnesota Statutes 2006, section 256.741, subdivision 2a, is amended to read:
28.5 		Subd. 2a.Families-first Distribution of child support arrearages. (a) The 
28.6 	state shall distribute current child support and maintenance received by the state to an 
28.7 	individual who assigns the right to that support under subdivision 2, paragraph (a).
28.8 	(b) When the public authority collects child support arrearages on behalf of an 
28.9 	individual who is receiving public assistance provided under MFIP or MFIP-R under 
28.10 	this chapter, MFIP under chapter 256J, or work first under chapter 256K, and the public 
28.11 	authority has the option of applying the collection to arrears permanently assigned to the 
28.12 	state or to arrears temporarily assigned to the state, the public authority shall first apply the 
28.13 	collection to satisfy those arrears that are permanently assigned to the state.
28.14 	(c) When the public authority collects child support arrearages on behalf of an 
28.15 	individual who is not receiving public assistance, the public authority shall first apply the 
28.16 	collection to satisfy those arrears that are not permanently assigned to the state.
28.17 	(d) When the public authority collects child support arrearages certified under the 
28.18 	federal tax offset, the public authority shall first apply the collection to satisfy those arrears 
28.19 	that are permanently assigned to the state.

28.20 	Sec. 4. Minnesota Statutes 2006, section 256.741, subdivision 3, is amended to read:
28.21 		Subd. 3.Existing assignments. Assignments based on the receipt of public 
28.22 	assistance in existence prior to July 1, 1997, are permanently assigned to the state. Arrears 
28.23 	that accrued prior to the receipt of assistance that were assigned to the state between July 
28.24 	1, 1997, and October 1, 2009, must no longer be assigned as of October 1, 2009.

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

28.26 	Sec. 5. Minnesota Statutes 2007 Supplement, section 256J.621, is amended to read:
28.27 	256J.621 WORK PARTICIPATION BONUS FOOD BENEFITS.
28.28 	(a) Effective March 1, 2010, upon exiting the diversionary work program (DWP) or 
28.29 	upon terminating the Minnesota family investment program (MFIP)cash assistance with 
28.30 	earnings, a participant who is employed may be eligible for transitional assistance work 
28.31 	participation food benefits of $75 per month to assist in meeting the family's basic needs 
28.32 	as the participant continues to move toward self-sufficiency.
29.1 	(b) To be eligible for a transitional assistance payment work participation food 
29.2 	benefits, the participant shall not receive MFIP cash assistance or diversionary work 
29.3 	program assistance during the month and the participant or participants must meet the 
29.4 	following work requirements:
29.5 	(1) if the participant is a single caregiver and has a child under six years of age, the 
29.6 	participant must be employed at least 87 hours per month;
29.7 	(2) if the participant is a single caregiver and does not have a child under six years of 
29.8 	age, the participant must be employed at least 130 hours per month; or
29.9 	(3) if the household is a two-parent family, at least one of the parents must be 
29.10 	employed an average of at least 130 hours per month.
29.11 	Whenever a participant exits the diversionary work program or is terminated from 
29.12 	MFIP cash assistance and meets the other criteria in this section, transitional assistance is
29.13 	work participation food benefits are available for up to 24 consecutive months.
29.14 	(c) Expenditures on the program are maintenance of effort state funds for participants 
29.15 	under paragraph (b), clauses (1) and (2). Expenditures for participants under paragraph 
29.16 	(b), clause (3), are nonmaintenance of effort funds. Months in which a participant receives 
29.17 	transitional assistancework participation food benefits under this section do not count 
29.18 	toward the participant's MFIP 60-month time limit.

29.19 	Sec. 6. Minnesota Statutes 2006, section 518A.50, is amended to read:
29.20 	518A.50 PAYMENT TO PUBLIC AGENCY.
29.21 	(a) This section applies to all proceedings involving a support order, including, but 
29.22 	not limited to, a support order establishing an order for past support or reimbursement 
29.23 	of public assistance.
29.24 	(b) The court shall direct that all payments ordered for maintenance or support 
29.25 	be made to the public authority responsible for child support enforcement so long as 
29.26 	the obligee is receiving or has applied for public assistance, or has applied for child 
29.27 	support or maintenance collection services. Public authorities responsible for child 
29.28 	support enforcement may act on behalf of other public authorities responsible for child 
29.29 	support enforcement, including the authority to represent the legal interests of or execute 
29.30 	documents on behalf of the other public authority in connection with the establishment, 
29.31 	enforcement, and collection of child support, maintenance, or medical support, and 
29.32 	collection on judgments.
29.33 	(c) Payments made to the public authority other than payments under section 
29.34 	518A.53 must be credited as of the date the payment is received by the central collections 
30.1 	unit., except that payments made under section 518A.53 may be considered to have been 
30.2 	paid as of the date the obligor received the remainder of the income.
30.3 	(d) Monthly amounts received by the public agency responsible for child support 
30.4 	enforcement from the obligor that are greater than the monthly amount of public assistance 
30.5 	granted to the obligee must be remitted to the obligee.

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

30.7 	Sec. 7. Minnesota Statutes 2006, section 518A.53, subdivision 5, is amended to read:
30.8 		Subd. 5.Payor of funds responsibilities. (a) An order for or notice of withholding 
30.9 	is binding on a payor of funds upon receipt. Withholding must begin no later than the first 
30.10 	pay period that occurs after 14 days following the date of receipt of the order for or notice 
30.11 	of withholding. In the case of a financial institution, preauthorized transfers must occur in 
30.12 	accordance with a court-ordered payment schedule.
30.13 	(b) A payor of funds shall withhold from the income payable to the obligor the 
30.14 	amount specified in the order or notice of withholding and amounts specified under 
30.15 	subdivisions 6 and 9 and shall remit the amounts withheld to the public authority within 
30.16 	seven business days of the date the obligor is paid the remainder of the income. The payor 
30.17 	of funds shall include with the remittance the Social Security number of the obligor, the 
30.18 	case type indicator as provided by the public authority and the date the obligor is paid 
30.19 	the remainder of the income. The obligor is considered to have paid the amount withheld 
30.20 	as of the date the obligor received the remainder of the income. A payor of funds may 
30.21 	combine all amounts withheld from one pay period into one payment to each public 
30.22 	authority, but shall separately identify each obligor making payment.
30.23 	(c) A payor of funds shall not discharge, or refuse to hire, or otherwise discipline an 
30.24 	employee as a result of wage or salary withholding authorized by this section. A payor of 
30.25 	funds shall be liable to the obligee for any amounts required to be withheld. A payor of 
30.26 	funds that fails to withhold or transfer funds in accordance with this section is also liable 
30.27 	to the obligee for interest on the funds at the rate applicable to judgments under section 
30.28 	549.09, computed from the date the funds were required to be withheld or transferred. 
30.29 	A payor of funds is liable for reasonable attorney fees of the obligee or public authority 
30.30 	incurred in enforcing the liability under this paragraph. A payor of funds that has failed 
30.31 	to comply with the requirements of this section is subject to contempt sanctions under 
30.32 	section 518A.73. If the payor of funds is an employer or independent contractor and 
30.33 	violates this subdivision, a court may award the obligor twice the wages lost as a result 
30.34 	of this violation. If a court finds a payor of funds violated this subdivision, the court 
31.1 	shall impose a civil fine of not less than $500. The liabilities in this paragraph apply to 
31.2 	intentional noncompliance with this section. 
31.3 	(d) If a single employee is subject to multiple withholding orders or multiple notices 
31.4 	of withholding for the support of more than one child, the payor of funds shall comply 
31.5 	with all of the orders or notices to the extent that the total amount withheld from the 
31.6 	obligor's income does not exceed the limits imposed under the Consumer Credit Protection 
31.7 	Act, United States Code, title 15, section 1673(b), giving priority to amounts designated in 
31.8 	each order or notice as current support as follows:
31.9 	(1) if the total of the amounts designated in the orders for or notices of withholding 
31.10 	as current support exceeds the amount available for income withholding, the payor of 
31.11 	funds shall allocate to each order or notice an amount for current support equal to the 
31.12 	amount designated in that order or notice as current support, divided by the total of the 
31.13 	amounts designated in the orders or notices as current support, multiplied by the amount 
31.14 	of the income available for income withholding; and
31.15 	(2) if the total of the amounts designated in the orders for or notices of withholding 
31.16 	as current support does not exceed the amount available for income withholding, the 
31.17 	payor of funds shall pay the amounts designated as current support, and shall allocate to 
31.18 	each order or notice an amount for past due support, equal to the amount designated in 
31.19 	that order or notice as past due support, divided by the total of the amounts designated in 
31.20 	the orders or notices as past due support, multiplied by the amount of income remaining 
31.21 	available for income withholding after the payment of current support.
31.22 	(e) When an order for or notice of withholding is in effect and the obligor's 
31.23 	employment is terminated, the obligor and the payor of funds shall notify the public 
31.24 	authority of the termination within ten days of the termination date. The termination 
31.25 	notice shall include the obligor's home address and the name and address of the obligor's 
31.26 	new payor of funds, if known.
31.27 	(f) A payor of funds may deduct one dollar from the obligor's remaining salary for 
31.28 	each payment made pursuant to an order for or notice of withholding under this section to 
31.29 	cover the expenses of withholding.

