1.1 	A bill for an act
1.2 	relating to state government; establishing the health and human services budget; 
1.3 	making changes to licensing; Minnesota family investment program, children, 
1.4 	and adult supports; child support; the Department of Health and health care; 
1.5 	health care programs; making technical changes; chemical and mental health; 
1.6 	continuing care programs; establishing the State-County Results, Accountability, 
1.7 	and Service Delivery Redesign; public health; health-related fees; making 
1.8 	forecast adjustments; creating work groups and pilot projects; requiring reports; 
1.9 	increasing fees; appropriating money for health and human services;amending 
1.10 	Minnesota Statutes 2008, sections 13.465, subdivision 8; 62J.495; 62J.496; 
1.11 	62J.497, subdivisions 1, 2, by adding subdivisions; 62J.692, subdivision 7; 
1.12 	103I.208, subdivision 2; 125A.744, subdivision 3; 144.0724, subdivisions 2, 4, 
1.13 	8, by adding subdivisions; 144.121, subdivisions 1a, 1b; 144.122; 144.1222, 
1.14 	subdivision 1a; 144.125, subdivision 1; 144.218, subdivision 1; 144.225, 
1.15 	subdivision 2; 144.2252; 144.226, subdivisions 1, 4; 144.72, subdivisions 
1.16 	1, 3; 144.9501, subdivisions 22b, 26a, by adding subdivisions; 144.9505, 
1.17 	subdivisions 1g, 4; 144.9508, subdivisions 2, 3, 4; 144.9512, subdivision 2; 
1.18 	144.966, by adding a subdivision; 144.97, subdivisions 2, 4, 6, by adding 
1.19 	subdivisions; 144.98, subdivisions 1, 2, 3, by adding subdivisions; 144.99, 
1.20 	subdivision 1; 144A.073, by adding a subdivision; 144A.44, subdivision 
1.21 	2; 144A.46, subdivision 1; 148.108; 148.6445, by adding a subdivision; 
1.22 	148D.180, subdivisions 1, 2, 3, 5; 148E.180, subdivisions 1, 2, 3, 5; 153A.17; 
1.23 	156.015; 157.15, by adding a subdivision; 157.16; 157.22; 176.011, subdivision 
1.24 	9; 245.4885, subdivision 1; 245A.03, by adding a subdivision; 245A.10, 
1.25 	subdivisions 2, 3, 4, 5, by adding subdivisions; 245A.11, subdivision 2a, by 
1.26 	adding a subdivision; 245A.16, subdivisions 1, 3; 245C.03, subdivision 2; 
1.27 	245C.04, subdivisions 1, 3; 245C.05, subdivision 4; 245C.08, subdivision 
1.28 	2; 245C.10, subdivision 3, by adding subdivisions; 245C.17, by adding a 
1.29 	subdivision; 245C.20; 245C.21, subdivision 1a; 245C.23, subdivision 2; 246.50, 
1.30 	subdivision 5, by adding subdivisions; 246.51, by adding subdivisions; 246.511; 
1.31 	246.52; 246B.01, by adding subdivisions; 252.46, by adding a subdivision; 
1.32 	252.50, subdivision 1; 254A.02, by adding a subdivision; 254A.16, by adding 
1.33 	a subdivision; 254B.03, subdivisions 1, 3, by adding a subdivision; 254B.05, 
1.34 	subdivision 1; 254B.09, subdivision 2; 256.01, subdivision 2b, by adding 
1.35 	subdivisions; 256.476, subdivisions 5, 11; 256.962, subdivisions 2, 6; 256.963, 
1.36 	by adding a subdivision; 256.969, subdivision 3a; 256.975, subdivision 7; 
1.37 	256B.04, subdivision 16; 256B.055, subdivisions 7, 12; 256B.056, subdivisions 
1.38 	3, 3b, 3c, by adding a subdivision; 256B.057, subdivisions 3, 9, by adding a 
1.39 	subdivision; 256B.0575; 256B.0595, subdivisions 1, 2; 256B.06, subdivisions 
2.1 	4, 5; 256B.0621, subdivision 2; 256B.0625, subdivisions 3c, 7, 8, 8a, 9, 13e, 
2.2 	17, 19a, 19c, 26, 41, 47; 256B.0631, subdivision 1; 256B.0651; 256B.0652; 
2.3 	256B.0653; 256B.0654; 256B.0655, subdivisions 1b, 4; 256B.0657, subdivisions 
2.4 	2, 6, 8, by adding a subdivision; 256B.08, by adding a subdivision; 256B.0911, 
2.5 	subdivisions 1, 1a, 3, 3a, 4a, 5, 6, 7, by adding subdivisions; 256B.0913, 
2.6 	subdivision 4; 256B.0915, subdivisions 3e, 3h, 5, by adding a subdivision; 
2.7 	256B.0916, subdivision 2; 256B.0917, by adding a subdivision; 256B.092, 
2.8 	subdivision 8a, by adding subdivisions; 256B.0944, by adding a subdivision; 
2.9 	256B.0945, subdivision 4; 256B.0947, subdivision 1; 256B.15, subdivisions 
2.10 	1, 1a, 1h, 2, by adding subdivisions; 256B.37, subdivisions 1, 5; 256B.437, 
2.11 	subdivision 6; 256B.441, subdivisions 48, 55, by adding subdivisions; 256B.49, 
2.12 	subdivisions 12, 13, 14, 17, by adding subdivisions; 256B.501, subdivision 4a; 
2.13 	256B.5011, subdivision 2; 256B.5012, by adding a subdivision; 256B.5013, 
2.14 	subdivision 1; 256B.69, subdivisions 5a, 5c, 5f; 256B.76, subdivisions 1, 4, by 
2.15 	adding a subdivision; 256B.761; 256D.03, subdivision 4; 256D.051, subdivision 
2.16 	2a; 256D.0515; 256D.06, subdivision 2; 256D.09, subdivision 6; 256D.44, 
2.17 	subdivision 5; 256D.49, subdivision 3; 256G.02, subdivision 6; 256I.03, 
2.18 	subdivision 7; 256I.05, subdivisions 1a, 7c; 256J.20, subdivision 3; 256J.24, 
2.19 	subdivisions 5a, 10; 256J.37, subdivision 3a, by adding a subdivision; 256J.38, 
2.20 	subdivision 1; 256J.45, subdivision 3; 256J.575, subdivisions 3, 6, 7; 256J.621; 
2.21 	256J.626, subdivision 6; 256J.751, by adding a subdivision; 256J.95, subdivision 
2.22 	12; 256L.04, subdivision 10a, by adding a subdivision; 256L.05, subdivision 1, 
2.23 	by adding subdivisions; 256L.11, subdivisions 1, 7; 256L.12, subdivision 9; 
2.24 	256L.17, subdivision 3; 259.89, subdivision 1; 260C.317, subdivision 4; 327.14, 
2.25 	by adding a subdivision; 327.15; 327.16; 327.20, subdivision 1, by adding a 
2.26 	subdivision; 393.07, subdivision 10; 501B.89, by adding a subdivision; 518A.53, 
2.27 	subdivisions 1, 4, 10; 519.05; 604A.33, subdivision 1; 609.232, subdivision 11; 
2.28 	626.556, subdivision 3c; 626.5572, subdivisions 6, 13, 21; Laws 2003, First 
2.29 	Special Session chapter 14, article 13C, section 2, subdivision 1, as amended; 
2.30 	Laws 2007, chapter 147, article 19, section 3, subdivision 4, as amended; 
2.31 	proposing coding for new law in Minnesota Statutes, chapters 62Q; 144; 156; 
2.32 	246B; 254B; 256; 256B; proposing coding for new law as Minnesota Statutes, 
2.33 	chapter 402A; repealing Minnesota Statutes 2008, sections 62U.08; 103I.112; 
2.34 	144.9501, subdivision 17b; 148D.180, subdivision 8; 246.51, subdivision 1; 
2.35 	246.53, subdivision 3; 256.962, subdivision 7; 256B.0655, subdivisions 1, 1a, 
2.36 	1c, 1d, 1e, 1f, 1g, 1h, 1i, 2, 3, 5, 6, 7, 8, 9, 10, 11, 12, 13; 256B.071, subdivisions 
2.37 	1, 2, 3, 4; 256B.092, subdivision 5a; 256B.19, subdivision 1d; 256B.431, 
2.38 	subdivision 23; 256D.46; 256I.06, subdivision 9; 256J.626, subdivision 7; 
2.39 	259.83, subdivision 3; 259.89, subdivisions 2, 3, 4; 327.14, subdivisions 5, 6; 
2.40 	Laws 1988, chapter 689, section 251; Minnesota Rules, parts 4626.2015, subpart 
2.41 	9; 9100.0400, subparts 1, 3; 9100.0500; 9100.0600; 9500.1243, subpart 3; 
2.42 	9500.1261, subparts 3, 4, 5, 6; 9555.6125, subpart 4, item B.
2.43 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

2.44 	ARTICLE 1
2.45 	LICENSING

2.46 	Section 1. Minnesota Statutes 2008, section 245A.10, subdivision 2, is amended to 
2.47 	read:
2.48 		Subd. 2.County fees for background studies and licensing inspections. (a) For 
2.49 	purposes of family and group family child care licensing under this chapter, a county 
2.50 	agency may charge a fee to an applicant or license holder to recover the actual cost of 
3.1 	background studies, but in any case not to exceed $100 annually. A county agency may 
3.2 	also charge a license fee to an applicant or license holder not to exceed $50 for a one-year 
3.3 	license or $100 for a two-year license.
3.4 	(b) A county agency may charge a fee to a legal nonlicensed child care provider or 
3.5 	applicant for authorization to recover the actual cost of background studies completed 
3.6 	under section 119B.125, but in any case not to exceed $100 annually. 
3.7 	(c) Counties may elect to reduce or waive the fees in paragraph (a) or (b):
3.8 	(1) in cases of financial hardship;
3.9 	(2)  if the county has a shortage of providers in the county's area;
3.10 	(3) for new providers; or
3.11 	(4) for providers who have attained at least 16 hours of training before seeking 
3.12 	initial licensure.
3.13 	(d) Counties may allow providers to pay the applicant fees in paragraph (a) or (b) on 
3.14 	an installment basis for up to one year. If the provider is receiving child care assistance 
3.15 	payments from the state, the provider may have the fees under paragraph (a) or (b) 
3.16 	deducted from the child care assistance payments for up to one year and the state shall 
3.17 	reimburse the county for the county fees collected in this manner.
3.18 	(e) For purposes of adult foster care and child foster care licensing under this 
3.19 	chapter, a county agency may charge a fee to a corporate applicant or corporate license 
3.20 	holder to recover the actual cost of background studies. A county agency may also charge 
3.21 	a fee to a corporate applicant or corporate license holder to recover the actual cost of 
3.22 	licensing inspections, not to exceed $500 annually.
3.23 	(f) Counties may elect to reduce or waive the fees in paragraph (e) under the 
3.24 	following circumstances: 
3.25 	(1) in cases of financial hardship; 
3.26 	(2) if the county has a shortage of providers in the county's area; or
3.27 	(3) for new providers.

3.28 	Sec. 2. Minnesota Statutes 2008, section 245A.10, subdivision 3, is amended to read:
3.29 		Subd. 3.Application fee for initial license or certification. (a) For fees required 
3.30 	under subdivision 1, an applicant for an initial license or certification issued by the 
3.31 	commissioner shall submit a $500 $750 application fee with each new application required 
3.32 	under this subdivision. The application fee shall not be prorated, is nonrefundable, and 
3.33 	is in lieu of the annual license or certification fee that expires on December 31. The 
3.34 	commissioner shall not process an application until the application fee is paid.
4.1 	(b) Except as provided in clauses (1) to (3), an applicant shall apply for a license 
4.2 	to provide services at a specific location.
4.3 	(1) For a license to provide waivered residential-based habilitation services to 
4.4 	persons with developmental disabilities or related conditions under chapter 245B, an 
4.5 	applicant shall submit an application for each county in which the waivered services will 
4.6 	be provided. Upon licensure, the license holder may provide services to persons in that 
4.7 	county plus no more than three persons at any one time in each of up to ten additional 
4.8 	counties. A license holder in one county may not provide services under the home and 
4.9 	community-based waiver for persons with developmental disabilities to more than three 
4.10 	people in a second county without holding a separate license for that second county. 
4.11 	Applicants or licensees providing services under this clause to not more than three persons 
4.12 	remain subject to the inspection fees established in section 245A.10, subdivision 2, for 
4.13 	each location.
4.14 	(2) For a license to provide supported employment, crisis respite, or 
4.15 	semi-independent living services to persons with developmental disabilities or related 
4.16 	conditions under chapter 245B, an applicant shall submit a single application to provide 
4.17 	services statewide.
4.18 	(3) For a license to provide independent living assistance for youth under section 
4.19 	245A.22, an applicant shall submit a single application to provide services statewide. 

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

4.24
4.25
4.26
4.27		Licensed Capacity
	Child Care Center
License Fee Fiscal Year 
2010
	Other Program
License FeeFiscal 
Year 2011 and 
thereafter
	
4.28		1 to 24 persons
	$225 $295
		$400 $360
	
4.29		25 to 49 persons
	$340 $410
		$600 $475
	
4.30		50 to 74 persons
	$450 $520
		$800 $585
	
4.31		75 to 99 persons
	$565 $635
		$1,000 $700
	
4.32		100 to 124 persons
	$675 $745
		$1,200 $810
	
4.33		125 to 149 persons
	$900 $970
		$1,400$1,035
	
4.34
4.35		150 to 174 persons
	$1,050
 $1,120
		$1,600 $1,185
	
4.36
4.37		175 to 199 persons
	$1,200
 $1,270
		$1,800 $1,335
	
5.1
5.2		200 to 224 persons
	$1,350
 $1,420
		$2,000 $1,485
	
5.3
5.4		225 or more persons
	$1,500
 $1,570
		$2,500 $1,635
	
5.5 	(b) A day training and habilitation program serving persons with developmental 
5.6 	disabilities or related conditions shall be assessed a license fee based on the schedule in 
5.7 	paragraph (a) unless the license holder serves more than 50 percent of the same persons 
5.8 	at two or more locations in the community. Except as provided in paragraph (c), when a 
5.9 	day training and habilitation program serves more than 50 percent of the same persons in 
5.10 	two or more locations in a community, the day training and habilitation program shall pay 
5.11 	a license fee based on the licensed capacity of the largest facility and the other facility 
5.12 	or facilities shall be charged a license fee based on a licensed capacity of a residential 
5.13 	program serving one to 24 persons. 
5.14 	(c) When a day training and habilitation program serving persons with developmental 
5.15 	disabilities or related conditions seeks a single license allowed under section 245B.07, 
5.16 	subdivision 12, clause (2) or (3), the licensing fee must be based on the combined licensed 
5.17 	capacity for each location. 

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

5.23
5.24		Licensed Capacity
	License Fee Fiscal 
Year 2010
	License Fee Fiscal Year 
2011 and thereafter

5.25		1 to 24 persons
	$930
	$1,460
	
5.26		25 to 49 persons
	$1,130
	$1,660
	
5.27		50 to 74 persons
	$1,330
	$1,860
	
5.28		75 to 99 persons
	$1,530
	$2,060
	
5.29		100 or more persons
	$1,730
	$2,260

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

6.1
6.2		Licensed Capacity
	License Fee Fiscal 
Year 2010
	License Fee Fiscal Year 
2011 and thereafter

6.3		1 to 24 persons
	$925
	$1,430
	
6.4		25 to 49 persons
	$1,125
	$1,630
	
6.5		50 to 74 persons
	$1,325
	$1,830
	
6.6		75 to 99 persons
	$1,525
	$2,030
	
6.7		100 to 124 persons
	$1,725
	$2,230
	
6.8		125 to 149 persons
	$1,925
	$2,430
	
6.9		150 to 174 persons
	$2,125
	$2,630
	
6.10		175 to 199 persons
	$2,325
	$2,830
	
6.11		200 to 224 persons
	$2,525
	$3,030
	
6.12		225 or more persons
	$3,025
	$3,530
	
6.13 	(b) A day training and habilitation program licensed under chapter 245B must 
6.14 	be assessed a license fee based on the schedule in paragraph (a) unless the license 
6.15 	holder serves more than 50 percent of the same persons at two or more locations in the 
6.16 	community. Except as provided in paragraph (c), when a day training and habilitation 
6.17 	program serves more than 50 percent of the same persons in two or more locations in a 
6.18 	community, the day training and habilitation program shall pay a license fee based on the 
6.19 	licensed capacity of the largest facility and the other facility or facilities must be charged a 
6.20 	license fee based on a licensed capacity of a residential program serving one to 24 persons.
6.21 	(c) When a day training and habilitation program serving persons with developmental 
6.22 	disabilities seeks a single license allowed under section 245B.07, subdivision 12, clause (2) 
6.23 	or (3), the licensing fee must be based on the combined licensed capacity for each location.

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

6.30
6.31		Licensed Capacity
	License Fee Fiscal 
Year 2010
	License Fee Fiscal Year 
2011 and thereafter

6.32		1 to 24 persons
	$1,000
	$1,600
	
6.33		25 to 49 persons
	$1,200
	$1,800
	
6.34		50 to 74 persons
	$1,400
	$2,000
	
6.35		75 or more persons
	$1,600
	$2,200

7.1 	Sec. 7. Minnesota Statutes 2008, section 245A.10, is amended by adding a subdivision 
7.2 	to read:
7.3 		Subd. 4d.License fee for program providing crisis respite. (a) In fiscal year 
7.4 	2010, a program licensed to provide crisis respite services for persons with developmental 
7.5 	disabilities under chapter 245B shall pay an annual nonrefundable license fee of $1,600.
7.6 	(b) In fiscal year 2011 and thereafter, a program licensed to provide crisis respite 
7.7 	services for persons with developmental disabilities under chapter 245B shall pay an 
7.8 	annual nonrefundable license fee of $2,000.

7.9 	Sec. 8. Minnesota Statutes 2008, section 245A.10, is amended by adding a subdivision 
7.10 	to read:
7.11 		Subd. 4e.License fee for program providing residential-based habilitation 
7.12 	services. (a) In fiscal year 2010, a program licensed to provide residential-based 
7.13 	habilitation services for persons with developmental disabilities under chapter 245B 
7.14 	shall pay an annual nonrefundable license fee that is based on a base rate of $715 plus 
7.15 	$50 times the number of clients served on the first day of August of the current license 
7.16 	year. State-operated programs are exempt from the license fee under this paragraph and 
7.17 	paragraph (b).
7.18 	(b) In fiscal year 2011 and thereafter, a program licensed to provide residential-based 
7.19 	habilitation services for persons with developmental disabilities under chapter 245B shall 
7.20 	pay an annual nonrefundable license fee that is based on a base rate of $1,000 plus $70 
7.21 	times the number of clients served on the first day of August of the current license year.

7.22 	Sec. 9. Minnesota Statutes 2008, section 245A.10, is amended by adding a subdivision 
7.23 	to read:
7.24 		Subd. 4f.License fee for program providing semi-independent living services 
7.25 	or supported employment services. (a) In fiscal year 2010, a program licensed to 
7.26 	provide semi-independent living services for persons with developmental disabilities 
7.27 	under chapter 245B or supported employment services for persons with developmental 
7.28 	disabilities under chapter 245B shall pay an annual nonrefundable license fee of $1,250.
7.29 	(b) In fiscal year 2011 and thereafter, a program licensed to provide semi-independent 
7.30 	living services for persons with developmental disabilities under chapter 245B or 
7.31 	supported employment services for persons with developmental disabilities under chapter 
7.32 	245B shall pay an annual nonrefundable license fee of $2,000.

8.1 	Sec. 10. Minnesota Statutes 2008, section 245A.10, is amended by adding a 
8.2 	subdivision to read:
8.3 		Subd. 4g.License fee for residential program serving persons with physical 
8.4 	disabilities. A residential program licensed under Minnesota Rules, parts 9570.2000 to 
8.5 	9570.3400, to serve persons with physical disabilities shall pay an annual nonrefundable 
8.6 	license fee based on the following schedule:

8.7
8.8		Licensed Capacity
	License Fee Fiscal 
Year 2010
	License Fee Fiscal Year 
2011 and thereafter

8.9		1 to 24 persons
	$713
	$1,025
	
8.10		25 to 49 persons
	$913
	$1,225
	
8.11		50 to 74 persons
	$1,113
	$1,425
	
8.12		75 to 99 persons
	$1,313
	$1,625
	
8.13		100 to 124 persons
	$1,513
	$1,825
	
8.14		125 or more persons
	$1,713
	$2,025

8.15 	Sec. 11. Minnesota Statutes 2008, section 245A.10, is amended by adding a 
8.16 	subdivision to read:
8.17 		Subd. 4h.License fee for residential programs serving adults with mental 
8.18 	illness. (a) In fiscal year 2010, a residential program licensed under Minnesota Rules, 
8.19 	parts 9520.0500 to 9520.0670, to serve adults with mental illness shall pay an annual 
8.20 	nonrefundable license fee of $2,450.
8.21 	(b) In fiscal year 2011 and thereafter, a residential program licensed under Minnesota 
8.22 	Rules, parts 9520.0500 to 9520.0670, to serve adults with mental illness shall pay an 
8.23 	annual nonrefundable license fee of $4,400.

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

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

9.3
9.4		Licensed Capacity
	License Fee Fiscal 
Year 2010
	License Fee Fiscal Year 
2011 and thereafter

9.5		1 to 24 persons
	$755
	$1,035
	
9.6		25 to 49 persons
	$955
	$1,235
	
9.7		50 to 74 persons
	$1,155
	$1,435
	
9.8		75 to 99 persons
	$1,355
	$1,635
	
9.9		100 to 124 persons
	$1,555
	$1,835
	
9.10		125 or more persons
	$1,755
	$2,035
	
9.11 	(b) In fiscal year 2010, if a license issued to a program under Minnesota Rules, parts 
9.12 	9530.6405 to 9530.6505, does not have a stated licensed capacity, the drug or chemical 
9.13 	dependency treatment program shall pay an annual nonrefundable license fee based on a 
9.14 	licensed capacity of one to 24 persons for fiscal year 2010.
9.15 	(c) In fiscal year 2011 and thereafter, if a license issued to a program under Minnesota 
9.16 	Rules, parts 9530.6405 to 9530.6505, does not have a stated licensed capacity, the drug or 
9.17 	chemical dependency treatment program shall pay an annual nonrefundable license fee 
9.18 	based on a licensed capacity of one to 24 persons for fiscal year 2011 and thereafter.

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

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

9.30 	Sec. 16. Minnesota Statutes 2008, section 245A.10, subdivision 5, is amended to read:
9.31 		Subd. 5.License or Mental health center or mental health clinic certification fee 
9.32 	for other programs. (a) Except as provided in paragraphs (b) and (c), a program without 
9.33 	a stated licensed capacity shall pay a license or certification fee of $400.
10.1 	(b) A mental health center or mental health clinic requesting certification for 
10.2 	purposes of insurance and subscriber contract reimbursement under Minnesota Rules, 
10.3 	parts 9520.0750 to 9520.0870, shall pay a certification fee of $1,000 per year. If the 
10.4 	mental health center or mental health clinic provides services at a primary location with 
10.5 	satellite facilities, the satellite facilities shall be certified with the primary location without 
10.6 	an additional charge.
10.7 	(c) A program licensed to provide residential-based habilitation services under the 
10.8 	home and community-based waiver for persons with developmental disabilities shall pay 
10.9 	an annual license fee that includes a base rate of $250 plus $38 times the number of clients 
10.10 	served on the first day of August of the current license year. State-operated programs are 
10.11 	exempt from the license fee under this paragraph.

10.12 	Sec. 17. Minnesota Statutes 2008, section 245A.10, is amended by adding a 
10.13 	subdivision to read:
10.14 		Subd. 7.Human services licensing revenue and appropriations. Effective July 
10.15 	1, 2011:
10.16 	(1) departmental earnings collected under subdivisions 3, 4 to 4l, and 5 shall be 
10.17 	deposited in the state government special revenue fund; and
10.18 	(2) the direct appropriation to the department for licensing activities in subdivisions 
10.19 	3, 4 to 4l, and 5 shall be transferred from the general fund to the state government special 
10.20 	revenue fund.

10.21 	Sec. 18. Minnesota Statutes 2008, section 245A.11, subdivision 2a, is amended to read:
10.22 		Subd. 2a.Adult foster care license capacity. The commissioner shall issue adult 
10.23 	foster care licenses with a maximum licensed capacity of four beds, including nonstaff 
10.24 	roomers and boarders, except that the commissioner may issue a license with a capacity of 
10.25 	five beds, including roomers and boarders, according to paragraphs (a) to (e).
10.26 	(a) An adult foster care license holder may have a maximum license capacity of five 
10.27 	if all persons in care are age 55 or over and do not have a serious and persistent mental 
10.28 	illness or a developmental disability.
10.29 	(b) The commissioner may grant variances to paragraph (a) to allow a foster care 
10.30 	provider with a licensed capacity of five persons to admit an individual under the age of 55 
10.31 	if the variance complies with section 245A.04, subdivision 9, and approval of the variance 
10.32 	is recommended by the county in which the licensed foster care provider is located.  
10.33 	(c) The commissioner may grant variances to paragraph (a) to allow the use of a fifth 
10.34 	bed for emergency crisis services for a person with serious and persistent mental illness 
11.1 	or a developmental disability, regardless of age, if the variance complies with section 
11.2 	245A.04, subdivision 9, and approval of the variance is recommended by the county in 
11.3 	which the licensed foster care provider is located.  
11.4 	(d) Notwithstanding paragraph (a),If the 2009 legislature adopts a rate reduction 
11.5 	that impacts providers of adult foster care services, the commissioner may issue an adult 
11.6 	foster care license with a capacity of five adults if the fifth bed does not increase the 
11.7 	overall statewide capacity of licensed adult foster care beds in homes that are not the 
11.8 	primary residence of the license holder, over the licensed capacity in such homes on July 
11.9 	1, 2009, as identified in a plan submitted to the commissioner by the county, when the 
11.10 	capacity is recommended by the county licensing agency of the county in which the 
11.11 	facility is located and if the recommendation verifies that:
11.12 	(1) the facility meets the physical environment requirements in the adult foster 
11.13 	care licensing rule;
11.14 	(2) the five-bed living arrangement is specified for each resident in the resident's:
11.15 	(i) individualized plan of care;
11.16 	(ii) individual service plan under section 256B.092, subdivision 1b, if required; or  
11.17 	(iii) individual resident placement agreement under Minnesota Rules, part 
11.18 	9555.5105, subpart 19, if required;
11.19 	(3) the license holder obtains written and signed informed consent from each 
11.20 	resident or resident's legal representative documenting the resident's informed choice to 
11.21 	living in the home and that the resident's refusal to consent would not have resulted in 
11.22 	service termination; and
11.23 	(4) the facility was licensed for adult foster care before March 1, 2003 2009.
11.24 	(e) The commissioner shall not issue a new adult foster care license under paragraph 
11.25 	(d) after June 30, 2005 2011. The commissioner shall allow a facility with an adult foster 
11.26 	care license issued under paragraph (d) before June 30, 2005 2011, to continue with a 
11.27 	capacity of five adults if the license holder continues to comply with the requirements in 
11.28 	paragraph (d).

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

11.30 	Sec. 19. Minnesota Statutes 2008, section 245A.11, is amended by adding a 
11.31 	subdivision to read:
11.32 		Subd. 8.Alternate overnight supervision technology; adult foster care license.
 11.33 	(a) The commissioner may grant an applicant or license holder an adult foster care license 
11.34 	for a residence that does not have a caregiver in the residence during normal sleeping 
11.35 	hours as required under Minnesota Rules, part 9555.5105, subpart 37, item B, but uses 
12.1 	monitoring technology to alert the license holder when an incident occurs that may 
12.2 	jeopardize the health, safety, or rights of a foster care recipient. The applicant or license 
12.3 	holder must comply with all other requirements under Minnesota Rules, parts 9555.5105 
12.4 	to 9555.6265, and the requirements under this subdivision. The license printed by the 
12.5 	commissioner must state in bold and large font:
12.6 	(1) that staff are not present on-site overnight; and
12.7 	(2) the telephone number of the county's common entry point for making reports of 
12.8 	suspected maltreatment of vulnerable adults under section 626.557, subdivision 9.
12.9 	(b) Applications for a license under this section must be submitted directly to 
12.10 	the Department of Human Services licensing division. The licensing division must 
12.11 	immediately notify the host county and lead county contract agency and the host county 
12.12 	licensing agency. The licensing division must collaborate with the county licensing 
12.13 	agency in the review of the application and the licensing of the program.
12.14 	(c) Before a license is issued by the commissioner, and for the duration of the license, 
12.15 	the applicant or license holder must establish, maintain, and document the implementation 
12.16 	of written policies and procedures addressing the requirements in paragraphs (d) to (f).
12.17 	(d) The applicant or license holder must have policies and procedures that:
12.18 	(1) establish characteristics of target populations that will be admitted into the home 
12.19 	and characteristics of populations that will not be accepted into the home;
12.20 	(2) explain the discharge process when a foster care recipient requires overnight 
12.21 	supervision or other services that cannot be provided by the license holder due to the 
12.22 	limited hours that the license holder is on-site;
12.23 	(3) describe the types of events to which the program will respond with a physical 
12.24 	presence when those events occur in the home during time when staff are not on-site, and 
12.25 	how the license holder's response plan meets the requirements in paragraph (e), clause 
12.26 	(1) or (2);
12.27 	(4) establish a process for documenting a review of the implementation and 
12.28 	effectiveness of the response protocol for the response required under paragraph (e), 
12.29 	clause (1) or (2). The documentation must include:
12.30 	(i) a description of the triggering incident;
12.31 	(ii) the date and time of the triggering incident;
12.32 	(iii) the time of the response or responses under paragraph (e), clause (1) or (2);
12.33 	(iv) whether the response met the resident's needs;
12.34 	(v) whether the existing policies and response protocols were followed; and
12.35 	(vi) whether the existing policies and protocols are adequate or need modification.
13.1 	When no physical presence response is completed for a three-month period, the 
13.2 	license holder's written policies and procedures must require a physical presence response 
13.3 	drill be to conducted for which the effectiveness of the response protocol under paragraph 
13.4 	(e), clause (1) or (2), will be reviewed and documented as required under this clause; and
13.5 	(5) establish that emergency and nonemergency phone numbers are posted in a 
13.6 	prominent location in a common area of the home where they can be easily observed by a 
13.7 	person responding to an incident who is not otherwise affiliated with the home.
13.8 	(e) The license holder must document and include in the license application which 
13.9 	response alternative under clause (1) or (2) is in place for responding to situations that 
13.10 	present a serious risk to the health, safety, or rights of people receiving foster care services 
13.11 	in the home:
13.12 	(1) response alternative (1) requires only the technology to provide an electronic 
13.13 	notification or alert to the license holder that an event is underway that requires a response. 
13.14 	Under this alternative, no more than ten minutes will pass before the license holder will be 
13.15 	physically present on-site to respond to the situation; or
13.16 	(2) response alternative (2) requires the electronic notification and alert system 
13.17 	under alternative (1), but more than ten minutes may pass before the license holder is 
13.18 	present on-site to respond to the situation. Under alternative (2), all of the following 
13.19 	conditions are met:
13.20 	(i) the license holder has a written description of the interactive technological 
13.21 	applications that will assist the licenser holder in communicating with and assessing the 
13.22 	needs related to care, health, and safety of the foster care recipients. This interactive 
13.23 	technology must permit the license holder to remotely assess the well being of the foster 
13.24 	care recipient without requiring the initiation or participation by the foster care recipient. 
13.25 	Requiring the foster care recipient to initiate a telephone call or answer a telephone call 
13.26 	does not meet this requirement;
13.27 	(ii) the license holder documents how the remote license holder is qualified and 
13.28 	capable of meeting the needs of the foster care recipients and assessing foster care 
13.29 	recipients' needs under item (i), during the absence of the license holder on-site;
13.30 	(iii) the license holder maintains written procedures to dispatch emergency response 
13.31 	personnel to the site in the event of an identified emergency; and
13.32 	(iv) each foster care recipient's individualized plan of care, individual service plan 
13.33 	under section 256B.092, subdivision 1b, if required, or individual resident placement 
13.34 	agreement under Minnesota Rules, part 9555.5105, subpart 19, if required, identifies the 
13.35 	maximum response time, which may be greater than ten minutes, for the license holder 
13.36 	to be on-site for that foster care recipient.
14.1 	(f) All placement agreements, individual service agreements, and plans applicable 
14.2 	to the foster care recipient must clearly state that the adult foster care license category is 
14.3 	a program without the presence of a caregiver in the residence during normal sleeping 
14.4 	hours; the protocols in place for responding to situations that present a serious risk to 
14.5 	health, safety, or rights of foster care recipients under paragraph (e), clause (1) or (2); and a 
14.6 	signed informed consent from each foster care recipient or the person's legal representative 
14.7 	documenting the person's or legal representative's agreement with placement in the 
14.8 	program. If electronic monitoring technology is used in the home, the informed consent 
14.9 	form must also explain the following:
14.10 	(1) how any electronic monitoring is incorporated into the alternative supervision 
14.11 	system;
14.12 	(2) the backup system for any electronic monitoring in times of electrical outages or 
14.13 	other equipment malfunctions;
14.14 	(3) how the license holder is trained on the use of the technology;
14.15 	(4) the event types and license holder response times established under paragraph (e);
14.16 	(5) how the license holder protects the foster care recipient's privacy related to 
14.17 	electronic monitoring and related to any electronically recorded data generated by the 
14.18 	monitoring system. The consent form must explain where and how the electronically 
14.19 	recorded data is stored, with whom it will be shared, and how long it is retained; and
14.20 	(6) the risks and benefits of the alternative overnight supervision system. 
14.21 	The written explanations under clauses (1) to (6) may be accomplished through 
14.22 	cross-references to other policies and procedures as long as they are explained to the 
14.23 	person giving consent, and the person giving consent is offered a copy.
14.24 	(g) Nothing in this section requires the applicant or license holder to develop or 
14.25 	maintain separate or duplicative policies, procedures, documentation, consent forms, or 
14.26 	individual plans that may be required for other licensing standards, if the requirements of 
14.27 	this section are incorporated into those documents.
14.28 	(h) The commissioner may grant variances to the requirements of this section 
14.29 	according to section 245A.04, subdivision 9.
14.30 	(i) For the purposes of paragraphs (c) to (h), "license holder" has the meaning 
14.31 	under section 245A.02, subdivision 9, and additionally includes all staff, volunteers, and 
14.32 	contractors affiliated with the license holder.

14.33 	Sec. 20. Minnesota Statutes 2008, section 245A.16, subdivision 1, is amended to read:
14.34 		Subdivision 1.Delegation of authority to agencies. (a) County agencies and 
14.35 	private agencies that have been designated or licensed by the commissioner to perform 
15.1 	licensing functions and activities under section 245A.04 and background studies for 
15.2 	adult foster care, family adult day services, and family child care, under chapter 245C; to 
15.3 	recommend denial of applicants under section 245A.05; to issue correction orders, to issue 
15.4 	variances, and recommend a conditional license under section 245A.06, or to recommend 
15.5 	suspending or revoking a license or issuing a fine under section 245A.07, shall comply 
15.6 	with rules and directives of the commissioner governing those functions and with this 
15.7 	section. The following variances are excluded from the delegation of variance authority 
15.8 	and may be issued only by the commissioner:
15.9 	(1) dual licensure of family child care and child foster care, dual licensure of child 
15.10 	and adult foster care, and adult foster care and family child care;
15.11 	(2) adult foster care maximum capacity;
15.12 	(3) adult foster care minimum age requirement;
15.13 	(4) child foster care maximum age requirement;
15.14 	(5) variances regarding disqualified individuals except that county agencies may 
15.15 	issue variances under section 245C.30 regarding disqualified individuals when the county 
15.16 	is responsible for conducting a consolidated reconsideration according to sections 245C.25
15.17 	and 245C.27, subdivision 2, clauses (a) and (b), of a county maltreatment determination 
15.18 	and a disqualification based on serious or recurring maltreatment; and
15.19 	(6) the required presence of a caregiver in the adult foster care residence during 
15.20 	normal sleeping hours.
15.21 	(b) County agencies must report information about disqualification reconsiderations 
15.22 	under sections 245C.25 and 245C.27, subdivision 2, paragraphs (a) and (b), and variances 
15.23 	granted under paragraph (a), clause (5), to the commissioner at least monthly in a format 
15.24 	prescribed by the commissioner.
15.25 	(c) For family day care programs, the commissioner may authorize licensing reviews 
15.26 	every two years after a licensee has had at least one annual review.
15.27 	(d) For family adult day services programs, the commissioner may authorize 
15.28 	licensing reviews every two years after a licensee has had at least one annual review.
15.29 	(e) A license issued under this section may be issued for up to two years.

15.30 	Sec. 21. Minnesota Statutes 2008, section 245A.16, subdivision 3, is amended to read:
15.31 		Subd. 3.Recommendations to commissioner. The county or private agency 
15.32 	shall not make recommendations to the commissioner regarding licensure without first 
15.33 	conducting an inspection, and for adult foster care, family adult day services, and family 
15.34 	child care, a background study of the applicant under chapter 245C. The county or private 
16.1 	agency must forward its recommendation to the commissioner regarding the appropriate 
16.2 	licensing action within 20 working days of receipt of a completed application.

16.3 	Sec. 22. Minnesota Statutes 2008, section 245C.04, subdivision 1, is amended to read:
16.4 		Subdivision 1.Licensed programs. (a) The commissioner shall conduct a 
16.5 	background study of an individual required to be studied under section 245C.03, 
16.6 	subdivision 1, at least upon application for initial license for all license types. 
16.7 	(b) The commissioner shall conduct a background study of an individual required to 
16.8 	be studied under section 245C.03, subdivision 1, at reapplication for a license for adult 
16.9 	foster care, family adult day services, and family child care. 
16.10 	(c) The commissioner is not required to conduct a study of an individual at the time 
16.11 	of reapplication for a license if the individual's background study was completed by the 
16.12 	commissioner of human services for an adult foster care license holder that is also:
16.13 	(1) registered under chapter 144D; or
16.14 	(2) licensed to provide home and community-based services to people with 
16.15 	disabilities at the foster care location and the license holder does not reside in the foster 
16.16 	care residence; and
16.17 	(3) the following conditions are met:
16.18 	(i) a study of the individual was conducted either at the time of initial licensure or 
16.19 	when the individual became affiliated with the license holder;
16.20 	(ii) the individual has been continuously affiliated with the license holder since 
16.21 	the last study was conducted; and
16.22 	(iii) the last study of the individual was conducted on or after October 1, 1995.
16.23 	(d) From July 1, 2007, to June 30, 2009, the commissioner of human services shall 
16.24 	conduct a study of an individual required to be studied under section 245C.03, at the 
16.25 	time of reapplication for a child foster care license. The county or private agency shall 
16.26 	collect and forward to the commissioner the information required under section 245C.05, 
16.27 	subdivisions 1, paragraphs (a) and (b), and 5, paragraphs (a) and (b). The background 
16.28 	study conducted by the commissioner of human services under this paragraph must 
16.29 	include a review of the information required under section 245C.08, subdivisions 1, 
16.30 	paragraph (a), clauses (1) to (5), 3, and 4.
16.31 	(e) The commissioner of human services shall conduct a background study of an 
16.32 	individual specified under section 245C.03, subdivision 1, paragraph (a), clauses (2) 
16.33 	to (6), who is newly affiliated with a child foster care license holder. The county or 
16.34 	private agency shall collect and forward to the commissioner the information required 
16.35 	under section 245C.05, subdivisions 1 and 5. The background study conducted by the 
17.1 	commissioner of human services under this paragraph must include a review of the 
17.2 	information required under section 245C.08, subdivisions 1, 3, and 4.
17.3 	(f) From January 1, 2010, to December 31, 2012, unless otherwise specified in 
17.4 	paragraph (c), the commissioner shall conduct a study of an individual required to be 
17.5 	studied under section 245C.03 at the time of reapplication for an adult foster care license. 
17.6 	The county shall collect and forward to the commissioner the information required under 
17.7 	section 245C.05, subdivision 1, paragraphs (a) and (b), and subdivision 5, paragraphs (a) 
17.8 	and (b). The background study conducted by the commissioner under this paragraph 
17.9 	must include a review of the information required under section 245C.08, subdivision 1, 
17.10 	paragraph (a), clauses (1) to (5), and subdivisions 3 and 4.
17.11 	(g) The commissioner shall conduct a background study of an individual specified 
17.12 	under section 245C.03, subdivision 1, paragraph (a), clauses (2) to (6), who is newly 
17.13 	affiliated with an adult foster care license holder. The county shall collect and forward 
17.14 	to the commissioner the information required under section 245C.05, subdivision 1, 
17.15 	paragraphs (a) and (b), and subdivision 5, paragraphs (a) and (b). The background 
17.16 	study conducted by the commissioner under this paragraph must include a review of 
17.17 	the information required under section 245C.08, subdivision 1, paragraph (a), and 
17.18 	subdivisions 3 and 4.
17.19 	 (h) Applicants for licensure, license holders, and other entities as provided in this 
17.20 	chapter must submit completed background study forms to the commissioner before 
17.21 	individuals specified in section 245C.03, subdivision 1, begin positions allowing direct 
17.22 	contact in any licensed program. 
17.23 	(g) (i)  For purposes of this section, a physician licensed under chapter 147 is 
17.24 	considered to be continuously affiliated upon the license holder's receipt from the 
17.25 	commissioner of health or human services of the physician's background study results.

17.26 	Sec. 23. Minnesota Statutes 2008, section 245C.05, subdivision 4, is amended to read:
17.27 		Subd. 4.Electronic transmission. For background studies conducted by the 
17.28 	Department of Human Services, the commissioner shall implement a system for the 
17.29 	electronic transmission of:
17.30 	(1) background study information to the commissioner; 
17.31 	(2) background study results to the license holder; and
17.32 	(3) background study results to county and private agencies for background studies 
17.33 	conducted by the commissioner for child foster care; and
17.34 	(4) background study results to county agencies for background studies conducted 
17.35 	by the commissioner for adult foster care.

18.1 	Sec. 24. Minnesota Statutes 2008, section 245C.08, subdivision 2, is amended to read:
18.2 		Subd. 2.Background studies conducted by a county agency. (a) For a background 
18.3 	study conducted by a county agency for adult foster care, family adult day services, and 
18.4 	family child care services, the commissioner shall review:
18.5 	(1) information from the county agency's record of substantiated maltreatment 
18.6 	of adults and the maltreatment of minors;
18.7 	(2) information from juvenile courts as required in subdivision 4 for individuals 
18.8 	listed in section 245C.03, subdivision 1, clauses (2), (5), and (6); and
18.9 	(3) information from the Bureau of Criminal Apprehension.
18.10 	(b) If the individual has resided in the county for less than five years, the study shall 
18.11 	include the records specified under paragraph (a) for the previous county or counties of 
18.12 	residence for the past five years.
18.13 	(c) Notwithstanding expungement by a court, the county agency may consider 
18.14 	information obtained under paragraph (a), clause (3), unless the commissioner received 
18.15 	notice of the petition for expungement and the court order for expungement is directed 
18.16 	specifically to the commissioner.

18.17 	Sec. 25. Minnesota Statutes 2008, section 245C.10, is amended by adding a 
18.18 	subdivision to read:
18.19 		Subd. 5.Adult foster care services. The commissioner shall recover the cost 
18.20 	of background studies required under section 245C.03, subdivision 1, for the purposes 
18.21 	of adult foster care licensing, through a fee of no more than $20 per study charged to 
18.22 	the license holder. The fees collected under this subdivision are appropriated to the 
18.23 	commissioner for the purpose of conducting background studies.

18.24 	Sec. 26. Minnesota Statutes 2008, section 245C.10, is amended by adding a 
18.25 	subdivision to read:
18.26 		Subd. 8.Private agencies. The commissioner shall recover the cost of conducting 
18.27 	background studies under section 245C.33 for studies initiated by private agencies for the 
18.28 	purpose of adoption through a fee of no more than $70 per study charged to the private 
18.29 	agency. The fees collected under this subdivision are appropriated to the commissioner for 
18.30 	the purpose of conducting background studies.

18.31 	Sec. 27. Minnesota Statutes 2008, section 245C.17, is amended by adding a 
18.32 	subdivision to read:
19.1 		Subd. 6.Notice to county agency. For studies on individuals related to a license to 
19.2 	provide adult foster care, the commissioner shall also provide a notice of the background 
19.3 	study results to the county agency that initiated the background study.

19.4 	Sec. 28. Minnesota Statutes 2008, section 245C.20, is amended to read:
19.5 	245C.20 LICENSE HOLDER RECORD KEEPING.
19.6 	A licensed program shall document the date the program initiates a background 
19.7 	study under this chapter in the program's personnel files. When a background study is 
19.8 	completed under this chapter, a licensed program shall maintain a notice that the study 
19.9 	was undertaken and completed in the program's personnel files. Except when background 
19.10 	studies are initiated through the commissioner's online system, if a licensed program 
19.11 	has not received a response from the commissioner under section 245C.17 within 45 
19.12 	days of initiation of the background study request, the licensed program must contact the 
19.13 	commissioner human services licensing division to inquire about the status of the study.   If 
19.14 	a license holder initiates a background study under the commissioner's online system, but 
19.15 	the background study subject's name does not appear in the list of active or recent studies 
19.16 	initiated by that license holder, the license holder must either contact the human services 
19.17 	licensing division or resubmit the background study information online for that individual.

19.18 	Sec. 29. Minnesota Statutes 2008, section 245C.21, subdivision 1a, is amended to read:
19.19 		Subd. 1a.Submission of reconsideration request to county or private agency.
 19.20 	(a) For disqualifications related to studies conducted by county agencies for family child 
19.21 	care and family adult day services, and for disqualifications related to studies conducted 
19.22 	by the commissioner for child foster care and adult foster care, the individual shall 
19.23 	submit the request for reconsideration to the county or private agency that initiated the 
19.24 	background study.
19.25 	(b) For disqualifications related to studies conducted by the commissioner for child 
19.26 	foster care, the individual shall submit the request for reconsideration to the private agency 
19.27 	that initiated the background study.
19.28 	(c) A reconsideration request shall be submitted within 30 days of the individual's 
19.29 	receipt of the disqualification notice or the time frames specified in subdivision 2, 
19.30 	whichever time frame is shorter.
19.31 	(c) (d)  The county or private agency shall forward the individual's request for 
19.32 	reconsideration and provide the commissioner with a recommendation whether to set aside 
19.33 	the individual's disqualification.

20.1 	Sec. 30. Minnesota Statutes 2008, section 245C.23, subdivision 2, is amended to read:
20.2 		Subd. 2.Commissioner's notice of disqualification that is not set aside. (a) The 
20.3 	commissioner shall notify the license holder of the disqualification and order the license 
20.4 	holder to immediately remove the individual from any position allowing direct contact 
20.5 	with persons receiving services from the license holder if:
20.6 	(1) the individual studied does not submit a timely request for reconsideration 
20.7 	under section 245C.21;
20.8 	(2) the individual submits a timely request for reconsideration, but the commissioner 
20.9 	does not set aside the disqualification for that license holder under section 245C.22;
20.10 	(3) an individual who has a right to request a hearing under sections 245C.27 and 
20.11 	256.045, or 245C.28 and chapter 14 for a disqualification that has not been set aside, does 
20.12 	not request a hearing within the specified time; or
20.13 	(4) an individual submitted a timely request for a hearing under sections 245C.27
20.14 	and 256.045, or 245C.28 and chapter 14, but the commissioner does not set aside the 
20.15 	disqualification under section 245A.08, subdivision 5, or 256.045.
20.16 	(b) If the commissioner does not set aside the disqualification under section 245C.22, 
20.17 	and the license holder was previously ordered under section 245C.17 to immediately 
20.18 	remove the disqualified individual from direct contact with persons receiving services or 
20.19 	to ensure that the individual is under continuous, direct supervision when providing direct 
20.20 	contact services, the order remains in effect pending the outcome of a hearing under 
20.21 	sections 245C.27 and 256.045, or 245C.28 and chapter 14.
20.22 	(c) For background studies related to child foster care, the commissioner shall 
20.23 	also notify the county or private agency that initiated the study of the results of the 
20.24 	reconsideration.
20.25 	(d) For background studies related to adult foster care, the commissioner shall also 
20.26 	notify the county that initiated the study of the results of the reconsideration.

20.27 	Sec. 31. Minnesota Statutes 2008, section 256B.092, is amended by adding a 
20.28 	subdivision to read:
20.29 		Subd. 5b.Revised per diem based on legislated rate reduction. Notwithstanding 
20.30 	section 252.28, subdivision 3, paragraph (d), if the 2009 legislature adopts a rate reduction 
20.31 	that impacts payment to providers of adult foster care services, the commissioner may 
20.32 	issue adult foster care licenses that permit a capacity of five adults. The application for a 
20.33 	five-bed license must meet the requirements of section 245A.11, subdivision 2a. Prior to 
20.34 	admission of the fifth recipient of adult foster care services, the county must negotiate a 
20.35 	revised per diem rate for room and board and waiver services that reflects the legislated 
21.1 	rate reduction and results in an overall average per diem reduction for all foster care 
21.2 	recipients in that home. The revised per diem must allow the provider to maintain, as 
21.3 	much as possible, the level of services or enhanced services provided in the residence, 
21.4 	while mitigating the losses of the legislated rate reduction.

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

21.6 	Sec. 32. Minnesota Statutes 2008, section 256B.49, subdivision 17, is amended to read:
21.7 		Subd. 17.Cost of services and supports. (a) The commissioner shall ensure 
21.8 	that the average per capita expenditures estimated in any fiscal year for home and 
21.9 	community-based waiver recipients does not exceed the average per capita expenditures 
21.10 	that would have been made to provide institutional services for recipients in the absence 
21.11 	of the waiver.
21.12 	(b) The commissioner shall implement on January 1, 2002, one or more aggregate, 
21.13 	need-based methods for allocating to local agencies the home and community-based 
21.14 	waivered service resources available to support recipients with disabilities in need of 
21.15 	the level of care provided in a nursing facility or a hospital. The commissioner shall 
21.16 	allocate resources to single counties and county partnerships in a manner that reflects 
21.17 	consideration of:
21.18 	(1) an incentive-based payment process for achieving outcomes;
21.19 	(2) the need for a state-level risk pool;
21.20 	(3) the need for retention of management responsibility at the state agency level; and
21.21 	(4) a phase-in strategy as appropriate.
21.22 	(c) Until the allocation methods described in paragraph (b) are implemented, the 
21.23 	annual allowable reimbursement level of home and community-based waiver services 
21.24 	shall be the greater of:
21.25 	(1) the statewide average payment amount which the recipient is assigned under the 
21.26 	waiver reimbursement system in place on June 30, 2001, modified by the percentage of 
21.27 	any provider rate increase appropriated for home and community-based services; or
21.28 	(2) an amount approved by the commissioner based on the recipient's extraordinary 
21.29 	needs that cannot be met within the current allowable reimbursement level. The 
21.30 	increased reimbursement level must be necessary to allow the recipient to be discharged 
21.31 	from an institution or to prevent imminent placement in an institution. The additional 
21.32 	reimbursement may be used to secure environmental modifications; assistive technology 
21.33 	and equipment; and increased costs for supervision, training, and support services 
21.34 	necessary to address the recipient's extraordinary needs. The commissioner may approve 
21.35 	an increased reimbursement level for up to one year of the recipient's relocation from an 
22.1 	institution or up to six months of a determination that a current waiver recipient is at 
22.2 	imminent risk of being placed in an institution.
22.3 	(d) Beginning July 1, 2001, medically necessary private duty nursing services will be 
22.4 	authorized under this section as complex and regular care according to sections 256B.0651
22.5 	and 256B.0653 to 256B.0656. The rate established by the commissioner for registered 
22.6 	nurse or licensed practical nurse services under any home and community-based waiver as 
22.7 	of January 1, 2001, shall not be reduced.
22.8 	(e) Notwithstanding section 252.28, subdivision 3, paragraph (d), if the 2009 
22.9 	legislature adopts a rate reduction that impacts payment to providers of adult foster care 
22.10 	services, the commissioner may issue adult foster care licenses that permit a capacity of 
22.11 	five adults. The application for a five-bed license must meet the requirements of section 
22.12 	245A.11, subdivision 2a. Prior to admission of the fifth recipient of adult foster care 
22.13 	services, the county must negotiate a revised per diem rate for room and board and waiver 
22.14 	services that reflects the legislated rate reduction and results in an overall average per 
22.15 	diem reduction for all foster care recipients in that home. The revised per diem must allow 
22.16 	the provider to maintain, as much as possible, the level of services or enhanced services 
22.17 	provided in the residence, while mitigating the losses of the legislated rate reduction.

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

22.19 	Sec. 33. WAIVER.
 22.20 	By December 1, 2009, the commissioner shall request all federal approvals and 
22.21 	waiver amendments to the disability home and community-based waivers to allow properly 
22.22 	licensed adult foster care homes to provide residential services for up to five individuals.

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

22.24 	Sec. 34.  REPEALER.
 22.25 	(a) Minnesota Statutes 2008, section 256B.092, subdivision 5a, is repealed effective 
22.26 	July 1, 2009.
22.27 	(b) Minnesota Rules, part 9555.6125, subpart 4, item B, is repealed.

22.28 	ARTICLE 2
22.29 	MFIP, CHILDREN, AND ADULT SUPPORTS

22.30 	Section 1. Minnesota Statutes 2008, section 256D.051, subdivision 2a, is amended to 
22.31 	read:
23.1 		Subd. 2a.Duties of commissioner. In addition to any other duties imposed by law, 
23.2 	the commissioner shall:
23.3 	(1) based on this section and section 256D.052 and Code of Federal Regulations, 
23.4 	title 7, section 273.7, supervise the administration of food stamp employment and training 
23.5 	services to county agencies; 
23.6 	(2) disburse money appropriated for food stamp employment and training services 
23.7 	to county agencies based upon the county's costs as specified in section 256D.051, 
23.8 	subdivision 6c; 
23.9 	(3) accept and supervise the disbursement of any funds that may be provided by the 
23.10 	federal government or from other sources for use in this state for food stamp employment 
23.11 	and training services;
23.12 	(4) apply for the maximum allowable federal matching funds under United States 
23.13 	Code, title 7, section 2025, paragraph (h), for state expenditures made on behalf of family 
23.14 	stabilization services participants voluntarily engaged in food stamp employment and 
23.15 	training activities, where appropriate;
23.16 	(5) cooperate with other agencies including any agency of the United States or of 
23.17 	another state in all matters concerning the powers and duties of the commissioner under 
23.18 	this section and section 256D.052; and 
23.19 	(5) (6) in cooperation with the commissioner of employment and economic 
23.20 	development, ensure that each component of an employment and training program carried 
23.21 	out under this section is delivered through a statewide workforce development system, 
23.22 	unless the component is not available locally through such a system.

23.23 	Sec. 2. Minnesota Statutes 2008, section 256D.0515, is amended to read:
23.24 	256D.0515 ASSET LIMITATIONS FOR FOOD STAMP HOUSEHOLDS.
23.25 	All food stamp households must be determined eligible for the benefit discussed 
23.26 	under section 256.029. Food stamp households must demonstrate that:
23.27 	(1) their gross income meets the federal Food Stamp requirements under United 
23.28 	States Code, title 7, section 2014(c); and
23.29 	(2) they have financial resources, excluding vehicles, of less than $7,000.

23.30 	Sec. 3. Minnesota Statutes 2008, section 256D.06, subdivision 2, is amended to read:
23.31 		Subd. 2.Emergency need. (a) Notwithstanding the provisions of subdivision 1, a 
23.32 	grant of emergency general assistance shall, to the extent funds are available, be made to 
23.33 	an eligible single adult, married couple, or family for an emergency need, as defined in 
23.34 	rules promulgated by the commissioner, where the recipient requests temporary assistance 
24.1 	not exceeding 30 days if an emergency situation appears to exist under criteria adopted by 
24.2 	the county agency and the individual or family is ineligible for MFIP or DWP or is not a 
24.3 	participant of MFIP or DWP and whose annual net income is no greater than 200 percent 
24.4 	of the federal poverty level for the previous calendar year. If an applicant or recipient 
24.5 	relates facts to the county agency which may be sufficient to constitute an emergency 
24.6 	situation, the county agency shall, to the extent funds are available, advise the person of the 
24.7 	procedure for applying for assistance according to this subdivision. An emergency general 
24.8 	assistance grant is available to a recipient not more than once in any 12-month period. 
24.9 	(b) Funding for an emergency general assistance program is limited to the 
24.10 	appropriation. Each fiscal year, the commissioner shall allocate to counties the money 
24.11 	appropriated for emergency general assistance grants based on each county agency's 
24.12 	average share of state's emergency general expenditures for the immediate past three fiscal 
24.13 	years as determined by the commissioner, and may reallocate any unspent amounts to 
24.14 	other counties.
24.15 	(c) No county shall be allocated less than $1,000 for the fiscal year.
24.16 	(d) Should an emergency be declared as provided in section 12.31, the commissioner 
24.17 	may immediately reallocate unspent funds without regard to the other provisions of this 
24.18 	section to meet the emergency needs. The emergency reallocation must be excluded from 
24.19 	calculations for subsequent allocations as provided in paragraphs (b) and (c).
24.20 	(e) Any emergency general assistance expenditures by a county above the amount of 
24.21 	the commissioner's allocation to the county must be made from county funds.