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

31.31 	Sec. 8. Laws 2007, chapter 147, article 2, section 21, the effective date, is amended to 
31.32 	read:

31.33 	EFFECTIVE DATE. Subdivision 1 is effective February 1, 2008, and subdivision 
31.34 	2 is effective May 1, 2008 March 1, 2009.

32.1 	Sec. 9. Laws 2007, chapter 147, article 19, section 3, subdivision 1, is amended to read:

32.2	Subdivision 1. Total Appropriation
 	$ 
	5,294,627,000 
	$ 
	5,695,458,000 

32.3	Appropriations by Fund 
	
32.4		2008 
	2009 
	
32.5	General 
	4,614,727,000 
	4,940,293,000 
	
32.6
32.7	State Government 
Special Revenue 
	549,000 
	565,000 
	
32.8	Health Care Access 
	426,628,000 
	492,759,000 
	
32.9	Federal TANF 
	250,537,000 
	260,051,000 
	
32.10	Lottery Prize Fund 
	2,185,000 
	1,790,000 
	
32.11 	The amounts that may be spent for each 
32.12 	purpose are specified in the following 
32.13 	subdivisions. 
32.14 	Receipts for Systems Projects.
32.15 	Appropriations and federal receipts for 
32.16 	information system projects for MAXIS, 
32.17 	PRISM, MMIS, and SSIS must be deposited 
32.18 	in the state system account authorized in 
32.19 	Minnesota Statutes, section 256.014. Money 
32.20 	appropriated for computer projects approved 
32.21 	by the Minnesota Office of Enterprise 
32.22 	Technology, funded by the legislature, and 
32.23 	approved by the commissioner of finance, 
32.24 	may be transferred from one project to 
32.25 	another and from development to operations 
32.26 	as the commissioner of human services 
32.27 	considers necessary. Any unexpended 
32.28 	balance in the appropriation for these 
32.29 	projects does not cancel but is available for 
32.30 	ongoing development and operations. 
32.31 	Pay for Performance. (a) Of the general 
32.32 	fund appropriation, $272,000 each year 
32.33 	is available to the commissioner of 
32.34 	human services only under the following 
32.35 	circumstances: 
33.1 	(1) $272,000 shall be made available by the 
33.2 	commissioner of finance on January 1, 2009, 
33.3 	only after notification by the commissioner 
33.4 	of human services to the commissioner of 
33.5 	finance and to the chairs of the relevant house 
33.6 	of representatives and senate finance and 
33.7 	policy committees that the average number 
33.8 	of days from the receipt of a MinnesotaCare 
33.9 	application at the state processing unit until 
33.10 	the initial eligibility determination of the 
33.11 	application was 30 days or less during the 
33.12 	period October 1, 2007, to September 30, 
33.13 	2008. Applications transferred from counties 
33.14 	to the state processing unit are excluded from 
33.15 	this calculation; and 
33.16 	(2) $272,000 shall be made available by the 
33.17 	commissioner of finance on January 1, 2009, 
33.18 	only after notification by the commissioner 
33.19 	of human services to the commissioner of 
33.20 	finance and to the chairs of the relevant 
33.21 	house of representatives and senate finance 
33.22 	and policy committees that the commissioner 
33.23 	initiated a separate treatment program for 
33.24 	persons in the Minnesota sex offenders 
33.25 	program who are between the ages of 18 and 
33.26 	25 by January 1, 2008. 
33.27 	(b) Regardless of whether these 
33.28 	appropriations are made available to 
33.29 	the commissioner of human services, they 
33.30 	shall be part of base level funding for the 
33.31 	biennium beginning July 1, 2009. 
33.32 	Purchasing Alliance Fund Transfer.
33.33 	On September 1, 2007, any remaining 
33.34 	balance in the purchasing alliance stop-loss 
33.35 	fund account established under Minnesota 
34.1 	Statutes, section 256.956, shall transfer to 
34.2 	the general fund. 
34.3 	Nonfederal Share Transfers. The 
34.4 	nonfederal share of activities for which 
34.5 	federal administrative reimbursement is 
34.6 	appropriated to the commissioner may be 
34.7 	transferred to the special revenue fund. 
34.8 	TANF Maintenance of Effort. (a) In order 
34.9 	to meet the basic MOE requirements of the 
34.10 	TANF block grant specified under Code 
34.11 	of Federal Regulations, title 45, section 
34.12 	263.1, the commissioner may only report 
34.13 	nonfederal money expended for allowable 
34.14 	activities listed in the following clauses as 
34.15 	TANF/MOE expenditures: 
34.16 	(1) MFIP cash, diversionary work program, 
34.17 	and food assistance benefits under Minnesota 
34.18 	Statutes, chapter 256J; 
34.19 	(2) the child care assistance programs 
34.20 	under Minnesota Statutes, sections 119B.03
34.21 	and 119B.05, and county child care 
34.22 	administrative costs under Minnesota 
34.23 	Statutes, section 119B.15; 
34.24 	(3) state and county MFIP administrative 
34.25 	costs under Minnesota Statutes, chapters 
34.26 	256J and 256K; 
34.27 	(4) state, county, and tribal MFIP 
34.28 	employment services under Minnesota 
34.29 	Statutes, chapters 256J and 256K; 
34.30 	(5) expenditures made on behalf of 
34.31 	noncitizen MFIP recipients who qualify 
34.32 	for the medical assistance without federal 
34.33 	financial participation program under 
34.34 	Minnesota Statutes, section 256B.06, 
35.1 	subdivision 4, paragraphs (d), (e), and (j); 
35.2 	and 
35.3 	(6) qualifying working family credit 
35.4 	expenditures under Minnesota Statutes, 
35.5 	section 290.0671. 
35.6 	(b) The commissioner shall ensure that 
35.7 	sufficient qualified nonfederal expenditures 
35.8 	are made each year to meet the state's 
35.9 	TANF/MOE requirements. For the activities 
35.10 	listed in paragraph (a), clauses (2) to 
35.11 	(6), the commissioner may only report 
35.12 	expenditures that are excluded from the 
35.13 	definition of assistance under Code of 
35.14 	Federal Regulations, title 45, section 260.31. 
35.15 	(c) The commissioner shall ensure that the 
35.16 	MOE used by the commissioner of finance 
35.17 	for the February and November forecasts 
35.18 	required under Minnesota Statutes, section 
35.19 	16A.103, contains expenditures under 
35.20 	paragraph (a), clause (1), equal to at least 16 
35.21 	percent of the total required under Code of 
35.22 	Federal Regulations, title 45, section 263.1. 
35.23 	(d) For the federal fiscal year beginning 
35.24 	October 1, 2007, the commissioner may not 
35.25 	claim an amount of TANF/MOE in excess of 
35.26 	the 75 percent standard in Code of Federal 
35.27 	Regulations, title 45, section 263.1(a)(2), 
35.28 	except:
35.29 	(1) to the extent necessary to meet the 80 
35.30 	percent standard under Code of Federal 
35.31 	Regulations, title 45, section 263.1(a)(1), 
35.32 	if it is determined by the commissioner 
35.33 	that the state will not meet the TANF work 
35.34 	participation target rate for the current year;
36.1 	(2) to provide any additional amounts under 
36.2 	Code of Federal Regulations, title 45, section 
36.3 	264.5, that relate to replacement of TANF 
36.4 	funds due to the operation of TANF penalties; 
36.5 	(3) to provide any additional amounts that 
36.6 	may contribute to avoiding or reducing 
36.7 	TANF work participation penalties through 
36.8 	the operation of the excess MOE provisions 
36.9 	of Code of Federal Regulations, title 45, 
36.10 	section 261.43(a)(2); and 
36.11 	(4) for the purposes of clauses (1) to (3), 
36.12 	the commissioner may supplement the 
36.13 	MOE claim with working family credit 
36.14 	expenditures to the extent such expenditures 
36.15 	or other qualified expenditures are otherwise 
36.16 	available after considering the expenditures 
36.17 	allowed in this section.
36.18 	(e) If allowable by the federal Office of 
36.19 	Family Assistance, the commissioner may 
36.20 	claim excess MOE with respect to federal 
36.21 	fiscal years 2006 and 2007 to the extent 
36.22 	that working family credit expenditures are 
36.23 	otherwise available to supplement the state's 
36.24 	MOE claim for those years after considering 
36.25 	the expenditures allowed in this subdivision. 
36.26 	If other qualified expenditures are available, 
36.27 	the commissioner may use those expenditures 
36.28 	as excess MOE and by April 15, 2009, 
36.29 	shall report those expenditures to the chairs 
36.30 	of the senate and house of representatives 
36.31 	Finance Committees, the senate Health and 
36.32 	Human Services Budget Division, and house 
36.33 	of representatives Health Care and Human 
36.34 	Services Finance Division.
37.1 	(d) (f) Minnesota Statutes, section 256.011, 
37.2 	subdivision 3, which requires that federal 
37.3 	grants or aids secured or obtained under that 
37.4 	subdivision be used to reduce any direct 
37.5 	appropriations provided by law, does not 
37.6 	apply if the grants or aids are federal TANF 
37.7 	funds. 
37.8 	(e) (g) Notwithstanding any contrary 
37.9 	provision in this article, this rider expires 
37.10 	June 30, 2011. 
37.11 	Working Family Credit Expenditures as 
37.12 	TANF/MOE. The commissioner may claim 
37.13 	as TANF/MOE up to $6,707,000 per year 
37.14 	for fiscal year 2008 through fiscal year 2011. 
37.15 	Notwithstanding any contrary provision in 
37.16 	this article, this rider expires June 30, 2011. 
37.17 	Additional Working Family Credit 
37.18 	Expenditures to be Claimed for 
37.19 	TANF/MOE. In addition to the amounts 
37.20 	provided in this section, the commissioner 
37.21 	may count the following amounts of working 
37.22 	family credit expenditure as TANF/MOE: 
37.23 	(1) fiscal year 2008, $11,097,000
37.24 	$28,222,000; 
37.25 	(2) fiscal year 2009, $25,401,000
37.26 	$42,905,000; 
37.27 	(3) fiscal year 2010, $20,398,000
37.28 	$29,026,000; and 
37.29 	(4) fiscal year 2011, $19,841,000
37.30 	$28,361,000. 
37.31 	Notwithstanding any contrary provision in 
37.32 	this article, this rider expires June 30, 2011. 
37.33 	Capitation Rate Increase. Of the health care 
37.34 	access fund appropriations to the University 
38.1 	of Minnesota in the higher education 
38.2 	omnibus appropriation bill, $2,157,000 in 
38.3 	fiscal year 2008 and $2,157,000 in fiscal year 
38.4 	2009 are to be used to increase the capitation 
38.5 	payments under Minnesota Statutes, section 
38.6 	256B.69. 