24.22 	Sec. 4. Minnesota Statutes 2008, section 256D.09, subdivision 6, is amended to read:
24.23 		Subd. 6.Recovery of overpayments. (a) If an amount of general assistance or 
24.24 	family general assistance is paid to a recipient in excess of the payment due, it shall be 
24.25 	recoverable by the county agency. The agency shall give written notice to the recipient of 
24.26 	its intention to recover the overpayment.
24.27 	(b) Except as provided for interim assistance in section 256D.06, subdivision 
24.28 	5, when an overpayment occurs, the county agency shall recover the overpayment 
24.29 	from a current recipient by reducing the amount of aid payable to the assistance unit of 
24.30 	which the recipient is a member, for one or more monthly assistance payments, until 
24.31 	the overpayment is repaid. All county agencies in the state shall reduce the assistance 
24.32 	payment by three percent of the assistance unit's standard of need in nonfraud cases and 
24.33 	ten percent where fraud has occurred, or the amount of the monthly payment, whichever is 
24.34 	less, for all overpayments.
25.1 	(c) In cases when there is both an overpayment and underpayment, the county 
25.2 	agency shall offset one against the other in correcting the payment.
25.3 	(d) Overpayments may also be voluntarily repaid, in part or in full, by the individual, 
25.4 	in addition to the aid reductions provided in this subdivision, to include further voluntary 
25.5 	reductions in the grant level agreed to in writing by the individual, until the total amount 
25.6 	of the overpayment is repaid.
25.7 	(e) The county agency shall make reasonable efforts to recover overpayments to 
25.8 	persons no longer on assistance under standards adopted in rule by the commissioner 
25.9 	of human services. The county agency need not attempt to recover overpayments of 
25.10 	less than $35 paid to an individual no longer on assistance if the individual does not 
25.11 	receive assistance again within three years, unless the individual has been convicted of 
25.12 	violating section 256.98. 
25.13 	(f) Establishment of an overpayment is limited to 12 months prior to the month of 
25.14 	discovery due to an agency error and six years prior to the month of discovery due to a 
25.15 	client error or an intentional program violation determined under section 256.046.

25.16 	Sec. 5. Minnesota Statutes 2008, section 256D.49, subdivision 3, is amended to read:
25.17 		Subd. 3.Overpayment of monthly grants and recovery of ATM errors. (a) When 
25.18 	the county agency determines that an overpayment of the recipient's monthly payment 
25.19 	of Minnesota supplemental aid has occurred, it shall issue a notice of overpayment 
25.20 	to the recipient. If the person is no longer receiving Minnesota supplemental aid, the 
25.21 	county agency may request voluntary repayment or pursue civil recovery. If the person is 
25.22 	receiving Minnesota supplemental aid, the county agency shall recover the overpayment 
25.23 	by withholding an amount equal to three percent of the standard of assistance for the 
25.24 	recipient or the total amount of the monthly grant, whichever is less. 
25.25 	(b) Establishment of an overpayment is limited to 12 months prior to the month of 
25.26 	discovery due to an agency error and six years prior to the month of discovery due to a 
25.27 	client error or an intentional program violation determined under section 256.046.
25.28 	(c) For recipients receiving benefits via electronic benefit transfer, if the overpayment 
25.29 	is a result of an automated teller machine (ATM) dispensing funds in error to the recipient, 
25.30 	the agency may recover the ATM error by immediately withdrawing funds from the 
25.31 	recipient's electronic benefit transfer account, up to the amount of the error. 
25.32 	(d) Residents of nursing homes, regional treatment centers, andlicensed residential 
25.33 	facilities with negotiated rates shall not have overpayments recovered from their personal 
25.34 	needs allowance.

26.1 	Sec. 6. Minnesota Statutes 2008, section 256I.03, subdivision 7, is amended to read:
26.2 		Subd. 7.Countable income. "Countable income" means all income received by an 
26.3 	applicant or recipient less any applicable exclusions or disregards. For a recipient of any 
26.4 	cash benefit from the SSI program, countable income means the SSI benefit limit in effect 
26.5 	at the time the person is in a GRH setting less $20, less the medical assistance personal 
26.6 	needs allowance. If the SSI limit has been reduced for a person due to events occurring 
26.7 	prior to the persons entering the GRH setting, countable income means actual income less 
26.8 	any applicable exclusions and disregards.

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

26.10 	Sec. 7. Minnesota Statutes 2008, section 256I.05, subdivision 7c, is amended to read:
26.11 		Subd. 7c.Demonstration project. The commissioner is authorized to pursue the 
26.12 	expansion of a demonstration project under federal food stamp regulation for the purpose 
26.13 	of gaining additional federal reimbursement of food and nutritional costs currently paid by 
26.14 	the state group residential housing program. The commissioner shall seek approval no 
26.15 	later than January 1, 2004 October 1, 2009. Any reimbursement received is nondedicated 
26.16 	revenue to the general fund.

26.17 	Sec. 8. Minnesota Statutes 2008, section 256J.20, subdivision 3, is amended to read:
26.18 		Subd. 3.Other property limitations. To be eligible for MFIP, the equity value of 
26.19 	all nonexcluded real and personal property of the assistance unit must not exceed $2,000 
26.20 	for applicants and $5,000 for ongoing participants. The value of assets in clauses (1) to 
26.21 	(19) must be excluded when determining the equity value of real and personal property:
26.22 	(1) a licensed vehicle up to a loan value of less than or equal to $15,000 $7,500. If the 
26.23 	assistance unit owns more than one licensed vehicle, the county agency shall determine the 
26.24 	loan value of all additional vehicles and exclude the combined loan value of less than or 
26.25 	equal to $7,500. The county agency shall apply any excess loan value as if it were equity 
26.26 	value to the asset limit described in this section,. If the assistance unit owns more than 
26.27 	one licensed vehicle, the county agency shall determine the vehicle with the highest loan 
26.28 	value and count only the loan value over $7,500, excluding: (i) the value of one vehicle 
26.29 	per physically disabled person when the vehicle is needed to transport the disabled unit 
26.30 	member; this exclusion does not apply to mentally disabled people; (ii) the value of special 
26.31 	equipment for a disabled member of the assistance unit; and (iii) any vehicle used for 
26.32 	long-distance travel, other than daily commuting, for the employment of a unit member.
26.33 	The county agency shall count the loan value of all other vehicles and apply this 
26.34 	amount as if it were equity value to the asset limit described in this section. To establish the 
27.1 	loan value of vehicles, a county agency must use the N.A.D.A. Official Used Car Guide, 
27.2 	Midwest Edition, for newer model cars. When a vehicle is not listed in the guidebook, 
27.3 	or when the applicant or participant disputes the loan value listed in the guidebook as 
27.4 	unreasonable given the condition of the particular vehicle, the county agency may require 
27.5 	the applicant or participant document the loan value by securing a written statement from 
27.6 	a motor vehicle dealer licensed under section 168.27, stating the amount that the dealer 
27.7 	would pay to purchase the vehicle. The county agency shall reimburse the applicant or 
27.8 	participant for the cost of a written statement that documents a lower loan value; 
27.9 	(2) the value of life insurance policies for members of the assistance unit;
27.10 	(3) one burial plot per member of an assistance unit;
27.11 	(4) the value of personal property needed to produce earned income, including 
27.12 	tools, implements, farm animals, inventory, business loans, business checking and 
27.13 	savings accounts used at least annually and used exclusively for the operation of a 
27.14 	self-employment business, and any motor vehicles if at least 50 percent of the vehicle's use 
27.15 	is to produce income and if the vehicles are essential for the self-employment business;
27.16 	(5) the value of personal property not otherwise specified which is commonly 
27.17 	used by household members in day-to-day living such as clothing, necessary household 
27.18 	furniture, equipment, and other basic maintenance items essential for daily living;
27.19 	(6) the value of real and personal property owned by a recipient of Supplemental 
27.20 	Security Income or Minnesota supplemental aid;
27.21 	(7) the value of corrective payments, but only for the month in which the payment 
27.22 	is received and for the following month;
27.23 	(8) a mobile home or other vehicle used by an applicant or participant as the 
27.24 	applicant's or participant's home;
27.25 	(9) money in a separate escrow account that is needed to pay real estate taxes or 
27.26 	insurance and that is used for this purpose;
27.27 	(10) money held in escrow to cover employee FICA, employee tax withholding, 
27.28 	sales tax withholding, employee worker compensation, business insurance, property rental, 
27.29 	property taxes, and other costs that are paid at least annually, but less often than monthly;
27.30 	(11) monthly assistance payments for the current month's or short-term emergency 
27.31 	needs under section 256J.626, subdivision 2; 
27.32 	(12) the value of school loans, grants, or scholarships for the period they are 
27.33 	intended to cover;
27.34 	(13) payments listed in section 256J.21, subdivision 2, clause (9), which are held 
27.35 	in escrow for a period not to exceed three months to replace or repair personal or real 
27.36 	property; 
28.1 	(14) income received in a budget month through the end of the payment month;
28.2 	(15) savings from earned income of a minor child or a minor parent that are set aside 
28.3 	in a separate account designated specifically for future education or employment costs;
28.4 	(16) the federal earned income credit, Minnesota working family credit, state and 
28.5 	federal income tax refunds, state homeowners and renters credits under chapter 290A, 
28.6 	property tax rebates and other federal or state tax rebates in the month received and the 
28.7 	following month;
28.8 	(17) payments excluded under federal law as long as those payments are held in a 
28.9 	separate account from any nonexcluded funds;
28.10 	(18) the assets of children ineligible to receive MFIP benefits because foster care or 
28.11 	adoption assistance payments are made on their behalf; and
28.12 	(19) the assets of persons whose income is excluded under section 256J.21, 
28.13 	subdivision 2, clause (43). 

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

28.15 	Sec. 9. Minnesota Statutes 2008, section 256J.24, subdivision 5a, is amended to read:
28.16 		Subd. 5a.Food portion of MFIP transitional standard. The commissioner 
28.17 	shall adjust the food portion of the MFIP transitional standard by October 1 each year 
28.18 	beginning October 1998 as needed to reflect the cost-of-living adjustments to the food 
28.19 	Stamp support program. The commissioner shall annually publish in the State Register
28.20 	the transitional standard for an assistance unit of sizes one to ten in the State Register 
28.21 	whenever an adjustment is made.

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

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

28.33 	EFFECTIVE DATE. This section is effective October 1, 2010.

29.1 	Sec. 11. Minnesota Statutes 2008, section 256J.37, subdivision 3a, is amended to read:
29.2 		Subd. 3a.Rental subsidies; unearned income. (a) Effective July 1, 2003, The 
29.3 	county agency shall count $50$100 of the value of public and assisted rental subsidies 
29.4 	provided through the Department of Housing and Urban Development (HUD) as unearned 
29.5 	income to the cash portion of the MFIP grant. The full amount of the subsidy must be 
29.6 	counted as unearned income when the subsidy is less than $50 $100. The income from 
29.7 	this subsidy shall be budgeted according to section 256J.34. 
29.8 	(b) The provisions of this subdivision shall not apply to an MFIP assistance unit 
29.9 	which includes a participant who is:
29.10 	(1) age 60 or older;
29.11 	(2) a caregiver who is suffering from an illness, injury, or incapacity that has been 
29.12 	certified by a qualified professional when the illness, injury, or incapacity is expected 
29.13 	to continue for more than 30 days and prevents the person from obtaining or retaining 
29.14 	employment; or
29.15 	(3) a caregiver whose presence in the home is required due to the illness or 
29.16 	incapacity of another member in the assistance unit, a relative in the household, or a foster 
29.17 	child in the household when the illness or incapacity and the need for the participant's 
29.18 	presence in the home has been certified by a qualified professional and is expected to 
29.19 	continue for more than 30 days.
29.20 	(c) The provisions of this subdivision shall not apply to an MFIP assistance unit 
29.21 	where the parental caregiver is an SSI recipient.
29.22 	(d) Prior to implementing this provision, the commissioner must identify the MFIP 
29.23 	participants subject to this provision and provide written notice to these participants at 
29.24 	least 30 days before the first grant reduction. The notice must inform the participant of the 
29.25 	basis for the potential grant reduction, the exceptions to the provision, if any, and inform 
29.26 	the participant of the steps necessary to claim an exception. A person who is found not to 
29.27 	meet one of the exceptions to the provision must be notified and informed of the right to a 
29.28 	fair hearing under section 256J.40. The notice must also inform the participant that the 
29.29 	participant may be eligible for a rent reduction resulting from a reduction in the MFIP 
29.30 	grant and encourage the participant to contact the local housing authority. 

29.31 	EFFECTIVE DATE. This section is effective October 1, 2010.

29.32 	Sec. 12. Minnesota Statutes 2008, section 256J.37, is amended by adding a subdivision 
29.33 	to read:
29.34 		Subd. 11.Treatment of Supplemental Security Income. Effective March 1, 
29.35 	2010, the county shall reduce the cash portion of the MFIP grant by up to $125 for an 
30.1 	MFIP assistance unit that includes one or more Supplemental Security Income (SSI) 
30.2 	recipients who reside in the household, and who would otherwise be included in the MFIP 
30.3 	assistance unit under section 256J.24, subdivision 2, but are excluded solely due to the 
30.4 	SSI recipient status under section 256J.24, subdivision 3, paragraph (a), clause (1). If 
30.5 	the SSI recipient or recipients receive less than $125 of SSI, only the amount received 
30.6 	must be used in calculating the MFIP cash assistance payment. This provision does not 
30.7 	apply to relative caregivers who could elect to be included in the MFIP assistance unit 
30.8 	under section 256J.24, subdivision 4, unless the caregiver's children or stepchildren are 
30.9 	included in the MFIP assistance unit.

30.10 	EFFECTIVE DATE. This section is effective October 1, 2010.

30.11 	Sec. 13. Minnesota Statutes 2008, section 256J.38, subdivision 1, is amended to read:
30.12 		Subdivision 1.Scope of overpayment. (a) When a participant or former participant 
30.13 	receives an overpayment due to agency, client, or ATM error, or due to assistance received 
30.14 	while an appeal is pending and the participant or former participant is determined 
30.15 	ineligible for assistance or for less assistance than was received, the county agency must 
30.16 	recoup or recover the overpayment using the following methods:
30.17 	(1) reconstruct each affected budget month and corresponding payment month;
30.18 	(2) use the policies and procedures that were in effect for the payment month; and
30.19 	(3) do not allow employment disregards in section 256J.21, subdivision 3 or 4, in the 
30.20 	calculation of the overpayment when the unit has not reported within two calendar months 
30.21 	following the end of the month in which the income was received.  
30.22 	(b) Establishment of an overpayment is limited to 12 months prior to the month of 
30.23 	discovery due to agency error and six years prior to the month of discovery due to client 
30.24 	error or an intentional program violation determined under section 256.046.

30.25 	Sec. 14. Minnesota Statutes 2008, section 256J.575, subdivision 3, is amended to read:
30.26 		Subd. 3.Eligibility. (a) The following MFIP or diversionary work program (DWP)
30.27 	participants are eligible for the services under this section:
30.28 	(1) a participant who meets the requirements for or has been granted a hardship 
30.29 	extension under section 256J.425, subdivision 2 or 3, except that it is not necessary for 
30.30 	the participant to have reached or be approaching 60 months of eligibility for this section 
30.31 	to apply;
30.32 	(2) a participant who is applying for Supplemental Security Income or Social 
30.33 	Security disability insurance; and
31.1 	(3) a participant who is a noncitizen who has been in the United States for 12 or 
31.2 	fewer months.
31.3 	(b) Families must meet all other eligibility requirements for MFIP established in 
31.4 	this chapter. Families are eligible for financial assistance to the same extent as if they 
31.5 	were participating in MFIP.
31.6 	(c) A participant under paragraph (a), clause (3), must be provided with English as a 
31.7 	second language opportunities and skills training for up to 12 months. After 12 months, 
31.8 	the case manager and participant must determine whether the participant should continue 
31.9 	with English as a second language classes or skills training, or both, and continue to 
31.10 	receive family stabilization services.

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

31.12 	Sec. 15. Minnesota Statutes 2008, section 256J.575, subdivision 6, is amended to read:
31.13 		Subd. 6.Cooperation with services requirements. (a) To be eligible, A participant 
31.14 	who is eligible for family stabilization services under this section shall comply with 
31.15 	paragraphs (b) to (d).
31.16 	(b) Participants shall engage in family stabilization plan services for the appropriate 
31.17 	number of hours per week that the activities are scheduled and available, unless good 
31.18 	cause exists for not doing so, as defined in section 256J.57, subdivision 1. The appropriate 
31.19 	number of hours must be based on the participant's plan.
31.20 	(c) The case manager shall review the participant's progress toward the goals in the 
31.21 	family stabilization plan every six months to determine whether conditions have changed, 
31.22 	including whether revisions to the plan are needed.
31.23 	(d) A participant's requirement to comply with any or all family stabilization plan 
31.24 	requirements under this subdivision is excused when the case management services, 
31.25 	training and educational services, or family support services identified in the participant's 
31.26 	family stabilization plan are unavailable for reasons beyond the control of the participant, 
31.27 	including when money appropriated is not sufficient to provide the services.

31.28 	Sec. 16. Minnesota Statutes 2008, section 256J.575, subdivision 7, is amended to read:
31.29 		Subd. 7.Sanctions. (a) The county agency or employment services provider must 
31.30 	follow the requirements of this subdivision at the time the county agency or employment 
31.31 	services provider has information that an MFIP recipient may meet the eligibility criteria 
31.32 	in subdivision 3. 
31.33 	(b) The financial assistance grant of a participating family is reduced according to 
31.34 	section 256J.46, if a participating adult fails without good cause to comply or continue 
32.1 	to comply with the family stabilization plan requirements in this subdivision, unless 
32.2 	compliance has been excused under subdivision 6, paragraph (d).
32.3 	(b) (c) Given the purpose of the family stabilization services  in this section and the 
32.4 	nature of the underlying family circumstances that act as barriers to both employment and 
32.5 	full compliance with program requirements, there must be a review by the county agency 
32.6 	prior to imposing a sanction to determine whether the plan was appropriated to the needs 
32.7 	of the participant and family, and. There must be a current assessment by a behavioral 
32.8 	health or medical professional confirming that the participant in all ways had the ability to 
32.9 	comply with the plan, as confirmed by a behavioral health or medical professional.
32.10 	(c) (d) Prior to the imposition of a sanction, the county agency or employment 
32.11 	services provider shall review the participant's case to determine if the family stabilization 
32.12 	plan is still appropriate and meet with the participant face-to-face. The participant may 
32.13 	bring an advocate The county agency or employment services provider must inform the 
32.14 	participant of the right to bring an advocate to the face-to-face meeting. 
32.15 	During the face-to-face meeting, the county agency shall:
32.16 	(1) determine whether the continued noncompliance can be explained and mitigated 
32.17 	by providing a needed family stabilization service, as defined in subdivision 2, paragraph 
32.18 	(d);
32.19 	(2) determine whether the participant qualifies for a good cause exception under 
32.20 	section 256J.57, or if the sanction is for noncooperation with child support requirements, 
32.21 	determine if the participant qualifies for a good cause exemption under section 256.741, 
32.22 	subdivision 10;
32.23 	(3) determine whether activities in the family stabilization plan are appropriate 
32.24 	based on the family's circumstances;
32.25 	(4) explain the consequences of continuing noncompliance;
32.26 	(5) identify other resources that may be available to the participant to meet the 
32.27 	needs of the family; and
32.28 	(6) inform the participant of the right to appeal under section 256J.40.
32.29 	If the lack of an identified activity or service can explain the noncompliance, the 
32.30 	county shall work with the participant to provide the identified activity.
32.31 	(d) If the participant fails to come to the face-to-face meeting, the case manager or a 
32.32 	designee shall attempt at least one home visit. If a face-to-face meeting is not conducted, 
32.33 	the county agency shall send the participant a written notice that includes the information 
32.34 	under paragraph (c).
32.35 	(e) After the requirements of paragraphs (c) and (d) are met and prior to imposition 
32.36 	of a sanction, the county agency shall provide a notice of intent to sanction under section 
33.1 	256J.57, subdivision 2, and, when applicable, a notice of adverse action under section 
33.2 	256J.31.
33.3 	(f) Section 256J.57 applies to this section except to the extent that it is modified 
33.4 	by this subdivision.

33.5 	Sec. 17. Minnesota Statutes 2008, section 256J.621, is amended to read:
33.6 	256J.621 WORK PARTICIPATION CASH BENEFITS.
33.7 	(a) Effective October 1, 2009, upon exiting the diversionary work program (DWP) 
33.8 	or upon terminating the Minnesota family investment program with earnings, a participant 
33.9 	who is employed may be eligible for work participation cash benefits of $75 $50 per 
33.10 	month to assist in meeting the family's basic needs as the participant continues to move 
33.11 	toward self-sufficiency.
33.12 	(b) To be eligible for work participation cash benefits, the participant shall not 
33.13 	receive MFIP or diversionary work program assistance during the month and the 
33.14 	participant or participants must meet the following work requirements:
33.15 	(1) if the participant is a single caregiver and has a child under six years of age, the 
33.16 	participant must be employed at least 87 hours per month;
33.17 	(2) if the participant is a single caregiver and does not have a child under six years of 
33.18 	age, the participant must be employed at least 130 hours per month; or
33.19 	(3) if the household is a two-parent family, at least one of the parents must be 
33.20 	employed an average of at least 130 hours per month.
33.21 	Whenever a participant exits the diversionary work program or is terminated from 
33.22 	MFIP and meets the other criteria in this section, work participation cash benefits are 
33.23 	available for up to 24 consecutive months.
33.24 	(c) Expenditures on the program are maintenance of effort state funds under 
33.25 	a separate state program for participants under paragraph (b), clauses (1) and (2). 
33.26 	Expenditures for participants under paragraph (b), clause (3), are nonmaintenance of effort 
33.27 	funds. Months in which a participant receives work participation cash benefits under this 
33.28 	section do not count toward the participant's MFIP 60-month time limit.

33.29 	Sec. 18. Minnesota Statutes 2008, section 256J.626, subdivision 6, is amended to read:
33.30 		Subd. 6.Base allocation to counties and tribes; definitions. (a) For purposes of 
33.31 	this section, the following terms have the meanings given.
33.32 	(1) "2002 historic spending base" means the commissioner's determination of 
33.33 	the sum of the reimbursement related to fiscal year 2002 of county or tribal agency 
33.34 	expenditures for the base programs listed in clause (6) (5), items (i) through (iv), and 
34.1 	earnings related to calendar year 2002 in the base program listed in clause (6) (5), item 
34.2 	(v), and the amount of spending in fiscal year 2002 in the base program listed in clause 
34.3 	(6) (5), item (vi), issued to or on behalf of persons residing in the county or tribal service 
34.4 	delivery area.
34.5 	(2) "Adjusted caseload factor" means a factor weighted:
34.6 	(i) 47 percent on the MFIP cases in each county at four points in time in the most 
34.7 	recent 12-month period for which data is available multiplied by the county's caseload 
34.8 	difficulty factor; and
34.9 	(ii) 53 percent on the count of adults on MFIP in each county and tribe at four points 
34.10 	in time in the most recent 12-month period for which data is available multiplied by the 
34.11 	county or tribe's caseload difficulty factor.
34.12 	(3) "Caseload difficulty factor" means a factor determined by the commissioner for 
34.13 	each county and tribe based upon the self-support index described in section 256J.751, 
34.14 	subdivision 2, clause (6).
34.15 	(4) "Initial allocation" means the amount potentially available to each county or tribe 
34.16 	based on the formula in paragraphs (b) through (d).
34.17 	(5)(4) "Final allocation" means the amount available to each county or tribe based 
34.18 	on the formula in paragraphs (b) through (d), after adjustment by subdivision 7 and (c).
34.19 	(6)(5) "Base programs" means the:
34.20 	(i) MFIP employment and training services under Minnesota Statutes 2002, section 
34.21 	256J.62, subdivision 1, in effect June 30, 2002;
34.22 	(ii) bilingual employment and training services to refugees under Minnesota Statutes 
34.23 	2002, section 256J.62, subdivision 6, in effect June 30, 2002;
34.24 	(iii) work literacy language programs under Minnesota Statutes 2002, section 
34.25 	256J.62, subdivision 7, in effect June 30, 2002;
34.26 	(iv) supported work program authorized in Laws 2001, First Special Session chapter 
34.27 	9, article 17, section 2, in effect June 30, 2002;
34.28 	(v) administrative aid program under section 256J.76 in effect December 31, 2002; 
34.29 	and
34.30 	(vi) emergency assistance program under Minnesota Statutes 2002, section 256J.48, 
34.31 	in effect June 30, 2002.
34.32 	(b) The commissioner shall:
34.33 	(1) beginning July 1, 2003, determine the initial allocation of funds available under 
34.34 	this section according to clause (2);
35.1 	(2) allocate all of the funds available for the period beginning July 1, 2003, and 
35.2 	ending December 31, 2004, to each county or tribe in proportion to the county's or tribe's 
35.3 	share of the statewide 2002 historic spending base;
35.4 	(3) determine for calendar year 2005 the initial allocation of funds to be made 
35.5 	available under this section in proportion to the county or tribe's initial allocation for the 
35.6 	period of July 1, 2003, to December 31, 2004;
35.7 	(4) determine for calendar year 2006 the initial allocation of funds to be made 
35.8 	available under this section based 90 percent on the proportion of the county or tribe's 
35.9 	share of the statewide 2002 historic spending base and ten percent on the proportion of 
35.10 	the county or tribe's share of the adjusted caseload factor;
35.11 	(5) determine for calendar year 2007 the initial allocation of funds to be made 
35.12 	available under this section based 70 percent on the proportion of the county or tribe's 
35.13 	share of the statewide 2002 historic spending base and 30 percent on the proportion of the 
35.14 	county or tribe's share of the adjusted caseload factor; and
35.15 	(6) determine for calendar year 2008 and subsequent years the initial allocation of
35.16 	allocate funds to be made available under this section based 50 percent on the proportion 
35.17 	of the county or tribe's share of the statewide 2002 historic spending base and 50 percent 
35.18 	on the proportion of the county or tribe's share of the adjusted caseload factor.
35.19 	(c) With the commencement of a new or expanded tribal TANF program or an 
35.20 	agreement under section 256.01, subdivision 2, paragraph (g), in which some or all of 
35.21 	the responsibilities of particular counties under this section are transferred to a tribe, 
35.22 	the commissioner shall:
35.23 	(1) in the case where all responsibilities under this section are transferred to a tribal 
35.24 	program, determine the percentage of the county's current caseload that is transferring to a 
35.25 	tribal program and adjust the affected county's allocation accordingly; and
35.26 	(2) in the case where a portion of the responsibilities under this section are 
35.27 	transferred to a tribal program, the commissioner shall consult with the affected county or 
35.28 	counties to determine an appropriate adjustment to the allocation.
35.29 	(d) Effective January 1, 2005, counties and tribes will have their final allocations 
35.30 	adjusted based on the performance provisions of subdivision 7.

35.31 	EFFECTIVE DATE. This section is effective July 1, 2010.

35.32 	Sec. 19. Minnesota Statutes 2008, section 256J.751, is amended by adding a 
35.33 	subdivision to read:
35.34 		Subd. 2a.County performance standards. (a) For the purpose of this section, the 
35.35 	following terms have the meanings given:
36.1 	(1) "Caseload reduction credit" (CRC) means the measure of how much the 
36.2 	Minnesota TANF caseload, including the separate state program caseload, has fallen 
36.3 	relative to the federal fiscal year 2005 caseload based on caseload data from October 
36.4 	1 to September 30.
36.5 	(2) "TANF participation rate target" means a 50 percent participation rate reduced by 
36.6 	the CRC as calculated by the Department of Human Services.
36.7 	(b) A county or tribe shall negotiate a multiyear improvement plan with the 
36.8 	commissioner if the county or tribe does not:
36.9 	(1) achieve the TANF participation rate target or a five percentage point improvement 
36.10 	over the county or tribe's previous year's TANF participation rate under subdivision 2, 
36.11 	clause (7), as averaged across 12 consecutive months for the most recent year for which 
36.12 	the measurements are available; or
36.13 	(2) perform within or above its range of expected performance on the annualized 
36.14 	three-year self-support index under subdivision 2, clause (6).
36.15 	(c) A county or tribe that has successfully negotiated an improvement plan must 
36.16 	provide a semiannual report indicating that the plan has been implemented, the impact of 
36.17 	the plan, and any anticipated changes to the plan.

36.18 	Sec. 20. Minnesota Statutes 2008, section 256J.95, subdivision 12, is amended to read:
36.19 		Subd. 12.Conversion or referral to MFIP. (a) If at any time during the DWP 
36.20 	application process or during the four-month DWP eligibility period, it is determined that 
36.21 	a participant is unlikely to benefit from the diversionary work program, the county shall 
36.22 	convert or refer the participant to MFIP as specified in paragraph (d). Participants who are 
36.23 	determined to be unlikely to benefit from the diversionary work program must develop 
36.24 	and sign an employment plan. Participants who meet any one of the criteria in paragraph 
36.25 	(b) shall be considered to be unlikely to benefit from DWP, provided the necessary 
36.26 	documentation is available to support the determination.
36.27 	(b) A participant who: meets the eligibility requirements under section 256J.575, 
36.28 	subdivision 3, must be considered to be unlikely to benefit from DWP, provided the 
36.29 	necessary documentation is available to support the determination.
36.30 	(1) has been determined by a qualified professional as being unable to obtain or retain 
36.31 	employment due to an illness, injury, or incapacity that is expected to last at least 60 days;
36.32 	(2) is required in the home as a caregiver because of the illness, injury, or incapacity, 
36.33 	of a family member, or a relative in the household, or a foster child, and the illness, injury, 
36.34 	or incapacity and the need for a person to provide assistance in the home has been certified 
36.35 	by a qualified professional and is expected to continue more than 60 days;
37.1 	(3) is determined by a qualified professional as being needed in the home to care for 
37.2 	a child or adult meeting the special medical criteria in section 256J.561, subdivision 2, 
37.3 	paragraph (d), clause (3); 
37.4 	(4) is pregnant and is determined by a qualified professional as being unable to 
37.5 	obtain or retain employment due to the pregnancy; or
37.6 	(5) has applied for SSI or SSDI.
37.7 	(c) In a two-parent family unit, both parents must be if one parent is determined 
37.8 	to be unlikely to benefit from the diversionary work program before, the family unit 
37.9 	can must be converted or referred to MFIP.
37.10 	(d) A participant who is determined to be unlikely to benefit from the diversionary 
37.11 	work program shall be converted to MFIP and, if the determination was made within 30 
37.12 	days of the initial application for benefits, no additional application form is required. 
37.13 	A participant who is determined to be unlikely to benefit from the diversionary work 
37.14 	program shall be referred to MFIP and, if the determination is made more than 30 
37.15 	days after the initial application, the participant must submit a program change request 
37.16 	form. The county agency shall process the program change request form by the first of 
37.17 	the following month to ensure that no gap in benefits is due to delayed action by the 
37.18 	county agency. In processing the program change request form, the county must follow 
37.19 	section 256J.32, subdivision 1, except that the county agency shall not require additional 
37.20 	verification of the information in the case file from the DWP application unless the 
37.21 	information in the case file is inaccurate, questionable, or no longer current. 
37.22 	(e) The county shall not request a combined application form for a participant who 
37.23 	has exhausted the four months of the diversionary work program, has continued need for 
37.24 	cash and food assistance, and has completed, signed, and submitted a program change 
37.25 	request form within 30 days of the fourth month of the diversionary work program. The 
37.26 	county must process the program change request according to section 256J.32, subdivision 
37.27 	1, except that the county agency shall not require additional verification of information 
37.28 	in the case file unless the information is inaccurate, questionable, or no longer current. 
37.29 	When a participant does not request MFIP within 30 days of the diversionary work 
37.30 	program benefits being exhausted, a new combined application form must be completed 
37.31 	for any subsequent request for MFIP. 

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

37.33 	Sec. 21. Minnesota Statutes 2008, section 393.07, subdivision 10, is amended to read:
37.34 		Subd. 10.Food stamp program; Maternal and Child Nutrition Act. (a) The local 
37.35 	social services agency shall establish and administer the food stamp program according 
38.1 	to rules of the commissioner of human services, the supervision of the commissioner as 
38.2 	specified in section 256.01, and all federal laws and regulations. The commissioner of 
38.3 	human services shall monitor food stamp program delivery on an ongoing basis to ensure 
38.4 	that each county complies with federal laws and regulations. Program requirements to be 
38.5 	monitored include, but are not limited to, number of applications, number of approvals, 
38.6 	number of cases pending, length of time required to process each application and deliver 
38.7 	benefits, number of applicants eligible for expedited issuance, length of time required 
38.8 	to process and deliver expedited issuance, number of terminations and reasons for 
38.9 	terminations, client profiles by age, household composition and income level and sources, 
38.10 	and the use of phone certification and home visits. The commissioner shall determine the 
38.11 	county-by-county and statewide participation rate. 
38.12 	(b) On July 1 of each year, the commissioner of human services shall determine a 
38.13 	statewide and county-by-county food stamp program participation rate. The commissioner 
38.14 	may designate a different agency to administer the food stamp program in a county if the 
38.15 	agency administering the program fails to increase the food stamp program participation 
38.16 	rate among families or eligible individuals, or comply with all federal laws and regulations 
38.17 	governing the food stamp program. The commissioner shall review agency performance 
38.18 	annually to determine compliance with this paragraph.
38.19 	(c) A person who commits any of the following acts has violated section 256.98 or 
38.20 	609.821, or both, and is subject to both the criminal and civil penalties provided under 
38.21 	those sections: 
38.22 	(1) obtains or attempts to obtain, or aids or abets any person to obtain by means of a 
38.23 	willful statement or misrepresentation, or intentional concealment of a material fact, food 
38.24 	stamps or vouchers issued according to sections 145.891 to 145.897 to which the person 
38.25 	is not entitled or in an amount greater than that to which that person is entitled or which 
38.26 	specify nutritional supplements to which that person is not entitled; or 
38.27 	(2) presents or causes to be presented, coupons or vouchers issued according to 
38.28 	sections 145.891 to 145.897 for payment or redemption knowing them to have been 
38.29 	received, transferred or used in a manner contrary to existing state or federal law; or 
38.30 	(3) willfully uses, possesses, or transfers food stamp coupons, authorization to 
38.31 	purchase cards or vouchers issued according to sections 145.891 to 145.897 in any manner 
38.32 	contrary to existing state or federal law, rules, or regulations; or 
38.33 	(4) buys or sells food stamp coupons, authorization to purchase cards, other 
38.34 	assistance transaction devices, vouchers issued according to sections 145.891 to 145.897, 
38.35 	or any food obtained through the redemption of vouchers issued according to sections 
38.36 	145.891 to 145.897 for cash or consideration other than eligible food. 
39.1 	(d) A peace officer or welfare fraud investigator may confiscate food stamps, 
39.2 	authorization to purchase cards, or other assistance transaction devices found in the 
39.3 	possession of any person who is neither a recipient of the food stamp program nor 
39.4 	otherwise authorized to possess and use such materials. Confiscated property shall be 
39.5 	disposed of as the commissioner may direct and consistent with state and federal food 
39.6 	stamp law. The confiscated property must be retained for a period of not less than 30 days 
39.7 	to allow any affected person to appeal the confiscation under section 256.045. 
39.8 	(e) Food stamp overpayment claims which are due in whole or in part to client 
39.9 	error shall be established by the county agency for a period of six years from the date of 
39.10 	any resultant overpayment. Establishment of a food stamp overpayment is limited to 12 
39.11 	months prior to the month of discovery due to an agency error and six years prior to the 
39.12 	month of discovery due to a client error or an intentional program violation determined 
39.13 	under section 256.046.
39.14 	(f) With regard to the federal tax revenue offset program only, recovery incentives 
39.15 	authorized by the federal food and consumer service shall be retained at the rate of 50 
39.16 	percent by the state agency and 50 percent by the certifying county agency.
39.17 	(g) A peace officer, welfare fraud investigator, federal law enforcement official, 
39.18 	or the commissioner of health may confiscate vouchers found in the possession of any 
39.19 	person who is neither issued vouchers under sections 145.891 to 145.897, nor otherwise 
39.20 	authorized to possess and use such vouchers. Confiscated property shall be disposed of 
39.21 	as the commissioner of health may direct and consistent with state and federal law. The 
39.22 	confiscated property must be retained for a period of not less than 30 days. 
39.23 	(h) The commissioner of human services may seek a waiver from the United States 
39.24 	Department of Agriculture to allow the state to specify foods that may and may not be 
39.25 	purchased in Minnesota with benefits funded by the federal Food Stamp Program. The 
39.26 	commissioner shall consult with the members of the house of representatives and senate 
39.27 	policy committees having jurisdiction over food support issues in developing the waiver. 
39.28 	The commissioner, in consultation with the commissioners of health and education, shall 
39.29 	develop a broad public health policy related to improved nutrition and health status. The 
39.30 	commissioner must seek legislative approval prior to implementing the waiver.

39.31 	Sec. 22. AMERICAN INDIAN CHILD WELFARE PROJECTS.
 39.32 	Notwithstanding Minnesota Statutes, section 16A.28, the commissioner of human 
39.33 	services shall extend payment of state fiscal year 2009 funds in state fiscal year 2010 
39.34 	to tribes participating in the American Indian child welfare projects under Minnesota 
39.35 	Statutes, section 256.01, subdivision 14b. Future extensions of payment for a tribe 
40.1 	participating in the Indian child welfare projects under Minnesota Statutes, section 256.01, 
40.2 	subdivision 14b, must be granted according to the commissioner's authority under 
40.3 	Minnesota Statutes, section 16A.28.

40.4 	Sec. 23.  REPEALER.
 40.5 	(a) Minnesota Statutes 2008, sections 256D.46; 256I.06, subdivision 9; and 
40.6 	256J.626, subdivision 7, are repealed.
40.7 	(b) Minnesota Rules, parts 9500.1243, subpart 3; and 9500.1261, subparts 3, 4, 5, 
40.8 	and 6, are repealed.

40.9 	ARTICLE 3
40.10 	CHILD SUPPORT

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

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

40.23 	Sec. 2. Minnesota Statutes 2008, section 518A.53, subdivision 4, is amended to read:
40.24 		Subd. 4.Collection services. (a) The commissioner of human services shall prepare 
40.25 	and make available to the courts a notice of services that explains child support and 
40.26 	maintenance collection services available through the public authority, including income 
40.27 	withholding, and the fees for such services. Upon receiving a petition for dissolution of 
40.28 	marriage or legal separation, the court administrator shall promptly send the notice of 
40.29 	services to the petitioner and respondent at the addresses stated in the petition.
40.30 	(b) Either the obligee or obligor may at any time apply to the public authority for 
40.31 	either full IV-D services or for income withholding only services.
41.1 	(c) For those persons applying for income withholding only services, a monthly 
41.2 	service fee of $15 must be charged to the obligor. This fee is in addition to the amount of 
41.3 	the support order and shall be withheld through income withholding. The public authority 
41.4 	shall explain the service options in this section to the affected parties and encourage the 
41.5 	application for full child support collection services.
41.6 	(d) If the obligee is not a current recipient of public assistance as defined in section 
41.7 	256.741, the person who applied for services may at any time choose to terminate either 
41.8 	full IV-D services or income withholding only services regardless of whether income 
41.9 	withholding is currently in place. The obligee or obligor may reapply for either full IV-D 
41.10 	services or income withholding only services at any time. Unless the applicant is a 
41.11 	recipient of public assistance as defined in section 256.741, a $25 application fee shall be 
41.12 	charged at the time of each application. 
41.13 	(e) When a person terminates IV-D services, if an arrearage for public assistance as 
41.14 	defined in section 256.741 exists, the public authority may continue income withholding, 
41.15 	as well as use any other enforcement remedy for the collection of child support, until all 
41.16 	public assistance arrears are paid in full. Income withholding shall be in an amount equal 
41.17 	to 20 percent of the support order in effect at the time the services terminated., unless the 
41.18 	support order includes a specific monthly payback amount. If the support order includes a 
41.19 	specific monthly payback amount, income withholding shall be in the specific amount 
41.20 	ordered. The provisions of this paragraph apply to all support orders in effect on or before 
41.21 	April 1, 2010, and to all support orders in effect after April 1, 2010. 

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

41.23 	Sec. 3. Minnesota Statutes 2008, section 518A.53, subdivision 10, is amended to read:
41.24 		Subd. 10.Arrearage order. (a) This section does not prevent the court from 
41.25 	ordering the payor of funds to withhold amounts to satisfy the obligor's previous arrearage 
41.26 	in support order payments. This remedy shall not operate to exclude availability of other 
41.27 	remedies to enforce judgments. The employer or payor of funds shall withhold from 
41.28 	the obligor's income an additional amount equal to 20 percent of the monthly child 
41.29 	support or maintenance obligation until the arrearage is paid., unless the support order 
41.30 	includes a specific monthly payback amount. If the support order includes a specific 
41.31 	monthly payback amount, income withholding shall be in the specific amount ordered. 
41.32 	The provisions of this paragraph apply to all support orders in effect on or before April 1, 
41.33 	2010, and to all support orders in effect after April 1, 2010. 
42.1 	(b) Notwithstanding any law to the contrary, funds from income sources included 
42.2 	in section 518A.26, subdivision 8, whether periodic or lump sum, are not exempt from 
42.3 	attachment or execution upon a judgment for child support arrearage. 
42.4 	(c) Absent an order to the contrary, if an arrearage exists at the time a support 
42.5 	order would otherwise terminate, income withholding shall continue in effect or may be 
42.6 	implemented in an amount equal to the support order plus an additional 20 percent of the 
42.7 	monthly child support obligation, until all arrears have been paid in full.

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

42.9 	ARTICLE 4
42.10 	STATE-OPERATED SERVICES

42.11 	Section 1. Minnesota Statutes 2008, section 246.50, subdivision 5, is amended to read:
42.12 		Subd. 5.Cost of care. "Cost of care" means the commissioner's charge for services 
42.13 	provided to any person admitted to a state facility.
42.14 	For purposes of this subdivision, "charge for services" means the cost of services, 
42.15 	treatment, maintenance, bonds issued for capital improvements, depreciation of buildings 
42.16 	and equipment, and indirect costs related to the operation of state facilities. The 
42.17 	commissioner may determine the charge for services on an anticipated average per diem 
42.18 	basis as an all inclusive charge per facility, per disability group, or per treatment program. 
42.19 	The commissioner may determine a charge per service, using a method that includes direct 
42.20 	and indirect costs. usual and customary fee charged for services provided to clients. The 
42.21 	usual and customary fee shall be established in a manner required to appropriately bill 
42.22 	services to all payers and shall include the costs related to the operations of any program 
42.23 	offered by the state.

42.24 	Sec. 2. Minnesota Statutes 2008, section 246.50, is amended by adding a subdivision 
42.25 	to read:
42.26 		Subd. 10.State-operated community-based program.  "State-operated 
42.27 	community-based program" means any program operated in the community including 
42.28 	community behavioral health hospitals, crisis centers, residential facilities, outpatient 
42.29 	services, and other community-based services developed and operated by the state and 
42.30 	under the commissioner's control.

42.31 	Sec. 3. Minnesota Statutes 2008, section 246.50, is amended by adding a subdivision 
42.32 	to read:
43.1 		Subd. 11.Health plan company. "Health plan company" has the meaning given it 
43.2 	in section 62Q.01, subdivision 4, and also includes a demonstration provider as defined in 
43.3 	section 256B.69, subdivision 2, paragraph (b), a county or group of counties participating 
43.4 	in county-based purchasing according to section 256B.692, and a children's mental health 
43.5 	collaborative under contract to provide medical assistance for individuals enrolled in 
43.6 	the prepaid medical assistance and MinnesotaCare programs under sections 245.493 to 
43.7 	245.495.

43.8 	Sec. 4. Minnesota Statutes 2008, section 246.51, is amended by adding a subdivision 
43.9 	to read:
43.10 		Subd. 1a.Clients in state-operated community-based programs; determination.
 43.11 	For clients admitted to a state-operated community-based program, the commissioner shall 
43.12 	make an investigation to determine the available health plan coverage for services being 
43.13 	provided. If the health plan coverage requires a co-pay or deductible, or if there is no 
43.14 	available health plan coverage, the commission shall make an investigation as necessary 
43.15 	to determine, and as circumstances require redetermine, what part of the noncovered 
43.16 	cost of care, if any, the client is able to pay. If the client is unable to pay the uncovered 
43.17 	cost of care, the commissioner shall make a determination as to the ability of the client's 
43.18 	relatives to pay. The client and relatives shall provide the commissioner documents and 
43.19 	proof necessary to determine their ability to pay. Failure to provide the commissioner with 
43.20 	sufficient information to determine ability to pay may make the client or relatives liable 
43.21 	for the full cost of care until the time when sufficient information is provided. If it is 
43.22 	determined that the responsible party does not have the ability to pay, the commissioner 
43.23 	shall waive payment of the portion that exceeds ability to pay under the determination.

43.24 	Sec. 5. Minnesota Statutes 2008, section 246.51, is amended by adding a subdivision 
43.25 	to read:
43.26 		Subd. 1b.Clients served by regional treatment centers or nursing homes; 
43.27 	determination.  For clients served in regional treatment centers or nursing homes operated 
43.28 	by state-operated services, the commissioner shall make investigation as necessary to 
43.29 	determine, and as circumstances require redetermine, what part of the cost of care, if any, 
43.30 	the client is able to pay. If the client is unable to pay the full cost of care, the commissioner 
43.31 	shall determine whether the client's relatives have the ability to pay. The client and 
43.32 	relatives shall provide the commissioner documents and proof necessary to determine their 
43.33 	ability to pay. Failure to provide the commissioner with sufficient information to determine 
43.34 	ability to pay may make the client or relatives liable for the full cost of care until the time 
44.1 	when sufficient information is provided. No parent shall be liable for the cost of care given 
44.2 	a client at a regional treatment center after the client has reached the age of 18 years.

44.3 	Sec. 6. Minnesota Statutes 2008, section 246.511, is amended to read:
44.4 	246.511 RELATIVE RESPONSIBILITY.
44.5 	Except for chemical dependency services paid for with funds provided under chapter 
44.6 	254B, a client's relatives shall not, pursuant to the commissioner's authority under section 
44.7 	246.51, be ordered to pay more than ten percent of the cost ofthe following: (1) for 
44.8 	services provided in a community-based service, the noncovered cost of care as determined 
44.9 	under the ability to pay determination; and (2) for services provided at a regional treatment 
44.10 	center operated by state-operated services, 20 percent of the cost of care, unless they 
44.11 	reside outside the state. Parents of children in state facilities shall have their responsibility 
44.12 	to pay determined according to section 252.27, subdivision 2, or in rules adopted under 
44.13 	chapter 254B if the cost of care is paid under chapter 254B. The commissioner may 
44.14 	accept voluntary payments in excess of ten 20 percent. The commissioner may require 
44.15 	full payment of the full per capita cost of care in state facilities for clients whose parent, 
44.16 	parents, spouse, guardian, or conservator do not reside in Minnesota.  

44.17 	Sec. 7. Minnesota Statutes 2008, section 246.52, is amended to read:
44.18 	246.52 PAYMENT FOR CARE; ORDER; ACTION.
44.19 	The commissioner shall issue an order to the client or the guardian of the estate, if 
44.20 	there be one, and relatives determined able to pay requiring them to pay monthly to the 
44.21 	state of Minnesota the amounts so determined the total of which shall not exceed the full 
44.22 	cost of care. Such order shall specifically state the commissioner's determination and shall 
44.23 	be conclusive unless appealed from as herein provided. When a client or relative fails to 
44.24 	pay the amount due hereunder the attorney general, upon request of the commissioner, 
44.25 	may institute, or direct the appropriate county attorney to institute, civil action to recover 
44.26 	such amount.

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

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

45.8 	Sec. 10. Minnesota Statutes 2008, section 246B.01, is amended by adding a 
45.9 	subdivision to read:
45.10 		Subd. 2a.Cost of care. "Cost of care" means the commissioner's charge for housing 
45.11 	and treatment services provided to any person admitted to the Minnesota sex offender 
45.12 	program.
45.13 	For purposes of this subdivision, "charge for housing and treatment services" means 
45.14 	the cost of services, treatment, maintenance, bonds issued for capital improvements, 
45.15 	depreciation of buildings and equipment, and indirect costs related to the operation of 
45.16 	state facilities. The commissioner may determine the charge for services on an anticipated 
45.17 	average per diem basis as an all-inclusive charge per facility.

45.18 	Sec. 11. Minnesota Statutes 2008, section 246B.01, is amended by adding a subdivision 
45.19 	to read:
45.20 		Subd. 2b.Local social services agency. "Local social services agency" means the 
45.21 	local social services agency of the client's county as defined in subdivision 1b and of the 
45.22 	county of commitment, and any other local social services agency possessing information 
45.23 	regarding, or requested by the commissioner to investigate, the financial circumstances 
45.24 	of a client.

45.25 	Sec. 12. [246B.07] PAYMENT FOR CARE AND TREATMENT: 
45.26 	DETERMINATION.
45.27 		Subdivision 1.Procedures. The commissioner shall make investigation as 
45.28 	necessary to determine, and as circumstances require redetermine, what part of the cost of 
45.29 	care, if any, the client is able to pay. The client shall provide the commissioner documents 
45.30 	and proof necessary to determine the ability to pay. Failure to provide the commissioner 
45.31 	with sufficient information to determine ability to pay may make the client liable for the 
45.32 	full cost of care until the time when sufficient information is provided.
46.1 		Subd. 2.Rules. The commissioner shall adopt, pursuant to the Administrative 
46.2 	Procedure Act, rules establishing uniform standards for determination of client liability 
46.3 	for care provided by the Minnesota sex offender program. These rules shall have the 
46.4 	force and effect of law.
46.5 		Subd. 3.Applicability. The commissioner may recover, under sections 246B.07 to 
46.6 	246B.10, the cost of any care provided by the Minnesota sex offender program.

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

46.14 	Sec. 14. [246B.09] CLAIM AGAINST ESTATE OF DECEASED CLIENT.
46.15 		Subdivision 1.Client's estate. Upon the death of a client, or a former client, the 
46.16 	total cost of care given the client, less the amount actually paid toward the cost of care by 
46.17 	the client, shall be filed by the commissioner as a claim against the estate of the client 
46.18 	with the court having jurisdiction to probate the estate and all proceeds collected by the 
46.19 	state in the case shall be divided between the state and county in proportion to the cost 
46.20 	of care each has borne.
46.21 		Subd. 2.Preferred status. An estate claim in subdivision 1 shall be considered an 
46.22 	expense of the last illness for purposes of section 524.3-805.
46.23 	If the commissioner of human services determines that the property or estate of a 
46.24 	client is not more than needed to care for and maintain the spouse and minor or dependent 
46.25 	children of a deceased client, the commissioner has the power to compromise the claim of 
46.26 	the state in a manner deemed just and proper.
46.27 		Subd. 3.Exception from statute of limitations. Any statute of limitations that 
46.28 	limits the commissioner in recovering the cost of care obligation incurred by a client or 
46.29 	former client must not apply to any claim against an estate made under this section to 
46.30 	recover cost of care.

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

47.8 	Sec. 16.  REPEALER.
 47.9 	Minnesota Statutes 2008, sections 246.51, subdivision 1; and 246.53, subdivision 
47.10 	3, are repealed.

47.11 	ARTICLE 5
47.12 	DEPARTMENT OF HEALTH AND HEALTH CARE

47.13 	Section 1. Minnesota Statutes 2008, section 13.465, subdivision 8, is amended to read:
47.14 		Subd. 8.Adoption records. Various adoption records are classified under section 
47.15 	259.53, subdivision 1. Access to the original birth record of a person who has been 
47.16 	adopted is governed by section 259.89 144.2253. 

47.17 	EFFECTIVE DATE. This section is effective August 1, 2010.

47.18 	Sec. 2. Minnesota Statutes 2008, section 62J.495, is amended to read:
47.19 	62J.495 HEALTH INFORMATION TECHNOLOGY AND 
47.20 	INFRASTRUCTURE.
47.21 		Subdivision 1.Implementation. By January 1, 2015, all hospitals and health care 
47.22 	providers must have in place an interoperable electronic health records system within their 
47.23 	hospital system or clinical practice setting. The commissioner of health, in consultation 
47.24 	with the e-Health Information Technology and Infrastructure Advisory Committee, 
47.25 	shall develop a statewide plan to meet this goal, including uniform standards to be used 
47.26 	for the interoperable system for sharing and synchronizing patient data across systems. 
47.27 	The standards must be compatible with federal efforts. The uniform standards must be 
47.28 	developed by January 1, 2009, with a status report on the development of these standards 
47.29 	submitted to the legislature by January 15, 2008 and updated on an ongoing basis. The 
47.30 	commissioner shall include an update on standards development as part of an annual 
47.31 	report to the legislature.
48.1 		Subd. 1a.Definitions. (a) "Certified electronic health record technology" means an 
48.2 	electronic health record that is certified pursuant to section 3001(c)(5) of the HITECH 
48.3 	Act to meet the standards and implementation specifications adopted under section 3004 
48.4 	as applicable.
48.5 	(b) "Commissioner" means the commissioner of health.
48.6 	(c) "Pharmaceutical electronic data intermediary" means any entity that provides 
48.7 	the infrastructure to connect computer systems or other electronic devices utilized 
48.8 	by prescribing practitioners with those used by pharmacies, health plans, third party 
48.9 	administrators, and pharmacy benefit manager in order to facilitate the secure transmission 
48.10 	of electronic prescriptions, refill authorization requests, communications, and other 
48.11 	prescription-related information between such entities.
48.12 	(d) "HITECH Act" means the Health Information Technology for Economic and 
48.13 	Clinical Health Act in division A, title XIII and division B, title IV of the American 
48.14 	Recovery and Reinvestment Act of 2009, including federal regulations adopted under 
48.15 	that act.
48.16 	(e) "Interoperable electronic health record" means an electronic health record that 
48.17 	securely exchanges health information with another electronic health record system that 
48.18 	meets national requirements for certification under the HITECH Act.
48.19 	(f) "Qualified electronic health record" means an electronic record of health-related 
48.20 	information on an individual that includes patient demographic and clinical health 
48.21 	information and has the capacity to:
48.22 	(1) provide clinical decision support;
48.23 	(2) support physician order entry;
48.24 	(3) capture and query information relevant to health care quality; and
48.25 	(4) exchange electronic health information with, and integrate such information 
48.26 	from, other sources.
48.27 		Subd. 2.E-Health Information Technology and Infrastructure Advisory 
48.28 	Committee. (a) The commissioner shall establish aan e-Health Information Technology 
48.29 	and Infrastructure Advisory Committee governed by section 15.059 to advise the 
48.30 	commissioner on the following matters:
48.31 	(1) assessment of the adoption and effective use of health information technology by 
48.32 	the state, licensed health care providers and facilities, and local public health agencies;
48.33 	(2) recommendations for implementing a statewide interoperable health information 
48.34 	infrastructure, to include estimates of necessary resources, and for determining standards 
48.35 	for administrative clinical data exchange, clinical support programs, patient privacy 
49.1 	requirements, and maintenance of the security and confidentiality of individual patient 
49.2 	data; 
49.3 	(3) recommendations for encouraging use of innovative health care applications 
49.4 	using information technology and systems to improve patient care and reduce the cost 
49.5 	of care, including applications relating to disease management and personal health 
49.6 	management that enable remote monitoring of patients' conditions, especially those with 
49.7 	chronic conditions; and 
49.8 	(4) other related issues as requested by the commissioner.
49.9 	(b) The members of the e-Health Information Technology and Infrastructure
49.10 	Advisory Committee shall include the commissioners, or commissioners' designees, of 
49.11 	health, human services, administration, and commerce and additional members to be 
49.12 	appointed by the commissioner to include persons representing Minnesota's local public 
49.13 	health agencies, licensed hospitals and other licensed facilities and providers, private 
49.14 	purchasers, the medical and nursing professions, health insurers and health plans, the 
49.15 	state quality improvement organization, academic and research institutions, consumer 
49.16 	advisory organizations with an interest and expertise in health information technology, and 
49.17 	other stakeholders as identified by the Health Information Technology and Infrastructure 
49.18 	Advisory Committee commissioner to fulfill the requirements of section 3013, paragraph 
49.19 	(g) of the HITECH Act.
49.20 	(c) The commissioner shall prepare and issue an annual report not later than January 
49.21 	30 of each year outlining progress to date in implementing a statewide health information 
49.22 	infrastructure and recommending future projects action on policy and necessary resources 
49.23 	to continue the promotion of adoption and effective use of health information technology.
49.24 	(d) Notwithstanding section 15.059, this subdivision expires June 30, 2015.
49.25 		Subd. 3.Interoperable electronic health record requirements. (a) To meet the 
49.26 	requirements of subdivision 1, hospitals and health care providers must meet the following 
49.27 	criteria when implementing an interoperable electronic health records system within their 
49.28 	hospital system or clinical practice setting.
49.29 	(a) The electronic health record must be a qualified electronic health record.
49.30 	(b) The electronic health record must be certified by the Certification Commission 
49.31 	for Healthcare Information Technology, or its successor Office of the National Coordinator 
49.32 	pursuant to the HITECH Act. This criterion only applies to hospitals and health care 
49.33 	providers whose practice setting is a practice setting covered by the Certification 
49.34 	Commission for Healthcare Information Technology certifications only if a certified 
49.35 	electronic health record product for the provider's particular practice setting is available. 
49.36 	This criterion shall be considered met if a hospital or health care provider is using an 
50.1 	electronic health records system that has been certified within the last three years, even if a 
50.2 	more current version of the system has been certified within the three-year period.
50.3 	(c) The electronic health record must meet the standards established according to 
50.4 	section 3004 of the HITECH Act as applicable.
50.5 	(d) The electronic health record must have the ability to generate information on 
50.6 	clinical quality measures and other measures reported under sections 4101, 4102, and 
50.7 	4201 of the HITECH Act.
50.8 	(c) (e) A health care provider who is a prescriber or dispenser of controlled 
50.9 	substances legend drugs must have an electronic health record system that meets the 
50.10 	requirements of section 62J.497.
50.11 		Subd. 4.Coordination with national HIT activities. (a) The commissioner, 
50.12 	in consultation with the e-Health Advisory Committee, shall update the statewide 
50.13 	implementation plan required under subdivision 2 and released June 2008, to be consistent 
50.14 	with the updated Federal HIT Strategic Plan released by the Office of the National 
50.15 	Coordinator in accordance with section 3001 of the HITECH Act.  The statewide plan 
50.16 	shall meet the requirements for a plan required under section 3013 of the HITECH Act.
50.17 	(b) The commissioner, in consultation with the e-Health Advisory Committee, shall 
50.18 	work to ensure coordination between state, regional, and national efforts to support and 
50.19 	accelerate efforts to effectively use health information technology to improve the quality 
50.20 	and coordination of health care and continuity of patient care among health care providers, 
50.21 	to reduce medical errors, to improve population health, to reduce health disparities, and 
50.22 	to reduce chronic disease.  The commissioner's coordination efforts shall include but not 
50.23 	be limited to:
50.24 	(1) assisting in the development and support of health information technology 
50.25 	regional extension centers established under section 3012(c) of the HITECH Act to 
50.26 	provide technical assistance and disseminate best practices; and
50.27 	(2) providing supplemental information to the best practices gathered by regional 
50.28 	centers to ensure that the information is relayed in a meaningful way to the Minnesota 
50.29 	health care community.
50.30 	(c) The commissioner, in consultation with the e-Health Advisory Committee, shall 
50.31 	monitor national activity related to health information technology and shall coordinate 
50.32 	statewide input on policy development.  The commissioner shall coordinate statewide 
50.33 	responses to proposed federal health information technology regulations in order to ensure 
50.34 	that the needs of the Minnesota health care community are adequately and efficiently 
50.35 	addressed in the proposed regulations. The commissioner's responses may include, but 
50.36 	are not limited to:
51.1 	(1) reviewing and evaluating any standard, implementation specification, or 
51.2 	certification criteria proposed by the national HIT standards committee;
51.3 	(2) reviewing and evaluating policy proposed by the national HIT policy 
51.4 	committee relating to the implementation of a nationwide health information technology 
51.5 	infrastructure;
51.6 	(3) monitoring and responding to activity related to the development of quality 
51.7 	measures and other measures as required by section 4101 of the HITECH Act. Any 
51.8 	response related to quality measures shall consider and address the quality efforts required 
51.9 	under chapter 62U; and
51.10 	(4) monitoring and responding to national activity related to privacy, security, and 
51.11 	data stewardship of electronic health information and individually identifiable health 
51.12 	information.
51.13 	(d) To the extent that the state is either required or allowed to apply, or designate an 
51.14 	entity to apply for or carry out activities and programs under section 3013 of the HITECH 
51.15 	Act, the commissioner of health, in consultation with the e-Health Advisory Committee 
51.16 	and the commissioner of human services, shall be the lead applicant or sole designating 
51.17 	authority. The commissioner shall make such designations consistent with the goals and 
51.18 	objectives of sections 62J.495 to 62J.497, and sections 62J.50 to 62J.61.
51.19 	(e) The commissioner of human services shall apply for funding necessary to 
51.20 	administer the incentive payments to providers authorized under title IV of the American 
51.21 	Recovery and Reinvestment Act.
51.22 	(f) The commissioner shall include in the report to the legislature information on the 
51.23 	activities of this subdivision and provide recommendations on any relevant policy changes 
51.24 	that should be considered in Minnesota.
51.25 		Subd. 5.Collection of data for assessment and eligibility determination. (a) 
51.26 	The commissioner of health, in consultation with the commissioner of human services, 
51.27 	may require providers, dispensers, group purchasers, and pharmaceutical electronic data 
51.28 	intermediaries to submit data in a form and manner specified by the commissioner to 
51.29 	assess the status of adoption, effective use, and interoperability of electronic health 
51.30 	records for the purpose of:
51.31 	(1) demonstrating Minnesota's progress on goals established by the Office of the 
51.32 	National Coordinator to accelerate the adoption and effective use of health information 
51.33 	technology established under the HITECH Act;
51.34 	(2) assisting the Center for Medicare and Medicaid Services and Department of 
51.35 	Human Services in determining eligibility of health care professionals and hospitals 
52.1 	to receive federal incentives for the adoption and effective use of health information 
52.2 	technology under the HITECH Act or other federal incentive programs;
52.3 	(3) assisting the Office of the National Coordinator in completing required 
52.4 	assessments of the impact of the implementation and effective use of health information 
52.5 	technology in achieving goals identified in the national strategic plan, and completing 
52.6 	studies required by the HITECH Act;
52.7 	(4) providing the data necessary to assist the Office of the National Coordinator in 
52.8 	conducting evaluations of regional extension centers as required by the HITECH Act; and
52.9 	(5) other purposes as necessary to support the implementation of the HITECH Act.
52.10 	(b) The commissioner shall coordinate with the commissioner of human services 
52.11 	and other state agencies in the collection of data required under this section to:
52.12 	(1) avoid duplicative reporting requirements;
52.13 	(2) maximize efficiencies in the development of reports on state activities as 
52.14 	required by HITECH; and
52.15 	(3) determine health professional and hospital eligibility for incentives available 
52.16 	under the HITECH Act.
52.17 		Subd. 6.Data classification. (a) Data collected on providers, dispensers, group 
52.18 	purchasers, and electronic data intermediaries under this section are private data on 
52.19 	individuals or nonpublic data, as defined in section 13.02. Notwithstanding the definition 
52.20 	of summary data in section 13.02, subdivision 19, summary data prepared under this 
52.21 	subdivision may be derived from nonpublic data.
52.22 	(b) Nothing in this section authorizes the collection of individual patient data.

52.23 	Sec. 3. Minnesota Statutes 2008, section 62J.496, is amended to read:
52.24 	62J.496 ELECTRONIC HEALTH RECORD SYSTEM REVOLVING 
52.25 	ACCOUNT AND LOAN PROGRAM.
52.26 		Subdivision 1.Account establishment. (a) An account is established to:provide 
52.27 	loans to eligible borrowers to assist in financing the installation or support of an 
52.28 	interoperable health record system. The system must provide for the interoperable 
52.29 	exchange of health care information between the applicant and, at a minimum, a hospital 
52.30 	system, pharmacy, and a health care clinic or other physician group.
52.31 	(1) finance the purchase of certified electronic health records or qualified electronic 
52.32 	health records as defined in section 62J.495, subdivision 1a;
52.33 	(2) enhance the utilization of electronic health record technology, which may include 
52.34 	costs associated with upgrading the technology to meet the criteria necessary to be a 
52.35 	certified electronic health record or a qualified electronic health record;
53.1 	(3) train personnel in the use of electronic health record technology; and
53.2 	(4) improve the secure electronic exchange of health information.
53.3 	(b) Amounts deposited in the account, including any grant funds obtained through 
53.4 	federal or other sources, loan repayments, and interest earned on the amounts shall be 
53.5 	used only for awarding loans or loan guarantees, as a source of reserve and security for 
53.6 	leveraged loans, or for the administration of the account.
53.7 	(c) The commissioner may accept contributions to the account from private sector 
53.8 	entities subject to the following provisions:
53.9 	(1) the contributing entity may not specify the recipient or recipients of any loan 
53.10 	issued under this subdivision;
53.11 	(2) the commissioner shall make public the identity of any private contributor to the 
53.12 	loan fund, as well as the amount of the contribution provided; and
53.13 	(3) the commissioner may issue letters of commendation or make other awards that 
53.14 	have no financial value to any such entity.
53.15 	A contributing entity may not specify that the recipient or recipients of any loan use 
53.16 	specific products or services, nor may the contributing entity imply that a contribution is 
53.17 	an endorsement of any specific product or service.
53.18 	(d) The commissioner may use the loan funds to reimburse private sector entities 
53.19 	for any contribution made to the loan fund. Reimbursement to private entities may not 
53.20 	exceed the principle amount contributed to the loan fund.
53.21 	(e) The commissioner may use funds deposited in the account to guarantee, or 
53.22 	purchase insurance for, a local obligation if the guarantee or purchase would improve 
53.23 	credit market access or reduce the interest rate applicable to the obligation involved.
53.24 	(f) The commissioner may use funds deposited in the account as a source of revenue 
53.25 	or security for the payment of principal and interest on revenue or bonds issued by the 
53.26 	state if the proceeds of the sale of the bonds will be deposited into the loan fund.
53.27 		Subd. 2.Eligibility. (a) "Eligible borrower" means one of the following:
53.28 	(1) federally qualified health centers;
53.29 	(1) (2) community clinics, as defined under section 145.9268;
53.30 	(2) (3) nonprofit hospitals eligible for rural hospital capital improvement grants, as 
53.31 	defined  in section 144.148 licensed under sections 144.50 to 144.56;
53.32 	(3) physician clinics located in a community with a population of less than 50,000 
53.33 	according to United States Census Bureau statistics and outside the seven-county 
53.34 	metropolitan area;
53.35 	(4) individual or small group physician practices that are focused primarily on 
53.36 	primary care;
54.1 	(4) (5) nursing facilities licensed under sections 144A.01 to 144A.27; and
54.2 	(6) local public health departments as defined in chapter 145A; and
54.3 	(5) (7) other providers of health or health care services approved by the 
54.4 	commissioner for which interoperable electronic health record capability would improve 
54.5 	quality of care, patient safety, or community health.
54.6 	 (b) The commissioner shall administer the loan fund to prioritize support and 
54.7 	assistance to:
54.8 	(1) critical access hospitals;
54.9 	(2) federally qualified health centers;
54.10 	(3) entities that serve uninsured, underinsured, and medically underserved 
54.11 	individuals, regardless of whether such area is urban or rural; and
54.12 	(4) individual or small group practices that are primarily focused on primary care.
54.13 	(b) To be eligible for a loan under this section, the (c) An eligible applicant must 
54.14 	submit a loan application to the commissioner of health on forms prescribed by the 
54.15 	commissioner. The application must include, at a minimum:
54.16 	(1) the amount of the loan requested and a description of the purpose or project 
54.17 	for which the loan proceeds will be used;
54.18 	(2) a quote from a vendor;
54.19 	(3) a description of the health care entities and other groups participating in the 
54.20 	project;
54.21 	(4) evidence of financial stability and a demonstrated ability to repay the loan; and
54.22 	(5) a description of how the system to be financed interconnects interoperates or 
54.23 	plans in the future to interconnect interoperate with other health care entities and provider 
54.24 	groups located in the same geographical area;
54.25 	(6) a plan on how the certified electronic health record technology will be maintained 
54.26 	and supported over time; and
54.27 	(7) any other requirements for applications included or developed pursuant to 
54.28 	section 3014 of the HITECH Act.
54.29 		Subd. 3.Loans and grants. (a) The commissioner of health may make a no interest
54.30 	grant, or a no interest loan or low interest loan to a provider or provider group who is 
54.31 	eligible under subdivision 2 on a first-come, first-served basis provided that the applicant 
54.32 	is able to comply with this section consistent with the priorities established in subdivision 
54.33 	2. The total accumulative loan principal must not exceed $1,500,000 $3,000,000 per loan.
54.34 	The interest rate for each loan, if imposed, shall not exceed the current market interest 
54.35 	rate. The commissioner of health has discretion over the size, interest rate, and number 
55.1 	of loans made. Nothing in this section shall require the commissioner to make a loan to 
55.2 	an eligible borrower under subdivision 2.
55.3 	(b) The commissioner of health may prescribe forms and establish an application 
55.4 	process and, notwithstanding section 16A.1283, may impose a reasonable nonrefundable 
55.5 	application fee to cover the cost of administering the loan program. Any application 
55.6 	fees imposed and collected under the electronic health records system revolving account 
55.7 	and loan program in this section are appropriated to the commissioner of health for the 
55.8 	duration of the loan program. The commissioner may apply for and use all federal funds 
55.9 	available through the HITECH Act to administer the loan program.
55.10 	(c) For loans approved prior to July 1, 2009, the borrower must begin repaying the 
55.11 	principal no later than two years from the date of the loan. Loans must be amortized no 
55.12 	later than six years from the date of the loan.
55.13 	(d) For loans granted on January 1, 2010, or thereafter, the borrower must begin 
55.14 	repaying the principle no later than one year from the date of the loan.  Loans must be 
55.15 	amortized no later than six years after the date of the loan.
55.16 	(d) Repayments (e) All repayments and interest paid on each loan must be credited 
55.17 	to the account.
55.18 	(f) The loan agreement shall include the assurances that borrower meets requirements 
55.19 	included or developed pursuant to section 3014 of the HITECH Act. The requirements 
55.20 	shall include, but are not limited to:
55.21 	(1) submitting reports on quality measures in compliance with regulations adopted 
55.22 	by the federal government;
55.23 	(2) demonstrating that any certified electronic health record technology purchased, 
55.24 	improved, or otherwise financially supported by this loan program is used to exchange 
55.25 	health information in a manner that, in accordance with law and standards applicable to 
55.26 	the exchange of information, improves the quality of health care;
55.27 	(3) including a plan on how the borrower intends to maintain and support the 
55.28 	certified electronic health record technology over time and the resources expected to be 
55.29 	used to maintain and support the technology purchased with the loan; and
55.30 	(4) complying with other requirements the secretary may require to use loans funds 
55.31 	under the HITECH Act.
55.32 		Subd. 4.Data classification. Data collected by the commissioner of health on the 
55.33 	application to determine eligibility under subdivision 2 and to monitor borrowers' default 
55.34 	risk or collect payments owed under subdivision 3 are (1) private data on individuals as 
55.35 	defined in section 13.02, subdivision 12; and (2) nonpublic data as defined in section 
56.1 	13.02, subdivision 9. The names of borrowers and the amounts of the loans granted 
56.2 	are public data.

56.3 	Sec. 4. Minnesota Statutes 2008, section 62J.497, subdivision 1, is amended to read:
56.4 		Subdivision 1.Definitions. For the purposes of this section, the following terms 
56.5 	have the meanings given.
56.6 	(a) "Backward compatible" means that the newer version of a data transmission 
56.7 	standard would retain, at a minimum, the full functionality of the versions previously 
56.8 	adopted, and would permit the successful completion of the applicable transactions with 
56.9 	entities that continue to use the older versions.
56.10 	(a) (b) "Dispense" or "dispensing" has the meaning given in section 151.01, 
56.11 	subdivision 30. Dispensing does not include the direct administering of a controlled 
56.12 	substance to a patient by a licensed health care professional.
56.13 	(b) (c) "Dispenser" means a person authorized by law to dispense a controlled 
56.14 	substance, pursuant to a valid prescription.
56.15 	(c) (d) "Electronic media" has the meaning given under Code of Federal Regulations, 
56.16 	title 45, part 160.103.
56.17 	(d) (e) "E-prescribing" means the transmission using electronic media of prescription 
56.18 	or prescription-related information between a prescriber, dispenser, pharmacy benefit 
56.19 	manager, or group purchaser, either directly or through an intermediary, including 
56.20 	an e-prescribing network. E-prescribing includes, but is not limited to, two-way 
56.21 	transmissions between the point of care and the dispenser and two-way transmissions 
56.22 	related to eligibility, formulary, and medication history information.
56.23 	(e) (f) "Electronic prescription drug program" means a program that provides for 
56.24 	e-prescribing.
56.25 	(f) (g) "Group purchaser" has the meaning given in section 62J.03, subdivision 6.
56.26 	(g) (h) "HL7 messages" means a standard approved by the standards development 
56.27 	organization known as Health Level Seven.
56.28 	(h) (i) "National Provider Identifier" or "NPI" means the identifier described under 
56.29 	Code of Federal Regulations, title 45, part 162.406.
56.30 	(i) (j) "NCPDP" means the National Council for Prescription Drug Programs, Inc.
56.31 	(j) (k) "NCPDP Formulary and Benefits Standard" means the National Council for 
56.32 	Prescription Drug Programs Formulary and Benefits Standard, Implementation Guide, 
56.33 	Version 1, Release 0, October 2005.
56.34 	(k) (l) "NCPDP SCRIPT Standard" means the National Council for Prescription 
56.35 	Drug Programs Prescriber/Pharmacist Interface SCRIPT Standard, Implementation 
57.1 	Guide Version 8, Release 1 (Version 8.1), October 2005, or the most recent standard 
57.2 	adopted by the Centers for Medicare and Medicaid Services for e-prescribing under 
57.3 	Medicare Part D as required by section 1860D-4(e)(4)(D) of the Social Security Act, and 
57.4 	regulations adopted under it. The standards shall be implemented according to the Centers 
57.5 	for Medicare and Medicaid Services schedule for compliance. Subsequently released 
57.6 	versions of the NCPDP SCRIPT Standard may be used, provided that the new version 
57.7 	of the standard is backward compatible to the current version adopted by the Centers for 
57.8 	Medicare and Medicaid Services.
57.9 	(l) (m) "Pharmacy" has the meaning given in section 151.01, subdivision 2.
57.10 	(m) (n) "Prescriber" means a licensed health care professional who is authorized to 
57.11 	prescribe a controlled substance under section 152.12, subdivision 1. practitioner, other 
57.12 	than a veterinarian, as defined in section 151.01, subdivision 23.
57.13 	(n) (o) "Prescription-related information" means information regarding eligibility for 
57.14 	drug benefits, medication history, or related health or drug information.
57.15 	(o) (p) "Provider" or "health care provider" has the meaning given in section 62J.03, 
57.16 	subdivision 8.

57.17 	Sec. 5. Minnesota Statutes 2008, section 62J.497, subdivision 2, is amended to read:
57.18 		Subd. 2.Requirements for electronic prescribing. (a) Effective January 1, 2011, 
57.19 	all providers, group purchasers, prescribers, and dispensers must establish and, maintain, 
57.20 	and use an electronic prescription drug program that complies. This program must comply
57.21 	with the applicable standards in this section for transmitting, directly or through an 
57.22 	intermediary, prescriptions and prescription-related information using electronic media.
57.23 	(b) Nothing in this section requires providers, group purchasers, prescribers, or 
57.24 	dispensers to conduct the transactions described in this section. If transactions described in 
57.25 	this section are conducted, they must be done electronically using the standards described 
57.26 	in this section. Nothing in this section requires providers, group purchasers, prescribers, 
57.27 	or dispensers to electronically conduct transactions that are expressly prohibited by other 
57.28 	sections or federal law.
57.29 	(c) Providers, group purchasers, prescribers, and dispensers must use either HL7 
57.30 	messages or the NCPDP SCRIPT Standard to transmit prescriptions or prescription-related 
57.31 	information internally when the sender and the recipient are part of the same legal entity. If 
57.32 	an entity sends prescriptions outside the entity, it must use the NCPDP SCRIPT Standard 
57.33 	or other applicable standards required by this section. Any pharmacy within an entity 
57.34 	must be able to receive electronic prescription transmittals from outside the entity using 
57.35 	the adopted NCPDP SCRIPT Standard. This exemption does not supersede any Health 
58.1 	Insurance Portability and Accountability Act (HIPAA) requirement that may require the 
58.2 	use of a HIPAA transaction standard within an organization.
58.3 	(d) Entities transmitting prescriptions or prescription-related information where the 
58.4 	prescriber is required by law to issue a prescription for a patient to a nonprescribing 
58.5 	provider that in turn forwards the prescription to a dispenser are exempt from the 
58.6 	requirement to use the NCPDP SCRIPT Standard when transmitting prescriptions or 
58.7 	prescription-related information.

58.8 	Sec. 6. Minnesota Statutes 2008, section 62J.497, is amended by adding a subdivision 
58.9 	to read:
58.10 		Subd. 4.Development and use of uniform formulary exception form. (a) The 
58.11 	commissioner of health, in consultation with the Minnesota Administrative Uniformity 
58.12 	Committee, shall develop by July 1, 2009, or six weeks after enactment of this subdivision, 
58.13 	whichever is later, a uniform formulary exception form that allows health care providers 
58.14 	to request exceptions from group purchaser formularies using a uniform form. Upon 
58.15 	development of the form, all health care providers must submit requests for formulary 
58.16 	exceptions using the uniform form, and all group purchasers must accept this form from 
58.17 	health care providers.
58.18 	(b) No later than January 1, 2011, the uniform formulary exception form must be 
58.19 	accessible and submitted by health care providers, and accepted and processed by group 
58.20 	purchasers, through secure electronic transmissions. Facsimile shall not be considered 
58.21 	secure electronic transmissions.

58.22 	Sec. 7. Minnesota Statutes 2008, section 62J.497, is amended by adding a subdivision 
58.23 	to read:
58.24 		Subd. 5.Electronic drug prior authorization standardization and transmission.
 58.25 	(a) The commissioner of health, in consultation with the Minnesota e-Health Advisory 
58.26 	Committee and the Minnesota Administrative Uniformity Committee, shall, by February 
58.27 	15, 2010, identify an outline on how best to standardize drug prior authorization request 
58.28 	transactions between providers and group purchasers with the goal of maximizing 
58.29 	administrative simplification and efficiency in preparation for electronic transmissions.
58.30 	(b) No later than January 1, 2011, drug prior authorization requests must be 
58.31 	accessible and submitted by health care providers, and accepted and processed by group 
58.32 	purchasers, electronically through secure electronic transmissions. Facsimile shall not be 
58.33 	considered electronic transmission.

59.1 	Sec. 8. [62Q.676] MEDICATION THERAPY MANAGEMENT.
59.2 	A pharmacy benefit manager that provides prescription drug services must make 
59.3 	available medication therapy management services for enrollees taking four or more 
59.4 	prescriptions to treat or prevent two or more chronic medical conditions. For purposes 
59.5 	of this section, "medication therapy management" means the provision of the following 
59.6 	pharmaceutical care services by a licensed pharmacist to optimize the therapeutic 
59.7 	outcomes of the patient's medications:
59.8 	(1) performing a comprehensive medication review to identify, resolve, and prevent 
59.9 	medication-related problems, including adverse drug events;
59.10 	(2) communicating essential information to the patient's other primary care 
59.11 	providers; and
59.12 	(3) providing verbal education and training designed to enhance patient 
59.13 	understanding and appropriate use of the patient's medications.
59.14 	Nothing in this section shall be construed to expand or modify the scope of practice 
59.15 	of the pharmacist as defined in section 151.01, subdivision 27.

59.16 	Sec. 9. Minnesota Statutes 2008, section 144.122, is amended to read:
59.17 	144.122 LICENSE, PERMIT, AND SURVEY FEES.
59.18 	(a) The state commissioner of health, by rule, may prescribe procedures and fees 
59.19 	for filing with the commissioner as prescribed by statute and for the issuance of original 
59.20 	and renewal permits, licenses, registrations, and certifications issued under authority of 
59.21 	the commissioner. The expiration dates of the various licenses, permits, registrations, 
59.22 	and certifications as prescribed by the rules shall be plainly marked thereon. Fees may 
59.23 	include application and examination fees and a penalty fee for renewal applications 
59.24 	submitted after the expiration date of the previously issued permit, license, registration, 
59.25 	and certification. The commissioner may also prescribe, by rule, reduced fees for permits, 
59.26 	licenses, registrations, and certifications when the application therefor is submitted 
59.27 	during the last three months of the permit, license, registration, or certification period. 
59.28 	Fees proposed to be prescribed in the rules shall be first approved by the Department of 
59.29 	Finance. All fees proposed to be prescribed in rules shall be reasonable. The fees shall be 
59.30 	in an amount so that the total fees collected by the commissioner will, where practical, 
59.31 	approximate the cost to the commissioner in administering the program. All fees collected 
59.32 	shall be deposited in the state treasury and credited to the state government special revenue 
59.33 	fund unless otherwise specifically appropriated by law for specific purposes.
59.34 	(b) The commissioner may charge a fee for voluntary certification of medical 
59.35 	laboratories and environmental laboratories, and for environmental and medical laboratory 
60.1 	services provided by the department, without complying with paragraph (a) or chapter 14. 
60.2 	Fees charged for environment and medical laboratory services provided by the department 
60.3 	must be approximately equal to the costs of providing the services.
60.4 	(c) The commissioner may develop a schedule of fees for diagnostic evaluations 
60.5 	conducted at clinics held by the services for children with disabilities program. All 
60.6 	receipts generated by the program are annually appropriated to the commissioner for use 
60.7 	in the maternal and child health program.
60.8 	(d) The commissioner shall set license fees for hospitals and nursing homes that are 
60.9 	not boarding care homes at the following levels:

60.10
60.11
60.12
60.13	Joint Commission on Accreditation of 
Healthcare Organizations (JCAHO) and 
American Osteopathic Association (AOA) 
hospitals
	$7,555$7,655 plus $13$16 per bed
	
60.14	Non-JCAHO and non-AOA hospitals
	$5,180$5,280 plus $247$250 per bed
	
60.15	Nursing home
	$183 plus $91 per bed
	
60.16 	The commissioner shall set license fees for outpatient surgical centers, boarding care 
60.17 	homes, and supervised living facilities at the following levels:

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

60.24	Prospective payment surveys for hospitals
	$
	900
	
60.25	Swing bed surveys for nursing homes
	$
	1,200
	
60.26	Psychiatric hospitals
	$
	1,400
	
60.27	Rural health facilities
	$
	1,100
	
60.28	Portable x-ray providers
	$
	500
	
60.29	Home health agencies
	$
	1,800
	
60.30	Outpatient therapy agencies
	$
	800
	
60.31	End stage renal dialysis providers
	$
	2,100
	
60.32	Independent therapists
	$
	800
	
60.33	Comprehensive rehabilitation outpatient facilities
	$
	1,200
	
60.34	Hospice providers
	$
	1,700
	
60.35	Ambulatory surgical providers
	$
	1,800
	
60.36	Hospitals
	$
	4,200
	
60.37
60.38
60.39	Other provider categories or additional
resurveys required to complete initial
certification
	Actual surveyor costs: average 
surveyor cost x number of hours 
for the survey process.
	
61.1 	These fees shall be submitted at the time of the application for federal certification 
61.2 	and shall not be refunded. All fees collected after the date that the imposition of fees is not 
61.3 	prohibited by federal law shall be deposited in the state treasury and credited to the state 
61.4 	government special revenue fund.

61.5 	Sec. 10. Minnesota Statutes 2008, section 144.218, subdivision 1, is amended to read:
61.6 		Subdivision 1.Adoption. (a) Upon receipt of a certified copy of an order, decree, 
61.7 	or certificate of adoption, the state registrar shall register a replacement vital record in 
61.8 	the new name of the adopted person. Except as provided in paragraph (b), the original 
61.9 	record of birth is confidential pursuant to private data on individuals, as defined in section 
61.10 	13.02, subdivision 3 12, and shall not be disclosed except pursuant to court order or 
61.11 	section 144.2252 or 144.2253.
61.12 	(b) The information contained on the original birth record, except for the registration 
61.13 	number, shall be provided on request to: (1) a parent who is named on the original birth 
61.14 	record; or (2) the adopted person who is the subject of the record if the person is at least 
61.15 	19 years of age, unless there is an affidavit of nondisclosure on file with the state registrar. 
61.16 	Upon the receipt of a certified copy of a court order of annulment of adoption the state 
61.17 	registrar shall restore the original vital record to its original place in the file.  

61.18 	EFFECTIVE DATE. This section is effective August 1, 2010.

61.19 	Sec. 11. Minnesota Statutes 2008, section 144.225, subdivision 2, is amended to read:
61.20 		Subd. 2.Data about births. (a) Except as otherwise provided in this subdivision, 
61.21 	data pertaining to the birth of a child to a woman who was not married to the child's father 
61.22 	when the child was conceived nor when the child was born, including the original record 
61.23 	of birth and the certified vital record, are confidential data. At the time of the birth of a 
61.24 	child to a woman who was not married to the child's father when the child was conceived 
61.25 	nor when the child was born, the mother may designate demographic data pertaining to 
61.26 	the birth as public. Notwithstanding the designation of the data as confidential, it may 
61.27 	be disclosed:
61.28 	(1) to a parent or guardian of the child;
61.29 	(2) to the child when the child is 16 years of age or older;
61.30 	(3) under paragraph (b) or (e); or
61.31 	(4) pursuant to a court order. For purposes of this section, a subpoena does not 
61.32 	constitute a court order.
61.33 	(b) Unless the child is adopted, data pertaining to the birth of a child that are not 
61.34 	accessible to the public become public data if 100 years have elapsed since the birth of 
62.1 	the child who is the subject of the data, or as provided under section 13.10, whichever 
62.2 	occurs first.  
62.3 	(c) If a child is adopted, data pertaining to the child's birth are governed by the 
62.4 	provisions relating to adoption records, including sections 13.10, subdivision 5; 144.218, 
62.5 	subdivision 1; 144.2252; 144.2253; and 259.89.  
62.6 	(d) The name and address of a mother under paragraph (a) and the child's date of 
62.7 	birth may be disclosed to the county social services or public health member of a family 
62.8 	services collaborative for purposes of providing services under section 124D.23.  
62.9 	(e) The commissioner of human services shall have access to birth records for:
62.10 	(1) the purposes of administering medical assistance, general assistance medical 
62.11 	care, and the MinnesotaCare program;
62.12 	(2) child support enforcement purposes; and
62.13 	(3) other public health purposes as determined by the commissioner of health.

62.14 	EFFECTIVE DATE. This section is effective August 1, 2010.

62.15 	Sec. 12. Minnesota Statutes 2008, section 144.2252, is amended to read:
62.16 	144.2252 ACCESS TO ORIGINAL BIRTH RECORD AFTER ADOPTION.
62.17 	(a) Whenever an adopted person requests the state registrar to disclose the 
62.18 	information on the adopted person's original birth record, the state registrar shall act 
62.19 	according to section 259.89 144.2253.  
62.20 	(b) The state registrar shall provide a transcript of an adopted person's original birth 
62.21 	record to an authorized representative of a federally recognized American Indian tribe 
62.22 	for the sole purpose of determining the adopted person's eligibility for enrollment or 
62.23 	membership. Information contained in the birth record may not be used to provide the 
62.24 	adopted person information about the person's birth parents, except as provided in this 
62.25 	section or section 259.83 144.2253.  

62.26 	EFFECTIVE DATE. This section is effective August 1, 2010.

62.27 	Sec. 13. [144.2253] ACCESS TO ORIGINAL BIRTH RECORDS BY ADOPTED 
62.28 	PERSON; DEPARTMENT DUTIES.
62.29 		Subdivision 1.Affidavits. The department shall prepare affidavit of disclosure and 
62.30 	nondisclosure forms under which a birth parent may agree to or object to the release of the 
62.31 	original birth record to the adopted person. The department shall make the forms readily 
62.32 	accessible to birth parents on the department's Web site.
63.1 		Subd. 2.Disclosure. Upon request, the state registrar shall provide a noncertified 
63.2 	copy of the original birth record to an adopted person age 19 or older, unless there is 
63.3 	an affidavit of nondisclosure on file.  The state registrar must comply with the terms of 
63.4 	affidavits of disclosure or affidavits of nondisclosure.
63.5 		Subd. 3.Rescission of affidavit. A birth parent may rescind an affidavit of 
63.6 	disclosure or an affidavit of nondisclosure at any time.
63.7 		Subd. 4.Affidavit of nondisclosure; access to birth record.  If an affidavit of 
63.8 	nondisclosure is on file with the registrar, an adopted person age 19 or older may petition 
63.9 	the appropriate court for disclosure of the original birth record pursuant to section 259.61. 
63.10 	The court shall grant the petition if, after consideration of the interests of all known 
63.11 	persons affected by the petition, the court determines that the benefits of disclosure of the 
63.12 	information are greater than the benefits of nondisclosure.
63.13 		Subd. 5.Information provided. (a) The department shall, in consultation with 
63.14 	adoption agencies and adoption advocates, provide information and educational materials 
63.15 	to adopted persons and birth parents about the changes in the law under this act affecting 
63.16 	accessibility to birth records. For purposes of this subdivision, an adoption advocate is a 
63.17 	nonprofit organization that works with adoption issues in Minnesota.
63.18 	(b) The department shall include a notice on the department Web site about the 
63.19 	change in the law under this act and direct individuals to private agencies and advocates 
63.20 	for post-adoption resources.
63.21 	(c) Adoption agencies may charge a fee for counseling and support services provided 
63.22 	to adopted persons and birth parents.

63.23 	EFFECTIVE DATE. This section is effective August 1, 2010.

63.24 	Sec. 14. Minnesota Statutes 2008, section 144.226, subdivision 1, is amended to read:
63.25 		Subdivision 1.Which services are for fee. The fees for the following services shall 
63.26 	be the following or an amount prescribed by rule of the commissioner:
63.27 	(a) The fee for the issuance of a certified vital record or a certification that the vital 
63.28 	record cannot be found is $9. No fee shall be charged for a certified birth, stillbirth, or 
63.29 	death record that is reissued within one year of the original issue, if an amendment is 
63.30 	made to the vital record and if the previously issued vital record is surrendered. The 
63.31 	fee is nonrefundable.
63.32 	(b) The fee for processing a request for the replacement of a birth record for 
63.33 	all events, except when filing a recognition of parentage pursuant to section 257.73, 
63.34 	subdivision 1, is $40. The fee is payable at the time of application and is nonrefundable.
64.1 	(c) The fee for processing a request for the filing of a delayed registration of 
64.2 	birth, stillbirth, or death is $40. The fee is payable at the time of application and is 
64.3 	nonrefundable. This fee includes one subsequent review of the request if the request 
64.4 	is not acceptable upon the initial receipt.
64.5 	(d) The fee for processing a request for the amendment of any vital record when 
64.6 	requested more than 45 days after the filing of the vital record is $40. No fee shall be 
64.7 	charged for an amendment requested within 45 days after the filing of the vital record. 
64.8 	The fee is payable at the time of application and is nonrefundable. This fee includes one 
64.9 	subsequent review of the request if the request is not acceptable upon the initial receipt.
64.10 	(e) The fee for processing a request for the verification of information from vital 
64.11 	records is $9 when the applicant furnishes the specific information to locate the vital 
64.12 	record. When the applicant does not furnish specific information, the fee is $20 per hour 
64.13 	for staff time expended. Specific information includes the correct date of the event and 
64.14 	the correct name of the registrant. Fees charged shall approximate the costs incurred in 
64.15 	searching and copying the vital records. The fee is payable at the time of application 
64.16 	and is nonrefundable.
64.17 	(f) The fee for processing a request for the issuance of a copy of any document on 
64.18 	file pertaining to a vital record or statement that a related document cannot be found is $9. 
64.19 	The fee is payable at the time of application and is nonrefundable.
64.20 	(g) The department shall charge a fee of $18 for noncertified copies of birth records 
64.21 	provided to adopted persons age 19 or older to cover the cost of providing the birth record 
64.22 	and any costs associated with the distribution of information to adopted persons and birth 
64.23 	parents required under section 144.2253, subdivision 5.

64.24 	EFFECTIVE DATE. This section is effective August 1, 2010.

64.25 	Sec. 15. Minnesota Statutes 2008, section 144.226, subdivision 4, is amended to read:
64.26 		Subd. 4.Vital records surcharge. (a) In addition to any fee prescribed under 
64.27 	subdivision 1, there is a nonrefundable surcharge of $2 for each certified and noncertified 
64.28 	birth, stillbirth, or death record, and for a certification that the record cannot be found. 
64.29 	The local or state registrar shall forward this amount to the commissioner of finance to 
64.30 	be deposited into the state government special revenue fund. This surcharge shall not be 
64.31 	charged under those circumstances in which no fee for a birth, stillbirth, or death record is 
64.32 	permitted under subdivision 1, paragraph (a).
64.33 	(b) Effective August 1, 2005, to June 30, 2009, the surcharge in paragraph (a) shall 
64.34 	be is $4.

65.1 	Sec. 16. Minnesota Statutes 2008, section 148.6445, is amended by adding a 
65.2 	subdivision to read:
65.3 		Subd. 2a.Duplicate license fee. The fee for a duplicate license is $25.

65.4 	Sec. 17. Minnesota Statutes 2008, section 259.89, subdivision 1, is amended to read:
65.5 		Subdivision 1.Request. An adopted person who is 19 years of age or over may 
65.6 	request the commissioner of health to disclose the information on the adopted person's 
65.7 	original birth record. The commissioner of health shall, within five days of receipt of 
65.8 	the request, notify the commissioner of human services' agent or licensed child-placing 
65.9 	agency when known, or the commissioner of human services when the agency is not 
65.10 	known in writing of the request by the adopted person.

65.11 	EFFECTIVE DATE. This section is effective August 1, 2010.

65.12 	Sec. 18. Minnesota Statutes 2008, section 260C.317, subdivision 4, is amended to read:
65.13 		Subd. 4.Rights of terminated parent. Upon entry of an order terminating the 
65.14 	parental rights of any person who is identified as a parent on the original birth record of 
65.15 	the child as to whom the parental rights are terminated, the court shall cause written 
65.16 	notice to be made to that person setting forth:
65.17 	(1) the right of the person to file at any time with the state registrar of vital statistics 
65.18 	a consent to disclosure, as defined in section 144.212, subdivision 11; and
65.19 	(2) the right of the person to file at any time with the state registrar of vital statistics 
65.20 	an affidavit stating that the information on the original birth record shall not be disclosed 
65.21 	as provided in section 144.2252 144.2253; and.
65.22 	(3) the effect of a failure to file either a consent to disclosure, as defined in section 
65.23 	144.212, subdivision 11, or an affidavit stating that the information on the original birth 
65.24 	record shall not be disclosed.  

65.25 	EFFECTIVE DATE. This section is effective August 1, 2010.

65.26 	Sec. 19.  REPEALER.
 65.27 	(a) Minnesota Statutes 2008, sections 259.83, subdivision 3; and 259.89, 
65.28 	subdivisions 2, 3, and 4, are repealed effective retroactively from August 1, 2008.
65.29 	(b) Minnesota Statutes 2008, section 62U.08, is repealed.

66.1 	ARTICLE 6
66.2 	HEALTH CARE PROGRAMS

66.3 	Section 1. Minnesota Statutes 2008, section 62J.692, subdivision 7, is amended to read:
66.4 		Subd. 7.Transfers from the commissioner of human services. (a) The amount 
66.5 	transferred according to section 256B.69, subdivision 5c, paragraph (a), clause (1), shall 
66.6 	be distributed by the commissioner annually to clinical medical education programs that 
66.7 	meet the qualifications of subdivision 3 based on the formula in subdivision 4, paragraph 
66.8 	(a). Of the amount transferred according to section 256B.69, subdivision 5c, paragraph 
66.9 	(a), clauses (1) to (4), $21,714,000 must be distributed as follows:
66.10 	(1) $2,157,000 by the commissioner to the University of Minnesota Board of 
66.11 	Regents for the purposes described in sections 137.38 to 137.40;
66.12 	(2) $1,035,360 by the commissioner to the Hennepin County Medical Center for 
66.13 	clinical medical education;
66.14 	(3) $17,400,000 by the commissioner to the University of Minnesota Board of 
66.15 	Regents for purposes of medical education;
66.16 	(4) $1,121,640 by the commissioner to clinical medical education dental innovation 
66.17 	grants in accordance with subdivision 7a; and
66.18 	(5) the remainder of the amount transferred according to section 256B.69, 
66.19 	subdivision 5c, paragraph (a), clauses (1) to (4), must be distributed by the commissioner 
66.20 	annually to clinical medical education programs that meet the qualifications of subdivision 
66.21 	3 based on the formula in subdivision 4, paragraph (a).
66.22 	(b) Fifty percent of the amount transferred according to section 256B.69, subdivision 
66.23 	5c, paragraph (a), clause (2), shall be distributed by the commissioner to the University of 
66.24 	Minnesota Board of Regents for the purposes described in sections 137.38 to 137.40. Of 
66.25 	the remaining amount transferred according to section 256B.69, subdivision 5c, paragraph 
66.26 	(a), clause (2), 24 percent of the amount shall be distributed by the commissioner to 
66.27 	the Hennepin County Medical Center for clinical medical education. The remaining 26 
66.28 	percent of the amount transferred shall be distributed by the commissioner in accordance 
66.29 	with subdivision 7a. If the federal approval is not obtained for the matching funds under 
66.30 	section 256B.69, subdivision 5c, paragraph (a), clause (2), 100 percent of the amount 
66.31 	transferred under this paragraph shall be distributed by the commissioner to the University 
66.32 	of Minnesota Board of Regents for the purposes described in sections 137.38 to 137.40.
66.33 	(c) The amount transferred according to section 256B.69, subdivision 5c, paragraph 
66.34 	(a), clauses (3) and (4), shall be distributed by the commissioner upon receipt to the 
67.1 	University of Minnesota Board of Regents for the purposes of clinical graduate medical 
67.2 	education.

67.3 	Sec. 2. Minnesota Statutes 2008, section 125A.744, subdivision 3, is amended to read:
67.4 		Subd. 3.Implementation. Consistent with section 256B.0625, subdivision 26, 
67.5 	school districts may enroll as medical assistance providers or subcontractors and bill 
67.6 	the Department of Human Services under the medical assistance fee for service claims 
67.7 	processing system for special education services which are covered services under chapter 
67.8 	256B, which are provided in the school setting for a medical assistance recipient, and for 
67.9 	whom the district has secured informed consent consistent with section 13.05, subdivision 
67.10 	4, paragraph (d), and section 256B.77, subdivision 2, paragraph (p), to bill for each type 
67.11 	of covered service. School districts shall be reimbursed by the commissioner of human 
67.12 	services for the federal share of individual education plan health-related services that 
67.13 	qualify for reimbursement by medical assistance, minus up to five percent retained by the 
67.14 	commissioner of human services for administrative costs, not to exceed $350,000 per 
67.15 	fiscal year. The commissioner may withhold up to five percent of each payment to a 
67.16 	school district. Following the end of each fiscal year, the commissioner shall settle up with 
67.17 	each school district in order to ensure that collections from each district for departmental 
67.18 	administrative costs are made on a pro rata basis according to federal earnings for these 
67.19 	services in each district. A school district is not eligible to enroll as a home care provider 
67.20 	or a personal care provider organization for purposes of billing home care services under 
67.21 	sections 256B.0651 and 256B.0653 to 256B.0656 until the commissioner of human 
67.22 	services issues a bulletin instructing county public health nurses on how to assess for the 
67.23 	needs of eligible recipients during school hours. To use private duty nursing services or 
67.24 	personal care services at school, the recipient or responsible party must provide written 
67.25 	authorization in the care plan identifying the chosen provider and the daily amount 
67.26 	of services to be used at school.

67.27 	Sec. 3. Minnesota Statutes 2008, section 256.01, subdivision 2b, is amended to read:
67.28 		Subd. 2b. Performance payments; performance measurement. (a) The 
67.29 	commissioner shall develop and implement a pay-for-performance system to provide 
67.30 	performance payments to eligible medical groups and clinics that demonstrate optimum 
67.31 	care in serving individuals with chronic diseases who are enrolled in health care 
67.32 	programs administered by the commissioner under chapters 256B, 256D, and 256L. 
67.33 	The commissioner may receive any federal matching money that is made available 
67.34 	through the medical assistance program for managed care oversight contracted through 
68.1 	vendors, including consumer surveys, studies, and external quality reviews as required 
68.2 	by the federal Balanced Budget Act of 1997, Code of Federal Regulations, title 42, part 
68.3 	438-managed care, subpart E-external quality review. Any federal money received 
68.4 	for managed care oversight is appropriated to the commissioner for this purpose. The 
68.5 	commissioner may expend the federal money received in either year of the biennium.
68.6 	(b) Effective July 1, 2008, or upon federal approval, whichever is later, the 
68.7 	commissioner shall develop and implement a patient incentive health program to provide 
68.8 	incentives and rewards to patients who are enrolled in health care programs administered 
68.9 	by the commissioner under chapters 256B, 256D, and 256L, and who have agreed to and 
68.10 	have met personal health goals established with the patients' primary care providers to 
68.11 	manage a chronic disease or condition, including but not limited to diabetes, high blood 
68.12 	pressure, and coronary artery disease. The commissioner, in consultation with the Health 
68.13 	and Human Services Policy Committee, shall develop and provide to the legislature by 
68.14 	December 15, 2009, a methodology and any draft legislation necessary to allow for the 
68.15 	release, upon request, of summary data as defined in section 13.02, subdivision 19, 
68.16 	on claims and utilization for medical assistance, general assistance medical care, and 
68.17 	MinnesotaCare enrollees at no charge to the University of Minnesota Medical School, the 
68.18 	Mayo Medical School, Northwestern Health Sciences University, the Institute for Clinical 
68.19 	Systems Improvement, and other research institutions, to conduct analyses of health care 
68.20 	outcomes and treatment effectiveness, provided the research institutions do not release 
68.21 	private or nonpublic data, or data for which dissemination is prohibited by law.

68.22 	Sec. 4. Minnesota Statutes 2008, section 256.01, is amended by adding a subdivision 
68.23 	to read:
68.24 		Subd. 18a.Public Assistance Reporting Information System. (a) Effective 
68.25 	October 1, 2009, the commissioner shall comply with the federal requirements in Public 
68.26 	Law 110-379 in implementing the Public Assistance Reporting Information System 
68.27 	(PARIS) to determine eligibility for all individuals applying for:
68.28 	(1) health care benefits under chapters 256B, 256D, and 256L; and
68.29 	(2) public benefits under chapters 119B, 256D, 256I, and the supplemental nutrition 
68.30 	assistance program.
68.31 	(b) The commissioner shall determine eligibility under paragraph (a) by performing 
68.32 	data matches, including matching with medical assistance, cash, child care, and 
68.33 	supplemental assistance programs operated by other states.

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

69.1 	Sec. 5. Minnesota Statutes 2008, section 256.962, subdivision 2, is amended to read:
69.2 		Subd. 2.Outreach grants. (a) The commissioner shall award grants to public and 
69.3 	private organizations, regional collaboratives, and regional health care outreach centers 
69.4 	for outreach activities, including, but not limited to: 
69.5 	(1) providing information, applications, and assistance in obtaining coverage 
69.6 	through Minnesota public health care programs;
69.7 	(2) collaborating with public and private entities such as hospitals, providers, health 
69.8 	plans, legal aid offices, pharmacies, insurance agencies, and faith-based organizations to 
69.9 	develop outreach activities and partnerships to ensure the distribution of information 
69.10 	and applications and provide assistance in obtaining coverage through Minnesota health 
69.11 	care programs; and
69.12 	(3) providing or collaborating with public and private entities to provide multilingual 
69.13 	and culturally specific information and assistance to applicants in areas of high 
69.14 	uninsurance in the state or populations with high rates of uninsurance; and
69.15 	(4) targeting geographic areas with high rates of (i) eligible but unenrolled children, 
69.16 	including children who reside in rural areas, or (ii) racial and ethnic minorities and health 
69.17 	disparity populations.
69.18 	(b) The commissioner shall ensure that all outreach materials are available in 
69.19 	languages other than English.
69.20 	(c) The commissioner shall establish an outreach trainer program to provide 
69.21 	training to designated individuals from the community and public and private entities on 
69.22 	application assistance in order for these individuals to provide training to others in the 
69.23 	community on an as-needed basis.

69.24 	Sec. 6. Minnesota Statutes 2008, section 256.962, subdivision 6, is amended to read:
69.25 		Subd. 6.School districts and charter schools. (a) At the beginning of each school 
69.26 	year, a school district  or charter school shall provide information to each student on the 
69.27 	availability of health care coverage through the Minnesota health care programs and how 
69.28 	to obtain an application for the Minnesota health care programs.
69.29 	(b) For each child who is determined to be eligible for the free and reduced-price 
69.30 	school lunch program, the district shall provide the child's family with information on how 
69.31 	to obtain an application for the Minnesota health care programs and application assistance.
69.32 	(c) A school district or charter school shall also ensure that applications and 
69.33 	information on application assistance are available at early childhood education sites and 
69.34 	public schools located within the district's jurisdiction.
70.1 	(d) (c) Each district shall designate an enrollment specialist to provide application 
70.2 	assistance and follow-up services with families who have indicated an interest in receiving 
70.3 	information or an application for the Minnesota health care program. A district is eligible 
70.4 	for the application assistance bonus described in subdivision 5.
70.5 	(e) Each (d) If a school district or charter school maintains a district Web site, the
70.6 	school district or charter school shall provide on their its Web site a link to information on 
70.7 	how to obtain an application and application assistance.

70.8 	Sec. 7. Minnesota Statutes 2008, section 256.963, is amended by adding a subdivision 
70.9 	to read:
70.10 		Subd. 3.Urgent dental care services. The commissioner of human services shall 
70.11 	authorize pilot projects to reduce the total costs to the state for dental services provided 
70.12 	to persons enrolled in Minnesota health care programs by reducing hospital emergency 
70.13 	room costs for preventable and nonemergency dental services. The commissioner may 
70.14 	provide start-up funding and establish special payment rates for urgent dental care services 
70.15 	provided as an alternative to emergency room services and may change or waive existing 
70.16 	payment policies in order to adequately reimburse providers for providing cost-effective 
70.17 	alternative services in outpatient or urgent care settings. The commissioner may establish 
70.18 	a project in conjunction with the initiative authorized under subdivisions 1 and 2, or 
70.19 	establish new initiatives, or may implement both approaches. 

70.20 	Sec. 8. Minnesota Statutes 2008, section 256.969, subdivision 3a, is amended to read:
70.21 		Subd. 3a.Payments. (a) Acute care hospital billings under the medical 
70.22 	assistance program must not be submitted until the recipient is discharged. However, 
70.23 	the commissioner shall establish monthly interim payments for inpatient hospitals that 
70.24 	have individual patient lengths of stay over 30 days regardless of diagnostic category. 
70.25 	Except as provided in section 256.9693, medical assistance reimbursement for treatment 
70.26 	of mental illness shall be reimbursed based on diagnostic classifications. Individual 
70.27 	hospital payments established under this section and sections 256.9685, 256.9686, and 
70.28 	256.9695, in addition to third party and recipient liability, for discharges occurring during 
70.29 	the rate year shall not exceed, in aggregate, the charges for the medical assistance covered 
70.30 	inpatient services paid for the same period of time to the hospital. This payment limitation 
70.31 	shall be calculated separately for medical assistance and general assistance medical 
70.32 	care services. The limitation on general assistance medical care shall be effective for 
70.33 	admissions occurring on or after July 1, 1991. Services that have rates established under 
70.34 	subdivision 11 or 12, must be limited separately from other services. After consulting with 
71.1 	the affected hospitals, the commissioner may consider related hospitals one entity and 
71.2 	may merge the payment rates while maintaining separate provider numbers. The operating 
71.3 	and property base rates per admission or per day shall be derived from the best Medicare 
71.4 	and claims data available when rates are established. The commissioner shall determine 
71.5 	the best Medicare and claims data, taking into consideration variables of recency of the 
71.6 	data, audit disposition, settlement status, and the ability to set rates in a timely manner. 
71.7 	The commissioner shall notify hospitals of payment rates by December 1 of the year 
71.8 	preceding the rate year. The rate setting data must reflect the admissions data used to 
71.9 	establish relative values. Base year changes from 1981 to the base year established for the 
71.10 	rate year beginning January 1, 1991, and for subsequent rate years, shall not be limited 
71.11 	to the limits ending June 30, 1987, on the maximum rate of increase under subdivision 
71.12 	1. The commissioner may adjust base year cost, relative value, and case mix index data 
71.13 	to exclude the costs of services that have been discontinued by the October 1 of the year 
71.14 	preceding the rate year or that are paid separately from inpatient services. Inpatient stays 
71.15 	that encompass portions of two or more rate years shall have payments established based 
71.16 	on payment rates in effect at the time of admission unless the date of admission preceded 
71.17 	the rate year in effect by six months or more. In this case, operating payment rates for 
71.18 	services rendered during the rate year in effect and established based on the date of 
71.19 	admission shall be adjusted to the rate year in effect by the hospital cost index.
71.20 	(b) For fee-for-service admissions occurring on or after July 1, 2002, the total 
71.21 	payment, before third-party liability and spenddown, made to hospitals for inpatient 
71.22 	services is reduced by .5 percent from the current statutory rates.
71.23 	(c) In addition to the reduction in paragraph (b), the total payment for fee-for-service 
71.24 	admissions occurring on or after July 1, 2003, made to hospitals for inpatient services 
71.25 	before third-party liability and spenddown, is reduced five percent from the current 
71.26 	statutory rates. Mental health services within diagnosis related groups 424 to 432, and 
71.27 	facilities defined under subdivision 16 are excluded from this paragraph.
71.28 	(d) In addition to the reduction in paragraphs (b) and (c), the total payment for 
71.29 	fee-for-service admissions occurring on or after July 1, 2005, made to hospitals for 
71.30 	inpatient services before third-party liability and spenddown, is reduced 6.0 percent 
71.31 	from the current statutory rates. Mental health services within diagnosis related groups 
71.32 	424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph. 
71.33 	Notwithstanding section 256.9686, subdivision 7, for purposes of this paragraph, medical 
71.34 	assistance does not include general assistance medical care. Payments made to managed 
71.35 	care plans shall be reduced for services provided on or after January 1, 2006, to reflect 
71.36 	this reduction.
72.1 	(e) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for 
72.2 	fee-for-service admissions occurring on or after July 1, 2008, through June 30, 2009, made 
72.3 	to hospitals for inpatient services before third-party liability and spenddown, is reduced 
72.4 	3.46 percent from the current statutory rates. Mental health services with diagnosis related 
72.5 	groups 424 to 432 and facilities defined under subdivision 16 are excluded from this 
72.6 	paragraph. Payments made to managed care plans shall be reduced for services provided 
72.7 	on or after January 1, 2009, through June 30, 2009, to reflect this reduction.
72.8 	(f) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for 
72.9 	fee-for-service admissions occurring on or after July 1, 2009, through June 30, 2010, made 
72.10 	to hospitals for inpatient services before third-party liability and spenddown, is reduced 
72.11 	1.9 percent from the current statutory rates. Mental health services with diagnosis related 
72.12 	groups 424 to 432 and facilities defined under subdivision 16 are excluded from this 
72.13 	paragraph. Payments made to managed care plans shall be reduced for services provided 
72.14 	on or after July 1, 2009, through June 30, 2010, to reflect this reduction.
72.15 	(g) In addition to the reductions in paragraphs (b), (c), and (d), the total payment 
72.16 	for fee-for-service admissions occurring on or after July 1, 2010, made to hospitals for 
72.17 	inpatient services before third-party liability and spenddown, is reduced 1.79 percent 
72.18 	from the current statutory rates. Mental health services with diagnosis related groups 
72.19 	424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph. 
72.20 	Payments made to managed care plans shall be reduced for services provided on or after 
72.21 	July 1, 2010, to reflect this reduction.
72.22 	(h) In addition to the reductions in paragraphs (b), (c), (d), (f), and (g), the total 
72.23 	payment for fee-for-service admissions occurring on or after July 1, 2009, made to 
72.24 	hospitals for inpatient services before third-party liability and spenddown, is reduced 
72.25 	3.0 percent from the current statutory rates. Facilities defined under subdivision 16 are 
72.26 	excluded from this paragraph. Payments made to managed care plans shall be reduced for 
72.27 	services provided on or after January 1, 2010, to reflect this reduction.
72.28 	(i) In addition to the reductions in paragraphs (b) and (h), the total payment for 
72.29 	fee-for-service admissions occurring on or after July 1, 2009, made to hospitals for mental 
72.30 	health services within diagnosis-related groups 424 to 432 before third-party liability and 
72.31 	spenddown, is reduced 5.2 percent from the current statutory rates. Facilities defined under 
72.32 	subdivision 16 are excluded from this paragraph. Payments made to managed care plans 
72.33 	shall be reduced for services provided on or after January 1, 2010, to reflect this reduction.

72.34 	Sec. 9. Minnesota Statutes 2008, section 256B.056, subdivision 3, is amended to read:
73.1 		Subd. 3.Asset limitations for individuals and families. To be eligible for medical 
73.2 	assistance, a person must not individually own more than $3,000 in assets, or if a member 
73.3 	of a household with two family members, husband and wife, or parent and child, the 
73.4 	household must not own more than $6,000 in assets, plus $200 for each additional legal 
73.5 	dependent. In addition to these maximum amounts, an eligible individual or family may 
73.6 	accrue interest on these amounts, but they must be reduced to the maximum at the time 
73.7 	of an eligibility redetermination. The accumulation of the clothing and personal needs 
73.8 	allowance according to section 256B.35 must also be reduced to the maximum at the 
73.9 	time of the eligibility redetermination. The value of assets that are not considered in 
73.10 	determining eligibility for medical assistance is the value of those assets excluded under 
73.11 	the supplemental security income program for aged, blind, and disabled persons, with 
73.12 	the following exceptions: 
73.13 	(1) household goods and personal effects are not considered;
73.14 	(2) capital and operating assets of a trade or business that the local agency 
73.15 	determines are necessary to the person's ability to earn an income are not considered. A 
73.16 	bank account that contains personal income or assets, or is used to pay personal expenses, 
73.17 	is not considered a capital or operating asset of a trade or business;
73.18 	(3) motor vehicles are excluded to the same extent excluded by the supplemental 
73.19 	security income program;
73.20 	(4) assets designated as burial expenses are excluded to the same extent excluded by 
73.21 	the supplemental security income program. Burial expenses funded by annuity contracts 
73.22 	or life insurance policies must irrevocably designate the individual's estate as contingent 
73.23 	beneficiary to the extent proceeds are not used for payment of selected burial expenses; and
73.24 	(5) effective upon federal approval, for a person who no longer qualifies as an 
73.25 	employed person with a disability due to loss of earnings, assets allowed while eligible 
73.26 	for medical assistance under section 256B.057, subdivision 9, are not considered for 12 
73.27 	months, beginning with the first month of ineligibility as an employed person with a 
73.28 	disability, to the extent that the person's total assets remain within the allowed limits of 
73.29 	section 256B.057, subdivision 9, paragraph (c).
73.30 	The assets specified in clause (2) must be disclosed to the local agency at the time of 
73.31 	application and at the time of an eligibility redetermination, and must be verified upon 
73.32 	request of the local agency.