38.7 	Sec. 10.  REPEALER.
 38.8 	Minnesota Statutes 2006, sections 256.741, subdivision 15; and 256J.24, subdivision 
38.9 	6, are repealed.

38.10 	ARTICLE 4
38.11 	HEALTH CARE

38.12 	Section 1. Minnesota Statutes 2006, section 256.969, subdivision 2b, is amended to 
38.13 	read:
38.14 		Subd. 2b.Operating payment rates. In determining operating payment rates for 
38.15 	admissions occurring on or after the rate year beginning January 1, 1991, and every two 
38.16 	years after, or more frequently as determined by the commissioner, the commissioner 
38.17 	shall obtain operating data from an updated base year and establish operating payment 
38.18 	rates per admission for each hospital based on the cost-finding methods and allowable 
38.19 	costs of the Medicare program in effect during the base year. Rates under the general 
38.20 	assistance medical care, medical assistance, and MinnesotaCare programs shall not be 
38.21 	rebased to more current data on January 1, 1997, and January 1, 2005, and for the first 
38.22 	year of the rebased period beginning January 1, 2009. The base year operating payment 
38.23 	rate per admission is standardized by the case mix index and adjusted by the hospital 
38.24 	cost index, relative values, and disproportionate population adjustment. The cost and 
38.25 	charge data used to establish operating rates shall only reflect inpatient services covered 
38.26 	by medical assistance and shall not include property cost information and costs recognized 
38.27 	in outlier payments.

38.28 	Sec. 2. Minnesota Statutes 2006, section 256.969, subdivision 20, is amended to read:
38.29 		Subd. 20.Increases in medical assistance inpatient payments; conditions. (a) 
38.30 	Medical assistance inpatient payments shall increase 20 percent for inpatient hospital 
38.31 	originally paid admissions, excluding Medicare crossovers, that occurred between July 1, 
38.32 	1988 and December 31, 1990, if: (i) the hospital had 100 or fewer Minnesota medical 
38.33 	assistance annualized paid admissions, excluding Medicare crossovers, that were paid by 
39.1 	March 1, 1988, for the period January 1, 1987 to June 30, 1987; (ii) the hospital had 100 
39.2 	or fewer licensed beds on March 1, 1988; (iii) the hospital is located in Minnesota; and 
39.3 	(iv) the hospital is not located in a city of the first class as defined in section 410.01. 
39.4 	For purposes of this paragraph, medical assistance does not include general assistance 
39.5 	medical care. 
39.6 	(b) Medical assistance inpatient payments shall increase 15 percent for inpatient 
39.7 	hospital originally paid admissions, excluding Medicare crossovers, that occurred between 
39.8 	July 1, 1988 and December 31, 1990, if: (i) the hospital had more than 100 but fewer 
39.9 	than 250 Minnesota medical assistance annualized paid admissions, excluding Medicare 
39.10 	crossovers, that were paid by March 1, 1988, for the period January 1, 1987 to June 30, 
39.11 	1987; (ii) the hospital had 100 or fewer licensed beds on March 1, 1988; (iii) the hospital 
39.12 	is located in Minnesota; and (iv) the hospital is not located in a city of the first class as 
39.13 	defined in section 410.01. For purposes of this paragraph, medical assistance does not 
39.14 	include general assistance medical care. 
39.15 	(c) Medical assistance inpatient payment rates shall increase 20 percent for inpatient 
39.16 	hospital originally paid admissions, excluding Medicare crossovers, that occur on or 
39.17 	after October 1, 1992, if: (i) the hospital had 100 or fewer Minnesota medical assistance 
39.18 	annualized paid admissions, excluding Medicare crossovers, that were paid by March 
39.19 	1, 1988, for the period January 1, 1987 to June 30, 1987; (ii) the hospital had 100 or 
39.20 	fewer licensed beds on March 1, 1988; (iii) the hospital is located in Minnesota; and (iv) 
39.21 	the hospital is not located in a city of the first class as defined in section 410.01. For a 
39.22 	hospital that qualifies for an adjustment under this paragraph and under subdivision 9 or 
39.23 	23, the hospital must be paid the adjustment under subdivisions 9 and 23, as applicable, 
39.24 	plus any amount by which the adjustment under this paragraph exceeds the adjustment 
39.25 	under those subdivisions. For this paragraph, medical assistance does not include general 
39.26 	assistance medical care. 
39.27 	(d) Medical assistance inpatient payment rates shall increase 15 percent for inpatient 
39.28 	hospital originally paid admissions, excluding Medicare crossovers, that occur after 
39.29 	September 30, 1992, if: (i) the hospital had more than 100 but fewer than 250 Minnesota 
39.30 	medical assistance annualized paid admissions, excluding Medicare crossovers, that 
39.31 	were paid by March 1, 1988, for the period January 1, 1987 to June 30, 1987; (ii) the 
39.32 	hospital had 100 or fewer licensed beds on March 1, 1988; (iii) the hospital is located in 
39.33 	Minnesota; and (iv) the hospital is not located in a city of the first class as defined in 
39.34 	section 410.01. For a hospital that qualifies for an adjustment under this paragraph and 
39.35 	under subdivision 9 or 23, the hospital must be paid the adjustment under subdivisions 
39.36 	9 and 23, as applicable, plus any amount by which the adjustment under this paragraph 
40.1 	exceeds the adjustment under those subdivisions. For purposes of this paragraph, medical 
40.2 	assistance does not include general assistance medical care. 
40.3 	(e) For admissions occurring on or after July 1, 2008, fee-for-service inpatient 
40.4 	payments must increase eight percent for a hospital with a medical assistance inpatient 
40.5 	utilization rate of 17.95 percent of total patient days as of the base year in effect on July 1, 
40.6 	2005, and nine percent for a hospital with a medical assistance inpatient utilization rate of 
40.7 	59.60 percent of total patient days as of the base year in effect on July 1, 2005. Payments 
40.8 	made to managed care plans must not be increased to reflect this increase. For purposes of 
40.9 	this paragraph, medical assistance does not include general assistance medical care.