73.33 	EFFECTIVE DATE. This section is effective January 1, 2011, or upon federal 
73.34 	approval, whichever is later.

74.1 	Sec. 10. Minnesota Statutes 2008, section 256B.056, subdivision 3b, is amended to 
74.2 	read:
74.3 		Subd. 3b.Treatment of trusts. (a) A "medical assistance qualifying trust" is a 
74.4 	revocable or irrevocable trust, or similar legal device, established on or before August 
74.5 	10, 1993, by a person or the person's spouse under the terms of which the person 
74.6 	receives or could receive payments from the trust principal or income and the trustee 
74.7 	has discretion in making payments to the person from the trust principal or income. 
74.8 	Notwithstanding that definition, a medical assistance qualifying trust does not include: 
74.9 	(1) a trust set up by will; (2) a trust set up before April 7, 1986, solely to benefit a person 
74.10 	with a developmental disability living in an intermediate care facility for persons with 
74.11 	developmental disabilities; or (3) a trust set up by a person with payments made by the 
74.12 	Social Security Administration pursuant to the United States Supreme Court decision in 
74.13 	Sullivan v. Zebley, 110 S. Ct. 885 (1990). The maximum amount of payments that a 
74.14 	trustee of a medical assistance qualifying trust may make to a person under the terms of 
74.15 	the trust is considered to be available assets to the person, without regard to whether the 
74.16 	trustee actually makes the maximum payments to the person and without regard to the 
74.17 	purpose for which the medical assistance qualifying trust was established.
74.18 	(b) Except as provided in paragraphs (c) and (d), trusts established after August 10, 
74.19 	1993, are treated according to section 13611(b) of the Omnibus Budget Reconciliation 
74.20 	Act of 1993 (OBRA), Public Law 103-66.
74.21 	(c) For purposes of paragraph (d), a pooled trust means a trust established under 
74.22 	United States Code, title 42, section 1396p(d)(4)(C).
74.23 	(d) A beneficiary's interest in a pooled trust is considered an available asset unless 
74.24 	the trust provides that upon the death of the beneficiary or termination of the trust during 
74.25 	the beneficiary's lifetime, whichever is sooner, the department receives any amount 
74.26 	in excess of reasonable administrative fees remaining in the beneficiary's trust account 
74.27 	up to the amount of medical assistance benefits paid on behalf of the beneficiary under 
74.28 	the state medical assistance plan. The trust may provide the nonprofit trustee, prior 
74.29 	to payment to the state:
74.30 	(1) reimbursement of reasonable expenses incurred by the trustee on behalf of the 
74.31 	beneficiary which are subject to reimbursement under the terms of the trust; and
74.32 	(2) reimbursement of reasonable administrative costs and fees.
74.33 	A remainder interest may be retained by the nonprofit trustee that does not exceed 
74.34 	five percent of the remaining balance in the trust account upon the death of the beneficiary 
74.35 	or the termination of the trust, and must only be used for the benefit of disabled individuals 
74.36 	who have a beneficial interest in the pooled trust.

75.1 	EFFECTIVE DATE. This section is effective for pooled trust accounts established 
75.2 	on or after January 1, 2011.

75.3 	Sec. 11. Minnesota Statutes 2008, section 256B.056, subdivision 3c, is amended to 
75.4 	read:
75.5 		Subd. 3c.Asset limitations for families and children. A household of two or more 
75.6 	persons must not own more than $20,000 in total net assets, and a household of one 
75.7 	person must not own more than $10,000 in total net assets. In addition to these maximum 
75.8 	amounts, an eligible individual or family may accrue interest on these amounts, but they 
75.9 	must be reduced to the maximum at the time of an eligibility redetermination. The value of 
75.10 	assets that are not considered in determining eligibility for medical assistance for families 
75.11 	and children is the value of those assets excluded under the AFDC state plan as of July 16, 
75.12 	1996, as required by the Personal Responsibility and Work Opportunity Reconciliation 
75.13 	Act of 1996 (PRWORA), Public Law 104-193, with the following exceptions:
75.14 	(1) household goods and personal effects are not considered;
75.15 	(2) capital and operating assets of a trade or business up to $200,000 are not 
75.16 	considered, except that a bank account that contains personal income or assets, or is used to 
75.17 	pay personal expenses, is not considered a capital or operating asset of a trade or business;
75.18 	(3) one motor vehicle is excluded for each person of legal driving age who is 
75.19 	employed or seeking employment;
75.20 	(4) one burial plot and all other burial expenses equal to the supplemental security 
75.21 	income program asset limit are not considered for each individual;
75.22 	(5) court-ordered settlements up to $10,000 are not considered;
75.23 	(6) individual retirement accounts and funds are not considered; and
75.24 	(7) assets owned by children are not considered.
75.25 	The assets specified in clause (2) must be disclosed to the local agency at the time of 
75.26 	application and at the time of an eligibility redetermination, and must be verified upon 
75.27 	request of the local agency.

75.28 	EFFECTIVE DATE. This section is effective January 1, 2011, or upon federal 
75.29 	approval, whichever is later.

75.30 	Sec. 12. Minnesota Statutes 2008, section 256B.056, is amended by adding a 
75.31 	subdivision to read:
75.32 		Subd. 10a.Presumptive eligibility. Medical assistance is available during a 
75.33 	presumptive period of eligibility that meets the requirements of United States Code, 
76.1 	title 42, section 1396r-1a. Presumptive eligibility shall be determined by the state or 
76.2 	local agency for children under age 19 who appear to meet income requirements of 
76.3 	section 256B.057, subdivisions 1, 2, and 8, on the basis of preliminary information. The 
76.4 	presumptive period begins on the first day of the month in which presumptive eligibility is 
76.5 	determined. The agency must provide notice of presumptive eligibility and information 
76.6 	on the procedures for completing the eligibility process. The presumptive period ends 
76.7 	on the earlier of the date of the determination for medical assistance eligibility, or the 
76.8 	last day of the month following the presumptive eligibility determination if a complete 
76.9 	application with requested verifications is not submitted by that date. Enrollees who are 
76.10 	terminated for failure to complete an application or provide verifications cannot be granted 
76.11 	presumptive eligibility again for 12 months.

76.12 	EFFECTIVE DATE. This section is effective January 1, 2010, or upon federal 
76.13 	approval, whichever is later.

76.14 	Sec. 13. Minnesota Statutes 2008, section 256B.057, subdivision 3, is amended to read:
76.15 		Subd. 3.Qualified Medicare beneficiaries. A person who is entitled to Part A 
76.16 	Medicare benefits, whose income is equal to or less than 100 percent of the federal 
76.17 	poverty guidelines, and whose assets are no more than $10,000 for a single individual 
76.18 	and $18,000 for a married couple or family of two or more the maximum resource 
76.19 	level applied for the year for an individual or an individual and the individual's spouse 
76.20 	according to United States Code, title 42, section 1396d(p)(1)(C), is eligible for medical 
76.21 	assistance reimbursement of Part A and Part B premiums, Part A and Part B coinsurance 
76.22 	and deductibles, and cost-effective premiums for enrollment with a health maintenance 
76.23 	organization or a competitive medical plan under section 1876 of the Social Security Act. 
76.24 	Reimbursement of the Medicare coinsurance and deductibles, when added to the amount 
76.25 	paid by Medicare, must not exceed the total rate the provider would have received for the 
76.26 	same service or services if the person were a medical assistance recipient with Medicare 
76.27 	coverage. Increases in benefits under Title II of the Social Security Act shall not be 
76.28 	counted as income for purposes of this subdivision until July 1 of each year.

76.29 	EFFECTIVE DATE. This section is effective January 1, 2012.

76.30 	Sec. 14. Minnesota Statutes 2008, section 256B.057, subdivision 9, is amended to read:
76.31 		Subd. 9.Employed persons with disabilities. (a) Medical assistance may be paid 
76.32 	for a person who is employed and who:
76.33 	(1) meets the definition of disabled under the supplemental security income program;
77.1 	(2) is at least 16 but less than 65 years of age;
77.2 	(3) meets the asset limits in paragraph (c); and
77.3 	(4) effective November 1, 2003, pays a premium and other obligations under 
77.4 	paragraph (e).
77.5 	Any spousal income or assets shall be disregarded for purposes of eligibility and premium 
77.6 	determinations.
77.7 	(b) After the month of enrollment, a person enrolled in medical assistance under 
77.8 	this subdivision who:
77.9 	(1) is temporarily unable to work and without receipt of earned income due to a 
77.10 	medical condition, as verified by a physician, may retain eligibility for up to four calendar 
77.11 	months; or
77.12 	(2) effective January 1, 2004, loses employment for reasons not attributable to the 
77.13 	enrollee, may retain eligibility for up to four consecutive months after the month of job 
77.14 	loss. To receive a four-month extension, enrollees must verify the medical condition or 
77.15 	provide notification of job loss. All other eligibility requirements must be met and the 
77.16 	enrollee must pay all calculated premium costs for continued eligibility.
77.17 	(c) For purposes of determining eligibility under this subdivision, a person's assets 
77.18 	must not exceed $20,000, excluding:
77.19 	(1) all assets excluded under section 256B.056;
77.20 	(2) retirement accounts, including individual accounts, 401(k) plans, 403(b) plans, 
77.21 	Keogh plans, and pension plans; and
77.22 	(3) medical expense accounts set up through the person's employer.
77.23 	(d)(1) Effective January 1, 2004, for purposes of eligibility, there will be a $65 
77.24 	earned income disregard. To be eligible, a person applying for medical assistance under 
77.25 	this subdivision must have earned income above the disregard level.
77.26 	(2) Effective January 1, 2004, to be considered earned income, Medicare, Social 
77.27 	Security, and applicable state and federal income taxes must be withheld. To be eligible, 
77.28 	a person must document earned income tax withholding.
77.29 	(e)(1) A person whose earned and unearned income is equal to or greater than 100 
77.30 	percent of federal poverty guidelines for the applicable family size must pay a premium 
77.31 	to be eligible for medical assistance under this subdivision. The premium shall be based 
77.32 	on the person's gross earned and unearned income and the applicable family size using a 
77.33 	sliding fee scale established by the commissioner, which begins at one percent of income 
77.34 	at 100 percent of the federal poverty guidelines and increases to 7.5 percent of income 
77.35 	for those with incomes at or above 300 percent of the federal poverty guidelines. Annual 
78.1 	adjustments in the premium schedule based upon changes in the federal poverty guidelines 
78.2 	shall be effective for premiums due in July of each year.
78.3 	(2) Effective January 1, 2004, all enrollees must pay a premium to be eligible for 
78.4 	medical assistance under this subdivision. An enrollee shall pay the greater of a $35$50 
78.5 	premium or the premium calculated in clause (1).
78.6 	(3) Effective November 1, 2003, all enrollees who receive unearned income must 
78.7 	pay one-half of one2.5 percent of unearned income in addition to the premium amount.
78.8 	(4) Effective November 1, 2003, for enrollees whose income does not exceed 200 
78.9 	percent of the federal poverty guidelines and who are also enrolled in Medicare, the 
78.10 	commissioner must reimburse the enrollee for Medicare Part B premiums under section 
78.11 	256B.0625, subdivision 15, paragraph (a).
78.12 	(5) Increases in benefits under title II of the Social Security Act shall not be counted 
78.13 	as income for purposes of this subdivision until July 1 of each year.
78.14 	(f) A person's eligibility and premium shall be determined by the local county 
78.15 	agency. Premiums must be paid to the commissioner. All premiums are dedicated to 
78.16 	the commissioner.
78.17 	(g) Any required premium shall be determined at application and redetermined at 
78.18 	the enrollee's six-month income review or when a change in income or household size is 
78.19 	reported. Enrollees must report any change in income or household size within ten days 
78.20 	of when the change occurs. A decreased premium resulting from a reported change in 
78.21 	income or household size shall be effective the first day of the next available billing month 
78.22 	after the change is reported. Except for changes occurring from annual cost-of-living 
78.23 	increases, a change resulting in an increased premium shall not affect the premium amount 
78.24 	until the next six-month review.
78.25 	(h) Premium payment is due upon notification from the commissioner of the 
78.26 	premium amount required. Premiums may be paid in installments at the discretion of 
78.27 	the commissioner.
78.28 	(i) Nonpayment of the premium shall result in denial or termination of medical 
78.29 	assistance unless the person demonstrates good cause for nonpayment. Good cause exists 
78.30 	if the requirements specified in Minnesota Rules, part 9506.0040, subpart 7, items B to 
78.31 	D, are met. Except when an installment agreement is accepted by the commissioner, 
78.32 	all persons disenrolled for nonpayment of a premium must pay any past due premiums 
78.33 	as well as current premiums due prior to being reenrolled. Nonpayment shall include 
78.34 	payment with a returned, refused, or dishonored instrument. The commissioner may 
78.35 	require a guaranteed form of payment as the only means to replace a returned, refused, 
78.36 	or dishonored instrument.

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

79.2 	Sec. 15. Minnesota Statutes 2008, section 256B.057, is amended by adding a 
79.3 	subdivision to read:
79.4 		Subd. 11.Treatment for colorectal cancer. (a) State-only funded medical 
79.5 	assistance may be paid for an individual who:
79.6 	(1) has been screened for colorectal cancer by the colorectal cancer prevention 
79.7 	demonstration project;
79.8 	(2) according to the individual's treating health professional, needs treatment for 
79.9 	colorectal cancer;
79.10 	(3) meets income eligibility guidelines for the colorectal cancer prevention 
79.11 	demonstration project;
79.12 	(4) is under the age of 65; and
79.13 	(5) is not otherwise eligible for federally funded medical assistance or covered under 
79.14 	creditable coverage as defined under United States Code, title 42, section 1396a(aa).
79.15 	(b) Medical assistance provided under this subdivision shall be limited to services 
79.16 	provided during the period that the individual receives treatment for colorectal cancer.
79.17 	(c) An individual meeting the criteria in paragraph (a) is eligible for state-only 
79.18 	funded medical assistance without meeting the eligibility criteria relating to income and 
79.19 	assets in section 256B.056, subdivisions 1a to 5b.

79.20 	Sec. 16. Minnesota Statutes 2008, section 256B.0575, is amended to read:
79.21 	256B.0575 AVAILABILITY OF INCOME FOR INSTITUTIONALIZED 
79.22 	PERSONS.
79.23 		Subdivision 1.Income deductions. When an institutionalized person is determined 
79.24 	eligible for medical assistance, the income that exceeds the deductions in paragraphs (a) 
79.25 	and (b) must be applied to the cost of institutional care.
79.26 	(a) The following amounts must be deducted from the institutionalized person's 
79.27 	income in the following order:
79.28 	(1) the personal needs allowance under section 256B.35 or, for a veteran who 
79.29 	does not have a spouse or child, or a surviving spouse of a veteran having no child, the 
79.30 	amount of an improved pension received from the veteran's administration not exceeding 
79.31 	$90 per month;
79.32 	(2) the personal allowance for disabled individuals under section 256B.36;
80.1 	(3) if the institutionalized person has a legally appointed guardian or conservator, 
80.2 	five percent of the recipient's gross monthly income up to $100 as reimbursement for 
80.3 	guardianship or conservatorship services;
80.4 	(4) a monthly income allowance determined under section 256B.058, subdivision 
80.5 	2, but only to the extent income of the institutionalized spouse is made available to the 
80.6 	community spouse;
80.7 	(5) a monthly allowance for children under age 18 which, together with the net 
80.8 	income of the children, would provide income equal to the medical assistance standard 
80.9 	for families and children according to section 256B.056, subdivision 4, for a family size 
80.10 	that includes only the minor children. This deduction applies only if the children do not 
80.11 	live with the community spouse and only to the extent that the deduction is not included 
80.12 	in the personal needs allowance under section 256B.35, subdivision 1, as child support 
80.13 	garnished under a court order;
80.14 	(6) a monthly family allowance for other family members, equal to one-third of the 
80.15 	difference between 122 percent of the federal poverty guidelines and the monthly income 
80.16 	for that family member;
80.17 	(7) reparations payments made by the Federal Republic of Germany and reparations 
80.18 	payments made by the Netherlands for victims of Nazi persecution between 1940 and 
80.19 	1945;
80.20 	(8) all other exclusions from income for institutionalized persons as mandated by 
80.21 	federal law; and
80.22 	(9) amounts for reasonable expenses, as specified in subdivision 2, incurred for 
80.23 	necessary medical or remedial care for the institutionalized person that are recognized 
80.24 	under state law, not medical assistance covered expenses, and that are not subject to 
80.25 	payment by a third party.
80.26 	Reasonable expenses are limited to expenses that have not been previously used as a 
80.27 	deduction from income and are incurred during the enrollee's current period of eligibility, 
80.28 	including retroactive months associated with the current period of eligibility, for medical 
80.29 	assistance payment of long-term care services.
80.30 	For purposes of clause (6), "other family member" means a person who resides 
80.31 	with the community spouse and who is a minor or dependent child, dependent parent, or 
80.32 	dependent sibling of either spouse. "Dependent" means a person who could be claimed as 
80.33 	a dependent for federal income tax purposes under the Internal Revenue Code.
80.34 	(b) Income shall be allocated to an institutionalized person for a period of up to three 
80.35 	calendar months, in an amount equal to the medical assistance standard for a family 
80.36 	size of one if:
81.1 	(1) a physician certifies that the person is expected to reside in the long-term care 
81.2 	facility for three calendar months or less;
81.3 	(2) if the person has expenses of maintaining a residence in the community; and
81.4 	(3) if one of the following circumstances apply:
81.5 	(i) the person was not living together with a spouse or a family member as defined in 
81.6 	paragraph (a) when the person entered a long-term care facility; or
81.7 	(ii) the person and the person's spouse become institutionalized on the same date, in 
81.8 	which case the allocation shall be applied to the income of one of the spouses.
81.9 	For purposes of this paragraph, a person is determined to be residing in a licensed nursing 
81.10 	home, regional treatment center, or medical institution if the person is expected to remain 
81.11 	for a period of one full calendar month or more.
81.12 		Subd. 2.Reasonable expenses. (a) For the purposes of subdivision 1, paragraph 
81.13 	(a), clause (9), reasonable expenses are limited to expenses that have not been previously 
81.14 	used as a deduction from income and were not:
81.15 	(1) for long-term care expenses incurred during a period of ineligibility as defined in 
81.16 	section 256B.0595, subdivision 2;
81.17 	(2) incurred more than three months before the month of application associated with 
81.18 	the current period of eligibility;
81.19 	(3) for expenses incurred by a recipient that are duplicative of services that are 
81.20 	covered under chapter 256B; or
81.21 	(4) nursing facility expenses incurred without a timely assessment as required under 
81.22 	section 256B.0911.

81.23 	Sec. 17. Minnesota Statutes 2008, section 256B.0595, subdivision 1, is amended to 
81.24 	read:
81.25 		Subdivision 1. Prohibited transfers. (a) For transfers of assets made on or before 
81.26 	August 10, 1993, if an institutionalized person or the institutionalized person's spouse has 
81.27 	given away, sold, or disposed of, for less than fair market value, any asset or interest 
81.28 	therein, except assets other than the homestead that are excluded under the supplemental 
81.29 	security program, within 30 months before or any time after the date of institutionalization 
81.30 	if the person has been determined eligible for medical assistance, or within 30 months 
81.31 	before or any time after the date of the first approved application for medical assistance 
81.32 	if the person has not yet been determined eligible for medical assistance, the person is 
81.33 	ineligible for long-term care services for the period of time determined under subdivision 
81.34 	2. 
82.1 	(b) Effective for transfers made after August 10, 1993, an institutionalized person, an 
82.2 	institutionalized person's spouse, or any person, court, or administrative body with legal 
82.3 	authority to act in place of, on behalf of, at the direction of, or upon the request of the 
82.4 	institutionalized person or institutionalized person's spouse, may not give away, sell, or 
82.5 	dispose of, for less than fair market value, any asset or interest therein, except assets other 
82.6 	than the homestead that are excluded under the Supplemental Security Income program, 
82.7 	for the purpose of establishing or maintaining medical assistance eligibility. This applies 
82.8 	to all transfers, including those made by a community spouse after the month in which 
82.9 	the institutionalized spouse is determined eligible for medical assistance. For purposes of 
82.10 	determining eligibility for long-term care services, any transfer of such assets within 36 
82.11 	months before or any time after an institutionalized person requests medical assistance 
82.12 	payment of long-term care services, or 36 months before or any time after a medical 
82.13 	assistance recipient becomes an institutionalized person, for less than fair market value 
82.14 	may be considered. Any such transfer is presumed to have been made for the purpose 
82.15 	of establishing or maintaining medical assistance eligibility and the institutionalized 
82.16 	person is ineligible for long-term care services for the period of time determined under 
82.17 	subdivision 2, unless the institutionalized person furnishes convincing evidence to 
82.18 	establish that the transaction was exclusively for another purpose, or unless the transfer is 
82.19 	permitted under subdivision 3 or 4.  In the case of payments from a trust or portions of a 
82.20 	trust that are considered transfers of assets under federal law, or in the case of any other 
82.21 	disposal of assets made on or after February 8, 2006, any transfers made within 60 months 
82.22 	before or any time after an institutionalized person requests medical assistance payment of 
82.23 	long-term care services and within 60 months before or any time after a medical assistance 
82.24 	recipient becomes an institutionalized person, may be considered. 
82.25 	(c) This section applies to transfers, for less than fair market value, of income 
82.26 	or assets, including assets that are considered income in the month received, such as 
82.27 	inheritances, court settlements, and retroactive benefit payments or income to which the 
82.28 	institutionalized person or the institutionalized person's spouse is entitled but does not 
82.29 	receive due to action by the institutionalized person, the institutionalized person's spouse, 
82.30 	or any person, court, or administrative body with legal authority to act in place of, on 
82.31 	behalf of, at the direction of, or upon the request of the institutionalized person or the 
82.32 	institutionalized person's spouse. 
82.33 	(d) This section applies to payments for care or personal services provided by a 
82.34 	relative, unless the compensation was stipulated in a notarized, written agreement which 
82.35 	was in existence when the service was performed, the care or services directly benefited 
82.36 	the person, and the payments made represented reasonable compensation for the care 
83.1 	or services provided. A notarized written agreement is not required if payment for the 
83.2 	services was made within 60 days after the service was provided. 
83.3 	(e) This section applies to the portion of any asset or interest that an institutionalized 
83.4 	person, an institutionalized person's spouse, or any person, court, or administrative body 
83.5 	with legal authority to act in place of, on behalf of, at the direction of, or upon the request 
83.6 	of the institutionalized person or the institutionalized person's spouse, transfers to any 
83.7 	annuity that exceeds the value of the benefit likely to be returned to the institutionalized 
83.8 	person or institutionalized person's spouse while alive, based on estimated life expectancy 
83.9 	as determined according to the current actuarial tables published by the Office of the 
83.10 	Chief Actuary of the Social Security Administration. The commissioner may adopt rules 
83.11 	reducing life expectancies based on the need for long-term care. This section applies to an 
83.12 	annuity purchased on or after March 1, 2002, that: 
83.13 	(1) is not purchased from an insurance company or financial institution that is 
83.14 	subject to licensing or regulation by the Minnesota Department of Commerce or a similar 
83.15 	regulatory agency of another state; 
83.16 	(2) does not pay out principal and interest in equal monthly installments; or 
83.17 	(3) does not begin payment at the earliest possible date after annuitization. 
83.18 	(f) Effective for transactions, including the purchase of an annuity, occurring on or 
83.19 	after February 8, 2006, by or on behalf of an institutionalized person who has applied for 
83.20 	or is receiving long-term care services or the institutionalized person's spouse shall be 
83.21 	treated as the disposal of an asset for less than fair market value unless the department is 
83.22 	named a preferred remainder beneficiary  as described in section 256B.056, subdivision 
83.23 	11. Any subsequent change to the designation of the department as a preferred remainder 
83.24 	beneficiary shall result in the annuity being treated as a disposal of assets for less than 
83.25 	fair market value. The amount of such transfer shall be the maximum amount the 
83.26 	institutionalized person or the institutionalized person's spouse could receive from the 
83.27 	annuity or similar financial instrument. Any change in the amount of the income or 
83.28 	principal being withdrawn from the annuity or other similar financial instrument at the 
83.29 	time of the most recent disclosure shall be deemed to be a transfer of assets for less than 
83.30 	fair market value unless the institutionalized person or the institutionalized person's spouse 
83.31 	demonstrates that the transaction was for fair market value. In the event a distribution 
83.32 	of income or principal has been improperly distributed or disbursed from an annuity or 
83.33 	other retirement planning instrument of an institutionalized person or the institutionalized 
83.34 	person's spouse, a cause of action exists against the individual receiving the improper 
83.35 	distribution for the cost of medical assistance services provided or the amount of the 
83.36 	improper distribution, whichever is less. 
84.1 	(g) Effective for transactions, including the purchase of an annuity, occurring on 
84.2 	or after February 8, 2006, by or on behalf of an institutionalized person applying for or 
84.3 	receiving long-term care services shall be treated as a disposal of assets for less than fair 
84.4 	market value unless it is: 
84.5 	(i) an annuity described in subsection (b) or (q) of section 408 of the Internal 
84.6 	Revenue Code of 1986; or 
84.7 	(ii) purchased with proceeds from: 
84.8 	(A) an account or trust described in subsection (a), (c), or (p) of section 408 of the 
84.9 	Internal Revenue Code; 
84.10 	(B) a simplified employee pension within the meaning of section 408(k) of the 
84.11 	Internal Revenue Code; or 
84.12 	(C) a Roth IRA described in section 408A of the Internal Revenue Code; or 
84.13 	(iii) an annuity that is irrevocable and nonassignable; is actuarially sound as 
84.14 	determined in accordance with actuarial publications of the Office of the Chief Actuary of 
84.15 	the Social Security Administration; and provides for payments in equal amounts during 
84.16 	the term of the annuity, with no deferral and no balloon payments made.
84.17 	 (h) For purposes of this section, long-term care services include services in a nursing 
84.18 	facility, services that are eligible for payment according to section 256B.0625, subdivision 
84.19 	2, because they are provided in a swing bed, intermediate care facility for persons with 
84.20 	developmental disabilities, and home and community-based services provided pursuant 
84.21 	to sections 256B.0915, 256B.092, and 256B.49. For purposes of this subdivision and 
84.22 	subdivisions 2, 3, and 4, "institutionalized person" includes a person who is an inpatient 
84.23 	in a nursing facility or in a swing bed, or intermediate care facility for persons with 
84.24 	developmental disabilities or who is receiving home and community-based services under 
84.25 	sections 256B.0915, 256B.092, and 256B.49. 
84.26 	(i) This section applies to funds used to purchase a promissory note, loan, or 
84.27 	mortgage unless the note, loan, or mortgage: 
84.28 	(1) has a repayment term that is actuarially sound; 
84.29 	(2) provides for payments to be made in equal amounts during the term of the loan, 
84.30 	with no deferral and no balloon payments made; and 
84.31 	(3) prohibits the cancellation of the balance upon the death of the lender. 
84.32 	In the case of a promissory note, loan, or mortgage that does not meet an exception 
84.33 	in clauses (1) to (3), the value of such note, loan, or mortgage shall be the outstanding 
84.34 	balance due as of the date of the institutionalized person's request for medical assistance 
84.35 	payment of long-term care services. 
85.1 	(j) This section applies to the purchase of a life estate interest in another person's 
85.2 	home unless the purchaser resides in the home for a period of at least one year after the 
85.3 	date of purchase. 
85.4 	(k) This section applies to transfers into a pooled trust that qualifies under United 
85.5 	States Code, title 42, section 1396p(d)(4)(C), by:
85.6 	(1) a person age 65 or older or the person's spouse; or
85.7 	(2) any person, court, or administrative body with legal authority to act in place 
85.8 	of, on behalf of, at the direction of, or upon the request of a person age 65 or older or 
85.9 	the person's spouse.

85.10 	Sec. 18. Minnesota Statutes 2008, section 256B.0595, subdivision 2, is amended to 
85.11 	read:
85.12 		Subd. 2. Period of ineligibility for long-term care services. (a) For any 
85.13 	uncompensated transfer occurring on or before August 10, 1993, the number of months 
85.14 	of ineligibility for long-term care services shall be the lesser of 30 months, or the 
85.15 	uncompensated transfer amount divided by the average medical assistance rate for nursing 
85.16 	facility services in the state in effect on the date of application. The amount used to 
85.17 	calculate the average medical assistance payment rate shall be adjusted each July 1 to 
85.18 	reflect payment rates for the previous calendar year. The period of ineligibility begins 
85.19 	with the month in which the assets were transferred. If the transfer was not reported to 
85.20 	the local agency at the time of application, and the applicant received long-term care 
85.21 	services during what would have been the period of ineligibility if the transfer had been 
85.22 	reported, a cause of action exists against the transferee for the cost of long-term care 
85.23 	services provided during the period of ineligibility, or for the uncompensated amount of 
85.24 	the transfer, whichever is less. The uncompensated transfer amount is the fair market 
85.25 	value of the asset at the time it was given away, sold, or disposed of, less the amount of 
85.26 	compensation received. 
85.27 	(b) For uncompensated transfers made after August 10, 1993, the number of months 
85.28 	of ineligibility for long-term care services shall be the total uncompensated value of the 
85.29 	resources transferred divided by the average medical assistance rate for nursing facility 
85.30 	services in the state in effect on the date of application. The amount used to calculate 
85.31 	the average medical assistance payment rate shall be adjusted each July 1 to reflect 
85.32 	payment rates for the previous calendar year. The period of ineligibility begins with the 
85.33 	first day of the month after the month in which the assets were transferred except that 
85.34 	if one or more uncompensated transfers are made during a period of ineligibility, the 
85.35 	total assets transferred during the ineligibility period shall be combined and a penalty 
86.1 	period calculated to begin on the first day of the month after the month in which the first 
86.2 	uncompensated transfer was made. If the transfer was reported to the local agency after 
86.3 	the date that advance notice of a period of ineligibility that affects the next month could 
86.4 	be provided to the recipient and the recipient received medical assistance services or the 
86.5 	transfer was not reported to the local agency, and the applicant or recipient received 
86.6 	medical assistance services during what would have been the period of ineligibility if 
86.7 	the transfer had been reported, a cause of action exists against the transferee for that 
86.8 	portion of long-term care services provided during the period of ineligibility, or for the 
86.9 	uncompensated amount of the transfer, whichever is less. The uncompensated transfer 
86.10 	amount is the fair market value of the asset at the time it was given away, sold, or disposed 
86.11 	of, less the amount of compensation received. Effective for transfers made on or after 
86.12 	March 1, 1996, involving persons who apply for medical assistance on or after April 13, 
86.13 	1996, no cause of action exists for a transfer unless: 
86.14 	(1) the transferee knew or should have known that the transfer was being made by a 
86.15 	person who was a resident of a long-term care facility or was receiving that level of care in 
86.16 	the community at the time of the transfer; 
86.17 	(2) the transferee knew or should have known that the transfer was being made to 
86.18 	assist the person to qualify for or retain medical assistance eligibility; or 
86.19 	(3) the transferee actively solicited the transfer with intent to assist the person to 
86.20 	qualify for or retain eligibility for medical assistance. 
86.21 	(c) For uncompensated transfers made on or after February 8, 2006, the period 
86.22 	of ineligibility: 
86.23 	(1) for uncompensated transfers by or on behalf of individuals receiving medical 
86.24 	assistance payment of long-term care services, begins the first day of the month following 
86.25 	advance notice of the penalty period of ineligibility, but no later than the first day of the 
86.26 	month that follows three full calendar months from the date of the report or discovery 
86.27 	of the transfer; or 
86.28 	(2) for uncompensated transfers by individuals requesting medical assistance 
86.29 	payment of long-term care services, begins the date on which the individual is eligible 
86.30 	for medical assistance under the Medicaid state plan and would otherwise be receiving 
86.31 	long-term care services based on an approved application for such care but for the
86.32 	application of the penalty period of ineligibility resulting from the uncompensated 
86.33 	transfer; and 
86.34 	(3) cannot begin during any other period of ineligibility. 
86.35 	(d) If a calculation of a penalty period of ineligibility results in a partial month, 
86.36 	payments for long-term care services shall be reduced in an amount equal to the fraction. 
87.1 	(e) In the case of multiple fractional transfers of assets in more than one month for 
87.2 	less than fair market value on or after February 8, 2006, the period of ineligibility is 
87.3 	calculated by treating the total, cumulative, uncompensated value of all assets transferred 
87.4 	during all months on or after February 8, 2006, as one transfer. 
87.5 	(f) A period of ineligibility established under paragraph (c) may be eliminated if 
87.6 	all of the assets transferred for less than fair market value used to calculate the period of 
87.7 	ineligibility, or cash equal to the value of the assets at the time of the transfer, are returned 
87.8 	within 12 months after the date the period of ineligibility began. A period of ineligibility 
87.9 	must not be adjusted if less than the full amount of the transferred assets or the full cash 
87.10 	value of the transferred assets are returned.

87.11 	EFFECTIVE DATE. This section is effective for periods of ineligibility established 
87.12 	on or after January 1, 2011.

87.13 	Sec. 19. Minnesota Statutes 2008, section 256B.06, subdivision 4, is amended to read:
87.14 		Subd. 4. Citizenship requirements. (a) Eligibility for medical assistance is limited 
87.15 	to citizens of the United States, qualified noncitizens as defined in this subdivision, and 
87.16 	other persons residing lawfully in the United States. Citizens or nationals of the United 
87.17 	States must cooperate in obtaining satisfactory documentary evidence of citizenship or 
87.18 	nationality according to the requirements of the federal Deficit Reduction Act of 2005, 
87.19 	Public Law 109-171. 
87.20 	(b) "Qualified noncitizen" means a person who meets one of the following 
87.21 	immigration criteria: 
87.22 	(1) admitted for lawful permanent residence according to United States Code, title 8; 
87.23 	(2) admitted to the United States as a refugee according to United States Code, 
87.24 	title 8, section 1157; 
87.25 	(3) granted asylum according to United States Code, title 8, section 1158; 
87.26 	(4) granted withholding of deportation according to United States Code, title 8, 
87.27 	section 1253(h); 
87.28 	(5) paroled for a period of at least one year according to United States Code, title 8, 
87.29 	section 1182(d)(5); 
87.30 	(6) granted conditional entrant status according to United States Code, title 8, 
87.31 	section 1153(a)(7); 
87.32 	(7) determined to be a battered noncitizen by the United States Attorney General 
87.33 	according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, 
87.34 	title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200; 
88.1 	(8) is a child of a noncitizen determined to be a battered noncitizen by the United 
88.2 	States Attorney General according to the Illegal Immigration Reform and Immigrant 
88.3 	Responsibility Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill, 
88.4 	Public Law 104-200; or 
88.5 	(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public 
88.6 	Law 96-422, the Refugee Education Assistance Act of 1980. 
88.7 	(c) All qualified noncitizens who were residing in the United States before August 
88.8 	22, 1996, who otherwise meet the eligibility requirements of this chapter, are eligible for 
88.9 	medical assistance with federal financial participation. 
88.10 	(d) All qualified noncitizens who entered the United States on or after August 22, 
88.11 	1996, and who otherwise meet the eligibility requirements of this chapter, are eligible for 
88.12 	medical assistance with federal financial participation through November 30, 1996. 
88.13 	Beginning December 1, 1996, qualified noncitizens who entered the United States 
88.14 	on or after August 22, 1996, and who otherwise meet the eligibility requirements of this 
88.15 	chapter are eligible for medical assistance with federal participation for five years if they 
88.16 	meet one of the following criteria: 
88.17 	(i) refugees admitted to the United States according to United States Code, title 8, 
88.18 	section 1157; 
88.19 	(ii) persons granted asylum according to United States Code, title 8, section 1158; 
88.20 	(iii) persons granted withholding of deportation according to United States Code, 
88.21 	title 8, section 1253(h); 
88.22 	(iv) veterans of the United States armed forces with an honorable discharge for 
88.23 	a reason other than noncitizen status, their spouses and unmarried minor dependent 
88.24 	children; or 
88.25 	(v) persons on active duty in the United States armed forces, other than for training, 
88.26 	their spouses and unmarried minor dependent children. 
88.27 	Beginning December 1, 1996, qualified noncitizens who do not meet one of the 
88.28 	criteria in items (i) to (v) are eligible for medical assistance without federal financial 
88.29 	participation as described in paragraph (j). 
88.30 	Notwithstanding paragraph (j), beginning July 1, 2010, children and pregnant 
88.31 	women who are qualified noncitizens, as described in paragraph (b), are eligible for 
88.32 	medical assistance with federal financial participation as provided by the federal Children's 
88.33 	Health Insurance Program Reauthorization Act of 2009, Public Law 111-3.
88.34 	(e) Noncitizens who are not qualified noncitizens as defined in paragraph (b), who 
88.35 	are lawfully present in the United States, as defined in Code of Federal Regulations, title 
88.36 	8, section 103.12, and who otherwise meet the eligibility requirements of this chapter, are 
89.1 	eligible for medical assistance under clauses (1) to (3). These individuals must cooperate 
89.2 	with the United States Citizenship and Immigration Services to pursue any applicable 
89.3 	immigration status, including citizenship, that would qualify them for medical assistance 
89.4 	with federal financial participation. 
89.5 	(1) Persons who were medical assistance recipients on August 22, 1996, are eligible 
89.6 	for medical assistance with federal financial participation through December 31, 1996. 
89.7 	(2) Beginning January 1, 1997, persons described in clause (1) are eligible for 
89.8 	medical assistance without federal financial participation as described in paragraph (j). 
89.9 	(3) Beginning December 1, 1996, persons residing in the United States prior to 
89.10 	August 22, 1996, who were not receiving medical assistance and persons who arrived on 
89.11 	or after August 22, 1996, are eligible for medical assistance without federal financial 
89.12 	participation as described in paragraph (j). 
89.13 	(f) Nonimmigrants who otherwise meet the eligibility requirements of this chapter 
89.14 	are eligible for the benefits as provided in paragraphs (g) to (i). For purposes of this 
89.15 	subdivision, a "nonimmigrant" is a person in one of the classes listed in United States 
89.16 	Code, title 8, section 1101(a)(15). 
89.17 	(g) Payment shall also be made for care and services that are furnished to noncitizens, 
89.18 	regardless of immigration status, who otherwise meet the eligibility requirements of 
89.19 	this chapter, if such care and services are necessary for the treatment of an emergency 
89.20 	medical condition, except for organ transplants and related care and services and routine 
89.21 	prenatal care. 
89.22 	(h) For purposes of this subdivision, the term "emergency medical condition" means 
89.23 	a medical condition that meets the requirements of United States Code, title 42, section 
89.24 	1396b(v). 
89.25 	(i) Beginning July 1, 2009, pregnant noncitizens who are undocumented, 
89.26 	nonimmigrants, or eligible for medical assistance as described in paragraph (j),lawfully 
89.27 	present as designated in paragraph (e) and who are not covered by a group health plan 
89.28 	or health insurance coverage according to Code of Federal Regulations, title 42, section 
89.29 	457.310, and who otherwise meet the eligibility requirements of this chapter, are eligible 
89.30 	for medical assistance through the period of pregnancy, including labor and delivery,
89.31 	and 60 days postpartum, to the extent federal funds are available under title XXI of the 
89.32 	Social Security Act, and the state children's health insurance program, followed by 60 
89.33 	days postpartum without federal financial participation. 
89.34 	(j) Qualified noncitizens as described in paragraph (d), and all other noncitizens 
89.35 	lawfully residing in the United States as described in paragraph (e), who are ineligible 
89.36 	for medical assistance with federal financial participation and who otherwise meet the 
90.1 	eligibility requirements of chapter 256B and of this paragraph, are eligible for medical 
90.2 	assistance without federal financial participation. Qualified noncitizens as described 
90.3 	in paragraph (d) are only eligible for medical assistance without federal financial 
90.4 	participation for five years from their date of entry into the United States. 
90.5 	(k) Beginning October 1, 2003, persons who are receiving care and rehabilitation 
90.6 	services from a nonprofit center established to serve victims of torture and are otherwise 
90.7 	ineligible for medical assistance under this chapter are eligible for medical assistance 
90.8 	without federal financial participation. These individuals are eligible only for the period 
90.9 	during which they are receiving services from the center. Individuals eligible under this 
90.10 	paragraph shall not be required to participate in prepaid medical assistance. 

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

90.12 	Sec. 20. Minnesota Statutes 2008, section 256B.06, subdivision 5, is amended to read:
90.13 		Subd. 5.Deeming of sponsor income and resources. When determining eligibility 
90.14 	for any federal or state funded medical assistance under this section, the income 
90.15 	and resources of all noncitizens shall be deemed to include their sponsors' income 
90.16 	and resources as required under the Personal Responsibility and Work Opportunity 
90.17 	Reconciliation Act of 1996, title IV, Public Law 104-193, sections 421 and 422, and 
90.18 	subsequently set out in federal rules. This section is effective May 1, 1997. Beginning 
90.19 	July 1, 2010, sponsor deeming does not apply to pregnant women and children who are 
90.20 	qualified noncitizens, as described in section 256B.06, subdivision 4, paragraph (b).

90.21 	EFFECTIVE DATE. This section is effective July 1, 2010.

90.22 	Sec. 21. Minnesota Statutes 2008, section 256B.0625, subdivision 3c, is amended to 
90.23 	read:
90.24 		Subd. 3c. Health Services Policy Committee. (a) The commissioner, after 
90.25 	receiving recommendations from professional physician associations, professional 
90.26 	associations representing licensed nonphysician health care professionals, and consumer 
90.27 	groups, shall establish a 13-member Health Services Policy Committee, which consists of 
90.28 	12 voting members and one nonvoting member. The Health Services Policy Committee 
90.29 	shall advise the commissioner regarding health services pertaining to the administration 
90.30 	of health care benefits covered under the medical assistance, general assistance medical 
90.31 	care, and MinnesotaCare programs. The Health Services Policy Committee shall meet at 
90.32 	least quarterly. The Health Services Policy Committee shall annually elect a physician 
90.33 	chair from among its members, who shall work directly with the commissioner's medical 
91.1 	director, to establish the agenda for each meeting. The Health Services Policy Committee 
91.2 	shall also recommend criteria for verifying centers of excellence for specific aspects of 
91.3 	medical care where a specific set of combined services, a volume of patients necessary to 
91.4 	maintain a high level of competency, or a specific level of technical capacity is associated 
91.5 	with improved health outcomes. 
91.6 	(b) The commissioner shall establish a dental subcommittee to operate under the 
91.7 	Health Services Policy Committee. The dental subcommittee consists of general dentists, 
91.8 	dental specialists, safety net providers, dental hygienists, health plan company and county 
91.9 	and public health representatives, health researchers, consumers, and the Minnesota 
91.10 	Department of Health oral health director. The dental subcommittee shall advise the 
91.11 	commissioner regarding:
91.12 	(1) the critical access dental program under section 256B.76, subdivision 4;
91.13 	(2) any changes to the critical access dental provider program necessary to comply 
91.14 	with program expenditure limits;
91.15 	(3) dental coverage policy based on evidence, quality, continuity of care, and best 
91.16 	practices;
91.17 	(4) the development of dental delivery models; and
91.18 	(5) dental services to be added or eliminated from subdivision 9, paragraph (b).
91.19 	(c) The Health Services Policy Committee shall study approaches to making 
91.20 	provider reimbursement under the medical assistance, MinnesotaCare, and general 
91.21 	assistance medical care programs contingent on patient participation in a patient-centered 
91.22 	decision-making process, and shall evaluate the impact of these approaches on health 
91.23 	care quality, patient satisfaction, and health care costs. The committee shall present 
91.24 	findings and recommendations to the commissioner and the legislative committees with 
91.25 	jurisdiction over health care by January 15, 2010.

91.26 	Sec. 22. Minnesota Statutes 2008, section 256B.0625, subdivision 9, is amended to 
91.27 	read:
91.28 		Subd. 9.Dental services. (a) Medical assistance covers dental services. Dental 
91.29 	services include, with prior authorization, fixed bridges that are cost-effective for persons 
91.30 	who cannot use removable dentures because of their medical condition.
91.31 	(b) Medical assistance dental coverage for nonpregnant adults is limited to the 
91.32 	following services:
91.33 	(1) comprehensive exams, limited to once every five years;
91.34 	(2) periodic exams, limited to one per year;
91.35 	(3) limited exams;
92.1 	(4) bitewing x-rays, limited to one per year;
92.2 	(5) periapical x-rays;
92.3 	(6) panoramic x-rays, limited to one every five years, and only if provided in 
92.4 	conjunction with a posterior extraction or scheduled outpatient facility procedure, or as 
92.5 	medically necessary for the diagnosis and follow-up of oral and maxillofacial pathology 
92.6 	and trauma. Panoramic x-rays may be taken once every two years for patients who cannot 
92.7 	cooperate for intraoral film due to a developmental disability or medical condition that 
92.8 	does not allow for intraoral film placement;
92.9 	(7) prophylaxis, limited to one per year;
92.10 	(8) application of fluoride varnish, limited to one per year;
92.11 	(9) posterior fillings, all at the amalgam rate;
92.12 	(10) anterior fillings;
92.13 	(11) endodontics, limited to root canals on the anterior and premolars only;
92.14 	(12) removable prostheses, each dental arch limited to one every six years;
92.15 	(13) oral surgery, limited to extractions, biopsies, and incision and drainage of 
92.16 	abscesses;
92.17 	(14) palliative treatment and sedative fillings for relief of pain; and
92.18 	(15) full-mouth debridement, limited to one every five years.
92.19 	(c) In addition to the services specified in paragraph (b), medical assistance 
92.20 	covers the following services for adults, if provided in an outpatient hospital setting or 
92.21 	freestanding ambulatory surgical center as part of outpatient dental surgery:
92.22 	(1) periodontics, limited to periodontal scaling and root planing once every two 
92.23 	years;
92.24 	(2) general anesthesia; and
92.25 	(3) full-mouth survey once every five years.
92.26 	(d) Medical assistance covers dental services for children that are medically 
92.27 	necessary. The following guidelines apply:
92.28 	(1) posterior fillings are paid at the amalgam rate;
92.29 	(2) application of sealants once every five years per permanent molar; and
92.30 	(3) application of fluoride varnish once every six months.

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

92.32 	Sec. 23. Minnesota Statutes 2008, section 256B.0625, subdivision 13e, is amended to 
92.33 	read:
92.34 		Subd. 13e.Payment rates. (a) The basis for determining the amount of payment 
92.35 	shall be the lower of the actual acquisition costs of the drugs plus a fixed dispensing fee; 
93.1 	the maximum allowable cost set by the federal government or by the commissioner plus 
93.2 	the fixed dispensing fee; or the usual and customary price charged to the public. The 
93.3 	amount of payment basis must be reduced to reflect all discount amounts applied to the 
93.4 	charge by any provider/insurer agreement or contract for submitted charges to medical 
93.5 	assistance programs. The net submitted charge may not be greater than the patient liability 
93.6 	for the service. The pharmacy dispensing fee shall be $3.65, except that the dispensing fee 
93.7 	for intravenous solutions which must be compounded by the pharmacist shall be $8 per 
93.8 	bag, $14 per bag for cancer chemotherapy products, and $30 per bag for total parenteral 
93.9 	nutritional products dispensed in one liter quantities, or $44 per bag for total parenteral 
93.10 	nutritional products dispensed in quantities greater than one liter. Actual acquisition 
93.11 	cost includes quantity and other special discounts except time and cash discounts. 
93.12 	Effective July 1, 2008, the actual acquisition cost of a drug shall be estimated by the 
93.13 	commissioner, at average wholesale price minus 1415 percent. The actual acquisition 
93.14 	cost of antihemophilic factor drugs shall be estimated at the average wholesale price 
93.15 	minus 30 percent. The maximum allowable cost of a multisource drug may be set by the 
93.16 	commissioner and it shall be comparable to, but no higher than, the maximum amount 
93.17 	paid by other third-party payors in this state who have maximum allowable cost programs. 
93.18 	Establishment of the amount of payment for drugs shall not be subject to the requirements 
93.19 	of the Administrative Procedure Act.
93.20 	(b) An additional dispensing fee of $.30 may be added to the dispensing fee paid 
93.21 	to pharmacists for legend drug prescriptions dispensed to residents of long-term care 
93.22 	facilities when a unit dose blister card system, approved by the department, is used. Under 
93.23 	this type of dispensing system, the pharmacist must dispense a 30-day supply of drug. 
93.24 	The National Drug Code (NDC) from the drug container used to fill the blister card must 
93.25 	be identified on the claim to the department. The unit dose blister card containing the 
93.26 	drug must meet the packaging standards set forth in Minnesota Rules, part 6800.2700, 
93.27 	that govern the return of unused drugs to the pharmacy for reuse. The pharmacy provider 
93.28 	will be required to credit the department for the actual acquisition cost of all unused 
93.29 	drugs that are eligible for reuse. Over-the-counter medications must be dispensed in the 
93.30 	manufacturer's unopened package. The commissioner may permit the drug clozapine to be 
93.31 	dispensed in a quantity that is less than a 30-day supply.
93.32 	(c) Whenever a generically equivalent product is available, payment shall be on the 
93.33 	basis of the actual acquisition cost of the generic drug, or on the maximum allowable cost 
93.34 	established by the commissioner.
93.35 	(d) The basis for determining the amount of payment for drugs administered in an 
93.36 	outpatient setting shall be the lower of the usual and customary cost submitted by the 
94.1 	provider or the amount established for Medicare by the United States Department of 
94.2 	Health and Human Services pursuant to title XVIII, section 1847a of the federal Social 
94.3 	Security Act.
94.4 	(e) The commissioner may negotiate lower reimbursement rates for specialty 
94.5 	pharmacy products than the rates specified in paragraph (a). The commissioner may 
94.6 	require individuals enrolled in the health care programs administered by the department 
94.7 	to obtain specialty pharmacy products from providers with whom the commissioner has 
94.8 	negotiated lower reimbursement rates. Specialty pharmacy products are defined as those 
94.9 	used by a small number of recipients or recipients with complex and chronic diseases 
94.10 	that require expensive and challenging drug regimens. Examples of these conditions 
94.11 	include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis 
94.12 	C, growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms 
94.13 	of cancer. Specialty pharmaceutical products include injectable and infusion therapies, 
94.14 	biotechnology drugs, high-cost therapies, and therapies that require complex care. The 
94.15 	commissioner shall consult with the formulary committee to develop a list of specialty 
94.16 	pharmacy products subject to this paragraph. In consulting with the formulary committee 
94.17 	in developing this list, the commissioner shall take into consideration the population 
94.18 	served by specialty pharmacy products, the current delivery system and standard of care in 
94.19 	the state, and access to care issues. The commissioner shall have the discretion to adjust 
94.20 	the reimbursement rate to prevent access to care issues.

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

94.22 	Sec. 24. Minnesota Statutes 2008, section 256B.0625, subdivision 17, is amended to 
94.23 	read:
94.24 		Subd. 17.Transportation costs. (a) Medical assistance covers transportation costs 
94.25 	incurred solely for obtaining emergency medical care or transportation costs incurred 
94.26 	by eligible persons in obtaining emergency or nonemergency medical care when paid 
94.27 	directly to an ambulance company, common carrier, or other recognized providers of 
94.28 	transportation services.
94.29 	(b) Medical assistance covers special transportation, as defined in Minnesota Rules, 
94.30 	part 9505.0315, subpart 1, item F, if the recipient has a physical or mental impairment that 
94.31 	would prohibit the recipient from safely accessing and using a bus, taxi, other commercial 
94.32 	transportation, or private automobile.
94.33 	The commissioner may use an order by the recipient's attending physician to certify that 
94.34 	the recipient requires special transportation services. Special transportation includes 
95.1 	driver-assisted service to eligible individuals. Driver-assisted service includes passenger 
95.2 	pickup at and return to the individual's residence or place of business, assistance with 
95.3 	admittance of the individual to the medical facility, and assistance in passenger securement 
95.4 	or in securing of wheelchairs or stretchers in the vehicle. Special transportation providers 
95.5 	must obtain written documentation from the health care service provider who is serving 
95.6 	the recipient being transported, identifying the time that the recipient arrived. Special 
95.7 	transportation providers may not bill for separate base rates for the continuation of a trip 
95.8 	beyond the original destination. Special transportation providers must take recipients to 
95.9 	the nearest appropriate health care provider, using the most direct route available. The 
95.10 	maximum medical assistance reimbursement rates for special transportation services are:
95.11 	(1) $17 for the base rate and $1.35$1.65 per mile for services to eligible persons 
95.12 	who need a wheelchair-accessible van;
95.13 	(2) $11.50$8.50 for the base rate and $1.30 per mile for services to eligible persons 
95.14 	who do not need a wheelchair-accessible van; and
95.15 	(3) $60 for the base rate and $2.40 per mile, and an attendant rate of $9 per trip, for 
95.16 	services to eligible persons who need a stretcher-accessible vehicle.

95.17 	Sec. 25. Minnesota Statutes 2008, section 256B.0625, subdivision 26, is amended to 
95.18 	read:
95.19 		Subd. 26.Special education services. (a) Medical assistance covers medical 
95.20 	services identified in a recipient's individualized education plan and covered under the 
95.21 	medical assistance state plan. Covered services include occupational therapy, physical 
95.22 	therapy, speech-language therapy, clinical psychological services, nursing services, 
95.23 	school psychological services, school social work services, personal care assistants 
95.24 	serving as management aides, assistive technology devices, transportation services, 
95.25 	health assessments, and other services covered under the medical assistance state plan. 
95.26 	Mental health services eligible for medical assistance reimbursement must be provided or 
95.27 	coordinated through a children's mental health collaborative where a collaborative exists if 
95.28 	the child is included in the collaborative operational target population. The provision or 
95.29 	coordination of services does not require that the individual education plan be developed 
95.30 	by the collaborative.
95.31 	The services may be provided by a Minnesota school district that is enrolled as a 
95.32 	medical assistance provider or its subcontractor, and only if the services meet all the 
95.33 	requirements otherwise applicable if the service had been provided by a provider other 
95.34 	than a school district, in the following areas: medical necessity, physician's orders, 
95.35 	documentation, personnel qualifications, and prior authorization requirements. The 
96.1 	nonfederal share of costs for services provided under this subdivision is the responsibility 
96.2 	of the local school district as provided in section 125A.74. Services listed in a child's 
96.3 	individual education plan are eligible for medical assistance reimbursement only if those 
96.4 	services meet criteria for federal financial participation under the Medicaid program. 
96.5 	(b) Approval of health-related services for inclusion in the individual education plan 
96.6 	does not require prior authorization for purposes of reimbursement under this chapter. 
96.7 	The commissioner may require physician review and approval of the plan not more than 
96.8 	once annually or upon any modification of the individual education plan that reflects a 
96.9 	change in health-related services.
96.10 	(c) Services of a speech-language pathologist provided under this section are covered 
96.11 	notwithstanding Minnesota Rules, part 9505.0390, subpart 1, item L, if the person:
96.12 	(1) holds a masters degree in speech-language pathology;
96.13 	(2) is licensed by the Minnesota Board of Teaching as an educational 
96.14 	speech-language pathologist; and
96.15 	(3) either has a certificate of clinical competence from the American Speech and 
96.16 	Hearing Association, has completed the equivalent educational requirements and work 
96.17 	experience necessary for the certificate or has completed the academic program and is 
96.18 	acquiring supervised work experience to qualify for the certificate.
96.19 	(d) Medical assistance coverage for medically necessary services provided under 
96.20 	other subdivisions in this section may not be denied solely on the basis that the same or 
96.21 	similar services are covered under this subdivision.
96.22 	(e) The commissioner shall develop and implement package rates, bundled rates, or 
96.23 	per diem rates for special education services under which separately covered services are 
96.24 	grouped together and billed as a unit in order to reduce administrative complexity.
96.25 	(f) The commissioner shall develop a cost-based payment structure for payment 
96.26 	of these services. The commissioner shall reimburse claims submitted based on an 
96.27 	interim rate, and shall settle at a final rate once the department has determined it. The 
96.28 	commissioner shall notify the school district of the final rate. The school district has 60 
96.29 	days to appeal the final rate. To appeal the final rate, the school district shall file a written 
96.30 	appeal request to the commissioner within 60 days of the date the final rate determination 
96.31 	was mailed. The appeal request shall specify (1) the disputed items and (2) the name and 
96.32 	address of the person to contact regarding the appeal.
96.33 	(g) Effective July 1, 2000, medical assistance services provided under an individual 
96.34 	education plan or an individual family service plan by local school districts shall not count 
96.35 	against medical assistance authorization thresholds for that child.
97.1 	(h) Nursing services as defined in section 148.171, subdivision 15, and provided 
97.2 	as an individual education plan health-related service, are eligible for medical assistance 
97.3 	payment if they are otherwise a covered service under the medical assistance program. 
97.4 	Medical assistance covers the administration of prescription medications by a licensed 
97.5 	nurse who is employed by or under contract with a school district when the administration 
97.6 	of medications is identified in the child's individualized education plan. The simple 
97.7 	administration of medications alone is not covered under medical assistance when 
97.8 	administered by a provider other than a school district or when it is not identified in the 
97.9 	child's individualized education plan. 

97.10 	Sec. 26. Minnesota Statutes 2008, section 256B.0631, subdivision 1, is amended to 
97.11 	read:
97.12 		Subdivision 1.Co-payments. (a) Except as provided in subdivision 2, the medical 
97.13 	assistance benefit plan shall include the following co-payments for all recipients, effective 
97.14 	for services provided on or after October 1, 2003, and before January 1, 2009 July 1, 2009:
97.15 	(1) $3 per nonpreventive visit. For purposes of this subdivision, a visit means an 
97.16 	episode of service which is required because of a recipient's symptoms, diagnosis, or 
97.17 	established illness, and which is delivered in an ambulatory setting by a physician or 
97.18 	physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse, 
97.19 	audiologist, optician, or optometrist;
97.20 	(2) $3 for eyeglasses;
97.21 	(3) $6 for nonemergency visits to a hospital-based emergency room; and
97.22 	(4) $3 per brand-name drug prescription and $1 per generic drug prescription, 
97.23 	subject to a $12 per month maximum for prescription drug co-payments. No co-payments 
97.24 	shall apply to antipsychotic drugs when used for the treatment of mental illness.
97.25 	(b) Except as provided in subdivision 2, the medical assistance benefit plan shall 
97.26 	include the following co-payments for all recipients, effective for services provided on 
97.27 	or after January 1, 2009:
97.28 	(1) $6 for nonemergency visits to a hospital-based emergency room; 
97.29 	(2) (4) $3 per brand-name drug prescription and $1 per generic drug prescription, 
97.30 	subject to a $7 per month maximum for prescription drug co-payments. No co-payments 
97.31 	shall apply to antipsychotic drugs when used for the treatment of mental illness; and
97.32 	(3) (5) for individuals identified by the commissioner with income at or below 100 
97.33 	percent of the federal poverty guidelines, total monthly co-payments must not exceed five 
97.34 	percent of family income. For purposes of this paragraph, family income is the total 
98.1 	earned and unearned income of the individual and the individual's spouse, if the spouse is 
98.2 	enrolled in medical assistance and also subject to the five percent limit on co-payments.
98.3 	(c)(b) Recipients of medical assistance are responsible for all co-payments in this 
98.4 	subdivision.

98.5 	Sec. 27. [256B.0755] PAYMENT REFORM DEMONSTRATION PROJECT FOR 
98.6 	SPECIAL PATIENT POPULATIONS.
98.7 		Subdivision 1.Demonstration project. (a) The commissioner of human services, 
98.8 	in consultation with the commissioner of health, shall establish a payment reform 
98.9 	demonstration project implementing an alternative payment system for health care 
98.10 	providers serving an identified group of patients who are enrolled in a state health 
98.11 	care program, and are either high utilizers of high-cost health care services or have 
98.12 	characteristics that put them at high risk of becoming high utilizers.  The purpose of the 
98.13 	demonstration project is to implement and evaluate methods of reducing hospitalizations, 
98.14 	emergency room use, high-cost medications and specialty services, admissions to nursing 
98.15 	facilities, or use of long-term home and community-based services, in order to reduce the 
98.16 	total cost of care and services for the patients.   
98.17 	(b) The commissioner shall give the highest priority to projects that will serve 
98.18 	patients who have chronic medical conditions or complex medical needs that are 
98.19 	complicated by a physical disability, serious mental illness, or serious socioeconomic 
98.20 	factors such as poverty, homelessness, or language or cultural barriers.  The commissioner 
98.21 	shall also give the highest priority to providers or groups of providers who have the 
98.22 	highest concentrations of patients with these characteristics. 
98.23 	(c) The commissioner must implement this payment reform demonstration project 
98.24 	in a manner consistent with the payment reform initiative provided in sections 62U.02 
98.25 	to 62U.04.
98.26 	(d) For purposes of this section, "state health care program" means the medical 
98.27 	assistance, MinnesotaCare, and general assistance medical care programs.
98.28 		Subd. 2.Participation. (a) The commissioner shall request eligible providers or 
98.29 	groups of providers to submit a proposal to participate in the demonstration project by 
98.30 	September 1, 2009.  The providers who are interested in participating shall negotiate with 
98.31 	the commissioner to determine: 
98.32 	(1) the identified group of patients who are to be enrolled in the program; 
98.33 	(2) the services that are to be included in the total cost of care calculation; 
99.1 	(3) the methodology for calculating the total cost of care, which may take into 
99.2 	consideration the impact on costs to other state or local government programs including, 
99.3 	but not limited to, social services and income maintenance programs;  
99.4 	(4) the time period to be covered under the bid; 
99.5 	(5) the implementation of a risk adjustment mechanism to adjust for factors that are 
99.6 	beyond the control of the provider including nonclinical factors that will affect the cost 
99.7 	or outcomes of treatment;  
99.8 	(6) the payment reforms and payment methods to be used under the project, which 
99.9 	may include but are not limited to adjustments in fee-for-service payments, payment of 
99.10 	care coordination fees, payments for start-up and implementation costs to be recovered or 
99.11 	repaid later in the project, payments adjusted based on a provider's proportion of patients 
99.12 	who are enrolled in state health care programs; payments adjusted for the clinical or 
99.13 	socioeconomic complexity of the patients served, payment incentives tied to use of 
99.14 	inpatient and emergency room services, and periodic settle-up adjustments; 
99.15 	(7) methods of sharing financial risk and benefit between the commissioner and 
99.16 	the provider or groups of providers, which may include but are not limited to stop-loss 
99.17 	arrangements to cover high-cost outlier cases or costs that are beyond the control of the 
99.18 	provider, and risk-sharing and benefit-sharing corridors; and 
99.19 	(8) performance and outcome benchmarks to be used to measure performance, 
99.20 	achievement of cost-savings targets, and quality of care provided.
99.21 	(b) A provider or group of providers may submit a proposal for a demonstration 
99.22 	project in partnership with a health maintenance organization or county-based purchasing 
99.23 	plan for the purposes of sharing risk, claims processing, or administration of the project, 
99.24 	or to extend participation in the project to persons who are enrolled in prepaid health 
99.25 	care programs.
99.26 		Subd. 3.Total cost of care agreement. Based on negotiations, the commissioner 
99.27 	must enter into an agreement with interested and eligible providers or groups of providers 
99.28 	to implement projects that are designed to reduce the total cost of care for the identified 
99.29 	patients. To the extent possible, the projects shall begin implementation on January 1, 
99.30 	2010, or upon federal approval, whichever is later.
99.31 		Subd. 4.Eligibility. To be eligible to participate, providers or groups of providers 
99.32 	must meet certification standards for health care homes established by the Department of 
99.33 	Health and the Department of Human Services under section 256B.0751.
99.34 		Subd. 5.Alternative payments. The commissioner shall seek all federal waivers 
99.35 	and approvals necessary to implement this section and to obtain federal matching funds. To 
99.36 	the extent authorized by federal law, the commissioner may waive existing fee-for-service 
100.1 	payment rates, provider contract or performance requirements, consumer incentive 
100.2 	policies, or other requirements in statute or rule in order to allow the providers or groups 
100.3 	of providers to utilize alternative payment and financing methods that will appropriately 
100.4 	fund necessary and cost-effective primary care and care coordination services; establish 
100.5 	appropriate incentives for prevention, health promotion, and care coordination; and 
100.6 	mitigate financial harm to participating providers caused by the successful reduction in 
100.7 	preventable hospitalization, emergency room use, and other costly services.
100.8 		Subd. 6.Cost neutrality. The total cost, including administrative costs, of this 
100.9 	demonstration project must not exceed the costs that would otherwise be incurred by 
100.10 	the state had services to the state health care program enrollees participating in the 
100.11 	demonstration project been provided, as applicable for the enrollee, under fee-for-service 
100.12 	or through managed care or county-based purchasing plans.

100.13 	Sec. 28. Minnesota Statutes 2008, section 256B.08, is amended by adding a 
100.14 	subdivision to read:
100.15 		Subd. 4.Data from Social Security. The commissioner shall accept data from the 
100.16 	Social Security Administration in accordance with United States Code, title 42, section 
100.17 	1396U-5(a).

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

100.19 	Sec. 29. Minnesota Statutes 2008, section 256B.15, subdivision 1, is amended to read:
100.20 		Subdivision 1.Policy and applicability. (a) It is the policy of this state that 
100.21 	individuals or couples, either or both of whom participate in the medical assistance 
100.22 	program, use their own assets to pay their share of the total cost of their care during or 
100.23 	after their enrollment in the program according to applicable federal law and the laws of 
100.24 	this state. The following provisions apply:
100.25 	(1) subdivisions 1c to 1k shall not apply to claims arising under this section which 
100.26 	are presented under section 525.313;
100.27 	(2) the provisions of subdivisions 1c to 1k expanding the interests included in an 
100.28 	estate for purposes of recovery under this section give effect to the provisions of United 
100.29 	States Code, title 42, section 1396p, governing recoveries, but do not give rise to any 
100.30 	express or implied liens in favor of any other parties not named in these provisions;
100.31 	(3) the continuation of a recipient's life estate or joint tenancy interest in real 
100.32 	property after the recipient's death for the purpose of recovering medical assistance under 
100.33 	this section modifies common law principles holding that these interests terminate on 
100.34 	the death of the holder;
101.1 	(4) all laws, rules, and regulations governing or involved with a recovery of medical 
101.2 	assistance shall be liberally construed to accomplish their intended purposes;
101.3 	(5) a deceased recipient's life estate and joint tenancy interests continued under this 
101.4 	section shall be owned by the remaindermen or surviving joint tenants as their interests 
101.5 	may appear on the date of the recipient's death. They shall not be merged into the 
101.6 	remainder interest or the interests of the surviving joint tenants by reason of ownership. 
101.7 	They shall be subject to the provisions of this section. Any conveyance, transfer, sale, 
101.8 	assignment, or encumbrance by a remainderman, a surviving joint tenant, or their heirs, 
101.9 	successors, and assigns shall be deemed to include all of their interest in the deceased 
101.10 	recipient's life estate or joint tenancy interest continued under this section; and
101.11 	(6) the provisions of subdivisions 1c to 1k continuing a recipient's joint tenancy 
101.12 	interests in real property after the recipient's death do not apply to a homestead owned 
101.13 	of record, on the date the recipient dies, by the recipient and the recipient's spouse as 
101.14 	joint tenants with a right of survivorship. Homestead means the real property occupied 
101.15 	by the surviving joint tenant spouse as their sole residence on the date the recipient dies 
101.16 	and classified and taxed to the recipient and surviving joint tenant spouse as homestead 
101.17 	property for property tax purposes in the calendar year in which the recipient dies. For 
101.18 	purposes of this exemption, real property the recipient and their surviving joint tenant 
101.19 	spouse purchase solely with the proceeds from the sale of their prior homestead, own 
101.20 	of record as joint tenants, and qualify as homestead property under section 273.124 in 
101.21 	the calendar year in which the recipient dies and prior to the recipient's death shall be 
101.22 	deemed to be real property classified and taxed to the recipient and their surviving joint 
101.23 	tenant spouse as homestead property in the calendar year in which the recipient dies. 
101.24 	The surviving spouse, or any person with personal knowledge of the facts, may provide 
101.25 	an affidavit describing the homestead property affected by this clause and stating facts 
101.26 	showing compliance with this clause. The affidavit shall be prima facie evidence of the 
101.27 	facts it states.
101.28 	(b) For purposes of this section, "medical assistance" includes the medical assistance 
101.29 	program under this chapter and the general assistance medical care program under chapter 
101.30 	256D and alternative care for nonmedical assistance recipients under section 256B.0913.
101.31 	(c) For purposes of this section, beginning January 1, 2010, "medical assistance" 
101.32 	does not include Medicare cost-sharing benefits in accordance with United States Code, 
101.33 	title 42, section 1396p.
101.34 	(c) (d) All provisions in this subdivision, and subdivisions 1d, 1f, 1g, 1h, 1i, and 
101.35 	1j, related to the continuation of a recipient's life estate or joint tenancy interests in real 
101.36 	property after the recipient's death for the purpose of recovering medical assistance, are 
102.1 	effective only for life estates and joint tenancy interests established on or after August 1, 
102.2 	2003. For purposes of this paragraph, medical assistance does not include alternative care.

102.3 	Sec. 30. Minnesota Statutes 2008, section 256B.15, subdivision 1a, is amended to read:
102.4 		Subd. 1a.Estates subject to claims. (a) If a person receives any medical assistance 
102.5 	hereunder, on the person's death, if single, or on the death of the survivor of a married 
102.6 	couple, either or both of whom received medical assistance, or as otherwise provided 
102.7 	for in this section, the total amount paid for medical assistance rendered for the person 
102.8 	and spouse shall be filed as a claim against the estate of the person or the estate of the 
102.9 	surviving spouse in the court having jurisdiction to probate the estate or to issue a decree 
102.10 	of descent according to sections 525.31 to 525.313. 
102.11 	(b) For the purposes of this section, the person's estate must consist of:
102.12 	(1) the person's probate estate;
102.13 	(2) all of the person's interests or proceeds of those interests in real property the 
102.14 	person owned as a life tenant or as a joint tenant with a right of survivorship at the time of 
102.15 	the person's death;
102.16 	(3) all of the person's interests or proceeds of those interests in securities the person 
102.17 	owned in beneficiary form as provided under sections 524.6-301 to 524.6-311 at the time 
102.18 	of the person's death, to the extent the interests or proceeds of those interests become part 
102.19 	of the probate estate under section 524.6-307;
102.20 	(4) all of the person's interests in joint accounts, multiple-party accounts, and 
102.21 	pay-on-death accounts, brokerage accounts, investment accounts, or the proceeds of 
102.22 	those accounts, as provided under sections 524.6-201 to 524.6-214 at the time of the 
102.23 	person's death to the extent the interests become part of the probate estate under section 
102.24 	524.6-207; and
102.25 	(5) assets conveyed to a survivor, heir, or assign of the person through survivorship, 
102.26 	living trust, or other arrangements.
102.27 	(c) For the purpose of this section and recovery in a surviving spouse's estate for 
102.28 	medical assistance paid for a predeceased spouse, the estate must consist of all of the legal 
102.29 	title and interests the deceased individual's predeceased spouse had in jointly owned or 
102.30 	marital property at the time of the spouse's death, as defined in subdivision 2b, and the 
102.31 	proceeds of those interests, that passed to the deceased individual or another individual, a 
102.32 	survivor, an heir, or an assign of the predeceased spouse through a joint tenancy, tenancy 
102.33 	in common, survivorship, life estate, living trust, or other arrangement. A deceased 
102.34 	recipient who, at death, owned the property jointly with the surviving spouse shall have 
102.35 	an interest in the entire property.
103.1 	(d) For the purpose of recovery in a single person's estate or the estate of a survivor 
103.2 	of a married couple, "other arrangement" includes any other means by which title to all or 
103.3 	any part of the jointly owned or marital property or interest passed from the predeceased 
103.4 	spouse to another including, but not limited to, transfers between spouses which are 
103.5 	permitted, prohibited, or penalized for purposes of medical assistance.
103.6 	(e) A claim shall be filed if medical assistance was rendered for either or both 
103.7 	persons under one of the following circumstances:
103.8 	(a) (1) the person was over 55 years of age, and received services under this chapter;
103.9 	(b) (2) the person resided in a medical institution for six months or longer, received 
103.10 	services under this chapter, and, at the time of institutionalization or application for 
103.11 	medical assistance, whichever is later, the person could not have reasonably been expected 
103.12 	to be discharged and returned home, as certified in writing by the person's treating 
103.13 	physician. For purposes of this section only, a "medical institution" means a skilled 
103.14 	nursing facility, intermediate care facility, intermediate care facility for persons with 
103.15 	developmental disabilities, nursing facility, or inpatient hospital; or
103.16 	(c) (3) the person received general assistance medical care services under chapter 
103.17 	256D.
103.18 	(f) The claim shall be considered an expense of the last illness of the decedent for the 
103.19 	purpose of section 524.3-805. Notwithstanding any law or rule to the contrary, a state or 
103.20 	county agency with a claim under this section must be a creditor under section 524.6-307.
103.21 	Any statute of limitations that purports to limit any county agency or the state agency, 
103.22 	or both, to recover for medical assistance granted hereunder shall not apply to any claim 
103.23 	made hereunder for reimbursement for any medical assistance granted hereunder. Notice 
103.24 	of the claim shall be given to all heirs and devisees of the decedent whose identity can be 
103.25 	ascertained with reasonable diligence. The notice must include procedures and instructions 
103.26 	for making an application for a hardship waiver under subdivision 5; time frames for 
103.27 	submitting an application and determination; and information regarding appeal rights and 
103.28 	procedures. Counties are entitled to one-half of the nonfederal share of medical assistance 
103.29 	collections from estates that are directly attributable to county effort. Counties are entitled 
103.30 	to ten percent of the collections for alternative care directly attributable to county effort. 

103.31 	Sec. 31. Minnesota Statutes 2008, section 256B.15, subdivision 1h, is amended to read:
103.32 		Subd. 1h. Estates of specific persons receiving medical assistance. (a) For 
103.33 	purposes of this section, paragraphs (b) to (k) (j) apply if a person received medical 
103.34 	assistance for which a claim may be filed under this section and died single, or the 
104.1 	surviving spouse of the couple and was not survived by any of the persons described 
104.2 	in subdivisions 3 and 4. 
104.3 	(b) For purposes of this section, the person's estate consists of: (1) the person's 
104.4 	probate estate; (2) all of the person's interests or proceeds of those interests in real property 
104.5 	the person owned as a life tenant or as a joint tenant with a right of survivorship at the 
104.6 	time of the person's death; (3) all of the person's interests or proceeds of those interests in 
104.7 	securities the person owned in beneficiary form as provided under sections 524.6-301 to 
104.8 	524.6-311 at the time of the person's death, to the extent they become part of the probate 
104.9 	estate under section 524.6-307; (4) all of the person's interests in joint accounts, multiple 
104.10 	party accounts, and pay on death accounts, or the proceeds of those accounts, as provided 
104.11 	under sections 524.6-201 to 524.6-214 at the time of the person's death to the extent 
104.12 	they become part of the probate estate under section 524.6-207; and (5) the person's 
104.13 	legal title or interest at the time of the person's death in real property transferred under 
104.14 	a transfer on death deed under section 507.071, or in the proceeds from the subsequent 
104.15 	sale of the person's interest in the real property. Notwithstanding any law or rule to the 
104.16 	contrary, a state or county agency with a claim under this section shall be a creditor under 
104.17 	section 524.6-307. 
104.18 	(c) (b) Notwithstanding any law or rule to the contrary, the person's life estate or joint 
104.19 	tenancy interest in real property not subject to a medical assistance lien under sections 
104.20 	514.980 to 514.985 on the date of the person's death shall not end upon the person's death 
104.21 	and shall continue as provided in this subdivision. The life estate in the person's estate 
104.22 	shall be that portion of the interest in the real property subject to the life estate that is equal 
104.23 	to the life estate percentage factor for the life estate as listed in the Life Estate Mortality 
104.24 	Table of the health care program's manual for a person who was the age of the medical 
104.25 	assistance recipient on the date of the person's death. The joint tenancy interest in real 
104.26 	property in the estate shall be equal to the fractional interest the person would have owned 
104.27 	in the jointly held interest in the property had they and the other owners held title to the 
104.28 	property as tenants in common on the date the person died. 
104.29 	(d) (c) The court upon its own motion, or upon motion by the personal representative 
104.30 	or any interested party, may enter an order directing the remaindermen or surviving joint 
104.31 	tenants and their spouses, if any, to sign all documents, take all actions, and otherwise 
104.32 	fully cooperate with the personal representative and the court to liquidate the decedent's 
104.33 	life estate or joint tenancy interests in the estate and deliver the cash or the proceeds of 
104.34 	those interests to the personal representative and provide for any legal and equitable 
104.35 	sanctions as the court deems appropriate to enforce and carry out the order, including an 
104.36 	award of reasonable attorney fees. 
105.1 	(e) (d) The personal representative may make, execute, and deliver any conveyances 
105.2 	or other documents necessary to convey the decedent's life estate or joint tenancy interest 
105.3 	in the estate that are necessary to liquidate and reduce to cash the decedent's interest or 
105.4 	for any other purposes. 
105.5 	(f) (e) Subject to administration, all costs, including reasonable attorney fees, 
105.6 	directly and immediately related to liquidating the decedent's life estate or joint tenancy 
105.7 	interest in the decedent's estate, shall be paid from the gross proceeds of the liquidation 
105.8 	allocable to the decedent's interest and the net proceeds shall be turned over to the personal 
105.9 	representative and applied to payment of the claim presented under this section. 
105.10 	(g) (f) The personal representative shall bring a motion in the district court in which 
105.11 	the estate is being probated to compel the remaindermen or surviving joint tenants to 
105.12 	account for and deliver to the personal representative all or any part of the proceeds of any 
105.13 	sale, mortgage, transfer, conveyance, or any disposition of real property allocable to the 
105.14 	decedent's life estate or joint tenancy interest in the decedent's estate, and do everything 
105.15 	necessary to liquidate and reduce to cash the decedent's interest and turn the proceeds of 
105.16 	the sale or other disposition over to the personal representative. The court may grant any 
105.17 	legal or equitable relief including, but not limited to, ordering a partition of real estate 
105.18 	under chapter 558 necessary to make the value of the decedent's life estate or joint tenancy 
105.19 	interest available to the estate for payment of a claim under this section. 
105.20 	(h) (g) Subject to administration, the personal representative shall use all of the cash 
105.21 	or proceeds of interests to pay an allowable claim under this section. The remaindermen 
105.22 	or surviving joint tenants and their spouses, if any, may enter into a written agreement 
105.23 	with the personal representative or the claimant to settle and satisfy obligations imposed at 
105.24 	any time before or after a claim is filed. 
105.25 	(i) (h) The personal representative may, at their discretion, provide any or all of the 
105.26 	other owners, remaindermen, or surviving joint tenants with an affidavit terminating the 
105.27 	decedent's estate's interest in real property the decedent owned as a life tenant or as a joint 
105.28 	tenant with others, if the personal representative determines in good faith that neither the 
105.29 	decedent nor any of the decedent's predeceased spouses received any medical assistance 
105.30 	for which a claim could be filed under this section, or if the personal representative has 
105.31 	filed an affidavit with the court that the estate has other assets sufficient to pay a claim, as 
105.32 	presented, or if there is a written agreement under paragraph (h) (g), or if the claim, as 
105.33 	allowed, has been paid in full or to the full extent of the assets the estate has available 
105.34 	to pay it. The affidavit may be recorded in the office of the county recorder or filed in 
105.35 	the Office of the Registrar of Titles for the county in which the real property is located. 
105.36 	Except as provided in section 514.981, subdivision 6, when recorded or filed, the affidavit 
106.1 	shall terminate the decedent's interest in real estate the decedent owned as a life tenant or a 
106.2 	joint tenant with others. The affidavit shall:
106.3 	(1) be signed by the personal representative;
106.4 	(2) identify the decedent and the interest being terminated;
106.5 	(3) give recording information sufficient to identify the instrument that created the 
106.6 	interest in real property being terminated;
106.7 	(4) legally describe the affected real property;
106.8 	(5) state that the personal representative has determined that neither the decedent 
106.9 	nor any of the decedent's predeceased spouses received any medical assistance for which 
106.10 	a claim could be filed under this section;
106.11 	(6) state that the decedent's estate has other assets sufficient to pay the claim, as 
106.12 	presented, or that there is a written agreement between the personal representative and 
106.13 	the claimant and the other owners or remaindermen or other joint tenants to satisfy the 
106.14 	obligations imposed under this subdivision; and
106.15 	(7) state that the affidavit is being given to terminate the estate's interest under this 
106.16 	subdivision, and any other contents as may be appropriate.
106.17 	The recorder or registrar of titles shall accept the affidavit for recording or filing. The 
106.18 	affidavit shall be effective as provided in this section and shall constitute notice even if it 
106.19 	does not include recording information sufficient to identify the instrument creating the 
106.20 	interest it terminates. The affidavit shall be conclusive evidence of the stated facts. 
106.21 	(j) (i) The holder of a lien arising under subdivision 1c shall release the lien at 
106.22 	the holder's expense against an interest terminated under paragraph (h) (g) to the extent 
106.23 	of the termination. 
106.24 	(k) (j) If a lien arising under subdivision 1c is not released under paragraph (j) (i), 
106.25 	prior to closing the estate, the personal representative shall deed the interest subject to the 
106.26 	lien to the remaindermen or surviving joint tenants as their interests may appear. Upon 
106.27 	recording or filing, the deed shall work a merger of the recipient's life estate or joint 
106.28 	tenancy interest, subject to the lien, into the remainder interest or interest the decedent and 
106.29 	others owned jointly. The lien shall attach to and run with the property to the extent of 
106.30 	the decedent's interest at the time of the decedent's death. 

106.31 	Sec. 32. Minnesota Statutes 2008, section 256B.15, subdivision 2, is amended to read:
106.32 		Subd. 2.Limitations on claims. The claim shall include only the total amount 
106.33 	of medical assistance rendered after age 55 or during a period of institutionalization 
106.34 	described in subdivision 1a, clause (b) paragraph (e), and the total amount of general 
106.35 	assistance medical care rendered, and shall not include interest. Claims that have been 
107.1 	allowed but not paid shall bear interest according to section 524.3-806, paragraph (d). A 
107.2 	claim against the estate of a surviving spouse who did not receive medical assistance, for 
107.3 	medical assistance rendered for the predeceased spouse, shall be payable from the full 
107.4 	value of all of the predeceased spouse's assets and interests which are part of the surviving 
107.5 	spouse's estate under subdivisions 1a and 2b. Recovery of medical assistance expenses in 
107.6 	the nonrecipient surviving spouse's estate is limited to the value of the assets of the estate 
107.7 	that were marital property or jointly owned property at any time during the marriage. The 
107.8 	claim is not payable from the value of assets or proceeds of assets in the estate attributable 
107.9 	to a predeceased spouse whom the individual married after the death of the predeceased 
107.10 	recipient spouse for whom the claim is filed or from assets and the proceeds of assets in the 
107.11 	estate which the nonrecipient decedent spouse acquired with assets which were not marital 
107.12 	property or jointly owned property after the death of the predeceased recipient spouse.
107.13 	Claims for alternative care shall be net of all premiums paid under section 256B.0913, 
107.14 	subdivision 12, on or after July 1, 2003, and shall be limited to services provided on or 
107.15 	after July 1, 2003. Claims against marital property shall be limited to claims against 
107.16 	recipients who died on or after July 1, 2009.

107.17 	Sec. 33. Minnesota Statutes 2008, section 256B.15, is amended by adding a 
107.18 	subdivision to read:
107.19 		Subd. 2b.Controlling provisions. (a) For purposes of this subdivision and 
107.20 	subdivisions 1a and 2, paragraphs (b) to (d) apply.
107.21 	(b) At the time of death of a recipient spouse and solely for purpose of recovery of 
107.22 	medical assistance benefits received, a predeceased recipient spouse shall have a legal 
107.23 	title or interest in the undivided whole of all of the property which the recipient and the 
107.24 	recipient's surviving spouse owned jointly or which was marital property at any time 
107.25 	during their marriage regardless of the form of ownership and regardless of whether 
107.26 	it was owned or titled in the names of one or both the recipient and the recipient's 
107.27 	spouse. Title and interest in the property of a predeceased recipient spouse shall not end 
107.28 	or extinguish upon the person's death and shall continue for the purpose of allowing 
107.29 	recovery of medical assistance in the estate of the surviving spouse. Upon the death of 
107.30 	the predeceased recipient spouse, title and interest in the predeceased spouse's property 
107.31 	shall vest in the surviving spouse by operation of law and without the necessity for any 
107.32 	probate or decree of descent proceedings and shall continue to exist after the death of the 
107.33 	predeceased spouse and the surviving spouse to permit recovery of medical assistance. 
107.34 	The recipient spouse and the surviving spouse of a deceased recipient spouse shall not 
108.1 	encumber, disclaim, transfer, alienate, hypothecate, or otherwise divest themselves of 
108.2 	these interests before or upon death.
108.3 	(c) For purposes of this section, "marital property" includes any and all real or 
108.4 	personal property of any kind or interests in such property the predeceased recipient 
108.5 	spouse and their spouse, or either of them, owned at the time of their marriage to each 
108.6 	other or acquired during their marriage regardless of whether it was owned or titled in 
108.7 	the names of one or both of them. If either or both spouses of a married couple received 
108.8 	medical assistance, all property owned during the marriage or which either or both spouses 
108.9 	acquired during their marriage shall be presumed to be marital property for purposes of 
108.10 	recovering medical assistance unless there is clear and convincing evidence to the contrary.
108.11 	(d) The agency responsible for the claim for medical assistance for a recipient spouse 
108.12 	may, at its discretion, release specific real and personal property from the provisions of 
108.13 	this section. The release shall extinguish the interest created under paragraph (b) in the 
108.14 	land it describes upon filing or recording. The release need not be attested, certified, or 
108.15 	acknowledged as a condition of filing or recording and shall be filed or recorded in the 
108.16 	office of the county recorder or registrar of titles, as appropriate, in the county where the 
108.17 	real property is located. The party to whom the release is given shall be responsible for 
108.18 	paying all fees and costs necessary to record and file the release. If the property described 
108.19 	in the release is registered property, the registrar of titles shall accept it for recording and 
108.20 	shall record it on the certificate of title for each parcel of property described in the release. 
108.21 	If the property described in the release is abstract property, the recorder shall accept it 
108.22 	for filing and file it in the county's grantor-grantee indexes and any tract index the county 
108.23 	maintains for each parcel of property described in the release.

108.24 	Sec. 34. Minnesota Statutes 2008, section 256B.15, is amended by adding a 
108.25 	subdivision to read:
108.26 		Subd. 9.Commissioner's intervention. The commissioner shall be permitted to 
108.27 	intervene as a party in any proceeding involving recovery of medical assistance upon 
108.28 	filing a notice of intervention and serving such notice on the other parties.

108.29 	Sec. 35. Minnesota Statutes 2008, section 256B.69, subdivision 5a, is amended to read:
108.30 		Subd. 5a.Managed care contracts. (a) Managed care contracts under this section 
108.31 	and sections 256L.12 and 256D.03, shall be entered into or renewed on a calendar year 
108.32 	basis beginning January 1, 1996. Managed care contracts which were in effect on June 
108.33 	30, 1995, and set to renew on July 1, 1995, shall be renewed for the period July 1, 1995 
108.34 	through December 31, 1995 at the same terms that were in effect on June 30, 1995. The 
109.1 	commissioner may issue separate contracts with requirements specific to services to 
109.2 	medical assistance recipients age 65 and older.
109.3 	(b) A prepaid health plan providing covered health services for eligible persons 
109.4 	pursuant to chapters 256B, 256D, and 256L, is responsible for complying with the terms 
109.5 	of its contract with the commissioner. Requirements applicable to managed care programs 
109.6 	under chapters 256B, 256D, and 256L, established after the effective date of a contract 
109.7 	with the commissioner take effect when the contract is next issued or renewed.
109.8 	(c) Effective for services rendered on or after January 1, 2003, the commissioner shall 
109.9 	withhold five percent of managed care plan payments under this section and county-based 
109.10 	purchasing plan's payment rate under section 256B.692 for the prepaid medical assistance 
109.11 	and general assistance medical care programs pending completion of performance targets. 
109.12 	Each performance target must be quantifiable, objective, measurable, and reasonably 
109.13 	attainable, except in the case of a performance target based on a federal or state law or rule. 
109.14 	Criteria for assessment of each performance target must be outlined in writing prior to the 
109.15 	contract effective date. The managed care plan must demonstrate, to the commissioner's 
109.16 	satisfaction, that the data submitted regarding attainment of the performance target is 
109.17 	accurate. The commissioner shall periodically change the administrative measures used 
109.18 	as performance targets in order to improve plan performance across a broader range of 
109.19 	administrative services. The performance targets must include measurement of plan 
109.20 	efforts to contain spending on health care services and administrative activities. The 
109.21 	commissioner may adopt plan-specific performance targets that take into account factors 
109.22 	affecting only one plan, including characteristics of the plan's enrollee population. The 
109.23 	withheld funds must be returned no sooner than July of the following year if performance 
109.24 	targets in the contract are achieved. The commissioner may exclude special demonstration 
109.25 	projects under subdivision 23. A managed care plan or a county-based purchasing plan 
109.26 	under section 256B.692 may include as admitted assets under section 62D.044 any amount 
109.27 	withheld under this paragraph that is reasonably expected to be returned.
109.28 	(d)(1) Effective for services rendered on or after January 1, 2009, the commissioner 
109.29 	shall withhold three percent of managed care plan payments under this section and 
109.30 	county-based purchasing plan payments under section 256B.692 for the prepaid medical 
109.31 	assistance and general assistance medical care programs. The withheld funds must be 
109.32 	returned no sooner than July 1 and no later than July 31 of the following year. The 
109.33 	commissioner may exclude special demonstration projects under subdivision 23.
109.34 	(2) A managed care plan or a county-based purchasing plan under section 256B.692 
109.35 	may include as admitted assets under section 62D.044 any amount withheld under 
110.1 	this paragraph. The return of the withhold under this paragraph is not subject to the 
110.2 	requirements of paragraph (c).
110.3 	(e) Effective for services rendered on or after January 1, 2010, the commissioner 
110.4 	shall include as part of the performance targets described in paragraph (a) a reduction in 
110.5 	the health plan's emergency room utilization rate for state health care program enrollees 
110.6 	by a measurable rate of five percent from the plan's utilization rate for state health care 
110.7 	program enrollees for the previous calendar year.
110.8 	The withheld funds must be returned no sooner than July 1 and no later than July 
110.9 	31 of the following calendar year if the managed care plan or county-based purchasing 
110.10 	plan demonstrates to the satisfaction of the commissioner that a reduction in the utilization 
110.11 	rate was achieved.
110.12 	The withhold described in this paragraph shall continue for each consecutive 
110.13 	contract period until the health plan's emergency room utilization rate for state health care 
110.14 	program enrollees is reduced by 25 percent of the health plan's emergency room utilization 
110.15 	rate for state health care program enrollees for calendar year 2008.
110.16 	(f) A managed care plan or a county-based purchasing plan under section 256B.692 
110.17 	may include as admitted assets under section 62D.044 any amount withheld under this 
110.18 	section that is reasonably expected to be returned.

110.19 	Sec. 36. Minnesota Statutes 2008, section 256B.69, subdivision 5c, is amended to read:
110.20 		Subd. 5c.Medical education and research fund. (a) Except as provided in 
110.21 	paragraph (c), the commissioner of human services shall transfer each year to the medical 
110.22 	education and research fund established under section 62J.692, the following: 
110.23 	(1) an amount equal to the reduction in the prepaid medical assistance and prepaid 
110.24 	general assistance medical care payments as specified in this clause. Until January 1, 
110.25 	2002, the county medical assistance and general assistance medical care capitation base 
110.26 	rate prior to plan specific adjustments and after the regional rate adjustments under section 
110.27 	256B.69, subdivision 5b, is reduced 6.3 percent for Hennepin County, two percent for 
110.28 	the remaining metropolitan counties, and no reduction for nonmetropolitan Minnesota 
110.29 	counties; and after January 1, 2002, the county medical assistance and general assistance 
110.30 	medical care capitation base rate prior to plan specific adjustments is reduced 6.3 percent 
110.31 	for Hennepin County, two percent for the remaining metropolitan counties, and 1.6 percent 
110.32 	for nonmetropolitan Minnesota counties. Nursing facility and elderly waiver payments 
110.33 	and demonstration project payments operating under subdivision 23 are excluded from 
110.34 	this reduction. The amount calculated under this clause shall not be adjusted for periods 
110.35 	already paid due to subsequent changes to the capitation payments; 
111.1 	(2) beginning July 1, 2003, $2,157,000$4,314,000 from the capitation rates paid 
111.2 	under this section plus any federal matching funds on this amount;
111.3 	(3) beginning July 1, 2002, an additional $12,700,000 from the capitation rates 
111.4 	paid under this section; and
111.5 	(4) beginning July 1, 2003, an additional $4,700,000 from the capitation rates paid 
111.6 	under this section.
111.7 	(b) This subdivision shall be effective upon approval of a federal waiver which 
111.8 	allows federal financial participation in the medical education and research fund. Effective 
111.9 	July 1, 2009, and thereafter, the transfers required by paragraph (a), clauses (1) to (4), 
111.10 	shall not exceed the total amount transferred for fiscal year 2009. Any excess shall first 
111.11 	reduce the amounts otherwise required to be transferred under paragraph (a), clauses (2), 
111.12 	(3), and (4). Any excess following this reduction shall proportionally reduce the transfers 
111.13 	under paragraph (a), clause (1).
111.14 	(c) Effective July 1, 2003, the amount reduced from the prepaid general assistance 
111.15 	medical care payments under paragraph (a), clause (1), shall be transferred to the general 
111.16 	fund.
111.17 	(d) Beginning July 1, 2009, of the amounts in paragraph (a), the commissioner shall 
111.18 	transfer $21,714,000 each fiscal year to the medical education and research fund. The 
111.19 	balance of the transfers under paragraph (a) shall be transferred to the medical education 
111.20 	and research fund no earlier than July 1 of the following fiscal year.

111.21 	Sec. 37. Minnesota Statutes 2008, section 256B.69, subdivision 5f, is amended to read:
111.22 		Subd. 5f.Capitation rates. (a) Beginning July 1, 2002, the capitation rates paid 
111.23 	under this section are increased by $12,700,000 per year. Beginning July 1, 2003, the 
111.24 	capitation rates paid under this section are increased by $4,700,000 per year.
111.25 	(b) Beginning July 1, 2009, the capitation rates paid under this section are increased 
111.26 	each year by the lesser of $21,714,000 or an amount equal to the difference between the 
111.27 	estimated value of the reductions described in subdivision 5c, paragraph (a), clause (1), 
111.28 	and the amount of the limit described in subdivision 5c, paragraph (b).

111.29 	Sec. 38. [256B.695] PAYMENT FOR BASIC CARE SERVICES.
111.30 	Effective service date July 1, 2009, total payments for basic care services, except 
111.31 	prescription drugs, medical supplies, prosthetics, lab, radiology, medical transportation, 
111.32 	and services subject to or specifically exempted from section 256B.76, subdivision 1, 
111.33 	paragraph (c), shall be reduced by 3.0 percent, prior to third-party liability. Payments 
112.1 	made to managed care and county-based purchasing plans shall be reduced for services 
112.2 	provided on or after January 1, 2010, to reflect this reduction.

112.3 	Sec. 39. Minnesota Statutes 2008, section 256B.76, subdivision 1, is amended to read:
112.4 		Subdivision 1.Physician reimbursement.  (a) Effective for services rendered on 
112.5 	or after October 1, 1992, the commissioner shall make payments for physician services 
112.6 	as follows:
112.7 	(1) payment for level one Centers for Medicare and Medicaid Services' common 
112.8 	procedural coding system codes titled "office and other outpatient services," "preventive 
112.9 	medicine new and established patient," "delivery, antepartum, and postpartum care," 
112.10 	"critical care," cesarean delivery and pharmacologic management provided to psychiatric 
112.11 	patients, and level three codes for enhanced services for prenatal high risk, shall be paid 
112.12 	at the lower of (i) submitted charges, or (ii) 25 percent above the rate in effect on June 
112.13 	30, 1992. If the rate on any procedure code within these categories is different than the 
112.14 	rate that would have been paid under the methodology in section 256B.74, subdivision 2, 
112.15 	then the larger rate shall be paid; 
112.16 	(2) payments for all other services shall be paid at the lower of (i) submitted charges, 
112.17 	or (ii) 15.4 percent above the rate in effect on June 30, 1992; and
112.18 	(3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th 
112.19 	percentile of 1989, less the percent in aggregate necessary to equal the above increases 
112.20 	except that payment rates for home health agency services shall be the rates in effect 
112.21 	on September 30, 1992.
112.22 	(b) Effective for services rendered on or after January 1, 2000, payment rates for 
112.23 	physician and professional services shall be increased by three percent over the rates 
112.24 	in effect on December 31, 1999, except for home health agency and family planning 
112.25 	agency services. The increases in this paragraph shall be implemented January 1, 2000, 
112.26 	for managed care.
112.27 	(c) Effective for services rendered on or after July 1, 2009, payment rates for 
112.28 	physician and professional services shall be reduced by three percent over the rates in effect 
112.29 	on June 30, 2009, except for office or other outpatient services (procedure codes 99201 
112.30 	to 99215) and preventive medicine services (procedure codes 99381 to 99412) billed by 
112.31 	the following primary care specialties: general practitioner, internal medicine, pediatrics, 
112.32 	geriatric nurse practitioner, pediatric nurse practitioner, family practice nurse practitioner, 
112.33 	adult nurse practitioner, geriatrics, and family practice. The commissioner, effective 
112.34 	January 1, 2010, shall reduce capitation rates paid to managed care and county-based 
112.35 	purchasing plans under sections 256B.69 and 256B.692 to reflect this payment reduction.

113.1 	Sec. 40. Minnesota Statutes 2008, section 256B.76, subdivision 4, is amended to read:
113.2 		Subd. 4.Critical access dental providers.   Effective for dental services rendered 
113.3 	on or after January 1, 2002, the commissioner shall increase reimbursements to dentists 
113.4 	and dental clinics deemed by the commissioner to be critical access dental providers. 
113.5 	For dental services rendered on or after July 1, 2007, the commissioner shall increase 
113.6 	reimbursement by 30 percent above the reimbursement rate that would otherwise be paid to 
113.7 	the critical access dental provider. The commissioner shall pay the health plan companies 
113.8 	in amounts sufficient to reflect increased reimbursements to critical access dental providers 
113.9 	as approved by the commissioner. In determining which dentists and dental clinics shall 
113.10 	be deemed critical access dental providers, the commissioner shall review:
113.11 	(1) the utilization rate in the service area in which the dentist or dental clinic operates 
113.12 	for dental services to patients covered by medical assistance, general assistance medical 
113.13 	care, or MinnesotaCare as their primary source of coverage;
113.14 	(2) the level of services provided by the dentist or dental clinic to patients covered 
113.15 	by medical assistance, general assistance medical care, or MinnesotaCare as their primary 
113.16 	source of coverage; and
113.17 	(3) whether the level of services provided by the dentist or dental clinic is critical to 
113.18 	maintaining adequate levels of patient access within the service area.
113.19 	In the absence of a critical access dental provider in a service area, the commissioner may 
113.20 	designate a dentist or dental clinic as a critical access dental provider if the dentist or 
113.21 	dental clinic is willing to provide care to patients covered by medical assistance, general 
113.22 	assistance medical care, or MinnesotaCare at a level which significantly increases access 
113.23 	to dental care in the service area. The commissioner shall administer this subdivision 
113.24 	within the limits of available appropriations.

113.25 	Sec. 41. Minnesota Statutes 2008, section 256B.76, is amended by adding a 
113.26 	subdivision to read:
113.27 		Subd. 4a.Designation and termination of critical access dental providers. (a) 
113.28 	The commissioner shall not designate an individual dentist or clinic as a critical access 
113.29 	dental provider under subdivision 4 or section 256L.11, subdivision 7, when the owner or 
113.30 	any dentist employed by or under contract with the practice:
113.31 	(1) has been subject to a corrective or disciplinary action by the Minnesota Board of 
113.32 	Dentistry within the past five years or is currently subject to a corrective or disciplinary 
113.33 	action by the board. Designation shall not be made until the provider is no longer subject 
113.34 	to a corrective or disciplinary action;
113.35 	(2) does not bill on a clinic-specific location basis;
114.1 	(3) has been subject, within the past five years, to a postinvestigation action by the 
114.2 	commissioner of human services or contracted health plan when investigating services 
114.3 	provided to Minnesota health care program enrollees, including administrative sanctions, 
114.4 	monetary recovery, referral to state regulatory agency, referral to the state attorney general 
114.5 	or county attorney general, or issuance of a warning as specified in Minnesota Rules, parts 
114.6 	9505.2160 to 9505.2245. Designation shall not be considered until the January of the 
114.7 	year following documentation that the activity that resulted in postinvestigative action 
114.8 	has stopped; or
114.9 	(4) has not completed the application for critical access dental provider designation, 
114.10 	has submitted the application after the due date, provided incorrect information, or has 
114.11 	knowingly and willfully submitted a fraudulent designation form.
114.12 	(b) The commissioner shall terminate a critical access designation of an individual 
114.13 	dentist or clinic, if the owner or any dentist employed by or under contract with the 
114.14 	practice:
114.15 	(1) becomes subject to a disciplinary or corrective action by the Minnesota Board of 
114.16 	Dentistry. The provider shall not be considered for critical access designation until the 
114.17 	January following the year in which the action has ended; or
114.18 	(2) becomes subject to a postinvestigation action by the commissioner of human 
114.19 	services or contracted health plan including administrative sanctions, monetary recovery, 
114.20 	referral to state regulatory agency, referral to the state attorney general or county attorney 
114.21 	general, or issuance of a warning as specified in Minnesota Rules, parts 9505.2160 to 
114.22 	9505.2245. Designation shall not be considered until the January of the year following 
114.23 	documentation that the activity that resulted in postinvestigative action has stopped.
114.24 	(c) Any termination is retroactive to the date of the:
114.25 	(1) postinvestigative action; or
114.26 	(2) disciplinary or corrective action by the Minnesota Board of Dentistry.
114.27 	(d) A provider who has been terminated or not designated may appeal only through 
114.28 	the contested hearing process as defined in section 14.02, subdivision 3, by filing with the 
114.29 	commissioner a written request of appeal. The appeal request must be received by the 
114.30 	commissioner no later than 30 days after notification of termination or nondesignation.
114.31 	(e) The commissioner may make an exception to paragraph (a), clauses (1) and (3), 
114.32 	and paragraph (b), if an action taken by the Minnesota Board of Dentistry, commissioner 
114.33 	of human services, or contracted health plan is the result of a onetime event by an 
114.34 	individual employed or contracted by a group practice.

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

115.1 	Sec. 42. Minnesota Statutes 2008, section 256D.03, subdivision 4, is amended to read:
115.2 		Subd. 4.General assistance medical care; services. (a)(i) For a person who is 
115.3 	eligible under subdivision 3, paragraph (a), clause (2), item (i), general assistance medical 
115.4 	care covers, except as provided in paragraph (c):
115.5 	(1) inpatient hospital services;
115.6 	(2) outpatient hospital services;
115.7 	(3) services provided by Medicare certified rehabilitation agencies;
115.8 	(4) prescription drugs and other products recommended through the process 
115.9 	established in section 256B.0625, subdivision 13;
115.10 	(5) equipment necessary to administer insulin and diagnostic supplies and equipment 
115.11 	for diabetics to monitor blood sugar level;
115.12 	(6) eyeglasses and eye examinations provided by a physician or optometrist;
115.13 	(7) hearing aids;
115.14 	(8) prosthetic devices;
115.15 	(9) laboratory and X-ray services;
115.16 	(10) physician's services;
115.17 	(11) medical transportation except special transportation;
115.18 	(12) chiropractic services as covered under the medical assistance program;
115.19 	(13) podiatric services;
115.20 	(14) dental services as covered under the medical assistance program;
115.21 	(15) mental health services covered under chapter 256B;
115.22 	(16) prescribed medications for persons who have been diagnosed as mentally ill as 
115.23 	necessary to prevent more restrictive institutionalization;
115.24 	(17) medical supplies and equipment, and Medicare premiums, coinsurance and 
115.25 	deductible payments;
115.26 	(18) medical equipment not specifically listed in this paragraph when the use of 
115.27 	the equipment will prevent the need for costlier services that are reimbursable under 
115.28 	this subdivision;
115.29 	(19) services performed by a certified pediatric nurse practitioner, a certified family 
115.30 	nurse practitioner, a certified adult nurse practitioner, a certified obstetric/gynecological 
115.31 	nurse practitioner, a certified neonatal nurse practitioner, or a certified geriatric nurse 
115.32 	practitioner in independent practice, if (1) the service is otherwise covered under this 
115.33 	chapter as a physician service, (2) the service provided on an inpatient basis is not included 
115.34 	as part of the cost for inpatient services included in the operating payment rate, and (3) the 
115.35 	service is within the scope of practice of the nurse practitioner's license as a registered 
115.36 	nurse, as defined in section 148.171;
116.1 	(20) services of a certified public health nurse or a registered nurse practicing in 
116.2 	a public health nursing clinic that is a department of, or that operates under the direct 
116.3 	authority of, a unit of government, if the service is within the scope of practice of the 
116.4 	public health nurse's license as a registered nurse, as defined in section 148.171;
116.5 	(21) telemedicine consultations, to the extent they are covered under section 
116.6 	256B.0625, subdivision 3b; 
116.7 	(22) care coordination and patient education services provided by a community 
116.8 	health worker according to section 256B.0625, subdivision 49; and
116.9 	(23) regardless of the number of employees that an enrolled health care provider 
116.10 	may have, sign language interpreter services when provided by an enrolled health care 
116.11 	provider during the course of providing a direct, person-to-person covered health care 
116.12 	service to an enrolled recipient who has a hearing loss and uses interpreting services.
116.13 	(ii) Effective October 1, 2003, for a person who is eligible under subdivision 3, 
116.14 	paragraph (a), clause (2), item (ii), general assistance medical care coverage is limited 
116.15 	to inpatient hospital services, including physician services provided during the inpatient 
116.16 	hospital stay. A $1,000 deductible is required for each inpatient hospitalization.
116.17 	(b) Effective August 1, 2005, sex reassignment surgery is not covered under this 
116.18 	subdivision.
116.19 	(c) In order to contain costs, the commissioner of human services shall select 
116.20 	vendors of medical care who can provide the most economical care consistent with high 
116.21 	medical standards and shall where possible contract with organizations on a prepaid 
116.22 	capitation basis to provide these services. The commissioner shall consider proposals by 
116.23 	counties and vendors for prepaid health plans, competitive bidding programs, block grants, 
116.24 	or other vendor payment mechanisms designed to provide services in an economical 
116.25 	manner or to control utilization, with safeguards to ensure that necessary services are 
116.26 	provided. Before implementing prepaid programs in counties with a county operated or 
116.27 	affiliated public teaching hospital or a hospital or clinic operated by the University of 
116.28 	Minnesota, the commissioner shall consider the risks the prepaid program creates for the 
116.29 	hospital and allow the county or hospital the opportunity to participate in the program in a 
116.30 	manner that reflects the risk of adverse selection and the nature of the patients served by 
116.31 	the hospital, provided the terms of participation in the program are competitive with the 
116.32 	terms of other participants considering the nature of the population served. Payment for 
116.33 	services provided pursuant to this subdivision shall be as provided to medical assistance 
116.34 	vendors of these services under sections 256B.02, subdivision 8, and 256B.0625. For 
116.35 	payments made during fiscal year 1990 and later years, the commissioner shall consult 
117.1 	with an independent actuary in establishing prepayment rates, but shall retain final control 
117.2 	over the rate methodology.
117.3 	(d) Effective January 1, 2008, drug coverage under general assistance medical 
117.4 	care is limited to prescription drugs that:
117.5 	(i) are covered under the medical assistance program as described in section 
117.6 	256B.0625, subdivisions 13 and 13d; and
117.7 	(ii) are provided by manufacturers that have fully executed general assistance 
117.8 	medical care rebate agreements with the commissioner and comply with the agreements. 
117.9 	Prescription drug coverage under general assistance medical care must conform to 
117.10 	coverage under the medical assistance program according to section 256B.0625, 
117.11 	subdivisions 13 to 13g.
117.12 	 (e) Recipients eligible under subdivision 3, paragraph (a), shall pay the following 
117.13 	co-payments for services provided on or after October 1, 2003, and before January 1, 2009:
117.14 	(1) $25 for eyeglasses;
117.15 	(2) $25 for nonemergency visits to a hospital-based emergency room;
117.16 	(3) $3 per brand-name drug prescription and $1 per generic drug prescription, 
117.17 	subject to a $12 per month maximum for prescription drug co-payments. No co-payments 
117.18 	shall apply to antipsychotic drugs when used for the treatment of mental illness; and
117.19 	(4) 50 percent coinsurance on restorative dental services.
117.20 	(f) Recipients eligible under subdivision 3, paragraph (a), shall include the following 
117.21 	co-payments for services provided on or after January 1, 2009: 
117.22 	(1) $25 for nonemergency visits to a hospital-based emergency room; and
117.23 	(2) $3 per brand-name drug prescription and $1 per generic drug prescription, 
117.24 	subject to a $7 per month maximum for prescription drug co-payments. No co-payments 
117.25 	shall apply to antipsychotic drugs when used for the treatment of mental illness.
117.26 	(g) MS 2007 Supp [Expired]
117.27 	(h) Effective January 1, 2009, co-payments shall be limited to one per day per 
117.28 	provider for nonemergency visits to a hospital-based emergency room. Recipients of 
117.29 	general assistance medical care are responsible for all co-payments in this subdivision. 
117.30 	The general assistance medical care reimbursement to the provider shall be reduced by the 
117.31 	amount of the co-payment, except that reimbursement for prescription drugs shall not be 
117.32 	reduced once a recipient has reached the $7 per month maximum for prescription drug 
117.33 	co-payments. The provider collects the co-payment from the recipient. Providers may not 
117.34 	deny services to recipients who are unable to pay the co-payment.
118.1 	(i) General assistance medical care reimbursement to fee-for-service providers 
118.2 	and payments to managed care plans shall not be increased as a result of the removal of 
118.3 	the co-payments effective January 1, 2009.
118.4 	(j) Any county may, from its own resources, provide medical payments for which 
118.5 	state payments are not made.
118.6 	(k) Chemical dependency services that are reimbursed under chapter 254B must not 
118.7 	be reimbursed under general assistance medical care.
118.8 	(l) The maximum payment for new vendors enrolled in the general assistance 
118.9 	medical care program after the base year shall be determined from the average usual and 
118.10 	customary charge of the same vendor type enrolled in the base year.
118.11 	(m) The conditions of payment for services under this subdivision are the same 
118.12 	as the conditions specified in rules adopted under chapter 256B governing the medical 
118.13 	assistance program, unless otherwise provided by statute or rule.
118.14 	 (n) Inpatient and outpatient payments shall be reduced by five percent, effective July 
118.15 	1, 2003. This reduction is in addition to the five percent reduction effective July 1, 2003, 
118.16 	and incorporated by reference in paragraph (l).
118.17 	(o) Payments for all other health services except inpatient, outpatient, and pharmacy 
118.18 	services shall be reduced by five percent, effective July 1, 2003.
118.19 	(p) Payments to managed care plans shall be reduced by five percent for services 
118.20 	provided on or after October 1, 2003.
118.21 	(q) A hospital receiving a reduced payment as a result of this section may apply the 
118.22 	unpaid balance toward satisfaction of the hospital's bad debts.
118.23 	(r) Fee-for-service payments for nonpreventive visits shall be reduced by $3 for 
118.24 	services provided on or after January 1, 2006. For purposes of this subdivision, a visit 
118.25 	means an episode of service which is required because of a recipient's symptoms, 
118.26 	diagnosis, or established illness, and which is delivered in an ambulatory setting by 
118.27 	a physician or physician ancillary, chiropractor, podiatrist, advance practice nurse, 
118.28 	audiologist, optician, or optometrist.
118.29 	(s) Payments to managed care plans shall not be increased as a result of the removal 
118.30 	of the $3 nonpreventive visit co-payment effective January 1, 2006.
118.31 	(t) Payments for mental health services added as covered benefits after December 
118.32 	31, 2007, are not subject to the reductions in paragraphs (l), (n), (o), and (p).
118.33 	(u) In addition to the reductions in paragraphs (k) and (l), effective service date 
118.34 	July 1, 2009, total payments for basic care services, except prescription drugs, medical 
118.35 	supplies, prosthetics, lab, radiology, medical transportation, and services subject to or 
118.36 	specifically exempted from paragraph (v), shall be reduced by 3.0 percent, prior to 
119.1 	third-party liability. Payments made to managed care and county-based purchasing plans 
119.2 	shall be reduced for services provided on or after January 1, 2010, to reflect this reduction.
119.3 	(v) Effective for services rendered on or after July 1, 2009, payment rates for 
119.4 	physician and professional services shall be reduced by three percent over the rates in 
119.5 	effect on June 30, 2009, except for office or other outpatient services (procedure codes 
119.6 	99201 to 99215) and preventive medicine services (procedure codes 99381 to 99412) 
119.7 	billed by the following primary care specialties:  general practitioner, internal medicine, 
119.8 	pediatrics, geriatric nurse practitioner, pediatric nurse practitioner, family practice nurse 
119.9 	practitioner, adult nurse practitioner, geriatrics, and family practice.  The commissioner, 
119.10 	effective January 1, 2010, shall reduce capitation rates paid to managed care and 
119.11 	county-based purchasing plans under paragraph (c) to reflect this payment reduction.

119.12 	Sec. 43. Minnesota Statutes 2008, section 256L.04, subdivision 10a, is amended to 
119.13 	read:
119.14 		Subd. 10a.Sponsor's income and resources deemed available; documentation.
 119.15 	When determining eligibility for any federal or state benefits under sections 256L.01 to 
119.16 	256L.18, the income and resources of all noncitizens whose sponsor signed an affidavit of 
119.17 	support as defined under United States Code, title 8, section 1183a, shall be deemed to 
119.18 	include their sponsors' income and resources as defined in the Personal Responsibility 
119.19 	and Work Opportunity Reconciliation Act of 1996, title IV, Public Law 104-193, sections 
119.20 	421 and 422, and subsequently set out in federal rules. To be eligible for the program, 
119.21 	noncitizens must provide documentation of their immigration status. Beginning July 
119.22 	1, 2010, or upon federal approval, whichever is later, sponsor deeming does not apply 
119.23 	to pregnant women and children who are qualified noncitizens, as described in section 
119.24 	256B.06, subdivision 4, paragraph (b).

119.25 	EFFECTIVE DATE. This section is effective July 1, 2010, or upon federal 
119.26 	approval, whichever is later. The commissioner shall notify the revisor of statutes when 
119.27 	federal approval has been obtained.

119.28 	Sec. 44. Minnesota Statutes 2008, section 256L.04, is amended by adding a subdivision 
119.29 	to read:
119.30 		Subd. 14.Presumptive eligibility. MinnesotaCare is available during a presumptive 
119.31 	period of eligibility, for children who appear to meet the income requirements of 
119.32 	subdivision 1, on the basis of preliminary information. The presumptive period begins 
119.33 	on the first day of the month following the date on which presumptive eligibility is 
119.34 	determined by the state or local agency. The agency must provide notice of presumptive 
120.1 	eligibility and information on the procedures for completing the eligibility process. The 
120.2 	effective date of coverage for children who are determined presumptively eligible is in 
120.3 	accordance with section 256L.05, subdivision 3. The presumptive period ends on the 
120.4 	earlier of the date of the determination for MinnesotaCare eligibility, or the last day of 
120.5 	the month following the month the presumptive eligibility period begins if a complete 
120.6 	application with requested verifications is not submitted by that date. Applicants and 
120.7 	enrollees who are denied or terminated for failure to complete an application or provide 
120.8 	verifications cannot be granted presumptive eligibility again for 12 months.

120.9 	EFFECTIVE DATE. This section is effective January 1, 2010, or upon federal 
120.10 	approval, whichever is later.

120.11 	Sec. 45. Minnesota Statutes 2008, section 256L.05, subdivision 1, is amended to read:
120.12 		Subdivision 1.Application assistance and information availability. (a) 
120.13 	Applications and application assistance must be made available at provider offices, local 
120.14 	human services agencies, school districts, public and private elementary schools in which 
120.15 	25 percent or more of the students receive free or reduced price lunches, community health 
120.16 	offices, Women, Infants and Children (WIC) program sites, Head Start program sites, 
120.17 	public housing councils, crisis nurseries, child care centers, early childhood education 
120.18 	and preschool program sites, legal aid offices, and libraries. These sites may accept 
120.19 	applications and forward the forms to the commissioner or local county human services 
120.20 	agencies that choose to participate as an enrollment site. Otherwise, applicants may apply 
120.21 	directly to the commissioner or to participating local county human services agencies. 
120.22 	(b) Application assistance must be available for applicants choosing to file an 
120.23 	online application.
120.24 	(c) The commissioner and local agencies shall assist enrollees in choosing a 
120.25 	managed care organization by:
120.26 	(1) establishing a Web site to provide information about managed care organizations 
120.27 	and to allow online enrollment;
120.28 	(2) making applications and information on managed care organizations available 
120.29 	to applicants and enrollees according to Title VI of the Civil Rights Act and federal 
120.30 	regulations adopted under that law, or any guidance from the United States Department of 
120.31 	Health and Human Services; and
120.32 	(3) making benefit educators available to assist applicants in choosing a managed 
120.33 	care organization.