40.10 	Sec. 3. Minnesota Statutes 2006, section 256B.0571, subdivision 8, is amended to read:
40.11 		Subd. 8.Program established. (a) The commissioner, in cooperation with the 
40.12 	commissioner of commerce, shall establish the Minnesota partnership for long-term care 
40.13 	program to provide for the financing of long-term care through a combination of private 
40.14 	insurance and medical assistance.
40.15 	(b) An individual who meets the requirements in this paragraph is eligible to 
40.16 	participate in the partnership program. The individual must:
40.17 	(1) be a Minnesota resident at the time coverage first became effective under the 
40.18 	partnership policy; and
40.19 	(2) be a beneficiary of a partnership policy that (i) is issued on or after the effective 
40.20 	date of the state plan amendment implementing the partnership program in Minnesota, or 
40.21 	(ii) qualifies as a partnership policy under the provisions of subdivision 8a; and.
40.22 	(3) have exhausted all of the benefits under the partnership policy as described in this 
40.23 	section. Benefits received under a long-term care insurance policy before July 1, 2006, do 
40.24 	not count toward the exhaustion of benefits required in this subdivision.

40.25 	Sec. 4. Minnesota Statutes 2006, section 256B.0571, subdivision 9, is amended to read:
40.26 		Subd. 9.Medical assistance eligibility. (a) Upon application for medical assistance 
40.27 	program payment of long-term care services by an individual who meets the requirements 
40.28 	described in subdivision 8, the commissioner shall determine the individual's eligibility 
40.29 	for medical assistance according to paragraphs (b) to (i).
40.30 	(b) After determining assets subject to the asset limit under section 256B.056, 
40.31 	subdivision 3 or 3c, or 256B.057, subdivision 9 or 10, the commissioner shall allow the 
40.32 	individual to designate assets to be protected from recovery under subdivisions 13 and 
40.33 	15 up to the dollar amount of the benefits utilized under the partnership policy as of the 
40.34 	effective date of eligibility for medical assistance program payment of long-term care 
41.1 	services. Benefits utilized under a long-term care insurance policy before July 1, 2006, 
41.2 	do not count for the purpose of determining the amount of assets that can be designated. 
41.3 	Designated assets shall be disregarded for purposes of determining eligibility for payment 
41.4 	of long-term care services. The dollar amount of benefits utilized must be equal to the 
41.5 	amount of claims paid by the issuer under the policy as verified by the issuer.
41.6 	(c) The individual shall identify the designated assets and the full fair market value 
41.7 	of those assets and designate them as assets to be protected at the time of initial application 
41.8 	for medical assistance payment of long-term care services. The full fair market value of 
41.9 	real property or interests in real property shall be based on the most recent full assessed 
41.10 	value for property tax purposes for the real property, unless the individual provides a 
41.11 	complete professional appraisal by a licensed appraiser to establish the full fair market 
41.12 	value. The extent of a life estate in real property shall be determined using the life estate 
41.13 	table in the health care program's manual. Ownership of any asset in joint tenancy shall be 
41.14 	treated as ownership as tenants in common for purposes of its designation as a disregarded 
41.15 	asset. The unprotected value of any protected asset is subject to estate recovery according 
41.16 	to subdivisions 13 and 15.
41.17 	(d) The right to designate assets to be protected is personal to the individual and 
41.18 	ends when the individual dies, except as otherwise provided in subdivisions 13 and 
41.19 	15. It does not include the increase in the value of the protected asset and the income, 
41.20 	dividends, or profits from the asset. It may be exercised by the individual or by anyone 
41.21 	with the legal authority to do so on the individual's behalf. It shall not be sold, assigned, 
41.22 	transferred, or given away.
41.23 	(e) If the dollar amount of the benefits utilized under a partnership policy is greater 
41.24 	than the full fair market value of all assets protected at the time of the application for 
41.25 	medical assistance long-term care services, As the individual continues to utilize benefits 
41.26 	under a partnership policy after eligibility for medical assistance payment of long-term 
41.27 	care services begins, the individual may designate, for additional protection, an increase 
41.28 	in the value of protected assets and additional assets that become available during the 
41.29 	individual's lifetime for protection under this section up to the amount of additional 
41.30 	benefits utilized. The individual must make the designation in writing to the county agency 
41.31 	no later than the last date on which the individual must report a change in circumstances to 
41.32 	the county agency, as provided for under the medical assistance program. Any excess used 
41.33 	for this purpose shall not be available to the individual's estate to protect assets in the estate 
41.34 	from recovery under section 256B.15 or 524.3-1202, or otherwise. The amount used for 
41.35 	this purpose must reduce the unused amount of asset protection available to protect assets 
41.36 	in the individual's estate from recovery under section 256B.15 or 524.3-1202, or otherwise.
42.1 	(f) This section applies only to estate recovery under United States Code, title 42, 
42.2 	section 1396p, subsections (a) and (b), and does not apply to recovery authorized by other 
42.3 	provisions of federal law, including, but not limited to, recovery from trusts under United 
42.4 	States Code, title 42, section 1396p, subsection (d)(4)(A) and (C), or to recovery from 
42.5 	annuities, or similar legal instruments, subject to section 6012, subsections (a) and (b), of 
42.6 	the Deficit Reduction Act of 2005, Public Law 109-171.
42.7 	(g) An individual's protected assets owned by the individual's spouse who applies 
42.8 	for payment of medical assistance long-term care services shall not be protected assets or 
42.9 	disregarded for purposes of eligibility of the individual's spouse solely because they were 
42.10 	protected assets of the individual.
42.11 	(h) Assets designated under this subdivision shall not be subject to penalty under 
42.12 	section 256B.0595.
42.13 	(i) The commissioner shall otherwise determine the individual's eligibility 
42.14 	for payment of long-term care services according to medical assistance eligibility 
42.15 	requirements.

42.16 	Sec. 5. Minnesota Statutes 2007 Supplement, section 256B.0631, subdivision 1, 
42.17 	is amended to read:
42.18 		Subdivision 1.Co-payments. (a) Except as provided in subdivision 2, the medical 
42.19 	assistance benefit plan shall include the following co-payments for all recipients, effective 
42.20 	for services provided on or after October 1, 2003, and before January 1, 2009:
42.21 	(1) $3 per nonpreventive visit. For purposes of this subdivision, a visit means an 
42.22 	episode of service which is required because of a recipient's symptoms, diagnosis, or 
42.23 	established illness, and which is delivered in an ambulatory setting by a physician or 
42.24 	physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse, 
42.25 	audiologist, optician, or optometrist;
42.26 	(2) $3 for eyeglasses;
42.27 	(3) $6 for nonemergency visits to a hospital-based emergency room; and
42.28 	(4) $3 per brand-name drug prescription and $1 per generic drug prescription, 
42.29 	subject to a $12 per month maximum for prescription drug co-payments. No co-payments 
42.30 	shall apply to antipsychotic drugs when used for the treatment of mental illness.
42.31 	(b) Except as provided in subdivision 2, the medical assistance benefit plan shall 
42.32 	include the following co-payments for all recipients, effective for services provided on 
42.33 	or after January 1, 2009:
42.34 	(1) $6 for nonemergency visits to a hospital-based emergency room; and
43.1 	(2) $3 per brand-name drug prescription and $1 per generic drug prescription, 
43.2 	subject to a $7 per month maximum for prescription drug co-payments. No co-payments 
43.3 	shall apply to antipsychotic drugs when used for the treatment of mental illness.; and
43.4 	(3) for individuals identified by the commissioner with income at or below 100 
43.5 	percent of the federal poverty guidelines, total monthly co-payments must not exceed five 
43.6 	percent of family income. For purposes of this paragraph, family income is the total 
43.7 	earned and unearned income of the individual and the individual's spouse, if the spouse is 
43.8 	enrolled in medical assistance and also subject to the five percent limit on co-payments.
43.9 	(c) Recipients of medical assistance are responsible for all co-payments in this 
43.10 	subdivision.

43.11 	Sec. 6. Minnesota Statutes 2007 Supplement, section 256B.0631, subdivision 3, 
43.12 	is amended to read:
43.13 		Subd. 3.Collection. (a) The medical assistance reimbursement to the provider shall 
43.14 	be reduced by the amount of the co-payment, except that reimbursement for prescription 
43.15 	drugs reimbursements shall not be reduced:
43.16 	(1) once a recipient has reached the $12 per month maximum or the $7 per month 
43.17 	maximum effective January 1, 2009, for prescription drug co-payments; or
43.18 	(2) for a recipient identified by the commissioner under 100 percent of the federal 
43.19 	poverty guidelines who has met their monthly five percent co-payment limit.
43.20 	(b) The provider collects the co-payment from the recipient. Providers may not deny 
43.21 	services to recipients who are unable to pay the co-payment.
43.22 	(c) Medical assistance reimbursement to fee-for-service providers and payments to 
43.23 	managed care plans shall not be increased as a result of the removal of the co-payments 
43.24 	effective January 1, 2009.

43.25 	Sec. 7. [256B.194] FEDERAL PAYMENTS.
43.26 		Subdivision 1.Payments at actual cost.   Notwithstanding any other statute or rule 
43.27 	to the contrary, for providers that are units of government, the commissioner may limit 
43.28 	medical assistance and MinnesotaCare payments to a provider's actual cost of providing 
43.29 	services, according to the Centers for Medicare and Medicaid Services (CAMS) final rule 
43.30 	referenced in this subdivision. The commissioner may also require medical assistance 
43.31 	and MinnesotaCare providers to provide any information necessary to determine 
43.32 	Medicaid-related costs, and require the cooperation of providers in any audit or review 
43.33 	necessary to ensure payments are limited to cost. This section does not apply to providers 
43.34 	who are exempt from the provisions of  the CAMS final rule. This subdivision becomes 
44.1 	effective when the CAMS final rule, published May 29, 2007, at Federal Register, Vow. 
44.2 	72, No. 100, governing payments to providers that are units of government goes into 
44.3 	effect at the end of the moratorium imposed by Congress.
44.4 		Subd. 2.Loss of federal financial participation. For all transfers, certified 
44.5 	expenditures, and medical assistance payments listed in this subdivision, if the 
44.6 	commissioner determines that federal financial participation is no longer available for the 
44.7 	medical assistance payments listed, then related obligations for the nonfederal share of 
44.8 	payments and the medical assistance payments must terminate. The commissioner shall 
44.9 	notify all affected parties of the loss of federal financial participation, and the resulting 
44.10 	payments and obligations that are terminated. If the commissioner determines that federal 
44.11 	financial  participation is no longer available for any medical assistance payments or 
44.12 	contributions  to the nonfederal share of medical assistance payments that have already 
44.13 	been made, the commissioner may collect the medical assistance payments from providers 
44.14 	and return contributions of the nonfederal share to its source. The transfers, certified 
44.15 	expenditures, and medical assistance payments subject to this section are those specified in 
44.16 	section 62J.692, subdivision 7, paragraphs (b) and (c); 256B.19, subdivisions 1c and 1d; 
44.17 	256B.195; 256B.431, subdivision 23; and 256B.69, subdivision 5c, paragraph (a), clauses 
44.18 	(2) to (4); Laws 2002, chapter 220, article 17, section 2, subdivision 3; and Laws 2005, 
44.19 	First Special Session chapter 4, article 9, section 2, subdivision 1.

44.20 	Sec. 8. Minnesota Statutes 2007 Supplement, section 256B.199, is amended to read:
44.21 	256B.199 PAYMENTS REPORTED BY GOVERNMENTAL ENTITIES.
44.22 	(a) Effective July 1, 2007, the commissioner shall apply for federal matching funds 
44.23 	for the expenditures in paragraphs (b) and (c).
44.24 	(b) The commissioner shall apply for federal matching funds for certified public 
44.25 	expenditures as follows:
44.26 	(1) Hennepin County, and Hennepin County Medical Center, Ramsey County, 
44.27 	Regions Hospital, the University of Minnesota, and Fairview-University Medical Center
44.28 	shall report quarterly to the commissioner beginning June 1, 2007, payments made during 
44.29 	the second previous quarter that may qualify for reimbursement under federal law;
44.30 	(2) based on these reports, the commissioner shall apply for federal matching funds. 
44.31 	These funds are appropriated to the commissioner for the payments under section 256.969, 
44.32 	subdivision 27 to offset medical assistance expenditures; and
44.33 	(3) by May 1 of each year, beginning May 1, 2007, the commissioner shall inform 
44.34 	the nonstate entities listed in this paragraph (a) of the amount of federal disproportionate 
44.35 	share hospital payment money expected to be available in the current federal fiscal year.
45.1 	(c) The commissioner shall apply for federal matching funds for general assistance 
45.2 	medical care expenditures as follows:
45.3 	(1) for hospital services occurring on or after July 1, 2007, general assistance medical 
45.4 	care expenditures for fee-for-service inpatient and outpatient hospital payments made by 
45.5 	the department shall be used to apply for federal matching funds, except as limited below:
45.6 	(i) only those general assistance medical care expenditures made to an individual 
45.7 	hospital that would not cause the hospital to exceed its individual hospital limits under 
45.8 	section 1923 of the Social Security Act may be considered; and
45.9 	(ii) general assistance medical care expenditures may be considered only to the extent 
45.10 	of Minnesota's aggregate allotment under section 1923 of the Social Security Act; and
45.11 	(2) all hospitals must provide any necessary expenditure, cost, and revenue 
45.12 	information required by the commissioner as necessary for purposes of obtaining federal 
45.13 	Medicaid matching funds for general assistance medical care expenditures.