121.1 	Sec. 46. Minnesota Statutes 2008, section 256L.05, is amended by adding a subdivision 
121.2 	to read:
121.3 		Subd. 1c.Open enrollment and streamlined application and enrollment 
121.4 	process. (a) The commissioner and local agencies working in partnership must develop a 
121.5 	streamlined and efficient application and enrollment process for medical assistance and 
121.6 	MinnesotaCare enrollees that meets the criteria specified in this subdivision.
121.7 	(b) The commissioners of human services and education shall provide 
121.8 	recommendations to the legislature by January 15, 2010, on the creation of an open 
121.9 	enrollment process for medical assistance and MinnesotaCare that is coordinated with 
121.10 	the public education system. The recommendations must:
121.11 	(1) be developed in consultation with medical assistance and MinnesotaCare 
121.12 	enrollees and representatives from organizations that advocate on behalf of children and 
121.13 	families, low-income persons and minority populations, counties, school administrators 
121.14 	and nurses, health plans, and health care providers;
121.15 	 (2) be based on enrollment and renewal procedures best practices, including express 
121.16 	lane eligibility as required under subdivision 1d;
121.17 	(3) simplify the enrollment and renewal processes wherever possible; and
121.18 	(4) establish a process:
121.19 	(i) to disseminate information on medical assistance and MinnesotaCare to all 
121.20 	children in the public education system, including prekindergarten programs; and
121.21 	(ii) for the commissioner of human services to enroll children and other household 
121.22 	members who are eligible.
121.23 	The commissioner of human services in coordination with the commissioner of 
121.24 	education shall implement an open enrollment process by August 1, 2010, to be effective 
121.25 	beginning with the 2010-2011 school year.
121.26 	(c) The commissioner and local agencies shall develop an online application process 
121.27 	for medical assistance and MinnesotaCare.
121.28 	(d) The commissioner shall develop an application that is easily understandable 
121.29 	and does not exceed four pages in length.
121.30 	(e) The commissioner of human services shall present to the legislature, by January 
121.31 	15, 2010, an implementation plan for the open enrollment period and online application 
121.32 	process.

121.33 	EFFECTIVE DATE. This section is effective July 1, 2010, or upon federal 
121.34 	approval, which must be requested by the commissioner, whichever is later.

122.1 	Sec. 47. Minnesota Statutes 2008, section 256L.05, is amended by adding a subdivision 
122.2 	to read:
122.3 		Subd. 1d.Express lane eligibility. (a) Children who complete an application 
122.4 	for educational benefits and indicate an interest in enrolling in medical assistance or 
122.5 	MinnesotaCare on the application form shall have the form considered an application 
122.6 	for those programs.
122.7 	(b) The commissioner of education shall forward electronically the information for 
122.8 	families who are eligible for educational benefits to the commissioner of human services 
122.9 	as required under section 124D.1115.
122.10 	(c) The commissioner of human services shall accept the income determination 
122.11 	made by the commissioner of education in administering the free and reduced-price school 
122.12 	lunch program as proof of income for medical assistance and MinnesotaCare eligibility 
122.13 	until renewal. Within 30 days of receipt of information provided by the commissioner of 
122.14 	education under paragraph (d), the commissioner of human services shall:
122.15 	(1) enroll all eligible children in the medical assistance or MinnesotaCare programs; 
122.16 	and
122.17 	(2) provide information about medical assistance and MinnesotaCare to other 
122.18 	household members. The date of application for the medical assistance and MinnesotaCare 
122.19 	programs is the date on the signed application for educational benefits.

122.20 	Sec. 48. Minnesota Statutes 2008, section 256L.11, subdivision 1, is amended to read:
122.21 		Subdivision 1.Medical assistance rate to be used. (a) Payment to providers under 
122.22 	sections 256L.01 to 256L.11 shall be at the same rates and conditions established for 
122.23 	medical assistance, except as provided in subdivisions 2 to 6. 
122.24 	(b) Effective service date July 1, 2009, total payments for basic care services, except 
122.25 	prescription drugs, medical supplies, prosthetics, lab, radiology, medical transportation, 
122.26 	and services subject to or specifically exempted from paragraph (c), shall be reduced 
122.27 	by 3.0 percent, prior to third-party liability. Payments made to managed care and 
122.28 	county-based purchasing plans shall be reduced for services provided on or after January 
122.29 	1, 2010, to reflect this reduction.
122.30 	(c) Effective for services rendered on or after July 1, 2009, payment rates for 
122.31 	physician and professional services shall be reduced by three percent over the rates in 
122.32 	effect on June 30, 2009, except for office or other outpatient services (procedure codes 
122.33 	99201 to 99215) and preventive medicine services (procedure codes 99381 to 99412) 
122.34 	billed by the following primary care specialties:  general practitioner, internal medicine, 
122.35 	pediatrics, geriatric nurse practitioner, pediatric nurse practitioner, family practice nurse 
123.1 	practitioner, adult nurse practitioner, geriatrics, and family practice.  The commissioner, 
123.2 	effective January 1, 2010, shall reduce capitation rates paid to managed care and 
123.3 	county-based purchasing plans under section 256L.12 to reflect this payment reduction.

123.4 	Sec. 49. Minnesota Statutes 2008, section 256L.11, subdivision 7, is amended to read:
123.5 		Subd. 7.Critical access dental providers. Effective for dental services provided 
123.6 	to MinnesotaCare enrollees on or after January 1, 2007 2010, the commissioner shall 
123.7 	increase payment rates to dentists and dental clinics deemed by the commissioner to be 
123.8 	critical access providers under section 256B.76, subdivision 4 subdivisions 4 and 4a, by 
123.9 	50 30 percent above the payment rate that would otherwise be paid to the provider. The 
123.10 	commissioner shall pay the prepaid health plans under contract with the commissioner 
123.11 	amounts sufficient to reflect this rate increase. The prepaid health plan must pass this rate 
123.12 	increase to providers who have been identified by the commissioner as critical access 
123.13 	dental providers under section 256B.76, subdivision 4. The commissioner shall administer 
123.14 	this subdivision within the limits of available appropriations.

123.15 	Sec. 50. Minnesota Statutes 2008, section 256L.12, subdivision 9, is amended to read:
123.16 		Subd. 9.Rate setting; performance withholds. (a) Rates will be prospective, 
123.17 	per capita, where possible. The commissioner may allow health plans to arrange for 
123.18 	inpatient hospital services on a risk or nonrisk basis. The commissioner shall consult with 
123.19 	an independent actuary to determine appropriate rates.
123.20 	(b) For services rendered on or after January 1, 2003, to December 31, 2003, the 
123.21 	commissioner shall withhold .5 percent of managed care plan payments under this section 
123.22 	pending completion of performance targets. The withheld funds must be returned no 
123.23 	sooner than July 1 and no later than July 31 of the following year if performance targets 
123.24 	in the contract are achieved. A managed care plan may include as admitted assets under 
123.25 	section 62D.044 any amount withheld under this paragraph that is reasonably expected 
123.26 	to be returned. 
123.27 	(c)(b) For services rendered on or after January 1, 2004, the commissioner shall 
123.28 	withhold five percent of managed care plan payments and county-based purchasing 
123.29 	plan payments under this section pending completion of performance targets. Each 
123.30 	performance target must be quantifiable, objective, measurable, and reasonably attainable, 
123.31 	except in the case of a performance target based on a federal or state law or rule. Criteria 
123.32 	for assessment of each performance target must be outlined in writing prior to the 
123.33 	contract effective date. The managed care plan must demonstrate, to the commissioner's 
123.34 	satisfaction, that the data submitted regarding attainment of the performance target is 
124.1 	accurate. The commissioner shall periodically change the administrative measures used 
124.2 	as performance targets in order to improve plan performance across a broader range of 
124.3 	administrative services. The performance targets must include measurement of plan 
124.4 	efforts to contain spending on health care services and administrative activities. The 
124.5 	commissioner may adopt plan-specific performance targets that take into account factors 
124.6 	affecting only one plan, such as characteristics of the plan's enrollee population. The 
124.7 	withheld funds must be returned no sooner than July 1 and no later than July 31 of the 
124.8 	following calendar year if performance targets in the contract are achieved. A managed 
124.9 	care plan or a county-based purchasing plan under section 256B.692 may include as 
124.10 	admitted assets under section 62D.044 any amount withheld under this paragraph that is 
124.11 	reasonably expected to be returned.
124.12 	(c) Effective for services rendered on or after January 1, 2010, the commissioner 
124.13 	shall include as part of the performance targets described in paragraph (b) a reduction in 
124.14 	the plan's emergency room utilization rate for state health care program enrollees by a 
124.15 	measurable rate of five percent from the plan's utilization rate for the previous calendar 
124.16 	year.
124.17 	The withheld funds must be returned no sooner than July 1 and no later than July 
124.18 	31 of the following calendar year if the managed care plan or county-based purchasing 
124.19 	plan demonstrates to the satisfaction of the commissioner that a reduction in the utilization 
124.20 	rate was achieved.
124.21 	The withhold described in this paragraph shall continue for each consecutive 
124.22 	contract period until the health plan's emergency room utilization rate for state health care 
124.23 	program enrollees is reduced by 25 percent of the health plan's emergency room utilization 
124.24 	rate for state health care program enrollees for calendar year 2008.
124.25 	(d) A managed care plan or a county-based purchasing plan under section 256B.692 
124.26 	may include as admitted assets under section 62D.044 any amount withheld under this 
124.27 	section that is reasonably expected to be returned.

124.28 	Sec. 51. Minnesota Statutes 2008, section 256L.17, subdivision 3, is amended to read:
124.29 		Subd. 3.Documentation. (a) The commissioner of human services shall require 
124.30 	individuals and families, at the time of application or renewal, to indicate on a checkoff
124.31 	form developed by the commissioner whether they satisfy the MinnesotaCare asset 
124.32 	requirement. 
124.33 	(b) The commissioner may require individuals and families to provide any 
124.34 	information the commissioner determines necessary to verify compliance with the asset 
125.1 	requirement, if the commissioner determines that there is reason to believe that an 
125.2 	individual or family has assets that exceed the program limit.

125.3 	Sec. 52. Minnesota Statutes 2008, section 501B.89, is amended by adding a 
125.4 	subdivision to read:
125.5 		Subd. 4.Annual filing requirement for supplemental needs trusts. (a) A trustee 
125.6 	of a trust under subdivision 3 and United States Code, title 42, section 1396p(d)(4)(A) or 
125.7 	(C), shall submit to the commissioner of human services, at the time of a beneficiary's 
125.8 	request for medical assistance, the following information about the trust:
125.9 	(1) a copy of the trust instrument; and
125.10 	(2) an inventory of the beneficiary's trust account assets and the value of those assets.
125.11 	(b) A trustee of a trust under subdivision 3 and United States Code, title 42, section 
125.12 	1396p(d)(4)(A) or (C), shall submit an accounting of the beneficiary's trust account to the 
125.13 	commissioner of human services at least annually until the trust, or the beneficiary's 
125.14 	interest in the trust, terminates. Accountings are due on the anniversary of the execution 
125.15 	date of the trust unless another annual date is established by the terms of the trust. The 
125.16 	accounting must include the following information for the accounting period:
125.17 	(1) an inventory of trust assets and the value of those assets at the beginning of the 
125.18 	accounting period;
125.19 	(2) additions to the trust during the accounting period and the source of those 
125.20 	additions;
125.21 	(3) itemized distributions from the trust during the accounting period, including the 
125.22 	purpose of the distributions and to whom the distributions were made;
125.23 	(4) an inventory of trust assets and the value of those assets at the end of the 
125.24 	accounting period; and
125.25 	(5) changes to the trust instrument during the accounting period.
125.26 	(c) For the purpose of paragraph (b), an accounting period is 12 months unless an 
125.27 	accounting period of a different length is permitted by the commissioner.

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

125.30 	Sec. 53. Minnesota Statutes 2008, section 519.05, is amended to read:
125.31 	519.05 LIABILITY OF HUSBAND AND WIFE.
125.32 	(a) A spouse is not liable to a creditor for any debts of the other spouse. Where 
125.33 	husband and wife are living together, they shall be jointly and severally liable for 
126.1 	necessary medical services that have been furnished to either spouse, including any claims 
126.2 	arising under section 246.53, 256B.15, 256D.16, or 261.04, and necessary household 
126.3 	articles and supplies furnished to and used by the family. Notwithstanding this paragraph, 
126.4 	in a proceeding under chapter 518 the court may apportion such debt between the spouses.
126.5 	(b) Either spouse may close a credit card account or other unsecured consumer line 
126.6 	of credit on which both spouses are contractually liable, by giving written notice to the 
126.7 	creditor.

126.8 	Sec. 54. Laws 2003, First Special Session chapter 14, article 13C, section 2, subdivision 
126.9 	1, as amended by Laws 2004, chapter 272, article 2, section 2, is amended to read:

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

126.11	Summary by Fund
	
126.12	General
	3,301,811,000
	3,561,055,000
	
126.13
126.14	State Government 
Special Revenue
	534,000
	534,000
	
126.15	Health Care Access
	273,723,000
	302,272,000
	
126.16	Federal TANF
	270,425,000
	270,363,000
	
126.17	Lottery Cash Flow
	1,556,000
	1,556,000
	
126.18 	Federal Contingency Appropriation. (a) 
126.19 	Federal Medicaid funds made available 
126.20 	under title IV of the federal Jobs and Growth 
126.21 	Tax Relief Reconciliation Act of 2003 
126.22 	are appropriated to the commissioner of 
126.23 	human services for use in the state's medical 
126.24 	assistance and MinnesotaCare programs. 
126.25 	The commissioners of human services and 
126.26 	finance shall report to the legislative advisory 
126.27 	committee on the additional federal Medicaid 
126.28 	matching funds that will be available to the 
126.29 	state.
126.30 	(b) Because of the availability of these funds, 
126.31 	the following policies shall become effective:
126.32 	(1) medical assistance and MinnesotaCare 
126.33 	eligibility and local financial participation 
126.34 	changes provided for in this act may be 
126.35 	implemented prior to September 2, 2003, or 
127.1 	may be delayed as necessary to maximize 
127.2 	the use of federal funds received under 
127.3 	title IV of the Jobs and Growth Tax Relief 
127.4 	Reconciliation Act of 2003;
127.5 	(2) the aggregate cap on the services 
127.6 	identified in Minnesota Statutes, section 
127.7 	256L.035, paragraph (a), clause (3), shall 
127.8 	be increased from $2,000 to $5,000. This 
127.9 	increase shall expire at the end of fiscal year 
127.10 	2007. Funds may be transferred from the 
127.11 	general fund to the health care access fund as 
127.12 	necessary to implement this provision; and
127.13 	(3) the following payment shifts shall not be 
127.14 	implemented:
127.15 	(i) MFIP payment shift found in subdivision 
127.16 	11;
127.17 	(ii) the county payment shift found in 
127.18 	subdivision 1; and
127.19 	(iii) the delay in medical assistance 
127.20 	and general assistance medical care 
127.21 	fee-for-service payments found in 
127.22 	subdivision 6.
127.23 	(c) Notwithstanding section 14, paragraphs 
127.24 	(a) and (b) shall expire June 30, 2007.
127.25 	Receipts for Systems Projects.
127.26 	Appropriations and federal receipts for 
127.27 	information system projects for MAXIS, 
127.28 	PRISM, MMIS, and SSIS must be deposited 
127.29 	in the state system account authorized in 
127.30 	Minnesota Statutes, section 256.014. Money 
127.31 	appropriated for computer projects approved 
127.32 	by the Minnesota office of technology, 
127.33 	funded by the legislature, and approved 
127.34 	by the commissioner of finance may be 
128.1 	transferred from one project to another 
128.2 	and from development to operations as the 
128.3 	commissioner of human services considers 
128.4 	necessary. Any unexpended balance in 
128.5 	the appropriation for these projects does 
128.6 	not cancel but is available for ongoing 
128.7 	development and operations.
128.8 	Gifts. Notwithstanding Minnesota Statutes, 
128.9 	chapter 7, the commissioner may accept 
128.10 	on behalf of the state additional funding 
128.11 	from sources other than state funds for the 
128.12 	purpose of financing the cost of assistance 
128.13 	program grants or nongrant administration. 
128.14 	All additional funding is appropriated to the 
128.15 	commissioner for use as designated by the 
128.16 	grantor of funding.
128.17 	Systems Continuity. In the event of 
128.18 	disruption of technical systems or computer 
128.19 	operations, the commissioner may use 
128.20 	available grant appropriations to ensure 
128.21 	continuity of payments for maintaining the 
128.22 	health, safety, and well-being of clients 
128.23 	served by programs administered by the 
128.24 	department of human services. Grant funds 
128.25 	must be used in a manner consistent with the 
128.26 	original intent of the appropriation.
128.27 	Nonfederal Share Transfers. The 
128.28 	nonfederal share of activities for which 
128.29 	federal administrative reimbursement is 
128.30 	appropriated to the commissioner may be 
128.31 	transferred to the special revenue fund.
128.32 	TANF Funds Appropriated to Other 
128.33 	Entities. Any expenditures from the TANF 
128.34 	block grant shall be expended in accordance 
128.35 	with the requirements and limitations of part 
129.1 	A of title IV of the Social Security Act, as 
129.2 	amended, and any other applicable federal 
129.3 	requirement or limitation. Prior to any 
129.4 	expenditure of these funds, the commissioner 
129.5 	shall assure that funds are expended in 
129.6 	compliance with the requirements and 
129.7 	limitations of federal law and that any 
129.8 	reporting requirements of federal law are 
129.9 	met. It shall be the responsibility of any entity 
129.10 	to which these funds are appropriated to 
129.11 	implement a memorandum of understanding 
129.12 	with the commissioner that provides the 
129.13 	necessary assurance of compliance prior to 
129.14 	any expenditure of funds. The commissioner 
129.15 	shall receipt TANF funds appropriated 
129.16 	to other state agencies and coordinate all 
129.17 	related interagency accounting transactions 
129.18 	necessary to implement these appropriations. 
129.19 	Unexpended TANF funds appropriated to 
129.20 	any state, local, or nonprofit entity cancel 
129.21 	at the end of the state fiscal year unless 
129.22 	appropriating language permits otherwise.
129.23 	TANF Funds Transferred to Other Federal 
129.24 	Grants. The commissioner must authorize 
129.25 	transfers from TANF to other federal block 
129.26 	grants so that funds are available to meet the 
129.27 	annual expenditure needs as appropriated. 
129.28 	Transfers may be authorized prior to the 
129.29 	expenditure year with the agreement of the 
129.30 	receiving entity. Transferred funds must be 
129.31 	expended in the year for which the funds 
129.32 	were appropriated unless appropriation 
129.33 	language permits otherwise. In accelerating 
129.34 	transfer authorizations, the commissioner 
129.35 	must aim to preserve the future potential 
130.1 	transfer capacity from TANF to other block 
130.2 	grants.
130.3 	TANF Maintenance of Effort. (a) In 
130.4 	order to meet the basic maintenance of 
130.5 	effort (MOE) requirements of the TANF 
130.6 	block grant specified under Code of Federal 
130.7 	Regulations, title 45, section 263.1, the 
130.8 	commissioner may only report nonfederal 
130.9 	money expended for allowable activities 
130.10 	listed in the following clauses as TANF/MOE 
130.11 	expenditures:
130.12 	(1) MFIP cash, diversionary work program, 
130.13 	and food assistance benefits under Minnesota 
130.14 	Statutes, chapter 256J;
130.15 	(2) the child care assistance programs 
130.16 	under Minnesota Statutes, sections 119B.03
130.17 	and 119B.05, and county child care 
130.18 	administrative costs under Minnesota 
130.19 	Statutes, section 119B.15;
130.20 	(3) state and county MFIP administrative 
130.21 	costs under Minnesota Statutes, chapters 
130.22 	256J and 256K;
130.23 	(4) state, county, and tribal MFIP 
130.24 	employment services under Minnesota 
130.25 	Statutes, chapters 256J and 256K;
130.26 	(5) expenditures made on behalf of 
130.27 	noncitizen MFIP recipients who qualify 
130.28 	for the medical assistance without federal 
130.29 	financial participation program under 
130.30 	Minnesota Statutes, section 256B.06, 
130.31 	subdivision 4, paragraphs (d), (e), and (j); 
130.32 	and
131.1 	(6) qualifying working family credit 
131.2 	expenditures under Minnesota Statutes, 
131.3 	section 290.0671.
131.4 	(b) The commissioner shall ensure that 
131.5 	sufficient qualified nonfederal expenditures 
131.6 	are made each year to meet the state's 
131.7 	TANF/MOE requirements. For the activities 
131.8 	listed in paragraph (a), clauses (2) to 
131.9 	(6), the commissioner may only report 
131.10 	expenditures that are excluded from the 
131.11 	definition of assistance under Code of 
131.12 	Federal Regulations, title 45, section 260.31.
131.13 	(c) By August 31 of each year, the 
131.14 	commissioner shall make a preliminary 
131.15 	calculation to determine the likelihood 
131.16 	that the state will meet its annual federal 
131.17 	work participation requirement under Code 
131.18 	of Federal Regulations, title 45, sections 
131.19 	261.21 and 261.23, after adjustment for any 
131.20 	caseload reduction credit under Code of 
131.21 	Federal Regulations, title 45, section 261.41. 
131.22 	If the commissioner determines that the 
131.23 	state will meet its federal work participation 
131.24 	rate for the federal fiscal year ending that 
131.25 	September, the commissioner may reduce the 
131.26 	expenditure under paragraph (a), clause (1), 
131.27 	to the extent allowed under Code of Federal 
131.28 	Regulations, title 45, section 263.1(a)(2).
131.29 	(d) For fiscal years beginning with state 
131.30 	fiscal year 2003, the commissioner shall 
131.31 	assure that the maintenance of effort used 
131.32 	by the commissioner of finance for the 
131.33 	February and November forecasts required 
131.34 	under Minnesota Statutes, section 16A.103, 
131.35 	contains expenditures under paragraph (a), 
132.1 	clause (1), equal to at least 25 percent of 
132.2 	the total required under Code of Federal 
132.3 	Regulations, title 45, section 263.1.
132.4 	(e) If nonfederal expenditures for the 
132.5 	programs and purposes listed in paragraph 
132.6 	(a) are insufficient to meet the state's 
132.7 	TANF/MOE requirements, the commissioner 
132.8 	shall recommend additional allowable 
132.9 	sources of nonfederal expenditures to the 
132.10 	legislature, if the legislature is or will be in 
132.11 	session to take action to specify additional 
132.12 	sources of nonfederal expenditures for 
132.13 	TANF/MOE before a federal penalty is 
132.14 	imposed. The commissioner shall otherwise 
132.15 	provide notice to the legislative commission 
132.16 	on planning and fiscal policy under paragraph 
132.17 	(g).
132.18 	(f) If the commissioner uses authority 
132.19 	granted under section 11, or similar authority 
132.20 	granted by a subsequent legislature, to 
132.21 	meet the state's TANF/MOE requirement 
132.22 	in a reporting period, the commissioner 
132.23 	shall inform the chairs of the appropriate 
132.24 	legislative committees about all transfers 
132.25 	made under that authority for this purpose.
132.26 	(g) If the commissioner determines that 
132.27 	nonfederal expenditures under paragraph 
132.28 	(a) are insufficient to meet TANF/MOE 
132.29 	expenditure requirements, and if the 
132.30 	legislature is not or will not be in 
132.31 	session to take timely action to avoid a 
132.32 	federal penalty, the commissioner may 
132.33 	report nonfederal expenditures from 
132.34 	other allowable sources as TANF/MOE 
132.35 	expenditures after the requirements of this 
133.1 	paragraph are met. The commissioner 
133.2 	may report nonfederal expenditures 
133.3 	in addition to those specified under 
133.4 	paragraph (a) as nonfederal TANF/MOE 
133.5 	expenditures, but only ten days after the 
133.6 	commissioner of finance has first submitted 
133.7 	the commissioner's recommendations for 
133.8 	additional allowable sources of nonfederal 
133.9 	TANF/MOE expenditures to the members of 
133.10 	the legislative commission on planning and 
133.11 	fiscal policy for their review.
133.12 	(h) The commissioner of finance shall not 
133.13 	incorporate any changes in federal TANF 
133.14 	expenditures or nonfederal expenditures for 
133.15 	TANF/MOE that may result from reporting 
133.16 	additional allowable sources of nonfederal 
133.17 	TANF/MOE expenditures under the interim 
133.18 	procedures in paragraph (g) into the February 
133.19 	or November forecasts required under 
133.20 	Minnesota Statutes, section 16A.103, unless 
133.21 	the commissioner of finance has approved 
133.22 	the additional sources of expenditures under 
133.23 	paragraph (g).
133.24 	(i) Minnesota Statutes, section 256.011, 
133.25 	subdivision 3, which requires that federal 
133.26 	grants or aids secured or obtained under that 
133.27 	subdivision be used to reduce any direct 
133.28 	appropriations provided by law, do not apply 
133.29 	if the grants or aids are federal TANF funds.
133.30 	(j) Notwithstanding section 14, paragraph 
133.31 	(a), clauses (1) to (6), and paragraphs (b) to 
133.32 	(j) expire June 30, 2007.
133.33 	Working Family Credit Expenditures as 
133.34 	TANF MOE. The commissioner may claim 
133.35 	as TANF maintenance of effort up to the 
134.1 	following amounts of working family credit 
134.2 	expenditures for the following fiscal years:
134.3 	(1) fiscal year 2004, $7,013,000;
134.4 	(2) fiscal year 2005, $25,133,000;
134.5 	(3) fiscal year 2006, $6,942,000; and
134.6 	(4) fiscal year 2007, $6,707,000.
134.7 	Fiscal Year 2003 Appropriations 
134.8 	Carryforward. Effective the day following 
134.9 	final enactment, notwithstanding Minnesota 
134.10 	Statutes, section 16A.28, or any other law to 
134.11 	the contrary, state agencies and constitutional 
134.12 	offices may carry forward unexpended 
134.13 	and unencumbered nongrant operating 
134.14 	balances from fiscal year 2003 general fund 
134.15 	appropriations into fiscal year 2004 to offset 
134.16 	general budget reductions.
134.17 	Transfer of Grant Balances. Effective 
134.18 	the day following final enactment, the 
134.19 	commissioner of human services, with 
134.20 	the approval of the commissioner of 
134.21 	finance and after notification of the chair 
134.22 	of the senate health, human services and 
134.23 	corrections budget division and the chair 
134.24 	of the house of representatives health 
134.25 	and human services finance committee, 
134.26 	may transfer unencumbered appropriation 
134.27 	balances for the biennium ending June 30, 
134.28 	2003, in fiscal year 2003 among the MFIP, 
134.29 	MFIP child care assistance under Minnesota 
134.30 	Statutes, section 119B.05, general assistance, 
134.31 	general assistance medical care, medical 
134.32 	assistance, Minnesota supplemental aid, 
134.33 	and group residential housing programs, 
134.34 	and the entitlement portion of the chemical 
135.1 	dependency consolidated treatment fund, and 
135.2 	between fiscal years of the biennium.
135.3 	TANF Appropriation Cancellation.
135.4 	Notwithstanding the provisions of Laws 
135.5 	2000, chapter 488, article 1, section 16, 
135.6 	any prior appropriations of TANF funds 
135.7 	to the department of trade and economic 
135.8 	development or to the job skills partnership 
135.9 	board or any transfers of TANF funds from 
135.10 	another agency to the department of trade 
135.11 	and economic development or to the job 
135.12 	skills partnership board are not available 
135.13 	until expended, and if unobligated as of June 
135.14 	30, 2003, these appropriations or transfers 
135.15 	shall cancel to the TANF fund.
135.16 	Shift County Payment. The commissioner 
135.17 	shall make up to 100 percent of the 
135.18 	calendar year 2005 payments to counties for 
135.19 	developmental disabilities semi-independent 
135.20 	living services grants, developmental 
135.21 	disabilities family support grants, and 
135.22 	adult mental health grants from fiscal year 
135.23 	2006 appropriations. This is a onetime 
135.24 	payment shift. Calendar year 2006 and future 
135.25 	payments for these grants are not affected by 
135.26 	this shift. This provision expires June 30, 
135.27 	2006.
135.28 	Capitation Rate Increase. Of the health care 
135.29 	access fund appropriations to the University 
135.30 	of Minnesota in the higher education 
135.31 	omnibus appropriation bill, $2,157,000 in 
135.32 	fiscal year 2004 and $2,157,000 in fiscal year 
135.33 	2005 are to be used to increase the capitation 
135.34 	payments underfor fiscal years beginning 
135.35 	July 1, 2003, and thereafter, $2,157,000 each 
136.1 	year shall be transferred to the commissioner 
136.2 	for purposes of Minnesota Statutes, section 
136.3 	256B.69. Notwithstanding the provisions of 
136.4 	section 14, this provision shall not expire.

136.5 	Sec. 55. INCOME METHODOLOGY.
 136.6 	The commissioner of human services shall study approaches toward adopting a 
136.7 	uniform income methodology for families and children under medical assistance and 
136.8 	MinnesotaCare. The approaches to be examined by the commissioner must include, but 
136.9 	are not limited to: (1) replacing the MinnesotaCare gross income standard with a net 
136.10 	income standard based on the medical assistance families with children methodology; and 
136.11 	(2) replacing the medical assistance net income standard for families with children with 
136.12 	the MinnesotaCare gross income standard. The commissioner must evaluate the impact of 
136.13 	each approach on the number of potential MinnesotaCare and medical assistance enrolles 
136.14 	who are families and children and on administrative, health care, and other costs to the 
136.15 	state. The commissioner shall present findings and recommendations to the legislative 
136.16 	committees with jurisdiction over health care by January 15, 2010.

136.17 	Sec. 56. ADMINISTRATION OF MINNESOTACARE.
 136.18 	The commissioner of human services, in cooperation with representatives of 
136.19 	county human services agencies, shall develop a plan to administer the MinnesotaCare 
136.20 	program. The plan must require county agencies to administer MinnesotaCare in their 
136.21 	respective counties under the supervision of the state agency and the commissioner 
136.22 	of human services. The plan, to the extent feasible, must incorporate procedures and 
136.23 	requirements that are identical to or consistent with those procedures and requirements 
136.24 	that apply to county administration of the medical assistance program. The commissioner 
136.25 	shall present recommendations to the legislative committees with jurisdiction over health 
136.26 	care by January 15, 2010.

136.27 	Sec. 57. EXPENDITURE LIMIT.
 136.28 	For calendar years beginning on or after January 1, 2010, the commissioner of 
136.29 	human services shall limit annual expenditures for the critical access dental provider 
136.30 	program under Minnesota Statutes, sections 256B.76, subdivisions 4 and 4a, and 256L.11, 
136.31 	subdivision 7, to 75 percent of the expenditure level for the calendar year ending 
136.32 	December 31, 2008.

137.1 	Sec. 58. FEDERAL APPROVAL.
 137.2 	The commissioner of human services shall resubmit for federal approval the 
137.3 	elimination of depreciation for self-employed farmers in determining income eligibility 
137.4 	for MinnesotaCare passed in Laws 2007, chapter 147, article 5, section 33.

137.5 	Sec. 59. REPEALER.
 137.6 	Minnesota Statutes 2008, section 256.962, subdivision 7, is repealed.

137.7 	ARTICLE 7
137.8 	TECHNICAL

137.9 	Section 1. Minnesota Statutes 2008, section 125A.744, subdivision 3, is amended to 
137.10 	read:
137.11 		Subd. 3.Implementation. Consistent with section 256B.0625, subdivision 26, 
137.12 	school districts may enroll as medical assistance providers or subcontractors and bill 
137.13 	the Department of Human Services under the medical assistance fee for service claims 
137.14 	processing system for special education services which are covered services under chapter 
137.15 	256B, which are provided in the school setting for a medical assistance recipient, and for 
137.16 	whom the district has secured informed consent consistent with section 13.05, subdivision 
137.17 	4, paragraph (d), and section 256B.77, subdivision 2, paragraph (p), to bill for each type 
137.18 	of covered service. School districts shall be reimbursed by the commissioner of human 
137.19 	services for the federal share of individual education plan health-related services that 
137.20 	qualify for reimbursement by medical assistance, minus up to five percent retained by the 
137.21 	commissioner of human services for administrative costs, not to exceed $350,000 per 
137.22 	fiscal year. The commissioner may withhold up to five percent of each payment to a 
137.23 	school district. Following the end of each fiscal year, the commissioner shall settle up with 
137.24 	each school district in order to ensure that collections from each district for departmental 
137.25 	administrative costs are made on a pro rata basis according to federal earnings for these 
137.26 	services in each district. A school district is not eligible to enroll as a home care provider 
137.27 	or a personal care provider organization for purposes of billing home care services under 
137.28 	sections 256B.0651and 256B.0653 to 256B.0656and 256B.0659 until the commissioner 
137.29 	of human services issues a bulletin instructing county public health nurses on how to 
137.30 	assess for the needs of eligible recipients during school hours. To use private duty nursing 
137.31 	services or personal care services at school, the recipient or responsible party must provide 
137.32 	written authorization in the care plan identifying the chosen provider and the daily amount 
137.33 	of services to be used at school.

138.1 	Sec. 2. Minnesota Statutes 2008, section 144A.46, subdivision 1, is amended to read:
138.2 		Subdivision 1. License required. (a) A home care provider may not operate in the 
138.3 	state without a current license issued by the commissioner of health. A home care provider 
138.4 	may hold a separate license for each class of home care licensure. 
138.5 	(b) Within ten days after receiving an application for a license, the commissioner 
138.6 	shall acknowledge receipt of the application in writing. The acknowledgment must 
138.7 	indicate whether the application appears to be complete or whether additional information 
138.8 	is required before the application will be considered complete. Within 90 days after 
138.9 	receiving a complete application, the commissioner shall either grant or deny the license. 
138.10 	If an applicant is not granted or denied a license within 90 days after submitting a 
138.11 	complete application, the license must be deemed granted. An applicant whose license has 
138.12 	been deemed granted must provide written notice to the commissioner before providing a 
138.13 	home care service. 
138.14 	(c) Each application for a home care provider license, or for a renewal of a license, 
138.15 	shall be accompanied by a fee to be set by the commissioner under section 144.122. 
138.16 	(d) The commissioner of health, in consultation with the commissioner of human 
138.17 	services, shall provide recommendations to the legislature by February 15, 2009, for 
138.18 	provider standards for personal care assistant services as described in section 256B.0655
138.19 	256B.0659. 

138.20 	Sec. 3. Minnesota Statutes 2008, section 176.011, subdivision 9, is amended to read:
138.21 		Subd. 9. Employee. "Employee" means any person who performs services for 
138.22 	another for hire including the following: 
138.23 	(1) an alien; 
138.24 	(2) a minor; 
138.25 	(3) a sheriff, deputy sheriff, police officer, firefighter, county highway engineer, and 
138.26 	peace officer while engaged in the enforcement of peace or in the pursuit or capture of a 
138.27 	person charged with or suspected of crime; 
138.28 	(4) a person requested or commanded to aid an officer in arresting or retaking a 
138.29 	person who has escaped from lawful custody, or in executing legal process, in which 
138.30 	cases, for purposes of calculating compensation under this chapter, the daily wage of the 
138.31 	person shall be the prevailing wage for similar services performed by paid employees; 
138.32 	(5) a county assessor; 
138.33 	(6) an elected or appointed official of the state, or of a county, city, town, school 
138.34 	district, or governmental subdivision in the state. An officer of a political subdivision 
138.35 	elected or appointed for a regular term of office, or to complete the unexpired portion of a 
139.1 	regular term, shall be included only after the governing body of the political subdivision 
139.2 	has adopted an ordinance or resolution to that effect; 
139.3 	(7) an executive officer of a corporation, except those executive officers excluded 
139.4 	by section 176.041; 
139.5 	(8) a voluntary uncompensated worker, other than an inmate, rendering services in 
139.6 	state institutions under the commissioners of human services and corrections similar to 
139.7 	those of officers and employees of the institutions, and whose services have been accepted 
139.8 	or contracted for by the commissioner of human services or corrections as authorized by 
139.9 	law. In the event of injury or death of the worker, the daily wage of the worker, for the 
139.10 	purpose of calculating compensation under this chapter, shall be the usual wage paid at 
139.11 	the time of the injury or death for similar services in institutions where the services are 
139.12 	performed by paid employees; 
139.13 	(9) a voluntary uncompensated worker engaged in emergency management as 
139.14 	defined in section 12.03, subdivision 4, who is: 
139.15 	(i) registered with the state or any political subdivision of it, according to the 
139.16 	procedures set forth in the state or political subdivision emergency operations plan; and 
139.17 	(ii) acting under the direction and control of, and within the scope of duties approved 
139.18 	by, the state or political subdivision. 
139.19 	The daily wage of the worker, for the purpose of calculating compensation under this 
139.20 	chapter, shall be the usual wage paid at the time of the injury or death for similar services 
139.21 	performed by paid employees; 
139.22 	(10) a voluntary uncompensated worker participating in a program established by a 
139.23 	local social services agency. For purposes of this clause, "local social services agency" 
139.24 	means any agency established under section 393.01. In the event of injury or death of the 
139.25 	worker, the wage of the worker, for the purpose of calculating compensation under this 
139.26 	chapter, shall be the usual wage paid in the county at the time of the injury or death for 
139.27 	similar services performed by paid employees working a normal day and week; 
139.28 	(11) a voluntary uncompensated worker accepted by the commissioner of natural 
139.29 	resources who is rendering services as a volunteer pursuant to section 84.089. The daily 
139.30 	wage of the worker for the purpose of calculating compensation under this chapter, shall 
139.31 	be the usual wage paid at the time of injury or death for similar services performed by 
139.32 	paid employees; 
139.33 	(12) a voluntary uncompensated worker in the building and construction industry 
139.34 	who renders services for joint labor-management nonprofit community service projects. 
139.35 	The daily wage of the worker for the purpose of calculating compensation under this 
140.1 	chapter shall be the usual wage paid at the time of injury or death for similar services 
140.2 	performed by paid employees; 
140.3 	(13) a member of the military forces, as defined in section 190.05, while in state 
140.4 	active service, as defined in section 190.05, subdivision 5a. The daily wage of the member 
140.5 	for the purpose of calculating compensation under this chapter shall be based on the 
140.6 	member's usual earnings in civil life. If there is no evidence of previous occupation or 
140.7 	earning, the trier of fact shall consider the member's earnings as a member of the military 
140.8 	forces; 
140.9 	(14) a voluntary uncompensated worker, accepted by the director of the Minnesota 
140.10 	Historical Society, rendering services as a volunteer, pursuant to chapter 138. The daily 
140.11 	wage of the worker, for the purposes of calculating compensation under this chapter, 
140.12 	shall be the usual wage paid at the time of injury or death for similar services performed 
140.13 	by paid employees; 
140.14 	(15) a voluntary uncompensated worker, other than a student, who renders services 
140.15 	at the Minnesota State Academy for the Deaf or the Minnesota State Academy for the 
140.16 	Blind, and whose services have been accepted or contracted for by the commissioner of 
140.17 	education, as authorized by law. In the event of injury or death of the worker, the daily 
140.18 	wage of the worker, for the purpose of calculating compensation under this chapter, shall 
140.19 	be the usual wage paid at the time of the injury or death for similar services performed in 
140.20 	institutions by paid employees; 
140.21 	(16) a voluntary uncompensated worker, other than a resident of the veterans home, 
140.22 	who renders services at a Minnesota veterans home, and whose services have been 
140.23 	accepted or contracted for by the commissioner of veterans affairs, as authorized by law. 
140.24 	In the event of injury or death of the worker, the daily wage of the worker, for the purpose 
140.25 	of calculating compensation under this chapter, shall be the usual wage paid at the time of 
140.26 	the injury or death for similar services performed in institutions by paid employees; 
140.27 	(17) a worker performing services under section 256B.0655256B.0659 for a 
140.28 	recipient in the home of the recipient or in the community under section 256B.0625, 
140.29 	subdivision 19a, who is paid from government funds through a fiscal intermediary under 
140.30 	section 256B.0655, subdivision 7 256B.0659, subdivision 33. For purposes of maintaining 
140.31 	workers' compensation insurance, the employer of the worker is as designated in law 
140.32 	by the commissioner of the Department of Human Services, notwithstanding any other 
140.33 	law to the contrary;
140.34 	(18) students enrolled in and regularly attending the Medical School of the 
140.35 	University of Minnesota in the graduate school program or the postgraduate program. The 
140.36 	students shall not be considered employees for any other purpose. In the event of the 
141.1 	student's injury or death, the weekly wage of the student for the purpose of calculating 
141.2 	compensation under this chapter, shall be the annualized educational stipend awarded to 
141.3 	the student, divided by 52 weeks. The institution in which the student is enrolled shall 
141.4 	be considered the "employer" for the limited purpose of determining responsibility for 
141.5 	paying benefits under this chapter; 
141.6 	(19) a faculty member of the University of Minnesota employed for an academic 
141.7 	year is also an employee for the period between that academic year and the succeeding 
141.8 	academic year if: 
141.9 	(a) the member has a contract or reasonable assurance of a contract from the 
141.10 	University of Minnesota for the succeeding academic year; and 
141.11 	(b) the personal injury for which compensation is sought arises out of and in the 
141.12 	course of activities related to the faculty member's employment by the University of 
141.13 	Minnesota; 
141.14 	(20) a worker who performs volunteer ambulance driver or attendant services is an 
141.15 	employee of the political subdivision, nonprofit hospital, nonprofit corporation, or other 
141.16 	entity for which the worker performs the services. The daily wage of the worker for the 
141.17 	purpose of calculating compensation under this chapter shall be the usual wage paid at the 
141.18 	time of injury or death for similar services performed by paid employees; 
141.19 	(21) a voluntary uncompensated worker, accepted by the commissioner of 
141.20 	administration, rendering services as a volunteer at the Department of Administration. In 
141.21 	the event of injury or death of the worker, the daily wage of the worker, for the purpose of 
141.22 	calculating compensation under this chapter, shall be the usual wage paid at the time of the 
141.23 	injury or death for similar services performed in institutions by paid employees; 
141.24 	(22) a voluntary uncompensated worker rendering service directly to the Pollution 
141.25 	Control Agency. The daily wage of the worker for the purpose of calculating compensation 
141.26 	payable under this chapter is the usual going wage paid at the time of injury or death for 
141.27 	similar services if the services are performed by paid employees; 
141.28 	(23) a voluntary uncompensated worker while volunteering services as a first 
141.29 	responder or as a member of a law enforcement assistance organization while acting 
141.30 	under the supervision and authority of a political subdivision. The daily wage of the 
141.31 	worker for the purpose of calculating compensation payable under this chapter is the 
141.32 	usual going wage paid at the time of injury or death for similar services if the services 
141.33 	are performed by paid employees; 
141.34 	(24) a voluntary uncompensated member of the civil air patrol rendering service on 
141.35 	the request and under the authority of the state or any of its political subdivisions. The 
141.36 	daily wage of the member for the purposes of calculating compensation payable under this 
142.1 	chapter is the usual going wage paid at the time of injury or death for similar services if 
142.2 	the services are performed by paid employees; and 
142.3 	(25) a Minnesota Responds Medical Reserve Corps volunteer, as provided in 
142.4 	sections 145A.04 and 145A.06, responding at the request of or engaged in training 
142.5 	conducted by the commissioner of health. The daily wage of the volunteer for the purposes 
142.6 	of calculating compensation payable under this chapter is established in section 145A.06. 
142.7 	A person who qualifies under this clause and who may also qualify under another clause 
142.8 	of this subdivision shall receive benefits in accordance with this clause. 
142.9 	If it is difficult to determine the daily wage as provided in this subdivision, the trier 
142.10 	of fact may determine the wage upon which the compensation is payable. 

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

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

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

142.32 	Sec. 7. Minnesota Statutes 2008, section 256B.04, subdivision 16, is amended to read:
143.1 		Subd. 16. Personal care services. (a) Notwithstanding any contrary language in 
143.2 	this paragraph, the commissioner of human services and the commissioner of health shall 
143.3 	jointly promulgate rules to be applied to the licensure of personal care services provided 
143.4 	under the medical assistance program. The rules shall consider standards for personal care 
143.5 	services that are based on the World Institute on Disability's recommendations regarding 
143.6 	personal care services. These rules shall at a minimum consider the standards and 
143.7 	requirements adopted by the commissioner of health under section 144A.45, which the 
143.8 	commissioner of human services determines are applicable to the provision of personal 
143.9 	care services, in addition to other standards or modifications which the commissioner of 
143.10 	human services determines are appropriate. 
143.11 	The commissioner of human services shall establish an advisory group including 
143.12 	personal care consumers and providers to provide advice regarding which standards or 
143.13 	modifications should be adopted. The advisory group membership must include not less 
143.14 	than 15 members, of which at least 60 percent must be consumers of personal care services 
143.15 	and representatives of recipients with various disabilities and diagnoses and ages. At least 
143.16 	51 percent of the members of the advisory group must be recipients of personal care. 
143.17 	The commissioner of human services may contract with the commissioner of health 
143.18 	to enforce the jointly promulgated licensure rules for personal care service providers. 
143.19 	Prior to final promulgation of the joint rule the commissioner of human services 
143.20 	shall report preliminary findings along with any comments of the advisory group and a 
143.21 	plan for monitoring and enforcement by the Department of Health to the legislature by 
143.22 	February 15, 1992. 
143.23 	Limits on the extent of personal care services that may be provided to an individual 
143.24 	must be based on the cost-effectiveness of the services in relation to the costs of inpatient 
143.25 	hospital care, nursing home care, and other available types of care. The rules must 
143.26 	provide, at a minimum: 
143.27 	(1) that agencies be selected to contract with or employ and train staff to provide and 
143.28 	supervise the provision of personal care services; 
143.29 	(2) that agencies employ or contract with a qualified applicant that a qualified 
143.30 	recipient proposes to the agency as the recipient's choice of assistant; 
143.31 	(3) that agencies bill the medical assistance program for a personal care service 
143.32 	by a personal care assistant and supervision by a qualified professional supervising the 
143.33 	personal care assistant unless the recipient selects the fiscal agent option under section 
143.34 	256B.0655, subdivision 7 256B.0659, subdivision 33; 
143.35 	(4) that agencies establish a grievance mechanism; and 
143.36 	(5) that agencies have a quality assurance program. 
144.1 	(b) The commissioner may waive the requirement for the provision of personal care 
144.2 	services through an agency in a particular county, when there are less than two agencies 
144.3 	providing services in that county and shall waive the requirement for personal care 
144.4 	assistants required to join an agency for the first time during 1993 when personal care 
144.5 	services are provided under a relative hardship waiver under Minnesota Statutes 1992, 
144.6 	section 256B.0627, subdivision 4, paragraph (b), clause (7), and at least two agencies 
144.7 	providing personal care services have refused to employ or contract with the independent 
144.8 	personal care assistant. 

144.9 	Sec. 8. Minnesota Statutes 2008, section 256B.055, subdivision 12, is amended to read:
144.10 		Subd. 12. Disabled children. (a) A person is eligible for medical assistance if the 
144.11 	person is under age 19 and qualifies as a disabled individual under United States Code, 
144.12 	title 42, section 1382c(a), and would be eligible for medical assistance under the state 
144.13 	plan if residing in a medical institution, and the child requires a level of care provided in 
144.14 	a hospital, nursing facility, or intermediate care facility for persons with developmental 
144.15 	disabilities, for whom home care is appropriate, provided that the cost to medical 
144.16 	assistance under this section is not more than the amount that medical assistance would pay 
144.17 	for if the child resides in an institution. After the child is determined to be eligible under 
144.18 	this section, the commissioner shall review the child's disability under United States Code, 
144.19 	title 42, section 1382c(a) and level of care defined under this section no more often than 
144.20 	annually and may elect, based on the recommendation of health care professionals under 
144.21 	contract with the state medical review team, to extend the review of disability and level of 
144.22 	care up to a maximum of four years. The commissioner's decision on the frequency of 
144.23 	continuing review of disability and level of care is not subject to administrative appeal 
144.24 	under section 256.045. The county agency shall send a notice of disability review to the 
144.25 	enrollee six months prior to the date the recertification of disability is due. Nothing in this 
144.26 	subdivision shall be construed as affecting other redeterminations of medical assistance 
144.27 	eligibility under this chapter and annual cost-effective reviews under this section. 
144.28 	(b) For purposes of this subdivision, "hospital" means an institution as defined 
144.29 	in section 144.696, subdivision 3, 144.55, subdivision 3, or Minnesota Rules, part 
144.30 	4640.3600, and licensed pursuant to sections 144.50 to 144.58. For purposes of this 
144.31 	subdivision, a child requires a level of care provided in a hospital if the child is determined 
144.32 	by the commissioner to need an extensive array of health services, including mental health 
144.33 	services, for an undetermined period of time, whose health condition requires frequent 
144.34 	monitoring and treatment by a health care professional or by a person supervised by a 
144.35 	health care professional, who would reside in a hospital or require frequent hospitalization 
145.1 	if these services were not provided, and the daily care needs are more complex than 
145.2 	a nursing facility level of care. 
145.3 	A child with serious emotional disturbance requires a level of care provided in a 
145.4 	hospital if the commissioner determines that the individual requires 24-hour supervision 
145.5 	because the person exhibits recurrent or frequent suicidal or homicidal ideation or 
145.6 	behavior, recurrent or frequent psychosomatic disorders or somatopsychic disorders that 
145.7 	may become life threatening, recurrent or frequent severe socially unacceptable behavior 
145.8 	associated with psychiatric disorder, ongoing and chronic psychosis or severe, ongoing 
145.9 	and chronic developmental problems requiring continuous skilled observation, or severe 
145.10 	disabling symptoms for which office-centered outpatient treatment is not adequate, and 
145.11 	which overall severely impact the individual's ability to function. 
145.12 	(c) For purposes of this subdivision, "nursing facility" means a facility which 
145.13 	provides nursing care as defined in section 144A.01, subdivision 5, licensed pursuant to 
145.14 	sections 144A.02 to 144A.10, which is appropriate if a person is in active restorative 
145.15 	treatment; is in need of special treatments provided or supervised by a licensed nurse; or 
145.16 	has unpredictable episodes of active disease processes requiring immediate judgment 
145.17 	by a licensed nurse. For purposes of this subdivision, a child requires the level of care 
145.18 	provided in a nursing facility if the child is determined by the commissioner to meet 
145.19 	the requirements of the preadmission screening assessment document under section 
145.20 	256B.0911 and the home care independent rating document under section 256B.0655, 
145.21 	subdivision 4, clause (3) 256B.0659, adjusted to address age-appropriate standards for 
145.22 	children age 18 and under, pursuant to section 256B.0655, subdivision 3 256B.0659. 
145.23 	(d) For purposes of this subdivision, "intermediate care facility for persons with 
145.24 	developmental disabilities" or "ICF/MR" means a program licensed to provide services to 
145.25 	persons with developmental disabilities under section 252.28, and chapter 245A, and a 
145.26 	physical plant licensed as a supervised living facility under chapter 144, which together 
145.27 	are certified by the Minnesota Department of Health as meeting the standards in Code of 
145.28 	Federal Regulations, title 42, part 483, for an intermediate care facility which provides 
145.29 	services for persons with developmental disabilities who require 24-hour supervision 
145.30 	and active treatment for medical, behavioral, or habilitation needs. For purposes of this 
145.31 	subdivision, a child requires a level of care provided in an ICF/MR if the commissioner 
145.32 	finds that the child has a developmental disability in accordance with section 256B.092, 
145.33 	is in need of a 24-hour plan of care and active treatment similar to persons with 
145.34 	developmental disabilities, and there is a reasonable indication that the child will need 
145.35 	ICF/MR services. 
146.1 	(e) For purposes of this subdivision, a person requires the level of care provided 
146.2 	in a nursing facility if the person requires 24-hour monitoring or supervision and a plan 
146.3 	of mental health treatment because of specific symptoms or functional impairments 
146.4 	associated with a serious mental illness or disorder diagnosis, which meet severity criteria 
146.5 	for mental health established by the commissioner and published in March 1997 as 
146.6 	the Minnesota Mental Health Level of Care for Children and Adolescents with Severe 
146.7 	Emotional Disorders. 
146.8 	(f) The determination of the level of care needed by the child shall be made by 
146.9 	the commissioner based on information supplied to the commissioner by the parent or 
146.10 	guardian, the child's physician or physicians, and other professionals as requested by the 
146.11 	commissioner. The commissioner shall establish a screening team to conduct the level of 
146.12 	care determinations according to this subdivision. 
146.13 	(g) If a child meets the conditions in paragraph (b), (c), (d), or (e), the commissioner 
146.14 	must assess the case to determine whether: 
146.15 	(1) the child qualifies as a disabled individual under United States Code, title 42, 
146.16 	section 1382c(a), and would be eligible for medical assistance if residing in a medical 
146.17 	institution; and 
146.18 	(2) the cost of medical assistance services for the child, if eligible under this 
146.19 	subdivision, would not be more than the cost to medical assistance if the child resides in a 
146.20 	medical institution to be determined as follows: 
146.21 	(i) for a child who requires a level of care provided in an ICF/MR, the cost of 
146.22 	care for the child in an institution shall be determined using the average payment rate 
146.23 	established for the regional treatment centers that are certified as ICF's/MR; 
146.24 	(ii) for a child who requires a level of care provided in an inpatient hospital setting 
146.25 	according to paragraph (b), cost-effectiveness shall be determined according to Minnesota 
146.26 	Rules, part 9505.3520, items F and G; and 
146.27 	(iii) for a child who requires a level of care provided in a nursing facility according 
146.28 	to paragraph (c) or (e), cost-effectiveness shall be determined according to Minnesota 
146.29 	Rules, part 9505.3040, except that the nursing facility average rate shall be adjusted to 
146.30 	reflect rates which would be paid for children under age 16. The commissioner may 
146.31 	authorize an amount up to the amount medical assistance would pay for a child referred to 
146.32 	the commissioner by the preadmission screening team under section 256B.0911. 
146.33 	(h) Children eligible for medical assistance services under section 256B.055, 
146.34 	subdivision 12, as of June 30, 1995, must be screened according to the criteria in this 
146.35 	subdivision prior to January 1, 1996. Children found to be ineligible may not be removed 
146.36 	from the program until January 1, 1996. 

147.1 	Sec. 9. Minnesota Statutes 2008, section 256B.0621, subdivision 2, is amended to read:
147.2 		Subd. 2.Targeted case management; definitions. For purposes of subdivisions 3 
147.3 	to 10, the following terms have the meanings given them:
147.4 	(1) "home care service recipients" means those individuals receiving the following 
147.5 	services under sections 256B.0651 to 256B.0656 and 256B.0659: skilled nursing visits, 
147.6 	home health aide visits, private duty nursing, personal care assistants, or therapies 
147.7 	provided through a home health agency;
147.8 	(2) "home care targeted case management" means the provision of targeted case 
147.9 	management services for the purpose of assisting home care service recipients to gain 
147.10 	access to needed services and supports so that they may remain in the community;
147.11 	(3) "institutions" means hospitals, consistent with Code of Federal Regulations, title 
147.12 	42, section 440.10; regional treatment center inpatient services, consistent with section 
147.13 	245.474; nursing facilities; and intermediate care facilities for persons with developmental 
147.14 	disabilities;
147.15 	(4) "relocation targeted case management" includes the provision of both county 
147.16 	targeted case management and public or private vendor service coordination services 
147.17 	for the purpose of assisting recipients to gain access to needed services and supports if 
147.18 	they choose to move from an institution to the community. Relocation targeted case 
147.19 	management may be provided during the lesser of:
147.20 	(i) the last 180 consecutive days of an eligible recipient's institutional stay; or
147.21 	(ii) the limits and conditions which apply to federal Medicaid funding for this 
147.22 	service; and
147.23 	(5) "targeted case management" means case management services provided to help 
147.24 	recipients gain access to needed medical, social, educational, and other services and 
147.25 	supports.

147.26 	Sec. 10. Minnesota Statutes 2008, section 256B.0652, subdivision 3, is amended to 
147.27 	read:
147.28 		Subd. 3.Assessment and prior authorization process. Effective January 1, 1996, 
147.29 	for purposes of providing informed choice, coordinating of local planning decisions, and 
147.30 	streamlining administrative requirements, the assessment and prior authorization process 
147.31 	for persons receiving both home care and home and community-based waivered services 
147.32 	for persons with developmental disabilities shall meet the requirements of sections 
147.33 	256B.0651and 256B.0653 to 256B.0656and 256B.0659 with the following exceptions:
147.34 	(a) Upon request for home care services and subsequent assessment by the public 
147.35 	health nurse under sections 256B.0651and 256B.0653 to 256B.0656 and 256B.0659, 
148.1 	the public health nurse shall participate in the screening process, as appropriate, and, 
148.2 	if home care services are determined to be necessary, participate in the development 
148.3 	of a service plan coordinating the need for home care and home and community-based 
148.4 	waivered services with the assigned county case manager, the recipient of services, and 
148.5 	the recipient's legal representative, if any.
148.6 	(b) The public health nurse shall give prior authorization for home care services 
148.7 	to the extent that home care services are:
148.8 	(1) medically necessary;
148.9 	(2) chosen by the recipient and their legal representative, if any, from the array of 
148.10 	home care and home and community-based waivered services available;
148.11 	(3) coordinated with other services to be received by the recipient as described 
148.12 	in the service plan; and
148.13 	(4) provided within the county's reimbursement limits for home care and home and 
148.14 	community-based waivered services for persons with developmental disabilities.
148.15 	(c) If the public health agency is or may be the provider of home care services to the 
148.16 	recipient, the public health agency shall provide the commissioner of human services with 
148.17 	a written plan that specifies how the assessment and prior authorization process will be 
148.18 	held separate and distinct from the provision of services.

148.19 	Sec. 11. Minnesota Statutes 2008, section 256B.0657, subdivision 2, is amended to 
148.20 	read:
148.21 		Subd. 2.Eligibility. (a) The self-directed supports option is available to a person 
148.22 	who:
148.23 	(1) is a recipient of medical assistance as determined under sections 256B.055, 
148.24 	256B.056, and 256B.057, subdivision 9;
148.25 	(2) is eligible for personal care assistant services under section 256B.0655
148.26 	256B.0659;
148.27 	(3) lives in the person's own apartment or home, which is not owned, operated, or 
148.28 	controlled by a provider of services not related by blood or marriage;
148.29 	(4) has the ability to hire, fire, supervise, establish staff compensation for, and 
148.30 	manage the individuals providing services, and to choose and obtain items, related 
148.31 	services, and supports as described in the participant's plan. If the recipient is not able to 
148.32 	carry out these functions but has a legal guardian or parent to carry them out, the guardian 
148.33 	or parent may fulfill these functions on behalf of the recipient; and
148.34 	(5) has not been excluded or disenrolled by the commissioner.
149.1 	(b) The commissioner may disenroll or exclude recipients, including guardians and 
149.2 	parents, under the following circumstances:
149.3 	(1) recipients who have been restricted by the Primary Care Utilization Review 
149.4 	Committee may be excluded for a specified time period; 
149.5 	(2) recipients who exit the self-directed supports option during the recipient's 
149.6 	service plan year shall not access the self-directed supports option for the remainder of 
149.7 	that service plan year; and
149.8 	(3) when the department determines that the recipient cannot manage recipient 
149.9 	responsibilities under the program.

149.10 	Sec. 12. Minnesota Statutes 2008, section 256B.0657, subdivision 6, is amended to 
149.11 	read:
149.12 		Subd. 6.Services covered. (a) Services covered under the self-directed supports 
149.13 	option include:
149.14 	(1) personal care assistant services under section 256B.0655 256B.0659; and 
149.15 	(2) items, related services, and supports, including assistive technology, that increase 
149.16 	independence or substitute for human assistance to the extent expenditures would 
149.17 	otherwise be used for human assistance.
149.18 	(b) Items, supports, and related services purchased under this option shall not be 
149.19 	considered home care services for the purposes of section 144A.43.

149.20 	Sec. 13. Minnesota Statutes 2008, section 256B.0657, subdivision 8, is amended to 
149.21 	read:
149.22 		Subd. 8.Self-directed budget requirements. The budget for the provision of the 
149.23 	self-directed service option shall be equal to the greater of either:
149.24 	(1) the annual amount of personal care assistant services under section 256B.0655
149.25 	256B.0659 that the recipient has used in the most recent 12-month period; or 
149.26 	(2) the amount determined using the consumer support grant methodology under 
149.27 	section 256.476, subdivision 11, except that the budget amount shall include the federal 
149.28 	and nonfederal share of the average service costs.

149.29 	Sec. 14. Minnesota Statutes 2008, section 256B.49, subdivision 17, is amended to read:
149.30 		Subd. 17.Cost of services and supports. (a) The commissioner shall ensure 
149.31 	that the average per capita expenditures estimated in any fiscal year for home and 
149.32 	community-based waiver recipients does not exceed the average per capita expenditures 
150.1 	that would have been made to provide institutional services for recipients in the absence 
150.2 	of the waiver.
150.3 	(b) The commissioner shall implement on January 1, 2002, one or more aggregate, 
150.4 	need-based methods for allocating to local agencies the home and community-based 
150.5 	waivered service resources available to support recipients with disabilities in need of 
150.6 	the level of care provided in a nursing facility or a hospital. The commissioner shall 
150.7 	allocate resources to single counties and county partnerships in a manner that reflects 
150.8 	consideration of:
150.9 	(1) an incentive-based payment process for achieving outcomes;
150.10 	(2) the need for a state-level risk pool;
150.11 	(3) the need for retention of management responsibility at the state agency level; and
150.12 	(4) a phase-in strategy as appropriate.
150.13 	(c) Until the allocation methods described in paragraph (b) are implemented, the 
150.14 	annual allowable reimbursement level of home and community-based waiver services 
150.15 	shall be the greater of:
150.16 	(1) the statewide average payment amount which the recipient is assigned under the 
150.17 	waiver reimbursement system in place on June 30, 2001, modified by the percentage of 
150.18 	any provider rate increase appropriated for home and community-based services; or
150.19 	(2) an amount approved by the commissioner based on the recipient's extraordinary 
150.20 	needs that cannot be met within the current allowable reimbursement level. The 
150.21 	increased reimbursement level must be necessary to allow the recipient to be discharged 
150.22 	from an institution or to prevent imminent placement in an institution. The additional 
150.23 	reimbursement may be used to secure environmental modifications; assistive technology 
150.24 	and equipment; and increased costs for supervision, training, and support services 
150.25 	necessary to address the recipient's extraordinary needs. The commissioner may approve 
150.26 	an increased reimbursement level for up to one year of the recipient's relocation from an 
150.27 	institution or up to six months of a determination that a current waiver recipient is at 
150.28 	imminent risk of being placed in an institution.
150.29 	(d) Beginning July 1, 2001, medically necessary private duty nursing services 
150.30 	will be authorized under this section as complex and regular care according to sections 
150.31 	256B.0651and 256B.0653 to 256B.0656 and 256B.0659. The rate established by the 
150.32 	commissioner for registered nurse or licensed practical nurse services under any home and 
150.33 	community-based waiver as of January 1, 2001, shall not be reduced.

150.34 	Sec. 15. Minnesota Statutes 2008, section 256B.501, subdivision 4a, is amended to 
150.35 	read:
151.1 		Subd. 4a.Inclusion of home care costs in waiver rates. The commissioner 
151.2 	shall adjust the limits of the established average daily reimbursement rates for waivered 
151.3 	services to include the cost of home care services that may be provided to waivered 
151.4 	services recipients. This adjustment must be used to maintain or increase services and 
151.5 	shall not be used by county agencies for inflation increases for waivered services vendors. 
151.6 	Home care services referenced in this section are those listed in section 256B.0651, 
151.7 	subdivision 2. The average daily reimbursement rates established in accordance with 
151.8 	the provisions of this subdivision apply only to the combined average, daily costs of 
151.9 	waivered and home care services and do not change home care limitations under sections 
151.10 	256B.0651and 256B.0653 to 256B.0656 and 256B.0659. Waivered services recipients 
151.11 	receiving home care as of June 30, 1992, shall not have the amount of their services 
151.12 	reduced as a result of this section.

151.13 	Sec. 16. Minnesota Statutes 2008, section 256G.02, subdivision 6, is amended to read:
151.14 		Subd. 6.Excluded time. "Excluded time" means:
151.15 	(a) any period an applicant spends in a hospital, sanitarium, nursing home, shelter 
151.16 	other than an emergency shelter, halfway house, foster home, semi-independent living 
151.17 	domicile or services program, residential facility offering care, board and lodging facility 
151.18 	or other institution for the hospitalization or care of human beings, as defined in section 
151.19 	144.50, 144A.01, or 245A.02, subdivision 14; maternity home, battered women's shelter, 
151.20 	or correctional facility; or any facility based on an emergency hold under sections 
151.21 	253B.05, subdivisions 1 and 2, and 253B.07, subdivision 6;
151.22 	(b) any period an applicant spends on a placement basis in a training and habilitation 
151.23 	program, including a rehabilitation facility or work or employment program as defined 
151.24 	in section 268A.01; or receiving personal care assistant services pursuant to section 
151.25 	256B.0655, subdivision 2 256B.0659; semi-independent living services provided under 
151.26 	section 252.275, and Minnesota Rules, parts 9525.0500 to 9525.0660; day training and 
151.27 	habilitation programs and assisted living services; and
151.28 	(c) any placement for a person with an indeterminate commitment, including 
151.29 	independent living.

151.30 	Sec. 17. Minnesota Statutes 2008, section 256I.05, subdivision 1a, is amended to read:
151.31 		Subd. 1a.Supplementary service rates. (a) Subject to the provisions of section 
151.32 	256I.04, subdivision 3, the county agency may negotiate a payment not to exceed $426.37 
151.33 	for other services necessary to provide room and board provided by the group residence 
151.34 	if the residence is licensed by or registered by the Department of Health, or licensed by 
152.1 	the Department of Human Services to provide services in addition to room and board, 
152.2 	and if the provider of services is not also concurrently receiving funding for services for 
152.3 	a recipient under a home and community-based waiver under title XIX of the Social 
152.4 	Security Act; or funding from the medical assistance program under section 256B.0655, 
152.5 	subdivision 2 256B.0659, for personal care services for residents in the setting; or residing 
152.6 	in a setting which receives funding under Minnesota Rules, parts 9535.2000 to 9535.3000. 
152.7 	If funding is available for other necessary services through a home and community-based 
152.8 	waiver, or personal care services under section 256B.0655, subdivision 2 256B.0659, 
152.9 	then the GRH rate is limited to the rate set in subdivision 1. Unless otherwise provided 
152.10 	in law, in no case may the supplementary service rate exceed $426.37. The registration 
152.11 	and licensure requirement does not apply to establishments which are exempt from state 
152.12 	licensure because they are located on Indian reservations and for which the tribe has 
152.13 	prescribed health and safety requirements. Service payments under this section may be 
152.14 	prohibited under rules to prevent the supplanting of federal funds with state funds. The 
152.15 	commissioner shall pursue the feasibility of obtaining the approval of the Secretary of 
152.16 	Health and Human Services to provide home and community-based waiver services under 
152.17 	title XIX of the Social Security Act for residents who are not eligible for an existing home 
152.18 	and community-based waiver due to a primary diagnosis of mental illness or chemical 
152.19 	dependency and shall apply for a waiver if it is determined to be cost-effective.
152.20 	(b) The commissioner is authorized to make cost-neutral transfers from the GRH 
152.21 	fund for beds under this section to other funding programs administered by the department 
152.22 	after consultation with the county or counties in which the affected beds are located. 
152.23 	The commissioner may also make cost-neutral transfers from the GRH fund to county 
152.24 	human service agencies for beds permanently removed from the GRH census under a plan 
152.25 	submitted by the county agency and approved by the commissioner. The commissioner 
152.26 	shall report the amount of any transfers under this provision annually to the legislature.
152.27 	(c) The provisions of paragraph (b) do not apply to a facility that has its 
152.28 	reimbursement rate established under section 256B.431, subdivision 4, paragraph (c).

152.29 	Sec. 18. Minnesota Statutes 2008, section 256J.45, subdivision 3, is amended to read:
152.30 		Subd. 3.Good cause exemptions for not attending orientation. (a) The county 
152.31 	agency shall not impose the sanction under section 256J.46 if it determines that the 
152.32 	participant has good cause for failing to attend orientation. Good cause exists when:
152.33 	(1) appropriate child care is not available;
152.34 	(2) the participant is ill or injured;
153.1 	(3) a family member is ill and needs care by the participant that prevents the 
153.2 	participant from attending orientation. For a caregiver with a child or adult in the 
153.3 	household who meets the disability or medical criteria for home care services under 
153.4 	section 256B.0655, subdivision 1c 256B.0659, or a home and community-based waiver 
153.5 	services program under chapter 256B, or meets the criteria for severe emotional 
153.6 	disturbance under section 245.4871, subdivision 6, or for serious and persistent mental 
153.7 	illness under section 245.462, subdivision 20, paragraph (c), good cause also exists when 
153.8 	an interruption in the provision of those services occurs which prevents the participant 
153.9 	from attending orientation;
153.10 	(4) the caregiver is unable to secure necessary transportation;
153.11 	(5) the caregiver is in an emergency situation that prevents orientation attendance;
153.12 	(6) the orientation conflicts with the caregiver's work, training, or school schedule; or
153.13 	(7) the caregiver documents other verifiable impediments to orientation attendance 
153.14 	beyond the caregiver's control.
153.15 	(b) Counties must work with clients to provide child care and transportation 
153.16 	necessary to ensure a caregiver has every opportunity to attend orientation.

153.17 	Sec. 19. Minnesota Statutes 2008, section 604A.33, subdivision 1, is amended to read:
153.18 		Subdivision 1.Application. This section applies to residential treatment programs 
153.19 	for children or group homes for children licensed under chapter 245A, residential 
153.20 	services and programs for juveniles licensed under section 241.021, providers licensed 
153.21 	pursuant to sections 144A.01 to 144A.33 or sections 144A.43 to  144A.47, personal care 
153.22 	provider organizations under section 256B.0655, subdivision 1g 256B.0659, providers 
153.23 	of day training and habilitation services under sections 252.40 to 252.46, board and 
153.24 	lodging facilities licensed under chapter 157, intermediate care facilities for persons with 
153.25 	developmental disabilities, and other facilities licensed to provide residential services to 
153.26 	persons with developmental disabilities.

153.27 	Sec. 20. Minnesota Statutes 2008, section 609.232, subdivision 11, is amended to read:
153.28 		Subd. 11.Vulnerable adult. "Vulnerable adult" means any person 18 years of 
153.29 	age or older who:
153.30 	(1) is a resident inpatient of a facility;
153.31 	(2) receives services at or from a facility required to be licensed to serve adults 
153.32 	under sections 245A.01 to 245A.15, except that a person receiving outpatient services for 
153.33 	treatment of chemical dependency or mental illness, or one who is committed as a sexual 
154.1 	psychopathic personality or as a sexually dangerous person under chapter 253B, is not 
154.2 	considered a vulnerable adult unless the person meets the requirements of clause (4);
154.3 	(3) receives services from a home care provider required to be licensed under section 
154.4 	144A.46; or from a person or organization that exclusively offers, provides, or arranges 
154.5 	for personal care assistant services under the medical assistance program as authorized 
154.6 	under sections 256B.04, subdivision 16, 256B.0625, subdivision 19a, 256B.0651, and 
154.7 	256B.0653 to 256B.0656 and 256B.0659; or
154.8 	(4) regardless of residence or whether any type of service is received, possesses a 
154.9 	physical or mental infirmity or other physical, mental, or emotional dysfunction:
154.10 	(i) that impairs the individual's ability to provide adequately for the individual's 
154.11 	own care without assistance, including the provision of food, shelter, clothing, health 
154.12 	care, or supervision; and
154.13 	(ii) because of the dysfunction or infirmity and the need for assistance, the individual 
154.14 	has an impaired ability to protect the individual from maltreatment.

154.15 	Sec. 21. Minnesota Statutes 2008, section 626.5572, subdivision 6, is amended to read:
154.16 		Subd. 6.Facility. (a) "Facility" means a hospital or other entity required to be 
154.17 	licensed under sections 144.50 to 144.58; a nursing home required to be licensed to 
154.18 	serve adults under section 144A.02; a residential or nonresidential facility required to 
154.19 	be licensed to serve adults under sections 245A.01 to 245A.16; a home care provider 
154.20 	licensed or required to be licensed under section 144A.46; a hospice provider licensed 
154.21 	under sections 144A.75 to 144A.755; or a person or organization that exclusively offers, 
154.22 	provides, or arranges for personal care assistant services under the medical assistance 
154.23 	program as authorized under sections 256B.04, subdivision 16, 256B.0625, subdivision 
154.24 	19a, 256B.0651, and 256B.0653 to 256B.0656, and 256B.0659.
154.25 	(b) For home care providers and personal care attendants, the term "facility" refers 
154.26 	to the provider or person or organization that exclusively offers, provides, or arranges for 
154.27 	personal care services, and does not refer to the client's home or other location at which 
154.28 	services are rendered.

154.29 	Sec. 22. Minnesota Statutes 2008, section 626.5572, subdivision 21, is amended to 
154.30 	read:
154.31 		Subd. 21. Vulnerable adult. "Vulnerable adult" means any person 18 years of 
154.32 	age or older who: 
154.33 	(1) is a resident or inpatient of a facility; 
155.1 	(2) receives services at or from a facility required to be licensed to serve adults 
155.2 	under sections 245A.01 to 245A.15, except that a person receiving outpatient services for 
155.3 	treatment of chemical dependency or mental illness, or one who is served in the Minnesota 
155.4 	sex offender program on a court-hold order for commitment, or is committed as a sexual 
155.5 	psychopathic personality or as a sexually dangerous person under chapter 253B, is not 
155.6 	considered a vulnerable adult unless the person meets the requirements of clause (4); 
155.7 	(3) receives services from a home care provider required to be licensed under section 
155.8 	144A.46; or from a person or organization that exclusively offers, provides, or arranges 
155.9 	for personal care assistant services under the medical assistance program as authorized 
155.10 	under sections 256B.04, subdivision 16, 256B.0625, subdivision 19a, 256B.0651, and
155.11 	256B.0653 to 256B.0656, and 256B.0659; or 
155.12 	(4) regardless of residence or whether any type of service is received, possesses a 
155.13 	physical or mental infirmity or other physical, mental, or emotional dysfunction: 
155.14 	(i) that impairs the individual's ability to provide adequately for the individual's 
155.15 	own care without assistance, including the provision of food, shelter, clothing, health 
155.16 	care, or supervision; and 
155.17 	(ii) because of the dysfunction or infirmity and the need for assistance, the individual 
155.18 	has an impaired ability to protect the individual from maltreatment. 

155.19 	ARTICLE 8
155.20 	CHEMICAL AND MENTAL HEALTH

155.21 	Section 1. Minnesota Statutes 2008, section 245.4885, subdivision 1, is amended to 
155.22 	read:
155.23 		Subdivision 1.Admission criteria. The county board shall, (a) Prior to admission, 
155.24 	except in the case of emergency admission, determine the needed level of care for all 
155.25 	children referred for treatment of severe emotional disturbance in a treatment foster care 
155.26 	setting, residential treatment facility, or informally admitted to a regional treatment center
155.27 	shall undergo an assessment to determine the appropriate level of care if public funds are 
155.28 	used to pay for the services. The county board shall also determine the needed level of 
155.29 	care for all children admitted to an acute care hospital for treatment of severe emotional 
155.30 	disturbance if public funds other than reimbursement under chapters 256B and 256D 
155.31 	are used to pay for the services.
155.32 	(b) The county board shall determine the appropriate level of care when 
155.33 	county-controlled funds are used to pay for the services. When the child is enrolled in 
155.34 	a prepaid health program under section 256B.69, the enrolled child's contracted health 
155.35 	plan must determine the appropriate level of care. When the child is an Indian tribal 
156.1 	member seeking placement through the tribe in a tribally operated or contracted facility, 
156.2 	the tribe must determine the appropriate level of care. When more than one entity bears 
156.3 	responsibility for coverage, the entities shall coordinate level of care determination 
156.4 	activities to the extent possible.
156.5 	(c) The level of care determination shall determine whether the proposed treatment:
156.6 	(1) is necessary;
156.7 	(2) is appropriate to the child's individual treatment needs;
156.8 	(3) cannot be effectively provided in the child's home; and
156.9 	(4) provides a length of stay as short as possible consistent with the individual 
156.10 	child's need.
156.11 	(d) When a level of care determination is conducted, the county board responsible 
156.12 	entity may not determine that referral or admission to a treatment foster care setting, or
156.13 	residential treatment facility, or acute care hospital is not appropriate solely because 
156.14 	services were not first provided to the child in a less restrictive setting and the child failed 
156.15 	to make progress toward or meet treatment goals in the less restrictive setting. The level 
156.16 	of care determination must be based on a diagnostic assessment that includes a functional 
156.17 	assessment which evaluates family, school, and community living situations; and an 
156.18 	assessment of the child's need for care out of the home using a validated tool which 
156.19 	assesses a child's functional status and assigns an appropriate level of care. The validated 
156.20 	tool must be approved by the commissioner of human services. If a diagnostic assessment 
156.21 	including a functional assessment has been completed by a mental health professional 
156.22 	within the past 180 days, a new diagnostic assessment need not be completed unless in the 
156.23 	opinion of the current treating mental health professional the child's mental health status 
156.24 	has changed markedly since the assessment was completed. The child's parent shall be 
156.25 	notified if an assessment will not be completed and of the reasons. A copy of the notice 
156.26 	shall be placed in the child's file. Recommendations developed as part of the level of care 
156.27 	determination process shall include specific community services needed by the child and, 
156.28 	if appropriate, the child's family, and shall indicate whether or not these services are 
156.29 	available and accessible to the child and family.
156.30 	During the level of care determination process, the child, child's family, or child's 
156.31 	legal representative, as appropriate, must be informed of the child's eligibility for case 
156.32 	management services and family community support services and that an individual 
156.33 	family community support plan is being developed by the case manager, if assigned.
156.34 	The level of care determination shall comply with section 260C.212. Wherever 
156.35 	possible, The parent shall be consulted in the process, unless clinically inappropriate
156.36 	detrimental to the child.
157.1 	The level of care determination, and placement decision, and recommendations for 
157.2 	mental health services must be documented in the child's record.
157.3 	An alternate review process may be approved by the commissioner if the county 
157.4 	board demonstrates that an alternate review process has been established by the county 
157.5 	board and the times of review, persons responsible for the review, and review criteria are 
157.6 	comparable to the standards in clauses (1) to (4).

157.7 	Sec. 2. Minnesota Statutes 2008, section 254A.02, is amended by adding a subdivision 
157.8 	to read:
157.9 		Subd. 8a.Placing authority. "Placing authority" means a county, prepaid health 
157.10 	plan, or tribal governing board governed by Minnesota Rules, parts 9530.6600 to 
157.11 	9530.6655.

157.12 	Sec. 3. Minnesota Statutes 2008, section 254A.16, is amended by adding a subdivision 
157.13 	to read:
157.14 		Subd. 6.Monitoring. The commissioner shall gather and placing authorities shall 
157.15 	provide information to measure compliance with Minnesota Rules, parts 9530.6600 to 
157.16 	9530.6655. The commissioner shall specify the format for data collection to facilitate 
157.17 	tracking, aggregating, and using the information.

157.18 	Sec. 4. Minnesota Statutes 2008, section 254B.03, subdivision 1, is amended to read:
157.19 		Subdivision 1.Local agency duties. (a) Every local agency shall provide chemical 
157.20 	dependency services to persons residing within its jurisdiction who meet criteria 
157.21 	established by the commissioner for placement in a chemical dependency residential or 
157.22 	nonresidential treatment service. Chemical dependency money must be administered 
157.23 	by the local agencies according to law and rules adopted by the commissioner under 
157.24 	sections 14.001 to 14.69. 
157.25 	(b) In order to contain costs, the county board shall, with the approval of the 
157.26 	commissioner of human services,shall select eligible vendors of chemical dependency 
157.27 	services who can provide economical and appropriate treatment. Unless the local agency 
157.28 	is a social services department directly administered by a county or human services board, 
157.29 	the local agency shall not be an eligible vendor under section 254B.05. The commissioner 
157.30 	may approve proposals from county boards to provide services in an economical manner 
157.31 	or to control utilization, with safeguards to ensure that necessary services are provided. 
157.32 	If a county implements a demonstration or experimental medical services funding plan, 
157.33 	the commissioner shall transfer the money as appropriate. If a county selects a vendor 
158.1 	located in another state, the county shall ensure that the vendor is in compliance with the 
158.2 	rules governing licensure of programs located in the state.
158.3 	(c) A culturally specific vendor that provides assessments under a variance under 
158.4 	Minnesota Rules, part 9530.6610, shall be allowed to provide assessment services to 
158.5 	persons not covered by the variance.

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

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

158.11 	Sec. 6. Minnesota Statutes 2008, section 254B.03, is amended by adding a subdivision 
158.12 	to read:
158.13 		Subd. 9.Commissioner to select vendors and set rates. (a) Effective July 1, 2011, 
158.14 	the commissioner shall:
158.15 	(1) enter into agreements with eligible vendors that:
158.16 	(i) meet the standards in section 254B.05, subdivision 1;
158.17 	(ii) have good standing in all applicable licensure; and
158.18 	(iii) have a current approved provider agreement as a Minnesota health care program 
158.19 	provider; and
158.20 	(2) set rates for services reimbursed under this chapter.
158.21 	(b) When setting rates, the commissioner shall consider the complexity and the 
158.22 	acuity of the problems presented by the client.
158.23 	(c) When rates set under this section and rates set under section 254B.09, subdivision 
158.24 	8, apply to the same treatment placement, section 254B.09, subdivision 8, supersedes.

158.25 	Sec. 7. Minnesota Statutes 2008, section 254B.05, subdivision 1, is amended to read:
158.26 		Subdivision 1.Licensure required. Programs licensed by the commissioner are 
158.27 	eligible vendors. Hospitals may apply for and receive licenses to be eligible vendors, 
158.28 	notwithstanding the provisions of section 245A.03. American Indian programs located on 
158.29 	federally recognized tribal lands that provide chemical dependency primary treatment, 
158.30 	extended care, transitional residence, or outpatient treatment services, and are licensed by 
158.31 	tribal government are eligible vendors. Detoxification programs are not eligible vendors. 
158.32 	Programs that are not licensed as a chemical dependency residential or nonresidential 
158.33 	treatment program by the commissioner or by tribal government are not eligible vendors. 
159.1 	To be eligible for payment under the Consolidated Chemical Dependency Treatment Fund, 
159.2 	a vendor of a chemical dependency service must participate in the Drug and Alcohol 
159.3 	Abuse Normative Evaluation System and the treatment accountability plan.  
159.4 	Effective January 1, 2000, vendors of room and board are eligible for chemical 
159.5 	dependency fund payment if the vendor:
159.6 	(1) is certified by the county or tribal governing body as havinghas rules prohibiting 
159.7 	residents bringing chemicals into the facility or using chemicals while residing in the 
159.8 	facility and provide consequences for infractions of those rules;
159.9 	(2) has a current contract with a county or tribal governing body;
159.10 	(3) is determined to meet applicable health and safety requirements;
159.11 	(4) is not a jail or prison; and
159.12 	(5) is not concurrently receiving funds under chapter 256I for the recipient.

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

159.14 	Sec. 8. Minnesota Statutes 2008, section 254B.09, subdivision 2, is amended to read:
159.15 		Subd. 2.American Indian agreements. The commissioner may enter into 
159.16 	agreements with federally recognized tribal units to pay for chemical dependency 
159.17 	treatment services provided under Laws 1986, chapter 394, sections 8 to 20. The 
159.18 	agreements must clarify how the governing body of the tribal unit fulfills local agency 
159.19 	responsibilities regarding:
159.20 	(1) selection of eligible vendors under section 254B.03, subdivision 1;  
159.21 	(2) negotiation of agreements that establish vendor services and rates for programs 
159.22 	located on the tribal governing body's reservation;
159.23 	(3)(1) the form and manner of invoicing; and
159.24 	(4)(2) provide that only invoices for eligible vendors according to section 254B.05
159.25 	will be included in invoices sent to the commissioner for payment, to the extent that 
159.26 	money allocated under subdivisions 4 and 5 is used.  

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

159.28 	Sec. 9. [254B.11] MAXIMUM RATES.
159.29 	The commissioner shall publish maximum rates for vendors of the consolidated 
159.30 	chemical dependency treatment fund by July 1 of each year for implementation the 
159.31 	following January 1. Rates for calendar year 2010 must not exceed 185 percent of the 
159.32 	average rate on January 1, 2009, for each group of vendors with similar attributes. Unless 
159.33 	a new rate methodology is developed under section 254B.12, rates for services provided on 
160.1 	and after July 1, 2011, must not exceed 160 percent of the average rate on January 1, 2009, 
160.2 	for each group of vendors with similar attributes. Payment for services provided by Indian 
160.3 	Health Services or by agencies operated by Indian tribes for medical assistance-eligible 
160.4 	individuals must be governed by the applicable federal rate methodology.

160.5 	Sec. 10. [254B.12] RATE METHODOLOGY.
160.6 	(a) The commissioner shall, with broad-based stakeholder input, develop a 
160.7 	recommendation and present a report to the 2011 legislature, including proposed 
160.8 	legislation for a new rate methodology for the consolidated chemical dependency 
160.9 	treatment fund. The new methodology must replace county-negotiated rates with a 
160.10 	uniform statewide methodology that must include:
160.11 	(1) a graduated reimbursement scale based on the patients' level of acuity and 
160.12 	complexity; and
160.13 	(2) beginning July 1, 2012, retroactive quality incentive payments up to four percent 
160.14 	of each provider's prior-year approved chemical dependency fund claims.
160.15 	(b) The quality incentive payments under paragraph (a), clause (2), must be based on 
160.16 	each provider's performance in the prior year relating to certain program criteria, based on 
160.17 	best practices in addiction treatment. The quality incentive criteria under paragraph (a), 
160.18 	clause (2), may include program completion rates, national outcome measures, program 
160.19 	innovations, lack of licensing violations, and other measures to be determined by the 
160.20 	commissioner.

160.21 	Sec. 11. Minnesota Statutes 2008, section 256B.0625, subdivision 41, is amended to 
160.22 	read:
160.23 		Subd. 41.Residential services for children with severe emotional disturbance.
 160.24 	Medical assistance covers rehabilitative services in accordance with section 256B.0945
160.25 	that are provided by a county through a residential facility under contract with a county or 
160.26 	Indian tribe, for children who have been diagnosed with severe emotional disturbance and 
160.27 	have been determined to require the level of care provided in a residential facility.

160.28 	Sec. 12. Minnesota Statutes 2008, section 256B.0625, subdivision 47, is amended to 
160.29 	read:
160.30 		Subd. 47.Treatment foster care services. Effective July 1, 2007 2011, and subject 
160.31 	to federal approval, medical assistance covers treatment foster care services according to 
160.32 	section 256B.0946.

161.1 	Sec. 13. Minnesota Statutes 2008, section 256B.0944, is amended by adding a 
161.2 	subdivision to read:
161.3 		Subd. 4a.Alternative provider standards. If a provider entity demonstrates that, 
161.4 	due to geographic or other barriers, it is not feasible to provide mobile crisis intervention 
161.5 	services 24 hours a day, seven days a week, according to the standards in subdivision 4, 
161.6 	paragraph (b), clause (1), the commissioner may approve a crisis response provider based 
161.7 	on an alternative plan proposed by a provider entity. The alternative plan must:
161.8 	(1) result in increased access and a reduction in disparities in the availability of 
161.9 	crisis services; and
161.10 	(2) provide mobile services outside of the usual nine-to-five office hours and on 
161.11 	weekends and holidays.

161.12 	Sec. 14. Minnesota Statutes 2008, section 256B.0945, subdivision 4, is amended to 
161.13 	read:
161.14 		Subd. 4.Payment rates. (a) Notwithstanding sections 256B.19 and 256B.041, 
161.15 	payments to counties for residential services provided by a residential facility shall only 
161.16 	be made of federal earnings for services provided under this section, and the nonfederal 
161.17 	share of costs for services provided under this section shall be paid by the county from 
161.18 	sources other than federal funds or funds used to match other federal funds. Payment to 
161.19 	counties for services provided according to this section shall be a proportion of the per 
161.20 	day contract rate that relates to rehabilitative mental health services and shall not include 
161.21 	payment for costs or services that are billed to the IV-E program as room and board. 
161.22 	(b) Per diem rates paid to providers under this section by prepaid plans shall be the 
161.23 	proportion of the per-day contract rate that relates to rehabilitative mental health services 
161.24 	and shall not include payment for group foster care costs or services that are billed to the 
161.25 	county of financial responsibility.
161.26 	(c) (b) The commissioner shall set aside a portion not to exceed five percent of the 
161.27 	federal funds earned for county expenditures under this section to cover the state costs of 
161.28 	administering this section. Any unexpended funds from the set-aside shall be distributed 
161.29 	to the counties in proportion to their earnings under this section.
161.30 	(c) The payment rate negotiated and paid to a provider by prepaid health plans 
161.31 	under section 256B.69 for services under this section must be supplemented by the 
161.32 	commissioner from state appropriations to cover the nontreatment costs at a rate equal to 
161.33 	the portion of the county negotiated per diem attributable to nontreatment service costs for 
161.34 	that provider as determined by the commissioner of human services.
162.1 	(d) Payment for mental health rehabilitative services provided under this section by 
162.2 	or under contract with an Indian tribe or tribal organization or by agencies operated by or 
162.3 	under contract with an Indian tribe or tribal organization may be made according to section 
162.4 	256B.0625, subdivision 34, or other relevant federally approved rate setting methodology.

162.5 	Sec. 15. Minnesota Statutes 2008, section 256B.0947, subdivision 1, is amended to 
162.6 	read:
162.7 		Subdivision 1.Scope. Subject to federal approval Effective November 1, 2010, and 
162.8 	subject to federal approval, medical assistance covers medically necessary, intensive 
162.9 	nonresidential rehabilitative mental health services as defined in subdivision 2, for 
162.10 	recipients as defined in subdivision 3, when the services are provided by an entity meeting 
162.11 	the standards in this section.

162.12 	Sec. 16. Minnesota Statutes 2008, section 256B.761, is amended to read:
162.13 	256B.761 REIMBURSEMENT FOR MENTAL HEALTH SERVICES.
162.14 	(a) Effective for services rendered on or after July 1, 2001, payment for medication 
162.15 	management provided to psychiatric patients, outpatient mental health services, day 
162.16 	treatment services, home-based mental health services, and family community support 
162.17 	services shall be paid at the lower of (1) submitted charges, or (2) 75.6 percent of the 
162.18 	50th percentile of 1999 charges.
162.19 	(b) Effective July 1, 2001, the medical assistance rates for outpatient mental health 
162.20 	services provided by an entity that operates: (1) a Medicare-certified comprehensive 
162.21 	outpatient rehabilitation facility; and (2) a facility that was certified prior to January 1, 
162.22 	1993, with at least 33 percent of the clients receiving rehabilitation services in the most 
162.23 	recent calendar year who are medical assistance recipients, will be increased by 38 percent, 
162.24 	when those services are provided within the comprehensive outpatient rehabilitation 
162.25 	facility and provided to residents of nursing facilities owned by the entity.
162.26 	(c) Effective January 1, 2010, the rate for partial hospitalization for children is 
162.27 	increased to equal the rate for partial hospitalization for adults.

162.28 	Sec. 17. AUTISM SPECTRUM DISORDER JOINT TASK FORCE.
 162.29 	(a) The Autism Spectrum Disorder Joint Task Force is composed of 25 members, 
162.30 	appointed as follows:
162.31 	(1) two members of the senate, one appointed by the majority leader and one 
162.32 	appointed by the minority leader;
163.1 	(2) two members of the house of representatives, one from the majority party, 
163.2 	appointed by the speaker of the house, and one from the minority party, appointed by 
163.3 	the minority leader; and
163.4 	(3) 11 public members appointed by the legislature, with regard to geographic 
163.5 	diversity in the state, with the senate Subcommittee on Committees of the Committee on 
163.6 	Rules and Administration making the appointments for the senate, and the speaker of the 
163.7 	house making the appointments for the house:
163.8 	(i) three members who are parents of children with autism spectrum disorder (ASD), 
163.9 	two of whom shall be appointed by the senate, and one of whom shall be appointed by 
163.10 	the house;
163.11 	(ii) two members who have ASD, one of whom shall be appointed by the senate, and 
163.12 	one by the house;
163.13 	(iii) one member representing an agency that provides residential housing services to 
163.14 	individuals with ASD, appointed by the house;
163.15 	(iv) one member representing an agency that provides employment services to 
163.16 	individuals with ASD, appointed by the senate;
163.17 	(v) one member who is a behavior analyst, appointed by the house;
163.18 	(vi) two members who are providers of ASD therapy, with one member appointed 
163.19 	by the senate and one member appointed by the house; and
163.20 	(vii) one member who is a director of public school student support services;
163.21 	(4) two members appointed by the Minnesota chapter of the American Academy 
163.22 	of Pediatrics, one who is a developmental behavioral pediatrician and one who is a 
163.23 	general pediatrician;
163.24 	(5) one member appointed by the Minnesota Psychological Society who is a 
163.25 	neuropsychologist;
163.26 	(6) one member appointed by the Association of Minnesota Counties;
163.27 	(7) one member appointed by the Minnesota Association of School Administrators;
163.28 	(8) one member appointed by the Somali American Autism Foundation;
163.29 	(9) one member appointed by the ARC of Minnesota;
163.30 	(10) one member appointed by the Autism Society of Minnesota;
163.31 	(11) one member appointed by the Parent Advocacy Coalition for Educational 
163.32 	Rights; and
163.33 	(12) one member appointed by the Minnesota Council of Health Plans.
163.34 	Appointments must be made by September 1, 2009. The Legislative Coordinating 
163.35 	Commission shall provide meeting space for the task force. The senate member appointed 
163.36 	by the minority leader of the senate shall convene the first meeting of the task force no 
164.1 	later than October 1, 2009. The task force shall elect a chair from among the public 
164.2 	members at the first meeting.
164.3 	(b) The commissioners of education, employment and economic development, 
164.4 	health, and human services shall provide assistance to the task force, including providing 
164.5 	the task force with a count of children who have ASD with an individual education 
164.6 	program or an individual family service plan and children with ASD who have a 504 plan. 
164.7 	Additionally, the commissioner of human services shall submit a count of the adults with 
164.8 	ASD enrolled in social service programs and the number of individuals with ASD who are 
164.9 	enrolled in medical assistance and other waiver programs.
164.10 	(c) The task force shall develop recommendations and report on the following topics:
164.11 	(1) ways to improve services provided by all state and political subdivisions;
164.12 	(2) sources of public and private funding available for treatment and ways to 
164.13 	improve efficiency in the use of these funds;
164.14 	(3) methods to improve coordination in the delivery of service between public and 
164.15 	private agencies, health providers, and schools;
164.16 	(4) increasing the availability of and the training for medical providers and educators 
164.17 	who identify and provide services to individuals with ASD;
164.18 	(5) ways to enhance Minnesota's role in ASD research and delivery of service; 
164.19 	(6) methods to educate parents, family members, and the public on ASD and the 
164.20 	available services; and
164.21 	(7) treatment options supported by peer-reviewed, established scientific research 
164.22 	for individuals with ASD.
164.23 	(d) The task force shall coordinate with existing efforts at the Departments of 
164.24 	Education, Health, Human Services, and Employment and Economic Development 
164.25 	related to ASD.
164.26 	(e) By January 15 of each year, the task force shall provide a report regarding its 
164.27 	findings and consideration of the topics listed under paragraph (c), and the action taken 
164.28 	under paragraph (d), including draft legislation if necessary, to the chairs and ranking 
164.29 	minority members of the legislative committees with jurisdiction over health and human 
164.30 	services.

164.31 	EFFECTIVE DATE. This section is effective July 1, 2009, and expires June 30, 
164.32 	2011.

164.33 	Sec. 18. LAND SALE; MORATORIUM.
 164.34 	Surplus land surrounding the Anoka-Metro Regional Treatment Center must not be 
164.35 	sold for five years.

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

165.2 	Sec. 19. STATE-COUNTY CHEMICAL HEALTH CARE HOME PILOT 
165.3 	PROJECT.
 165.4 		Subdivision 1.Establishment; purpose. There is established a state-county 
165.5 	chemical health care home pilot project. The purpose of the pilot project is for the 
165.6 	Department of Human Services and counties to work in partnership to redesign the current 
165.7 	chemical health delivery system to promote greater accountability, productivity, and 
165.8 	results in the delivery of state chemical dependency services. The pilot project must look 
165.9 	to promote appropriate flexibility in a way that better aligns systems and services to offer 
165.10 	the most appropriate level of chemical health care services to the client. This may include, 
165.11 	but is not limited to, developing new governance agreements, performance agreements, 
165.12 	or service level agreements. The pilot projects must maintain eligibility levels under the 
165.13 	current programmatic entitlement structure, continue to meet the requirements of Rule 25 
165.14 	and Rule 31, and must not put at risk current and future federal funding toward chemical 
165.15 	health-related services in Minnesota.
165.16 		Subd. 2.Work group. A work group must be convened on or before July 1, 2009, 
165.17 	consisting of representatives from the Department of Human Services and participating 
165.18 	counties to develop final proposals for pilot projects meeting the requirements of this 
165.19 	section. This work group must focus its efforts on the need for systems change, mandate 
165.20 	and waiver relief, payment reform or other funding options, and outcomes. The work 
165.21 	group must report back to the legislative committees having jurisdiction over chemical 
165.22 	health by January 15, 2010, for final approval of pilot projects to be implemented starting 
165.23 	July 10, 2010.
165.24 		Subd. 3.Report. The Department of Human Services shall report back to the 
165.25 	legislative committees having jurisdiction over chemical health by January 15, 2011, 
165.26 	evaluating the effectiveness of pilot projects, including recommendations for how to 
165.27 	implement the pilot projects on a statewide basis.
165.28 		Subd. 4.Expiration. These pilot projects expire ......

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

165.30 	ARTICLE 9
165.31 	CONTINUING CARE

165.32 	Section 1. Minnesota Statutes 2008, section 144.0724, subdivision 2, is amended to 
165.33 	read:
166.1 		Subd. 2.Definitions. For purposes of this section, the following terms have the 
166.2 	meanings given.
166.3 	(a) "Assessment reference date" means the last day of the minimum data set 
166.4 	observation period. The date sets the designated endpoint of the common observation 
166.5 	period, and all minimum data set items refer back in time from that point.
166.6 	(b) "Case mix index" means the weighting factors assigned to the RUG-III 
166.7 	classifications.
166.8 	(c) "Index maximization" means classifying a resident who could be assigned to 
166.9 	more than one category, to the category with the highest case mix index.
166.10 	(d) "Minimum data set" means the assessment instrument specified by the Centers for 
166.11 	Medicare and Medicaid Services and designated by the Minnesota Department of Health.
166.12 	(e) "Representative" means a person who is the resident's guardian or conservator, 
166.13 	the person authorized to pay the nursing home expenses of the resident, a representative 
166.14 	of the nursing home ombudsman's office whose assistance has been requested, or any 
166.15 	other individual designated by the resident.
166.16 	(f) "Resource utilization groups" or "RUG" means the system for grouping a nursing 
166.17 	facility's residents according to their clinical and functional status identified in data 
166.18 	supplied by the facility's minimum data set.
166.19 	(g) "Activities of daily living" means grooming, dressing, bathing, transferring, 
166.20 	mobility, positioning, eating, and toileting.
166.21 	(h) "Nursing facility level of care determination" means the assessment process 
166.22 	that results in a determination of a resident's or prospective resident's need for nursing 
166.23 	facility level of care as established in subdivision 11 for purposes of medical assistance 
166.24 	payment of long-term care services for:
166.25 	(1) nursing facility services under section 256B.434 or 256B.441;
166.26 	(2) elderly waiver services under section 256B.0915;
166.27 	(3) CADI and TBI waiver services under section 256B.49; and
166.28 	(4) state payment of alternative care services under section 256B.0913.

166.29 	EFFECTIVE DATE. The section is effective July 1, 2011.

166.30 	Sec. 2. Minnesota Statutes 2008, section 144.0724, subdivision 4, is amended to read:
166.31 		Subd. 4.Resident assessment schedule. (a) A facility must conduct and 
166.32 	electronically submit to the commissioner of health case mix assessments that conform 
166.33 	with the assessment schedule defined by Code of Federal Regulations, title 42, section 
166.34 	483.20, and published by the United States Department of Health and Human Services, 
166.35 	Centers for Medicare and Medicaid Services, in the Long Term Care Assessment 
167.1 	Instrument User's Manual, version 2.0, October 1995, and subsequent clarifications made 
167.2 	in the Long-Term Care Assessment Instrument Questions and Answers, version 2.0, 
167.3 	August 1996. The commissioner of health may substitute successor manuals or question 
167.4 	and answer documents published by the United States Department of Health and Human 
167.5 	Services, Centers for Medicare and Medicaid Services, to replace or supplement the 
167.6 	current version of the manual or document.
167.7 	(b) The assessments used to determine a case mix classification for reimbursement 
167.8 	include the following:
167.9 	(1) a new admission assessment must be completed by day 14 following admission;
167.10 	(2) an annual assessment must be completed within 366 days of the last 
167.11 	comprehensive assessment;
167.12 	(3) a significant change assessment must be completed within 14 days of the 
167.13 	identification of a significant change; and
167.14 	(4) the second quarterly assessment following either a new admission assessment, 
167.15 	an annual assessment, or a significant change assessment, and all quarterly assessments 
167.16 	beginning October 1, 2006. Each quarterly assessment must be completed within 92 
167.17 	days of the previous assessment.
167.18 	(c) In addition to the assessments listed in paragraph (b), the assessments used to 
167.19 	determine nursing facility level of care include the following:
167.20 	(1) preadmission screening completed under section 256B.0911, subdivision 4a, 
167.21 	by a county, tribe, or managed care organization under contract with the Department 
167.22 	of Human Services; and
167.23 	(2) a face-to-face long-term care consultation assessment completed under section 
167.24 	256B.0911, subdivision 3a, 3b, or 4d, by a county, tribe, or managed care organization 
167.25 	under contract with the Department of Human Services.

167.26 	EFFECTIVE DATE. The section is effective July 1, 2011.

167.27 	Sec. 3. Minnesota Statutes 2008, section 144.0724, subdivision 8, is amended to read:
167.28 		Subd. 8.Request for reconsideration of resident classifications. (a) The resident, 
167.29 	or resident's representative, or the nursing facility or boarding care home may request that 
167.30 	the commissioner of health reconsider the assigned reimbursement classification. The 
167.31 	request for reconsideration must be submitted in writing to the commissioner within 
167.32 	30 days of the day the resident or the resident's representative receives the resident 
167.33 	classification notice. The request for reconsideration must include the name of the 
167.34 	resident, the name and address of the facility in which the resident resides, the reasons for 
167.35 	the reconsideration, the requested classification changes, and documentation supporting 
168.1 	the requested classification. The documentation accompanying the reconsideration request 
168.2 	is limited to documentation which establishes that the needs of the resident at the time of 
168.3 	the assessment justify a classification which is different than the classification established 
168.4 	by the commissioner of health.
168.5 	(b) Upon request, the nursing facility must give the resident or the resident's 
168.6 	representative a copy of the assessment form and the other documentation that was given 
168.7 	to the commissioner of health to support the assessment findings. The nursing facility 
168.8 	shall also provide access to and a copy of other information from the resident's record that 
168.9 	has been requested by or on behalf of the resident to support a resident's reconsideration 
168.10 	request. A copy of any requested material must be provided within three working days of 
168.11 	receipt of a written request for the information. If a facility fails to provide the material 
168.12 	within this time, it is subject to the issuance of a correction order and penalty assessment 
168.13 	under sections 144.653 and 144A.10. Notwithstanding those sections, any correction order 
168.14 	issued under this subdivision must require that the nursing facility immediately comply 
168.15 	with the request for information and that as of the date of the issuance of the correction 
168.16 	order, the facility shall forfeit to the state a $100 fine for the first day of noncompliance, and 
168.17 	an increase in the $100 fine by $50 increments for each day the noncompliance continues. 
168.18 	(c) In addition to the information required under paragraphs (a) and (b), a 
168.19 	reconsideration request from a nursing facility must contain the following information: (i) 
168.20 	the date the reimbursement classification notices were received by the facility; (ii) the date 
168.21 	the classification notices were distributed to the resident or the resident's representative; 
168.22 	and (iii) a copy of a notice sent to the resident or to the resident's representative. This 
168.23 	notice must inform the resident or the resident's representative that a reconsideration of the 
168.24 	resident's classification is being requested, the reason for the request, that the resident's 
168.25 	rate will change if the request is approved by the commissioner, the extent of the change, 
168.26 	that copies of the facility's request and supporting documentation are available for review, 
168.27 	and that the resident also has the right to request a reconsideration. If the facility fails to 
168.28 	provide the required information with the reconsideration request, the request must be 
168.29 	denied, and the facility may not make further reconsideration requests on that specific 
168.30 	reimbursement classification.
168.31 	(d) Reconsideration by the commissioner must be made by individuals not involved 
168.32 	in reviewing the assessment, audit, or reconsideration that established the disputed 
168.33 	classification. The reconsideration must be based upon the initial assessment and upon the 
168.34 	information provided to the commissioner under paragraphs (a) and (b). If necessary for 
168.35 	evaluating the reconsideration request, the commissioner may conduct on-site reviews. 
168.36 	Within 15 working days of receiving the request for reconsideration, the commissioner 
169.1 	shall affirm or modify the original resident classification. The original classification 
169.2 	must be modified if the commissioner determines that the assessment resulting in the 
169.3 	classification did not accurately reflect the needs or assessment characteristics of the 
169.4 	resident at the time of the assessment. The resident and the nursing facility or boarding 
169.5 	care home shall be notified within five working days after the decision is made. A decision 
169.6 	by the commissioner under this subdivision is the final administrative decision of the 
169.7 	agency for the party requesting reconsideration.
169.8 	(e) The resident classification established by the commissioner shall be the 
169.9 	classification that applies to the resident while the request for reconsideration is pending.
169.10 	If a request for reconsideration applies to an assessment used to determine nursing facility 
169.11 	level of care under subdivision 4, paragraph (c), the resident shall continue to be eligible 
169.12 	for nursing facility level of care while the request for reconsideration is pending.
169.13 	(f) The commissioner may request additional documentation regarding a 
169.14 	reconsideration necessary to make an accurate reconsideration determination.

169.15 	EFFECTIVE DATE. The section is effective July 1, 2011.

169.16 	Sec. 4. Minnesota Statutes 2008, section 144.0724, is amended by adding a subdivision 
169.17 	to read:
169.18 		Subd. 11.Nursing facility level of care. (a) For purposes of medical assistance 
169.19 	payment of long-term care services, a recipient must be determined, using assessments 
169.20 	defined in subdivision 4, to meet one of the following nursing facility level of care criteria:
169.21 	(1) the person needs the assistance of another person or constant supervision to begin 
169.22 	and complete at least four of the following activities of living: bathing, bed mobility, 
169.23 	dressing, eating, grooming, toileting, transferring, and walking; 
169.24 	(2) the person needs the assistance of another person or constant supervision to begin 
169.25 	and complete toileting, transferring, or positioning and the assistance cannot be scheduled;
169.26 	(3) the person has significant difficulty with memory, using information, daily 
169.27 	decision making, or behavioral needs that require intervention;
169.28 	(4) the person has had a qualifying nursing facility stay of at least 90 days; or
169.29 	(5) the person is determined to be at risk for nursing facility admission or 
169.30 	readmission through a face-to-face long-term care consultation assessment as specified 
169.31 	in section 256B.0911, subdivision 3a, 3b, or 4d, by a county, tribe, or managed care 
169.32 	organization under contract with the Department of Human Services. The person is 
169.33 	considered at risk under this clause if the person currently lives alone or will live alone 
169.34 	upon discharge and also meets one of the following criteria:
169.35 	(i) the person has experienced a fall resulting in a fracture;
170.1 	(ii) the person has been determined to be at risk of maltreatment or neglect, 
170.2 	including self-neglect; or
170.3 	(iii) the person has a sensory impairment that substantially impacts functional ability 
170.4 	and maintenance of a community residence.
170.5 	(b) The assessment used to establish medical assistance payment for nursing facility 
170.6 	services must be the most recent assessment performed under subdivision 4, paragraph 
170.7 	(b), that occurred no more than 90 calendar days before the effective date of medical 
170.8 	assistance eligibility for payment of long-term care services. In no case shall medical 
170.9 	assistance payment for long-term care services occur prior to the date of the determination 
170.10 	of nursing facility level of care.
170.11 	(c) The assessment used to establish medical assistance payment for long-term care 
170.12 	services provided under sections 256B.0915 and 256B.49 and alternative care payment 
170.13 	for services provided under section 256B.0913 must be the most recent face-to-face 
170.14 	assessment performed under subdivision 4, paragraph (c), clause (2), that occurred no 
170.15 	more than 60 calendar days before the effective date of medical assistance eligibility 
170.16 	for payment of long-term care services.

170.17 	EFFECTIVE DATE. The section is effective July 1, 2011.

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

170.24 	EFFECTIVE DATE. The section is effective July 1, 2011.

170.25 	Sec. 6. Minnesota Statutes 2008, section 144A.073, is amended by adding a 
170.26 	subdivision to read:
170.27 		Subd. 12.Extension of approval of moratorium exception projects.
 170.28 	Notwithstanding subdivision 3, the commissioner of health shall extend project approval 
170.29 	by an additional 18 months for an approved proposal for an exception to the nursing home 
170.30 	licensure and certification moratorium if the proposal was approved under this section 
170.31 	between July 1, 2007, and June 30, 2009.

170.32 	Sec. 7. Minnesota Statutes 2008, section 144A.44, subdivision 2, is amended to read:
171.1 		Subd. 2.Interpretation and enforcement of rights. These rights are established 
171.2 	for the benefit of persons who receive home care services. "Home care services" means 
171.3 	home care services as defined in section 144A.43, subdivision 3, and unlicensed personal 
171.4 	care assistance services, including services covered by medical assistance under section 
171.5 	256B.0625, subdivision 19a. A home care provider may not require a person to surrender 
171.6 	these rights as a condition of receiving services. A guardian or conservator or, when there 
171.7 	is no guardian or conservator, a designated person, may seek to enforce these rights. This 
171.8 	statement of rights does not replace or diminish other rights and liberties that may exist 
171.9 	relative to persons receiving home care services, persons providing home care services, or 
171.10 	providers licensed under Laws 1987, chapter 378. A copy of these rights must be provided 
171.11 	to an individual at the time home care services, including personal care assistance 
171.12 	services, are initiated. The copy shall also contain the address and phone number of the 
171.13 	Office of Health Facility Complaints and the Office of Ombudsman for Long-Term Care 
171.14 	and a brief statement describing how to file a complaint with these offices. Information 
171.15 	about how to contact the Office of Ombudsman for Long-Term Care shall be included in 
171.16 	notices of change in client fees and in notices where home care providers initiate transfer 
171.17 	or discontinuation of services. 

171.18 	Sec. 8. Minnesota Statutes 2008, section 245A.03, is amended by adding a subdivision 
171.19 	to read:
171.20 		Subd. 7.Licensing moratorium. (a) The commissioner shall not issue an 
171.21 	initial license for child foster care licensed under Minnesota Rules, parts 2960.3000 to 
171.22 	2960.3340, or adult foster care licensed under Minnesota Rules, parts 9555.5105 to 
171.23 	9555.6265, under this chapter for a physical location that will not be the primary residence 
171.24 	of the license holder for the entire period of licensure. If a license is issued during this 
171.25 	moratorium, and the license holder changes the license holder's primary residence away 
171.26 	from the physical location of the foster care license, the commissioner shall revoke the 
171.27 	license according to section 245A.07. Exceptions to the moratorium include:
171.28 	(1) foster care settings that are required to be registered under chapter 144D;
171.29 	(2) foster care licenses replacing foster care licenses in existence on the effective 
171.30 	date of this section and determined to be needed by the commissioner under paragraph (b);
171.31 	(3) new foster care licenses determined to be needed by the commissioner under 
171.32 	paragraph (b) for the closure of a nursing facility, ICF/MR, or regional treatment center;
171.33 	(4) new foster care licenses determined to be needed by the commissioner under 
171.34 	paragraph (b) for persons requiring hospital level of care; 
172.1 	(5) new foster care licenses determined to be needed by the commissioner for the 
172.2 	transition of people from personal care assistance to the home and community-based 
172.3 	services; or
172.4 	(6) new foster care residences in development that have received county approval 
172.5 	prior to June 1, 2009, but may not have received a license from the commissioner for 
172.6 	the actual residence.
172.7 	(b) The commissioner shall determine the need for newly licensed foster care homes 
172.8 	as defined under this subdivision. As part of the determination, the commissioner shall 
172.9 	consider the availability of foster care capacity in the area which the licensee seeks to 
172.10 	operate, and the recommendation of the local county board. The determination by the 
172.11 	commissioner must be final. A determination of need is not required for a change in 
172.12 	ownership at the same address.
172.13 	(c) Residential settings that would otherwise fall under the moratorium established in 
172.14 	paragraph (a), that are in the process of receiving an adult or child foster care license as of 
172.15 	July 1, 2009, must be able to continue to complete the process of receiving an adult or child 
172.16 	foster care license. For purposes of this paragraph, all of the following conditions must be 
172.17 	met to be considered in the process of receiving an adult or child foster care license:
172.18 	(1) participants have made decisions to move into the residential setting, including 
172.19 	documentation in each participant's care plans;
172.20 	(2) the provider has purchased housing or has made a financial investment in the 
172.21 	property;
172.22 	(3) the lead agency has approved the plans, including costs for the residential setting 
172.23 	for each individual;
172.24 	(4) the completion of the licensing process, including all necessary inspections, is 
172.25 	the only remaining component prior to being able to provide services; and
172.26 	(5) the needs of the individuals cannot be met within the existing capacity in that 
172.27 	county.
172.28 	To qualify for the process under this paragraph, the lead agency must submit 
172.29 	documentation to the commissioner by August 1, 2009, that all of the criteria in this 
172.30 	paragraph are met.
172.31 	(d) The commissioner shall study the effects of the license moratorium under this 
172.32 	subdivision and shall report back to the legislature by January 15, 2011.

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

173.1 	Sec. 9. Minnesota Statutes 2008, section 245A.11, is amended by adding a subdivision 
173.2 	to read:
173.3 		Subd. 8.Community residential setting license. (a) The commissioner shall 
173.4 	establish provider standards for residential support services that integrate service standards 
173.5 	and the residential setting under one license. The commissioner shall propose statutory 
173.6 	language and an implementation plan for licensing requirements for residential support 
173.7 	services to the legislature by January 15, 2011.
173.8 	(b) Providers licensed under chapter 245B, and providing, contracting, or arranging 
173.9 	for services in settings licensed as adult foster care under Minnesota Rules, parts 
173.10 	9555.5105 to 9555.6265, or child foster care under Minnesota Rules, parts 2960.3000 to 
173.11 	2960.3340; and meeting the provisions of section 256B.092, subdivision 11, paragraph 
173.12 	(b), must be required to obtain a community residential setting license.