45.14 	EFFECTIVE DATE. This section is effective retroactively from July 1, 2007.

45.15 	Sec. 9. Minnesota Statutes 2006, section 256B.69, subdivision 5a, is amended to read:
45.16 		Subd. 5a.Managed care contracts. (a) Managed care contracts under this section 
45.17 	and sections 256L.12 and 256D.03, shall be entered into or renewed on a calendar year 
45.18 	basis beginning January 1, 1996. Managed care contracts which were in effect on June 
45.19 	30, 1995, and set to renew on July 1, 1995, shall be renewed for the period July 1, 1995 
45.20 	through December 31, 1995 at the same terms that were in effect on June 30, 1995. The 
45.21 	commissioner may issue separate contracts with requirements specific to services to 
45.22 	medical assistance recipients age 65 and older.
45.23 	(b) A prepaid health plan providing covered health services for eligible persons 
45.24 	pursuant to chapters 256B, 256D, and 256L, is responsible for complying with the terms 
45.25 	of its contract with the commissioner. Requirements applicable to managed care programs 
45.26 	under chapters 256B, 256D, and 256L, established after the effective date of a contract 
45.27 	with the commissioner take effect when the contract is next issued or renewed.
45.28 	(c) Effective for services rendered on or after January 1, 2003, the commissioner 
45.29 	shall withhold five percent of managed care plan payments under this section for the 
45.30 	prepaid medical assistance and general assistance medical care programs pending 
45.31 	completion of performance targets. Each performance target must be quantifiable, 
45.32 	objective, measurable, and reasonably attainable, except in the case of a performance 
45.33 	target based on a federal or state law or rule. Criteria for assessment of each performance 
45.34 	target must be outlined in writing prior to the contract effective date. The withheld funds 
45.35 	must be returned no sooner than July of the following year if performance targets in the 
46.1 	contract are achieved. The commissioner may exclude special demonstration projects 
46.2 	under subdivision 23. A managed care plan or a county-based purchasing plan under 
46.3 	section 256B.692 may include as admitted assets under section 62D.044 any amount 
46.4 	withheld under this paragraph that is reasonably expected to be returned.
46.5 	(d)(1) Effective for services rendered on or after January 1, 2009, the commissioner 
46.6 	shall withhold two percent of managed care plan payments under this section for the 
46.7 	prepaid medical assistance and general assistance medical care programs. The withheld 
46.8 	funds must be returned no sooner than July 1 and no later than July 31 of the following 
46.9 	year. The commissioner may exclude special demonstration projects under subdivision 23.
46.10 	(2) A managed care plan or a county-based purchasing plan under section 256B.692 
46.11 	may include as admitted assets under section 62D.044 any amount withheld under 
46.12 	this paragraph. The return of the withhold under this paragraph is not subject to the 
46.13 	requirements of paragraph (c).

46.14 	Sec. 10. Minnesota Statutes 2006, section 256L.12, subdivision 9, is amended to read:
46.15 		Subd. 9.Rate setting; performance withholds. (a) Rates will be prospective, 
46.16 	per capita, where possible. The commissioner may allow health plans to arrange for 
46.17 	inpatient hospital services on a risk or nonrisk basis. The commissioner shall consult with 
46.18 	an independent actuary to determine appropriate rates.
46.19 	(b) For services rendered on or after January 1, 2003, to December 31, 2003, the 
46.20 	commissioner shall withhold .5 percent of managed care plan payments under this section 
46.21 	pending completion of performance targets. The withheld funds must be returned no 
46.22 	sooner than July 1 and no later than July 31 of the following year if performance targets 
46.23 	in the contract are achieved. A managed care plan may include as admitted assets under 
46.24 	section 62D.044 any amount withheld under this paragraph that is reasonably expected 
46.25 	to be returned.
46.26 	(c) For services rendered on or after January 1, 2004, the commissioner shall 
46.27 	withhold five percent of managed care plan payments under this section pending 
46.28 	completion of performance targets. Each performance target must be quantifiable, 
46.29 	objective, measurable, and reasonably attainable, except in the case of a performance 
46.30 	target based on a federal or state law or rule. Criteria for assessment of each performance 
46.31 	target must be outlined in writing prior to the contract effective date. The withheld 
46.32 	funds must be returned no sooner than July 1 and no later than July 31 of the following 
46.33 	calendar year if performance targets in the contract are achieved. A managed care plan or 
46.34 	a county-based purchasing plan under section 256B.692 may include as admitted assets 
47.1 	under section 62D.044 any amount withheld under this paragraph that is reasonably 
47.2 	expected to be returned.
47.3 	(d) For services rendered on or after January 1, 2009, the commissioner shall 
47.4 	withhold two percent of managed care plan payments under this section. The withheld 
47.5 	funds must be returned no sooner than July 1 and no later than July 31 of the following 
47.6 	calendar year. A managed care plan or a county-based purchasing plan under section 
47.7 	256B.692 may include as admitted assets under section 62D.044 any amount withheld 
47.8 	under this paragraph.

47.9 	Sec. 11. FEDERAL APPROVAL FOR INCREASED DISPROPORTIONATE 
47.10 	SHARE HOSPITAL PAYMENTS.
 47.11 	By January 1, 2009, the commissioner of human services, in cooperation with 
47.12 	hospitals with high rates of utilization by medical assistance enrollees, shall develop 
47.13 	and submit for federal approval a proposal to increase disproportionate share hospital 
47.14 	payments to Minnesota hospitals. In developing the proposal, the commissioner shall 
47.15 	consider, but is not required to adopt, disproportionate share hospital payment proposals 
47.16 	from other states that have received federal approval.

47.17 	Sec. 12. REPEALER.
 47.18 	Minnesota Statutes 2007 Supplement, section 256.969, subdivision 27, is repealed 
47.19 	retroactively from July 1, 2007.

47.20 	ARTICLE 5
47.21 	HEALTH AND HUMAN SERVICES APPROPRIATIONS

47.22	Section 1. HEALTH AND HUMAN SERVICES APPROPRIATION.
 	
47.23 	The sums shown in the columns marked "Appropriations" are added to or, if shown 
47.24 	in parentheses, subtracted from the appropriations in Laws 2007, chapter 147, or other 
47.25 	law to the agencies and for the purposes specified in this article. The appropriations 
47.26 	are from the general fund, or another named fund, and are available for the fiscal years 
47.27 	indicated for each purpose. The figures "2008" and "2009" used in this article mean 
47.28 	that the addition or subtraction from appropriations listed under them are available for 
47.29 	the fiscal year ending June 30, 2008, or June 30, 2009, respectively. "The first year" is 
47.30 	fiscal year 2008. "The second year" is fiscal year 2009. "The biennium" is fiscal years 
47.31 	2008 and 2009. Supplemental appropriations and reductions for the fiscal year ending 
47.32 	June 30, 2008, are effective the day following final enactment.

48.1				APPROPRIATIONS
	
48.2				Available for the Year
	
48.3				Ending June 30
	
48.4					2008
		2009

48.5	Sec. 2. HUMAN SERVICES

48.6	Subdivision 1.Total Appropriation
 	$
	(34,855,000)
	$
	(56,265,000)

48.7	Appropriations by Fund
	
48.8		2008
	2009
	
48.9	General
	(51,980,000)
	(80,296,000)
	
48.10	Health Care Access
	0
	(3,292,000)
	
48.11	Federal TANF
	17,125,000
	27,323,000

48.12	Subd. 2.Agency Management

48.13	Financial Operations
		0
		(5,867,000)
	
48.14 	The amounts that may be spent from the 
48.15 	appropriation for each purpose are as follows:
48.16 	Base Adjustment. The general fund base 
48.17 	is increased $23,000 in fiscal year 2010 and 
48.18 	$26,000 in fiscal year 2011.

48.19
48.20	Subd. 3.Revenue and Pass-Through Revenue 
Expenditures

48.21	Federal TANF
		25,000,000
		27,039,000
	
48.22 	Additional TANF Transfer to Social 
48.23 	Services Block Grant. In addition to 
48.24 	transfers allowed under prior law, $5,754,000 
48.25 	in fiscal year 2009 is appropriated to the 
48.26 	commissioner for the purposes of providing 
48.27 	services for families with children whose 
48.28 	incomes are at or below 200 percent 
48.29 	of the federal poverty guidelines. The 
48.30 	commissioner shall authorize a sufficient 
48.31 	transfer of funds from the state's federal 
48.32 	social services block grant to meet this 
48.33 	appropriation. The funds must be distributed 
48.34 	to counties for the children and community 
49.1 	services grant according to the formula for 
49.2 	state appropriations in Minnesota Statutes, 
49.3 	chapter 256M.

49.4
49.5	Subd. 4.Children and Economic Assistance 
Grants
 					
49.6 	The amounts that may be spent from this 
49.7 	appropriation for each purpose are as follows:

49.8	(a) MFIP/DWP Grants

49.9	Appropriations by Fund
	
49.10	General
	(17,125,000)
	(25,947,000)
	
49.11	Federal TANF
	17,125,000
	27,311,000

49.12	(b) MFIP Child Care Assistance Grants
		0
		0

49.13	(c) Children's Services Grants
		(311,000)
		(1,663,000)
	
49.14 	Base Adjustment. The general fund base 
49.15 	is increased $1,726,000 in fiscal year 2010 
49.16 	and $1,742,000 in fiscal year 2011 due to 
49.17 	the onetime increase in adoption assistance 
49.18 	grants and the onetime decreases in relative 
49.19 	custody assistance grants, and county shift 
49.20 	for children's mental health grants.
49.21 	Funding Usage. Up to 75 percent of the 
49.22 	fiscal year 2010 appropriation for children's 
49.23 	mental health screening grants may be used 
49.24 	to fund calendar year 2009 allocations for 
49.25 	these programs, with the resulting calendar 
49.26 	year funding pattern continuing into the 
49.27 	future.

49.28
49.29	Subd. 4a.Children and Economic Assistance 
Management

49.30	General
		0
		12,000

49.31	Children and Economic Assistance Operations

49.32	Appropriations by Fund
	
49.33	General
	0
	12,000

50.1 	MAXIS costs. $12,000 is appropriated in 
50.2 	fiscal year 2009 for MAXIS systems costs. 
50.3 	This appropriation is onetime only.

50.4	Subd. 5.Basic Health Care Grants
 					
50.5 	The amounts that may be spent from this 
50.6 	appropriation for each purpose are as follows:

50.7	(a) MinnesotaCare Grants

50.8	Health Care Access
		0
		(3,292,000)
	
50.9 	Incentive Program and Outreach Grants.
50.10 	Of the appropriation for the Minnesota health 
50.11 	care outreach program in Laws 2007, chapter 
50.12 	147, article 19, section 3, subdivision 7, 
50.13 	paragraph (b):
50.14 	(1) $400,000 in fiscal year 2009 from the 
50.15 	general fund and $200,000 in fiscal year 2009 
50.16 	from the health care access fund are for the 
50.17 	incentive program under Minnesota Statutes, 
50.18 	section 256.962, subdivision 5. For the 
50.19 	biennium  beginning July 1, 2009, base level 
50.20 	funding for this activity shall be $360,000 
50.21 	from the general fund and $160,000 from the 
50.22 	health care access fund; and
50.23 	(2) $100,000 in fiscal year 2009 from the 
50.24 	general fund and $50,000 in fiscal year 2009 
50.25 	from the health care access fund are for the 
50.26 	outreach grants under Minnesota Statutes, 
50.27 	section 256.962, subdivision 2. For the 
50.28 	biennium beginning July 1, 2009, base level 
50.29 	funding for this activity shall be $90,000 
50.30 	from the general fund and $40,000 from the 
50.31 	health  care access fund.

50.32
50.33	(b) MA Basic Health Care Grants - Families 
and Children
		(17,985,000)
		(24,848,000)
	
51.1 	Hospital Payment Delay. Notwithstanding 
51.2 	Laws 2005, First Special Session chapter 4, 
51.3 	article 9, section 2, subdivision 6, payments 
51.4 	from the Medicaid Management Information 
51.5 	System that would otherwise have been made 
51.6 	for inpatient hospital services for medical 
51.7 	assistance enrollees are delayed as follows: 
51.8 	(1) for fiscal year 2008, the last payments for 
51.9 	the month of June must be included in the 
51.10 	first payments in fiscal year 2009; and (2) 
51.11 	for fiscal year 2009, the last payments in the 
51.12 	month of June must be included in the first 
51.13 	payment of fiscal year 2010. The provisions 
51.14 	of Minnesota Statutes, section 16A.124, shall 
51.15 	not apply to these delayed payments.

51.16
51.17	(c) MA Basic Health Care Grants - Elderly and 
Disabled
		(14,028,000)
		(2,254,000)
	
51.18 	Minnesota Disability Health Options Rate 
51.19 	Setting Methodology. The commissioner 
51.20 	shall develop and implement a methodology 
51.21 	for risk adjusting payments for community 
51.22 	alternatives for disabled individuals (CADI) 
51.23 	and traumatic brain injury (TBI) home 
51.24 	and community-based waiver services 
51.25 	delivered under the Minnesota disability 
51.26 	health options program (MnDHO) effective 
51.27 	January 1, 2009. The commissioner shall 
51.28 	take into account the weighting system used 
51.29 	to determine county waiver allocations in 
51.30 	developing the new payment methodology. 
51.31 	Growth in the number of enrollees receiving 
51.32 	CADI or TBI waiver payments through 
51.33 	MnDHO is limited to an increase of 200 
51.34 	enrollees in each calendar year from January 
51.35 	2009 through December 2011. If those limits 
51.36 	are reached, additional members may be 
52.1 	enrolled in MnDHO for basic care services 
52.2 	only as defined under Minnesota Statutes, 
52.3 	section 256B.69, subdivision 28, and the 
52.4 	commissioner may establish a waiting list for 
52.5 	future access of MnDHO members to those 
52.6 	waiver services.
52.7 	Critical Access Dental Reimbursement.
52.8 	Effective for fiscal years beginning on or after 
52.9 	July 1, 2009, funding for medical assistance 
52.10 	critical access dental reimbursement rates 
52.11 	must be paid from the health care access 
52.12 	fund.

52.13	(d) General Assistance Medical Care Grants
		0
		(3,729,000)
	
52.14 	MinnesotaCare Outreach Grants Special 
52.15 	Revenue Account. The balance in the 
52.16 	MinnesotaCare outreach grants special 
52.17 	revenue account at the close of fiscal year 
52.18 	2008 must be transferred to the general fund.

52.19	Subd. 6.Health Care Management
 					
52.20 	The amounts that may be spent from the 
52.21 	appropriation for each purpose are as follows:

52.22	Health Care Administration
		0
		100,000

52.23	Subd. 7.Continuing Care Grants
 					
52.24 	The amounts that may be spent from the 
52.25 	appropriation for each purpose are as follows:

52.26	(a) MA Long-Term Care Facilities Grants
		(2,306,000)
		(2,291,000)

52.27
52.28	(b) MA Long-Term Care Waivers and Home 
Care Grants
		0
		(5,397,000)
	
52.29 	Manage Growth in TBI and CADI Waiver.
52.30 	During the fiscal years beginning on July 
52.31 	1, 2008, July 1, 2009, and July 1, 2010, 
52.32 	the commissioner shall allocate money 
52.33 	for home and community-based programs 
53.1 	covered under Minnesota Statutes, section 
53.2 	256B.49, to ensure a reduction in state 
53.3 	spending that is equivalent to limiting the 
53.4 	caseload growth of the traumatic brain injury 
53.5 	(TBI) waiver to 200 allocations in each 
53.6 	year of the biennium and the community 
53.7 	alternatives for disabled individuals (CADI) 
53.8 	waiver to 1,500 allocations each year of the 
53.9 	biennium. Priorities for the allocation of 
53.10 	funds must be for individuals anticipated to 
53.11 	be discharged from institutional settings or 
53.12 	who are at imminent risk of a placement in 
53.13 	an institutional setting. Notwithstanding any 
53.14 	contrary section in this article, this provision 
53.15 	expires June 30, 2011.

53.16	(c) Mental Health Grants
		0
		(4,555,000)
	
53.17 	Base Adjustment. The general fund base 
53.18 	is increased $5,270,000 in fiscal year 2010 
53.19 	and $5,450,000 in fiscal year 2011 due to the 
53.20 	county payment shift for adult mental health 
53.21 	grants.
53.22 	Targeted Case Management Work Group.
53.23 	$15,000 is appropriated from the general 
53.24 	fund for fiscal year 2009 to the commissioner 
53.25 	of human services for administrative costs 
53.26 	directly related to the operation of the 
53.27 	targeted case management work group.

53.28	(d) Chemical Dependency Entitlement Grants
		0
		(1,503,000)
	
53.29 	Payments for Substance Abuse Treatment.
53.30 	For services provided in fiscal year 2009, 
53.31 	county-negotiated rates and provider claims 
53.32 	to the consolidated chemical dependency 
53.33 	fund must not exceed rates charged for 
53.34 	services in excess of those in effect on 
53.35 	May 31, 2008. If statutes authorize a 
54.1 	cost-of-living adjustment during fiscal year 
54.2 	2009, then notwithstanding any law to the 
54.3 	contrary, fiscal year 2009 rates may not 
54.4 	exceed those in effect on May 31, 2008, plus 
54.5 	any authorized cost-of-living adjustments.
54.6 	Chemical Dependency Treatment Fund 
54.7 	Special Revenue Account. The lesser of 
54.8 	the balance of the consolidated chemical 
54.9 	dependency treatment fund at the close 
54.10 	of fiscal year 2008 or $2,650,000 must be 
54.11 	transferred and deposited into the general 
54.12 	fund.

54.13
54.14	(e) Chemical Dependency Nonentitlement 
Grants
		0
		2,150,000
	
54.15 	Base Level Adjustment. The general 
54.16 	fund base for chemical dependency 
54.17 	nonentitlement treatment grants shall be 
54.18 	increased by $150,000 for fiscal years 
54.19 	2010 and 2011 for increased grants for 
54.20 	methamphetamine treatment.
54.21 	American Indian Youth Program. Of the 
54.22 	general fund appropriation, $2,000,000 in 
54.23 	fiscal year 2009 is for grants to be awarded 
54.24 	competitively to American Indian tribes to 
54.25 	purchase or develop one or more culturally 
54.26 	specific treatment programs designed to 
54.27 	serve youth from native cultures. This 
54.28 	appropriation is onetime and available until 
54.29 	spent.

54.30	(f) Other Continuing Care Grants
		0
		(4,381,000)
	
54.31 	Base Level Adjustment. The general fund 
54.32 	base is increased $7,633,000 in fiscal year 
54.33 	2010 and $5,332,000 in fiscal year 2011, due 
54.34 	to the onetime reduction of HIV grants in 
54.35 	fiscal year 2009, an increase each year for 
55.1 	housing grants under Minnesota Statutes, 
55.2 	section 256B.0658, and the adjustment 
55.3 	for the county grant payment shift for 
55.4 	developmental disability semi-independent 
55.5 	services grants and developmental disability 
55.6 	family support grants.
55.7 	Housing Access Grants. Of the general 
55.8 	fund appropriation, $250,000 is appropriated 
55.9 	in fiscal year 2009 for housing access 
55.10 	grants under Minnesota Statutes, section 
55.11 	256B.0658.
55.12 	Funding Usage. Up to 75 percent of 
55.13 	the fiscal year 2010 appropriation for 
55.14 	developmental disability semi-independent 
55.15 	living services grants and developmental 
55.16 	disability family support grants may be used 
55.17 	to fund calendar year 2009 allocations for 
55.18 	these programs, with the resulting calendar 
55.19 	year funding pattern continuing into the 
55.20 	future.

55.21	Subd. 8.State-Operated Services
 					
55.22 	County Past Due Receivables. The 
55.23 	commissioner is authorized to withhold 
55.24 	county federal administrative reimbursement 
55.25 	when the county of financial responsibility 
55.26 	for cost-of-care payments due to the state 
55.27 	under Minnesota Statutes, section 246.54 
55.28 	or 253B.045, is 180 days past due. The 
55.29 	commissioner shall deposit the federal 
55.30 	administrative withholding into the general 
55.31 	fund to settle the claims with the county of 
55.32 	financial responsibility.

55.33	Mental Health Services
		(225,000)
		(300,000)

55.34	Sec. 3. Health Department
 					
56.1 	Federally Qualified Health Centers.
56.2 	Effective for fiscal years beginning on 
56.3 	or after July 1, 2009, the general fund 
56.4 	appropriation of $1,500,000 each fiscal year 
56.5 	for federally qualified health centers under 
56.6 	Minnesota Statutes, section 145.9269, is 
56.7 	eliminated and is replaced by a $1,500,000 
56.8 	appropriation each fiscal year from the health 
56.9 	care access fund.
56.10 	MERC Federal Compliance. Effective 
56.11 	for fiscal years beginning on or after July 
56.12 	1, 2009, the general fund appropriation of 
56.13 	$2,000,000 each fiscal year to the Mayo 
56.14 	Clinic for the purpose of providing transition 
56.15 	funding while federal compliance changes 
56.16 	are made to the medical education and 
56.17 	research cost funding distribution formula is 
56.18 	eliminated and is replaced by a $2,000,000 
56.19 	appropriation each fiscal year from the health 
56.20 	care access fund.

56.21 	ARTICLE 6
56.22 	HEALTH AND HUMAN SERVICES FORECAST CHANGES

56.23
56.24	Section 1. SUMMARY OF APPROPRIATIONS; DEPARTMENT OF HUMAN 
SERVICES FORECAST ADJUSTMENT.
 	
56.25 	The dollar amounts shown are added to or, if shown in parentheses, are subtracted 
56.26 	from the appropriations in Laws 2007, chapter 147, from the general fund, or any other 
56.27 	fund named, to the Department of Human Services for the purposes specified in this 
56.28 	article, to be available for the fiscal year indicated for each purpose. The figure "2008" 
56.29 	used in this article means that the appropriation or appropriations listed are available for 
56.30 	the fiscal year ending June 30, 2008. The figure "2009" used in this article means that the 
56.31 	appropriation or appropriations listed are available for the fiscal year ending June 30, 2009.

56.32					2008
		2009
	
56.33	General
			$
	6,739,000
	$
	52,350,000
	
56.34	Health Care Access
				(84,156,000)
		(96,019,000)
	
56.35	TANF
				(28,427,000)
		(7,441,000)
	
56.36	Total
			$
	 (105,844,000)
	$
	(51,110,000)

57.1
57.2	Sec. 2. COMMISSIONER OF HUMAN 
SERVICES

57.3	Subdivision 1.Total Appropriation
 	$
	(105,844,000)
	$
	(51,110,000)

57.4	Appropriations by Fund
	
57.5		2008
	2009
	
57.6	General
	6,739,000
	52,350,000
	
57.7	Health Care Access
	(84,156,000)
	(96,019,000)
	
57.8	TANF
	(28,427,000)
	(7,441,000)

57.9	Subd. 2.Revenue and Pass-Through

57.10	TANF
	1,187,000
	1,507,000

57.11
57.12	Subd. 3.Children and Economic Assistance 
Grants

57.13	General
	(4,960,000)
	5,925,000
	
57.14	TANF
	(29,614,000)
	(8,948,000)
	
57.15 	The amounts that may be spent from this 
57.16 	appropriation for each purpose are as follows:

57.17	(a) MFIP/DWP Grants

57.18	Appropriations by Fund
	
57.19	General
	25,139,000
	11,665,000
	
57.20	TANF
	(29,614,000)
	(8,948,000)

57.21	(b) MFIP Child Care Assistance Grants
		(26,141,000)
		(10,710,000)

57.22	(c) General Assistance Grants
		2,529,000
		6,033,000

57.23	(d) Minnesota Supplemental Aid Grants
		299,000
		500,000

57.24	(e) Group Residential Housing Grants
		(6,786,000)
		(1,563,000)

57.25	Subd. 4.Basic Health Care Grants

57.26	General
	30,075,000
	48,389,000
	
57.27	Health Care Access
	(84,156,000)
	(96,019,000)
	
57.28 	The amounts that may be spent from this 
57.29 	appropriation for each purpose are as follows:

57.30	(a) MinnesotaCare

57.31	Health Care Access
	(84,156,000)
	(96,019,000)

57.32
57.33	(b) MA Basic Health Care - Families and 
Children
		13,525,000
		7,005,000

58.1
58.2	(c) MA Basic Health Care - Elderly and 
Disabled
		(2,292,000)
		5,479,000

58.3	(d) General Assistance Medical Care
		18,842,000
		35,905,000

58.4	Subd. 5.Continuing Care Grants
 		(18,376,000)
		(1,964,000)
	
58.5 	The amounts that may be spent from this 
58.6 	appropriation for each purpose are as follows:

58.7	(a) MA Long-Term Care Facilities
		(10,986,000)
		(2,148,000)

58.8	(b) MA Long-Term Care Waivers
		(18,484,000)
		(13,598,000)

58.9	(c) Chemical Dependency Entitlement Grants
		11,094,000
		13,782,000

58.10 	ARTICLE 7
58.11 	APPROPRIATIONS AND TRANSFERS

58.12 	Section 1. DUPLICATE APPROPRIATIONS.
 58.13 	Unless another act explicitly provides otherwise, appropriations and transfers made 
58.14 	in this act and other acts must be implemented only once, even if the provision or a similar 
58.15 	provision with the same fiscal effect in the same fiscal year is included in another act. This 
58.16 	section applies to laws enacted in the 2008 regular session.