173.13 	Sec. 10. Minnesota Statutes 2008, section 252.46, is amended by adding a subdivision 
173.14 	to read:
173.15 		Subd. 1a.Day training and habilitation rates. The commissioner shall establish 
173.16 	a statewide rate-setting methodology for all day training and habilitation services. The 
173.17 	rate-setting methodology must abide by the principles of transparency and equitability 
173.18 	across the state. The methodology must involve a uniform process of structuring rates for 
173.19 	each service and must promote quality and participant choice.

173.20 	Sec. 11. Minnesota Statutes 2008, section 252.50, subdivision 1, is amended to read:
173.21 		Subdivision 1. Community-based programs established. The commissioner 
173.22 	shall establish a system of state-operated, community-based programs for persons with 
173.23 	developmental disabilities. For purposes of this section, "state-operated, community-based 
173.24 	program" means a program administered by the state to provide treatment and habilitation 
173.25 	in noninstitutional community settings to persons with developmental disabilities. 
173.26 	Employees of the programs, except clients who work within and benefit from these 
173.27 	treatment and habilitation programs, must be state employees under chapters 43A and 
173.28 	179A. Although any clients who work within and benefit from these treatment and 
173.29 	habilitation programs are not employees under chapters 43A and 179A, the Department 
173.30 	of Human Services may consider clients who work within and benefit from these 
173.31 	programs employees for federal tax purposes. The establishment of state-operated, 
173.32 	community-based programs must be within the context of a comprehensive definition of 
173.33 	the role of state-operated services in the state. The role of state-operated services must 
173.34 	be defined within the context of a comprehensive system of services for persons with 
174.1 	developmental disabilities. State-operated, community-based programs may include, but 
174.2 	are not limited to, community group homes, foster care, supportive living services, day 
174.3 	training and habilitation programs, and respite care arrangements. The commissioner 
174.4 	may operate the pilot projects established under Laws 1985, First Special Session 
174.5 	chapter 9, article 1, section 2, subdivision 6, and shall, within the limits of available 
174.6 	appropriations, establish additional state-operated, community-based programs for 
174.7 	persons with developmental disabilities. State-operated, community-based programs may 
174.8 	accept admissions from regional treatment centers, from the person's own home, or from 
174.9 	community programs. State-operated, community-based programs offering day program 
174.10 	services may be provided for persons with developmental disabilities who are living in 
174.11 	state-operated, community-based residential programs until July 1, 2000. No later than 
174.12 	1994, the commissioner, together with family members, counties, advocates, employee 
174.13 	representatives, and other interested parties, shall begin planning so that by July 1, 2000, 
174.14 	state-operated, community-based residential facilities will be in compliance with section 
174.15 	252.41, subdivision 9. 

174.16 	Sec. 12. Minnesota Statutes 2008, section 256.01, is amended by adding a subdivision 
174.17 	to read:
174.18 		Subd. 29.State medical review team. (a) To ensure the timely processing of 
174.19 	determinations of disability by the commissioner's state medical review team under 
174.20 	sections 256B.055, subdivision 7, paragraph (b), and 256B.057, subdivision 9, paragraph 
174.21 	(j), the commissioner shall review all medical evidence submitted by county agencies with 
174.22 	a referral and seek additional information from providers, applicants, and enrollees to 
174.23 	support the determination of disability where necessary.
174.24 	(b) Prior to a denial or withdrawal of a requested determination of disability due 
174.25 	to insufficient evidence, the commissioner shall (1) ensure that the missing evidence is 
174.26 	necessary and appropriate to a determination of disability, and (2) assist applicants and 
174.27 	enrollees to obtain the evidence, including, but not limited to, medical examinations 
174.28 	and electronic medical records.
174.29 	(c) The commissioner shall provide the chairs of the legislative committees with 
174.30 	jurisdiction over health and human services finance and budget the following information 
174.31 	on the activities of the state medical review team by February 1, 2010, and annually 
174.32 	thereafter:
174.33 	(1) the number of applications to the state medical review team that were denied, 
174.34 	approved, or withdrawn;
174.35 	(2) the average length of time from receipt of the application to a decision;
175.1 	(3) the number of appeals and appeal results;
175.2 	(4) for applicants, their age, health coverage at the time of application, hospitalization 
175.3 	history within three months of application, and whether an application for Social Security 
175.4 	or Supplemental Security Income benefits is pending; and 
175.5 	(5) specific information on the medical certification, licensure, or other credentials 
175.6 	of the person or persons performing the medical review determinations and length of 
175.7 	time in that position.

175.8 	Sec. 13. [256.0281] INTERAGENCY DATA EXCHANGE.
175.9 	The Department of Human Services, the Department of Health, and the Office of the 
175.10 	Ombudsman for Mental Health and Developmental Disabilities may establish interagency 
175.11 	agreements governing the electronic exchange of data on providers and individuals 
175.12 	collected, maintained, or used by each agency when such exchange is outlined by each 
175.13 	agency in an interagency agreement to accomplish the purposes in clauses (1) to (4):
175.14 	(1) to improve provider enrollment processes for home and community-based 
175.15 	services and state plan home care services;
175.16 	(2) to improve quality management of providers between state agencies;
175.17 	(3) to establish and maintain provider eligibility to participate as providers under 
175.18 	Minnesota health care programs; and
175.19 	(4) to meet the quality assurance reporting requirements under federal law under 
175.20 	section 1915(c) of the Social Security Act related to home and community-based waiver 
175.21 	programs.
175.22 	Each interagency agreement must include provisions to ensure anonymity of individuals, 
175.23 	including mandated reporters, and must outline the specific uses of and access to shared 
175.24 	data within each agency. Electronic interfaces between source data systems developed 
175.25 	under these interagency agreements must incorporate these provisions as well as other 
175.26 	HIPPA provisions related to individual data.

175.27 	Sec. 14. Minnesota Statutes 2008, section 256.476, subdivision 5, is amended to read:
175.28 		Subd. 5. Reimbursement, allocations, and reporting. (a) For the purpose of 
175.29 	transferring persons to the consumer support grant program from the family support 
175.30 	program and personal care assistant services, home health aide services, or private duty 
175.31 	nursing services, the amount of funds transferred by the commissioner between the 
175.32 	family support program account, the medical assistance account, or the consumer support 
175.33 	grant account shall be based on each county's participation in transferring persons to the 
175.34 	consumer support grant program from those programs and services. 
176.1 	(b) At the beginning of each fiscal year, county allocations for consumer support 
176.2 	grants shall be based on: 
176.3 	(1) the number of persons to whom the county board expects to provide consumer 
176.4 	supports grants; 
176.5 	(2) their eligibility for current program and services; 
176.6 	(3) the amount of nonfederal dollars monthly grant levels allowed under subdivision 
176.7 	11; and 
176.8 	(4) projected dates when persons will start receiving grants. County allocations shall 
176.9 	be adjusted periodically by the commissioner based on the actual transfer of persons or 
176.10 	service openings, and the nonfederal dollars monthly grant levels associated with those 
176.11 	persons or service openings, to the consumer support grant program. 
176.12 	(c) The amount of funds transferred by the commissioner from the medical 
176.13 	assistance account for an individual may be changed if it is determined by the county or its 
176.14 	agent that the individual's need for support has changed. 
176.15 	(d) The authority to utilize funds transferred to the consumer support grant account 
176.16 	for the purposes of implementing and administering the consumer support grant program 
176.17 	will not be limited or constrained by the spending authority provided to the program 
176.18 	of origination. 
176.19 	(e) The commissioner may use up to five percent of each county's allocation, as 
176.20 	adjusted, for payments for administrative expenses, to be paid as a proportionate addition 
176.21 	to reported direct service expenditures. 
176.22 	(f) The county allocation for each person or the person's legal representative or other 
176.23 	authorized representative cannot exceed the amount allowed under subdivision 11. 
176.24 	(g) The commissioner may recover, suspend, or withhold payments if the county 
176.25 	board, local agency, or grantee does not comply with the requirements of this section. 
176.26 	(h) Grant funds unexpended by consumers shall return to the state once a year. The 
176.27 	annual return of unexpended grant funds shall occur in the quarter following the end of 
176.28 	the state fiscal year. 

176.29 	Sec. 15. Minnesota Statutes 2008, section 256.476, subdivision 11, is amended to read:
176.30 		Subd. 11.Consumer support grant program after July 1, 2001. (a) Effective 
176.31 	July 1, 2001, the commissioner shall allocate consumer support grant resources to 
176.32 	serve additional individuals based on a review of Medicaid authorization and payment 
176.33 	information of persons eligible for a consumer support grant from the most recent fiscal 
176.34 	year. The commissioner shall use the following methodology to calculate maximum 
176.35 	allowable monthly consumer support grant levels:
177.1 	(1) For individuals whose program of origination is medical assistance home care 
177.2 	under sections 256B.0651 and 256B.0653 to 256B.0656, the maximum allowable monthly 
177.3 	grant levels are calculated by:
177.4 	(i) determining the nonfederal share 50 percent of the average service authorization 
177.5 	for each home care rating;
177.6 	(ii) calculating the overall ratio of actual payments to service authorizations by 
177.7 	program;
177.8 	(iii) applying the overall ratio to the average service authorization level of each 
177.9 	home care rating;
177.10 	(iv) adjusting the result for any authorized rate increases provided by the legislature; 
177.11 	and
177.12 	(v) adjusting the result for the average monthly utilization per recipient.
177.13 	(2) The commissioner may review and evaluate the methodology to reflect changes 
177.14 	in the home care program's overall ratio of actual payments to service authorizations
177.15 	programs.
177.16 	(b) Effective January 1, 2004, persons previously receiving exception grants will 
177.17 	have their grants calculated using the methodology in paragraph (a), clause (1). If a person 
177.18 	currently receiving an exception grant wishes to have their home care rating reevaluated, 
177.19 	they may request an assessment as defined in section 256B.0651, subdivision 1, paragraph 
177.20 	(b).

177.21 	Sec. 16. Minnesota Statutes 2008, section 256.975, subdivision 7, is amended to read:
177.22 		Subd. 7.Consumer information and assistance; senior linkage. (a) The 
177.23 	Minnesota Board on Aging shall operate a statewide information and assistance service 
177.24 	to aid older Minnesotans and their families in making informed choices about long-term 
177.25 	care options and health care benefits. Language services to persons with limited English 
177.26 	language skills may be made available. The service, known as Senior LinkAge Line, must 
177.27 	be available during business hours through a statewide toll-free number and must also 
177.28 	be available through the Internet.
177.29 	(b) The service must assist provide long-term care options counseling by assisting
177.30 	older adults, caregivers, and providers in accessing information about choices in long-term 
177.31 	care services that are purchased through private providers or available through public 
177.32 	options. The service must:
177.33 	(1) develop a comprehensive database that includes detailed listings in both 
177.34 	consumer- and provider-oriented formats;
178.1 	(2) make the database accessible on the Internet and through other telecommunication 
178.2 	and media-related tools;
178.3 	(3) link callers to interactive long-term care screening tools and make these tools 
178.4 	available through the Internet by integrating the tools with the database;
178.5 	(4) develop community education materials with a focus on planning for long-term 
178.6 	care and evaluating independent living, housing, and service options;
178.7 	(5) conduct an outreach campaign to assist older adults and their caregivers in 
178.8 	finding information on the Internet and through other means of communication;
178.9 	(6) implement a messaging system for overflow callers and respond to these callers 
178.10 	by the next business day;
178.11 	(7) link callers with county human services and other providers to receive more 
178.12 	in-depth assistance and consultation related to long-term care options;
178.13 	(8) link callers with quality profiles for nursing facilities and other providers 
178.14 	developed by the commissioner of health; and
178.15 	(9) incorporate information about housing with services and consumer rights 
178.16 	within the MinnesotaHelp.info network long-term care database to facilitate consumer 
178.17 	comparison of services and costs among housing with services establishments and with 
178.18 	other in-home services and to support financial self-sufficiency as long as possible. 
178.19 	Housing with services establishments and their arranged home care providers shall provide 
178.20 	information to the commissioner of human services that is consistent with information 
178.21 	required by the commissioner of health under section 144G.06, the Uniform Consumer 
178.22 	Information Guide price and other information requested by the commissioner of human 
178.23 	services regarding rents and services. The commissioners of human services and health 
178.24 	shall align the data elements required by this section, and section 144G.06, the Uniform 
178.25 	Consumer Information Guide, to provide consumers standardized information and ease 
178.26 	of comparison of long-term care options. The commissioner of human services shall 
178.27 	provide the data to the Minnesota Board on Aging for inclusion in the MinnesotaHelp.info 
178.28 	network long-term care database.; and
178.29 	(10) provide long-term care options counseling. Long-term care options counselors 
178.30 	shall:
178.31 	(i) for individuals not eligible for case management under a public program or 
178.32 	public funding source, provide interactive decision support whereby consumers, family 
178.33 	members, or other helpers are supported in their deliberations to determine appropriate 
178.34 	long-term care choices in the context of the consumer's needs, preferences, values, and 
178.35 	individual circumstances including implementing a community support plan;
179.1 	(ii) provide Web-based educational information and collateral written materials to 
179.2 	familiarize consumers, family members, or other helpers with the long-term care basics, 
179.3 	issues to be considered, and the range of options available in the community;
179.4 	(iii) provide long-term care futures planning defined as providing assistance to 
179.5 	individuals who anticipate having long-term care needs to develop a plan for the more 
179.6 	distant future; and
179.7 	(iv) provide expertise in benefits and financing options for long-term care including 
179.8 	Medicare, long-term care insurance, tax or employer-based incentives, reverse mortgages, 
179.9 	private pay options, and ways to access low or no-cost services or benefits through 
179.10 	volunteer-based or charitable programs.
179.11 	(c) The Minnesota Board on Aging shall conduct an evaluation of the effectiveness 
179.12 	of the statewide information and assistance, and submit this evaluation to the legislature 
179.13 	by December 1, 2002. The evaluation must include an analysis of funding adequacy, gaps 
179.14 	in service delivery, continuity in information between the service and identified linkages, 
179.15 	and potential use of private funding to enhance the service.

179.16 	Sec. 17. Minnesota Statutes 2008, section 256B.055, subdivision 7, is amended to read:
179.17 		Subd. 7.Aged, blind, or disabled persons. (a) Medical assistance may be paid for 
179.18 	a person who meets the categorical eligibility requirements of the supplemental security 
179.19 	income program or, who would meet those requirements except for excess income or 
179.20 	assets, and who meets the other eligibility requirements of this section.
179.21 	(b) Following a determination that the applicant is not aged or blind and does not 
179.22 	meet any other category of eligibility for medical assistance and has not been determined 
179.23 	disabled by the Social Security Administration, applicants under this subdivision shall be 
179.24 	referred to the commissioner's state medical review team for a determination of disability. 
179.25 	Disability shall be determined according to the rules of title XVI and title XIX of the 
179.26 	Social Security Act and pertinent rules and policies of the Social Security Administration.

179.27 	Sec. 18. Minnesota Statutes 2008, section 256B.057, subdivision 9, is amended to read:
179.28 		Subd. 9.Employed persons with disabilities. (a) Medical assistance may be paid 
179.29 	for a person who is employed and who:
179.30 	(1) meets the definition of disabled under the supplemental security income program;
179.31 	(2) is at least 16 but less than 65 years of age;
179.32 	(3) meets the asset limits in paragraph (c); and
179.33 	(4) effective November 1, 2003, pays a premium and other obligations under 
179.34 	paragraph (e).
180.1 	Any spousal income or assets shall be disregarded for purposes of eligibility and premium 
180.2 	determinations.
180.3 	(b) After the month of enrollment, a person enrolled in medical assistance under 
180.4 	this subdivision who:
180.5 	(1) is temporarily unable to work and without receipt of earned income due to a 
180.6 	medical condition, as verified by a physician, may retain eligibility for up to four calendar 
180.7 	months; or
180.8 	(2) effective January 1, 2004, loses employment for reasons not attributable to the 
180.9 	enrollee, may retain eligibility for up to four consecutive months after the month of job 
180.10 	loss. To receive a four-month extension, enrollees must verify the medical condition or 
180.11 	provide notification of job loss. All other eligibility requirements must be met and the 
180.12 	enrollee must pay all calculated premium costs for continued eligibility.
180.13 	(c) For purposes of determining eligibility under this subdivision, a person's assets 
180.14 	must not exceed $20,000, excluding:
180.15 	(1) all assets excluded under section 256B.056;
180.16 	(2) retirement accounts, including individual accounts, 401(k) plans, 403(b) plans, 
180.17 	Keogh plans, and pension plans; and
180.18 	(3) medical expense accounts set up through the person's employer.
180.19 	(d)(1) Effective January 1, 2004, for purposes of eligibility, there will be a $65 
180.20 	earned income disregard. To be eligible, a person applying for medical assistance under 
180.21 	this subdivision must have earned income above the disregard level.
180.22 	(2) Effective January 1, 2004, to be considered earned income, Medicare, Social 
180.23 	Security, and applicable state and federal income taxes must be withheld. To be eligible, 
180.24 	a person must document earned income tax withholding.
180.25 	(e)(1) A person whose earned and unearned income is equal to or greater than 100 
180.26 	percent of federal poverty guidelines for the applicable family size must pay a premium 
180.27 	to be eligible for medical assistance under this subdivision. The premium shall be based 
180.28 	on the person's gross earned and unearned income and the applicable family size using a 
180.29 	sliding fee scale established by the commissioner, which begins at one percent of income 
180.30 	at 100 percent of the federal poverty guidelines and increases to 7.5 percent of income 
180.31 	for those with incomes at or above 300 percent of the federal poverty guidelines. Annual 
180.32 	adjustments in the premium schedule based upon changes in the federal poverty guidelines 
180.33 	shall be effective for premiums due in July of each year.
180.34 	(2) Effective January 1, 2004, all enrollees must pay a premium to be eligible for 
180.35 	medical assistance under this subdivision. An enrollee shall pay the greater of a $35 
180.36 	premium or the premium calculated in clause (1).
181.1 	(3) Effective November 1, 2003, all enrollees who receive unearned income must 
181.2 	pay one-half of one percent of unearned income in addition to the premium amount.
181.3 	(4) Effective November 1, 2003, for enrollees whose income does not exceed 200 
181.4 	percent of the federal poverty guidelines and who are also enrolled in Medicare, the 
181.5 	commissioner must reimburse the enrollee for Medicare Part B premiums under section 
181.6 	256B.0625, subdivision 15, paragraph (a).
181.7 	(5) Increases in benefits under title II of the Social Security Act shall not be counted 
181.8 	as income for purposes of this subdivision until July 1 of each year.
181.9 	(f) A person's eligibility and premium shall be determined by the local county 
181.10 	agency. Premiums must be paid to the commissioner. All premiums are dedicated to 
181.11 	the commissioner.
181.12 	(g) Any required premium shall be determined at application and redetermined at 
181.13 	the enrollee's six-month income review or when a change in income or household size is 
181.14 	reported. Enrollees must report any change in income or household size within ten days 
181.15 	of when the change occurs. A decreased premium resulting from a reported change in 
181.16 	income or household size shall be effective the first day of the next available billing month 
181.17 	after the change is reported. Except for changes occurring from annual cost-of-living 
181.18 	increases, a change resulting in an increased premium shall not affect the premium amount 
181.19 	until the next six-month review.
181.20 	(h) Premium payment is due upon notification from the commissioner of the 
181.21 	premium amount required. Premiums may be paid in installments at the discretion of 
181.22 	the commissioner.
181.23 	(i) Nonpayment of the premium shall result in denial or termination of medical 
181.24 	assistance unless the person demonstrates good cause for nonpayment. Good cause exists 
181.25 	if the requirements specified in Minnesota Rules, part 9506.0040, subpart 7, items B to 
181.26 	D, are met. Except when an installment agreement is accepted by the commissioner, 
181.27 	all persons disenrolled for nonpayment of a premium must pay any past due premiums 
181.28 	as well as current premiums due prior to being reenrolled. Nonpayment shall include 
181.29 	payment with a returned, refused, or dishonored instrument. The commissioner may 
181.30 	require a guaranteed form of payment as the only means to replace a returned, refused, 
181.31 	or dishonored instrument.
181.32 	(j) Following a determination that the applicant is not aged or blind and does not 
181.33 	meet any other category of eligibility for medical assistance and has not been determined 
181.34 	disabled by the Social Security Administration, applicants under this subdivision shall be 
181.35 	referred to the commissioner's state medical review team for a determination of disability. 
182.1 	Disability shall be determined according to the rules of title XVI and title XIX of the 
182.2 	Social Security Act and pertinent rules and policies of the Social Security Administration.

182.3 	Sec. 19. Minnesota Statutes 2008, section 256B.0625, subdivision 7, is amended to 
182.4 	read:
182.5 		Subd. 7.Private duty nursing. Medical assistance covers private duty nursing 
182.6 	services in a recipient's home. Recipients who are authorized to receive private duty 
182.7 	nursing services in their home may use approved hours outside of the home during hours 
182.8 	when normal life activities take them outside of their home. To use private duty nursing 
182.9 	services at school, the recipient or responsible party must provide written authorization in 
182.10 	the care plan identifying the chosen provider and the daily amount of services to be used at 
182.11 	school. Medical assistance does not cover private duty nursing services for residents of a 
182.12 	hospital, nursing facility, intermediate care facility, or a health care facility licensed by the 
182.13 	commissioner of health, except as authorized in section 256B.64 for ventilator-dependent 
182.14 	recipients in hospitals or unless a resident who is otherwise eligible is on leave from the 
182.15 	facility and the facility either pays for the private duty nursing services or forgoes the 
182.16 	facility per diem for the leave days that private duty nursing services are used. Total 
182.17 	hours of service and payment allowed for services outside the home cannot exceed 
182.18 	that which is otherwise allowed in an in-home setting according to sections 256B.0651
182.19 	and 256B.0653256B.0654 to 256B.0656. All private duty nursing services must be 
182.20 	provided according to the limits established under sections 256B.0651 and 256B.0653
182.21 	to 256B.0656. Private duty nursing services may not be reimbursed if the nurse is the 
182.22 	family foster care provider of a recipient who is under age 18 except as allowed under 
182.23 	section 256B.0659, subdivision 4.

182.24 	Sec. 20. Minnesota Statutes 2008, section 256B.0625, subdivision 8, is amended to 
182.25 	read:
182.26 		Subd. 8.Physical therapy. Medical assistance covers physical therapy, as 
182.27 	described in section 148.65, and related services, including specialized maintenance 
182.28 	therapy. Services provided by a physical therapy assistant shall be reimbursed at the 
182.29 	same rate as services performed by a physical therapist when the services of the physical 
182.30 	therapy assistant are provided under the direction of a physical therapist who is on the 
182.31 	premises. Services provided by a physical therapy assistant that are provided under the 
182.32 	direction of a physical therapist who is not on the premises shall be reimbursed at 65 
182.33 	percent of the physical therapist rate.

183.1 	Sec. 21. Minnesota Statutes 2008, section 256B.0625, subdivision 8a, is amended to 
183.2 	read:
183.3 		Subd. 8a.Occupational therapy. Medical assistance covers occupational therapy, 
183.4 	as described in section 148.6404, and related services, including specialized maintenance 
183.5 	therapy. Services provided by an occupational therapy assistant shall be reimbursed at 
183.6 	the same rate as services performed by an occupational therapist when the services of 
183.7 	the occupational therapy assistant are provided under the direction of the occupational 
183.8 	therapist who is on the premises. Services provided by an occupational therapy assistant 
183.9 	that are provided under the direction of an occupational therapist who is not on the 
183.10 	premises shall be reimbursed at 65 percent of the occupational therapist rate.

183.11 	Sec. 22. Minnesota Statutes 2008, section 256B.0625, subdivision 19a, is amended to 
183.12 	read:
183.13 		Subd. 19a.Personal care assistant services. Medical assistance covers personal 
183.14 	care assistant services in a recipient's home. To qualify for personal care assistant services, 
183.15 	a recipient must require assistance and be determined dependent in one activity of daily 
183.16 	living as defined in section 256B.0659 or have a level I behavior as defined in section 
183.17 	256B.0659. Recipients or responsible parties must be able to identify the recipient's needs, 
183.18 	direct and evaluate task accomplishment, and provide for health and safety. Approved 
183.19 	hours may be used outside the home when normal life activities take them outside the 
183.20 	home. To use personal care assistant services at school, the recipient or responsible party 
183.21 	must provide written authorization in the care plan identifying the chosen provider and the 
183.22 	daily amount of services to be used at school. Total hours for services, whether actually 
183.23 	performed inside or outside the recipient's home, cannot exceed that which is otherwise 
183.24 	allowed for personal care assistant services in an in-home setting according to sections 
183.25 	256B.0651and 256B.0653 to 256B.0656. Medical assistance does not cover personal care 
183.26 	assistant services for residents of a hospital, nursing facility, intermediate care facility, 
183.27 	health care facility licensed by the commissioner of health, or unless a resident who is 
183.28 	otherwise eligible is on leave from the facility and the facility either pays for the personal 
183.29 	care assistant services or forgoes the facility per diem for the leave days that personal care 
183.30 	assistant services are used. All personal care assistant services must be provided according 
183.31 	to sections 256B.0651and 256B.0653 to 256B.0656. Personal care assistant services 
183.32 	may not be reimbursed if the personal care assistant is the spouse or legalpaid guardian 
183.33 	of the recipient or the parent of a recipient under age 18, or the responsible party or the 
183.34 	foster care provider of a recipient who cannot direct the recipient's own care unless, in the 
183.35 	case of a foster care provider,unless the foster home is the licensed provider's primary 
184.1 	residence and a county or state case manager visits the recipient as needed, but not less 
184.2 	than every six months, to monitor the health and safety of the recipient and to ensure the 
184.3 	goals of the care plan are met. Parents of adult recipients, adult children of the recipient 
184.4 	or adult siblings of the recipient may be reimbursed for personal care assistant services, 
184.5 	if they are granted a waiver under sections 256B.0651 and 256B.0653 to 256B.0656. 
184.6 	Notwithstanding the provisions of section 256B.0655, subdivision 2, paragraph (b), clause 
184.7 	(4) 256B.0659, the noncorporate legal unpaid guardian or conservator of an adult, who 
184.8 	is not the responsible party and not the personal care provider organization, may be 
184.9 	granted a hardship waiver under sections 256B.0651 and 256B.0653 to 256B.0656, to be
184.10 	reimbursed to provide personal care assistant services to the recipient if the guardian or 
184.11 	conservator meet all criteria for a personal care assistant according to section 256B.0659, 
184.12 	and shall not be considered to have a service provider interest for purposes of participation 
184.13 	on the screening team under section 256B.092, subdivision 7.

184.14 	Sec. 23. Minnesota Statutes 2008, section 256B.0625, subdivision 19c, is amended to 
184.15 	read:
184.16 		Subd. 19c.Personal care. (a) Medical assistance covers personal care assistant 
184.17 	services provided by an individual who is qualified to provide the services according 
184.18 	to subdivision 19a and sections 256B.0651and 256B.0653 to 256B.0656, where the 
184.19 	services have a statement of need by a physician, provided in accordance with a plan, and 
184.20 	are supervised by the recipient or a qualified professional. The physician's statement of 
184.21 	need for personal care assistant services shall be documented on a form approved by the 
184.22 	commissioner and include the diagnosis or condition of the person that results in a need 
184.23 	for personal care assistant services and be updated when the person's medical condition 
184.24 	requires a change, but at least annually if the need for personal care assistant services is 
184.25 	ongoing.
184.26 	(b) "Qualified professional" means a mental health professional as defined in section 
184.27 	245.462, subdivision 18, or 245.4871, subdivision 27; or a registered nurse as defined in 
184.28 	sections 148.171 to 148.285, or a licensed social worker as defined in section 148B.21; 
184.29 	or qualified developmental disabilities professional under section 245B.07, subdivision 
184.30 	4. As part of the assessment, the county public health nurse will assist the recipient or 
184.31 	responsible party to identify the most appropriate person to provide supervision of the 
184.32 	personal care assistant. The qualified professional shall perform the duties described
184.33 	required in Minnesota Rules, part 9505.0335, subpart 4 section 256B.0659.

185.1 	Sec. 24. Minnesota Statutes 2008, section 256B.0651, is amended to read:
185.2 	256B.0651 HOME CARE SERVICES.
185.3 		Subdivision 1.Definitions. (a) "Activities of daily living" includes eating, toileting, 
185.4 	grooming, dressing, bathing, transferring, mobility, and positioning For the purposes of 
185.5 	sections 256B.0651 to 256B.0656 and 256B.0659, the terms in paragraphs (b) to (g) 
185.6 	have the meanings given.
185.7 	(b) "Activities of daily living" has the meaning given in section 256B.0659, 
185.8 	subdivision 1, paragraph (b).
185.9 	(b) (c) "Assessment" means a review and evaluation of a recipient's need for home 
185.10 	care services conducted in person. Assessments for home health agency services shall be 
185.11 	conducted by a home health agency nurse. Assessments for medical assistance home care 
185.12 	services for developmental disability and alternative care services for developmentally 
185.13 	disabled home and community-based waivered recipients may be conducted by the county 
185.14 	public health nurse to ensure coordination and avoid duplication. Assessments must be 
185.15 	completed on forms provided by the commissioner within 30 days of a request for home 
185.16 	care services by a recipient or responsible party.
185.17 	(c) (d) "Home care services" means a health service, determined by the commissioner 
185.18 	as medically necessary, that is ordered by a physician and documented in a service plan 
185.19 	that is reviewed by the physician at least once every 60 days for the provision of home 
185.20 	health services, or private duty nursing, or at least once every 365 days for personal care. 
185.21 	Home care services are provided to the recipient at the recipient's residence that is a 
185.22 	place other than a hospital or long-term care facility or as specified in section 256B.0625
185.23 	means medical assistance covered services that are home health agency services, including 
185.24 	skilled nurse visits; home health aide visits; physical therapy, occupational therapy, 
185.25 	respiratory therapy, and language-speech pathology therapy; private duty nursing; and 
185.26 	personal care assistance.
185.27 	(e) "Home residence" means a residence owned or rented by the recipient either 
185.28 	alone, with roommates of the recipient's choosing, or with an unpaid responsible party 
185.29 	or legal representative; or a family foster home where the license holder lives with the 
185.30 	recipient and is not paid to provide home care services for the recipient.
185.31 	(d) (f) "Medically necessary" has the meaning given in Minnesota Rules, parts 
185.32 	9505.0170 to 9505.0475.
185.33 	(e) "Telehomecare" means the use of telecommunications technology by a home 
185.34 	health care professional to deliver home health care services, within the professional's 
185.35 	scope of practice, to a patient located at a site other than the site where the practitioner 
185.36 	is located.
186.1 	(g) "Ventilator-dependent" means an individual who receives mechanical ventilation 
186.2 	for life support at least six hours per day and is expected to be or has been dependent on a 
186.3 	ventilator for at least 30 consecutive days.
186.4 		Subd. 2.Services covered. Home care services covered under this section and 
186.5 	sections 256B.0653 256B.0652  to 256B.0656 and 256B.0659 include:
186.6 	(1) nursing services under section sections256B.0625, subdivision 6a, and 
186.7 	256B.0653;
186.8 	(2) private duty nursing services under section sections256B.0625, subdivision 
186.9 	7, and 256B.0654;
186.10 	(3) home health services under section sections256B.0625, subdivision 6a, and 
186.11 	256B.0653;
186.12 	(4) personal care assistant services under section sections256B.0625, subdivision 
186.13 	19a, and 256B.0659;
186.14 	(5) supervision of personal care assistant services provided by a qualified 
186.15 	professional under section sections256B.0625, subdivision 19a, and 256B.0659;
186.16 	(6) qualified professional of personal care assistant services under the fiscal 
186.17 	intermediary option as specified in section 256B.0655, subdivision 7;
186.18 	(7) (6) face-to-face assessments by county public health nurses for services under 
186.19 	section sections256B.0625, subdivision 19a, and 256B.0659; and
186.20 	(8) (7) service updates and review of temporary increases for personal care assistant 
186.21 	services by the county public health nurse for services under section sections256B.0625, 
186.22 	subdivision 19a, and 256B.0659.
186.23 		Subd. 3.Noncovered home care services. The following home care services are 
186.24 	not eligible for payment under medical assistance:
186.25 	(1) skilled nurse visits for the sole purpose of supervision of the home health aide;
186.26 	(2) a skilled nursing visit:
186.27 	(i) only for the purpose of monitoring medication compliance with an established 
186.28 	medication program for a recipient; or
186.29 	(ii) to administer or assist with medication administration, including injections, 
186.30 	prefilling syringes for injections, or oral medication set-up of an adult recipient, when as 
186.31 	determined and documented by the registered nurse, the need can be met by an available 
186.32 	pharmacy or the recipient is physically and mentally able to self-administer or prefill 
186.33 	a medication;
186.34 	(3) home care services to a recipient who is eligible for covered services under the 
186.35 	Medicare program or any other insurance held by the recipient;
186.36 	(4) services to other members of the recipient's household;
187.1 	(5) a visit made by a skilled nurse solely to train other home health agency workers;
187.2 	(6) any home care service included in the daily rate of the community-based 
187.3 	residential facility where the recipient is residing;
187.4 	(7) nursing and rehabilitation therapy services that are reasonably accessible to a 
187.5 	recipient outside the recipient's place of residence, excluding the assessment, counseling 
187.6 	and education, and personal assistant care;
187.7 	(8) any home health agency service, excluding personal care assistant services and 
187.8 	private duty nursing services, which are performed in a place other than the recipient's 
187.9 	residence; and
187.10 	(9) Medicare evaluation or administrative nursing visits on dual-eligible recipients 
187.11 	that do not qualify for Medicare visit billing.
187.12 	(1) services provided in a nursing facility, hospital, or intermediate care facility with 
187.13 	exceptions in section 256B.0653;
187.14 	(2) services for the sole purpose of monitoring medication compliance with an 
187.15 	established medication program for a recipient;
187.16 	(3) home care services for covered services under the Medicare program or any other 
187.17 	insurance held by the recipient;
187.18 	(4) services to other members of the recipient's household;
187.19 	(5) any home care service included in the daily rate of the community-based 
187.20 	residential facility where the recipient is residing;
187.21 	(6) nursing and rehabilitation therapy services that are reasonably accessible to a 
187.22 	recipient outside the recipient's place of residence, excluding the assessment, counseling 
187.23 	and education, and personal assistance care; or
187.24 	(7) Medicare evaluation or administrative nursing visits on dual-eligible recipients 
187.25 	that do not qualify for Medicare visit billing.
187.26 		Subd. 4.Prior Authorization; exceptions. All home care services above the limits 
187.27 	in subdivision 11 must receive the commissioner's prior authorization before services 
187.28 	begin, except when:
187.29 	(1) the home care services were required to treat an emergency medical condition 
187.30 	that if not immediately treated could cause a recipient serious physical or mental disability, 
187.31 	continuation of severe pain, or death. The provider must request retroactive authorization 
187.32 	no later than five working days after giving the initial service. The provider must be able 
187.33 	to substantiate the emergency by documentation such as reports, notes, and admission or 
187.34 	discharge histories;
187.35 	(2) the home care services were provided on or after the date on which the recipient's 
187.36 	eligibility began, but before the date on which the recipient was notified that the case was 
188.1 	opened. Authorization will be considered if the request is submitted by the provider 
188.2 	within 20 working days of the date the recipient was notified that the case was opened;
188.3 	a recipient's medical assistance eligibility has lapsed, is then retroactively reinstated, 
188.4 	and an authorization for home care services is completed based on the date of a current 
188.5 	assessment, eligibility, and request for authorization;
188.6 	(3) a third-party payor for home care services has denied or adjusted a payment. 
188.7 	Authorization requests must be submitted by the provider within 20 working days of the 
188.8 	notice of denial or adjustment. A copy of the notice must be included with the request;
188.9 	(4) the commissioner has determined that a county or state human services agency 
188.10 	has made an error; or
188.11 	(5) the professional nurse determines an immediate need for up to 40 skilled nursing 
188.12 	or home health aide visits per calendar year and submits a request for authorization within 
188.13 	20 working days of the initial service date, and medical assistance is determined to be 
188.14 	the appropriate payer. if a recipient enrolled in managed care experiences a temporary 
188.15 	disenrollment from a health plan, the commissioner shall accept the current health plan 
188.16 	authorization for personal care assistance services for up to 60 days. The request must 
188.17 	be received within the first 30 days of the disenrollment. If the recipient's reenrollment 
188.18 	in managed care is after the 60 days and before 90 days, the provider shall request an 
188.19 	additional 30-day extension of the current health plan authorization, for a total limit of 
188.20 	90 days from the time of disenrollment.
188.21 		Subd. 5.Retroactive authorization. A request for retroactive authorization will be 
188.22 	evaluated according to the same criteria applied to prior authorization requests.
188.23 		Subd. 6.Prior Authorization. (a) The commissioner, or the commissioner's 
188.24 	designee, shall review the assessment, service update, request for temporary services, 
188.25 	request for flexible use option, service plan, and any additional information that is 
188.26 	submitted. The commissioner shall, within 30 days after receiving a complete request, 
188.27 	assessment, and service plan, authorize home care services as follows: provided in this 
188.28 	section.
188.29 	(a) Home health services.(b) All Home health services provided by a home health 
188.30 	aide including skilled nurse visits and home health aide visits must be prior authorized 
188.31 	by the commissioner or the commissioner's designee. Prior Authorization must be based 
188.32 	on medical necessity and cost-effectiveness when compared with other care options. 
188.33 	The commissioner must receive the request for authorization of skilled nurse visits and 
188.34 	home health aide visits within 20 working days of the start of service. When home health 
188.35 	services are used in combination with personal care and private duty nursing, the cost of 
188.36 	all home care services shall be considered for cost-effectiveness. The commissioner shall 
189.1 	limit home health aide visits to no more than one visit each per day. The commissioner, or 
189.2 	the commissioner's designee, may authorize up to two skilled nurse visits per day.
189.3 	(b) Ventilator-dependent recipients.(c) If the recipient is ventilator-dependent, the 
189.4 	monthly medical assistance authorization for home care services shall not exceed what the 
189.5 	commissioner would pay for care at the highest cost hospital designated as a long-term 
189.6 	hospital under the Medicare program. For purposes of this paragraph, home care services 
189.7 	means all direct care services provided in the home that would be included in the payment 
189.8 	for care at the long-term hospital. "Ventilator-dependent" means an individual who 
189.9 	receives mechanical ventilation for life support at least six hours per day and is expected 
189.10 	to be or has been dependent for at least 30 consecutive days. Recipients who meet the 
189.11 	definition of ventilator dependent and the EN home care rating and utilize a combination 
189.12 	of home care services are limited up to a total of 24 hours of home care services per day. 
189.13 	Additional hours may be authorized when a recipient's assessment indicates a need for two 
189.14 	staff to perform activities. Additional time is limited to four hours per day.
189.15 		Subd. 7.Prior Authorization; time limits. (a) The commissioner or the 
189.16 	commissioner's designee shall determine the time period for which a prior an authorization 
189.17 	shall be effective and, if flexible use has been requested, whether to allow the flexible use 
189.18 	option. If the recipient continues to require home care services beyond the duration of 
189.19 	the prior authorization, the home care provider must request a new prior authorization. 
189.20 	A personal care provider agency must request a new personal care assistant services 
189.21 	assessment, or service update if allowed, at least 60 days prior to the end of the current 
189.22 	prior authorization time period. The request for the assessment must be made on a form 
189.23 	approved by the commissioner. Under no circumstances, other than the exceptions 
189.24 	in subdivision 4, shall a prior An authorization must be valid prior to the date the 
189.25 	commissioner receives the request or for no more than 12 months.
189.26 	The amount and type of personal care assistant services authorized based upon the 
189.27 	assessment and service plan must remain in effect for the recipient whether the recipient 
189.28 	chooses a different provider or enrolls or disenrolls from a managed care plan under 
189.29 	section 256B.0659, unless the service needs of the recipient change and a new assessment 
189.30 	is warranted under section 256B.0655, subdivision 1b.
189.31 	(b) A recipient who appeals a reduction in previously authorized home care 
189.32 	services may continue previously authorized services, other than temporary services 
189.33 	under subdivision 8, pending an appeal under section 256.045. The commissioner must 
189.34 	provide ensure that the recipient has a copy of the most recent service plan that contains a 
189.35 	detailed explanation of why the authorized services which areas of covered personal care 
189.36 	assistant tasks are reduced in amount from those requested by the home care providerand 
190.1 	provide notice of the amount of time per day reduced, and the reasons for the reduction in 
190.2 	the recipient's notice of denial, termination, or reduction.
190.3 		Subd. 8.Prior Authorization requests; temporary services. The agency nurse, 
190.4 	the independently enrolled private duty nurse, or county public health nurse may request 
190.5 	a temporary authorization for home care services by telephone. The commissioner may 
190.6 	approve a temporary level of home care services based on the assessment, and service 
190.7 	or care plan information, and primary payer coverage determination information as 
190.8 	required. Authorization for a temporary level of home care services including nurse 
190.9 	supervision is limited to the time specified by the commissioner, but shall not exceed 
190.10 	45 days, unless extended because the county public health nurse has not completed the 
190.11 	required assessment and service plan, or the commissioner's determination has not been 
190.12 	made. The level of services authorized under this provision shall have no bearing on a 
190.13 	future prior authorization.
190.14 		Subd. 9.Prior Authorization for foster care setting. (a) Home care services 
190.15 	provided in an adult or child foster care setting must receive prior authorization by the 
190.16 	department commissioner according to the limits established in subdivision 11.
190.17 	(b) The commissioner may not authorize:
190.18 	(1) home care services that are the responsibility of the foster care provider under the 
190.19 	terms of the foster care placement agreement, difficulty of care, and administrative rules;
190.20 	(2) personal care assistant services when the foster care license holder is also the 
190.21 	personal care provider or personal care assistant, unless the foster home is the licensed 
190.22 	provider's primary residence and unless the recipient can direct the recipient's own care, or 
190.23 	case management is provided as required in section 256B.0625, subdivision 19a; or
190.24 	(3) personal care assistant services when the responsible party is an employee of, or 
190.25 	under contract with, or has any direct or indirect financial relationship with the personal 
190.26 	care provider or personal care assistant, unless case management is provided as required 
190.27 	in section 256B.0625, subdivision 19a; or
190.28 	(4) (3) personal care assistant and private duty nursing services when the number
190.29 	of foster care residents licensed capacity is greater than four unless the county responsible 
190.30 	for the recipient's foster placement made the placement prior to April 1, 1992, requests 
190.31 	that personal care assistant and private duty nursing services be provided, and case 
190.32 	management is provided as required in section 256B.0625, subdivision 19a.
190.33 		Subd. 10.Limitation on payments. Medical assistance payments for home care 
190.34 	services shall be limited according to subdivisions 4 to 12 and sections 256B.0654, 
190.35 	subdivision 2, and 256B.0655, subdivisions 3 and 4.
191.1 		Subd. 11.Limits on services without prior authorization. A recipient may receive 
191.2 	the following home care services during a calendar year:
191.3 	(1) up to two face-to-face assessments to determine a recipient's need for personal 
191.4 	care assistant services;
191.5 	(2) one service update done to determine a recipient's need for personal care assistant 
191.6 	services; and
191.7 	(3) up to nine face-to-face skilled nurse visits.
191.8 		Subd. 12.Approval of home care services. The commissioner or the 
191.9 	commissioner's designee shall determine the medical necessity of home care services, the 
191.10 	level of caregiver according to subdivision 2, and the institutional comparison according to 
191.11 	subdivisions 4 to 12 and sections 256B.0654, subdivision 2, and 256B.0655, subdivisions 
191.12 	3 and 4 256B.0659, the cost-effectiveness of services, and the amount, scope, and duration 
191.13 	of home care services reimbursable by medical assistance, based on the assessment, 
191.14 	primary payer coverage determination information as required, the service plan, the 
191.15 	recipient's age, the cost of services, the recipient's medical condition, and diagnosis or 
191.16 	disability. The commissioner may publish additional criteria for determining medical 
191.17 	necessity according to section 256B.04.
191.18 		Subd. 13.Recovery of excessive payments. The commissioner shall seek 
191.19 	monetary recovery from providers of payments made for services which exceed the limits 
191.20 	established in this section and sections 256B.0653 to 256B.0656 and 256B.0659. This 
191.21 	subdivision does not apply to services provided to a recipient at the previously authorized 
191.22 	level pending an appeal under section 256.045, subdivision 10.
191.23 		Subd. 14.Referrals to Medicare providers required. Home care providers that 
191.24 	do not participate in or accept Medicare assignment must refer and document the referral 
191.25 	of dual-eligible recipients to Medicare providers when Medicare is determined to be the 
191.26 	appropriate payer for services and supplies and equipment. Providers must be terminated 
191.27 	from participation in the medical assistance program for failure to make these referrals.
191.28 		Subd. 15.Quality assurance for program integrity. The commissioner shall 
191.29 	maintain processes for monitoring ongoing program integrity including provider standards 
191.30 	and training, consumer surveys, and random reviews of documentation.
191.31 		Subd. 16.Oversight of enrolled providers. The commissioner shall establish 
191.32 	an ongoing quality assurance process for home care services. The commissioner has 
191.33 	the authority to request proof of documentation of meeting provider standards, quality 
191.34 	standards of care, correct billing practices, and other information. Failure to provide access 
191.35 	and information to demonstrate compliance with laws, rules, or policies must result in 
191.36 	suspension, denial, or termination of the provider agency's enrollment with the department.

192.1 	Sec. 25. Minnesota Statutes 2008, section 256B.0652, is amended to read:
192.2 	256B.0652 PRIOR AUTHORIZATION AND REVIEW OF HOME CARE 
192.3 	SERVICES.
192.4 		Subdivision 1.State coordination. The commissioner shall supervise the 
192.5 	coordination of the prior authorization and review of home care services that are 
192.6 	reimbursed by medical assistance.
192.7 		Subd. 2.Duties. (a) The commissioner may contract with or employ qualified 
192.8 	registered nurses and necessary support staff, or contract with qualified agencies, to 
192.9 	provide home care prior authorization and review services for medical assistance 
192.10 	recipients who are receiving home care services.
192.11 	(b) Reimbursement for the prior authorization function shall be made through the 
192.12 	medical assistance administrative authority. The state shall pay the nonfederal share. 
192.13 	The functions will be to:
192.14 	(1) assess the recipient's individual need for services required to be cared for safely 
192.15 	in the community;
192.16 	(2) ensure that a service care plan that meets the recipient's needs is developed 
192.17 	by the appropriate agency or individual;
192.18 	(3) ensure cost-effectiveness and nonduplication of medical assistance home care 
192.19 	services;
192.20 	(4) recommend the approval or denial of the use of medical assistance funds to pay 
192.21 	for home care services;
192.22 	(5) reassess the recipient's need for and level of home care services at a frequency 
192.23 	determined by the commissioner; and
192.24 	(6) conduct on-site assessments when determined necessary by the commissioner 
192.25 	and recommend changes to care plans that will provide more efficient and appropriate 
192.26 	home care.; and
192.27 	(7) on the department's Web site:
192.28 	(i) provide a link to MinnesotaHelp.info for a list of enrolled home care agencies 
192.29 	with the following information: main office address, contact information for the agency, 
192.30 	counties in which services are provided, type of home care services provided, whether 
192.31 	the personal care assistance choice option is offered, types of qualified professionals 
192.32 	employed, number of personal care assistants employed, and data on staff turnover; and
192.33 	(ii) post data on home care services including information from both fee-for-service 
192.34 	and managed care plans as available.
192.35 	(c) In addition, the commissioner or the commissioner's designee may:
193.1 	(1) review care plans, service plans, and reimbursement data for utilization of 
193.2 	services that exceed community-based standards for home care, inappropriate home care 
193.3 	services, medical necessity, home care services that do not meet quality of care standards, 
193.4 	or unauthorized services and make appropriate referrals within the department or to other 
193.5 	appropriate entities based on the findings;
193.6 	(2) assist the recipient in obtaining services necessary to allow the recipient to 
193.7 	remain safely in or return to the community;
193.8 	(3) coordinate home care services with other medical assistance services under 
193.9 	section 256B.0625;
193.10 	(4) assist the recipient with problems related to the provision of home care services;
193.11 	(5) assure the quality of home care services; and
193.12 	(6) assure that all liable third-party payers including, but not limited to, Medicare 
193.13 	have been used prior to medical assistance for home care services, including but not 
193.14 	limited to, home health agency, elected hospice benefit, waivered services, alternative care 
193.15 	program services, and personal care services.
193.16 	(d) For the purposes of this section, "home care services" means medical assistance 
193.17 	services defined under section 256B.0625, subdivisions 6a, 7, and 19a.
193.18 		Subd. 3.Assessment and prior authorization process for persons receiving 
193.19 	personal care assistance and developmental disabilities services. Effective January 1, 
193.20 	1996, For purposes of providing informed choice, coordinating of local planning decisions, 
193.21 	and streamlining administrative requirements, the assessment and prior authorization 
193.22 	process for persons receiving both home care and home and community-based waivered 
193.23 	services for persons with developmental disabilities shall meet the requirements of 
193.24 	sections 256B.0651 and 256B.0653 to 256B.0656 with the following exceptions:
193.25 	(a) Upon request for home care services and subsequent assessment by the public 
193.26 	health nurse under sections 256B.0651 and 256B.0653 to 256B.0656, the public health 
193.27 	nurse shall participate in the screening process, as appropriate, and, if home care 
193.28 	services are determined to be necessary, participate in the development of a service plan 
193.29 	coordinating the need for home care and home and community-based waivered services 
193.30 	with the assigned county case manager, the recipient of services, and the recipient's legal 
193.31 	representative, if any.
193.32 	(b) The public health nurse shall give prior authorization for home care services 
193.33 	to the extent that home care services are:
193.34 	(1) medically necessary;
193.35 	(2) chosen by the recipient and their legal representative, if any, from the array of 
193.36 	home care and home and community-based waivered services available;
194.1 	(3) coordinated with other services to be received by the recipient as described 
194.2 	in the service plan; and
194.3 	(4) provided within the county's reimbursement limits for home care and home and 
194.4 	community-based waivered services for persons with developmental disabilities.
194.5 	(c) If the public health agency is or may be the provider of home care services to the 
194.6 	recipient, the public health agency shall provide the commissioner of human services with 
194.7 	a written plan that specifies how the assessment and prior authorization process will be 
194.8 	held separate and distinct from the provision of services.

194.9 	Sec. 26. Minnesota Statutes 2008, section 256B.0653, is amended to read:
194.10 	256B.0653 HOME HEALTH AGENCY COVERED SERVICES.
194.11 		Subdivision 1.Homecare; skilled nurse visits Scope.  "Skilled nurse visits" are 
194.12 	provided in a recipient's residence under a plan of care or service plan that specifies a level 
194.13 	of care which the nurse is qualified to provide. These services are:
194.14 	(1) nursing services according to the written plan of care or service plan and accepted 
194.15 	standards of medical and nursing practice in accordance with chapter 148;
194.16 	(2) services which due to the recipient's medical condition may only be safely and 
194.17 	effectively provided by a registered nurse or a licensed practical nurse;
194.18 	(3) assessments performed only by a registered nurse; and
194.19 	(4) teaching and training the recipient, the recipient's family, or other caregivers 
194.20 	requiring the skills of a registered nurse or licensed practical nurse. This section applies to 
194.21 	home health agency services including, home health aide, skilled nursing visits, physical 
194.22 	therapy, occupational therapy, respiratory therapy, and speech language pathology therapy.
194.23 		Subd. 2.Telehomecare; skilled nurse visits Definitions.  Medical assistance 
194.24 	covers skilled nurse visits according to section 256B.0625, subdivision 6a, provided via 
194.25 	telehomecare, for services which do not require hands-on care between the home care 
194.26 	nurse and recipient. The provision of telehomecare must be made via live, two-way 
194.27 	interactive audiovisual technology and may be augmented by utilizing store-and-forward 
194.28 	technologies. Store-and-forward technology includes telehomecare services that do not 
194.29 	occur in real time via synchronous transmissions, and that do not require a face-to-face 
194.30 	encounter with the recipient for all or any part of any such telehomecare visit. Individually 
194.31 	identifiable patient data obtained through real-time or store-and-forward technology must 
194.32 	be maintained as health records according to sections 144.291 to 144.298. If the video 
194.33 	is used for research, training, or other purposes unrelated to the care of the patient, the 
194.34 	identity of the patient must be concealed. A communication between the home care nurse 
194.35 	and recipient that consists solely of a telephone conversation, facsimile, electronic mail, or 
195.1 	a consultation between two health care practitioners, is not to be considered a telehomecare 
195.2 	visit. Multiple daily skilled nurse visits provided via telehomecare are allowed. Coverage 
195.3 	of telehomecare is limited to two visits per day. All skilled nurse visits provided via 
195.4 	telehomecare must be prior authorized by the commissioner or the commissioner's 
195.5 	designee and will be covered at the same allowable rate as skilled nurse visits provided 
195.6 	in-person. For the purposes of this section, the following terms have the meanings given.
195.7 	(a) "Assessment" means an evaluation of the recipient's medical need for home 
195.8 	health agency services by a registered nurse or appropriate therapist that is conducted 
195.9 	within 30 days of a request and as specified in Code of Federal Regulations, title 42, 
195.10 	sections 484.1 to 494.55.
195.11 	(b) "Home care therapies" means occupational, physical, and respiratory therapy 
195.12 	and speech-language pathology services, provided in the home by a Medicare-certified 
195.13 	home health agency.
195.14 	(c) "Home health agency services" means services delivered in the recipient's home 
195.15 	residence, except as specified in section 256B.0625, by a home health agency to a recipient 
195.16 	with medical needs due to illness, disability, or physical conditions.
195.17 	(d) "Home health aide" means an employee of a home health agency who meets 
195.18 	the requirements of Code of Federal Regulations, title 42, sections 484.1 to 494.55, and 
195.19 	completes medically oriented tasks written in the plan of care for a recipient.
195.20 	(e) "Home health agency" means a home care provider agency that is 
195.21 	Medicare-certified satisfying the requirements of Code of Federal Regulations, title 42, 
195.22 	sections 484.1 to 494.55.
195.23 	(f) "Occupational therapy services" mean the services defined in Minnesota Rules, 
195.24 	part 9505.0390.
195.25 	(g) "Physical therapy services" mean the services defined in Minnesota Rules, part 
195.26 	9505.0390.
195.27 	(h) "Respiratory therapy services" mean the services defined in chapter 147C and 
195.28 	Minnesota Rules, part 4668.0003, subpart 37.
195.29 	(i) "Speech-language pathology services" mean the services defined in Minnesota 
195.30 	Rules, part 9505.0390.
195.31 	(j) "Skilled nurse visit" means a professional nursing visit to complete nursing tasks 
195.32 	required due to a recipient's medical condition that can only be safely provided by a 
195.33 	professional nurse to restore and maintain optimal health.
195.34 	(k) "Store-and-forward technology" means telehomecare services that do not occur 
195.35 	in real time via synchronous transmissions such as diabetic and vital sign monitoring.
196.1 	(l) "Telehomecare" means the use of telecommunications technology via 
196.2 	live, two-way interactive audiovisual technology which may be augmented by 
196.3 	store-and-forward technology.
196.4 	(m) "Telehomecare skilled nurse visit" means a visit by a professional nurse to 
196.5 	deliver a skilled nurse visit to a recipient located at a site other than the site where the 
196.6 	nurse is located and is used in combination with face-to-face skilled nurse visits to 
196.7 	adequately meet the recipient's needs.
196.8 		Subd. 3.Therapies through home health agencies Home health aide visits.
 196.9 	(a) Medical assistance covers physical therapy and related services, including specialized 
196.10 	maintenance therapy. Services provided by a physical therapy assistant shall be 
196.11 	reimbursed at the same rate as services performed by a physical therapist when the 
196.12 	services of the physical therapy assistant are provided under the direction of a physical 
196.13 	therapist who is on the premises. Services provided by a physical therapy assistant that are 
196.14 	provided under the direction of a physical therapist who is not on the premises shall be 
196.15 	reimbursed at 65 percent of the physical therapist rate. Direction of the physical therapy 
196.16 	assistant must be provided by the physical therapist as described in Minnesota Rules, part 
196.17 	9505.0390, subpart 1, item B. The physical therapist and physical therapist assistant may 
196.18 	not both bill for services provided to a recipient on the same day.
196.19 	(b) Medical assistance covers occupational therapy and related services, including 
196.20 	specialized maintenance therapy. Services provided by an occupational therapy assistant 
196.21 	shall be reimbursed at the same rate as services performed by an occupational therapist 
196.22 	when the services of the occupational therapy assistant are provided under the direction of 
196.23 	the occupational therapist who is on the premises. Services provided by an occupational 
196.24 	therapy assistant under the direction of an occupational therapist who is not on the 
196.25 	premises shall be reimbursed at 65 percent of the occupational therapist rate. Direction 
196.26 	of the occupational therapy assistant must be provided by the occupational therapist as 
196.27 	described in Minnesota Rules, part 9505.0390, subpart 1, item B. The occupational 
196.28 	therapist and occupational therapist assistant may not both bill for services provided 
196.29 	to a recipient on the same day.
196.30 	(a) Home health aide visits must be provided by a certified home health aide 
196.31 	using a written plan of care that is updated in compliance with Medicare regulations. 
196.32 	A home health aide shall provide hands-on personal care, perform simple procedures 
196.33 	as an extension of therapy or nursing services, and assist in instrumental activities of 
196.34 	daily living as defined in section 256B.0659. Home health aide visits must be provided 
196.35 	in the recipient's home.
197.1 	(b) All home health aide visits must have authorization under section 256B.0652. 
197.2 	The commissioner shall limit home health aide visits to no more than one visit per day 
197.3 	per recipient.
197.4 	(c) Home health aides must be supervised by a registered nurse or an appropriate 
197.5 	therapist when providing services that are an extension of therapy.
197.6 		Subd. 4.Skilled nurse visit services. (a) Skilled nurse visit services must be 
197.7 	provided by a registered nurse or a licensed practical nurse under the supervision of a 
197.8 	registered nurse, according to the written plan of care and accepted standards of medical 
197.9 	and nursing practice according to chapter 148. Skilled nurse visit services must be ordered 
197.10 	by a physician and documented in a plan of care that is reviewed and approved by the 
197.11 	ordering physician at least once every 60 days. All skilled nurse visits must be medically 
197.12 	necessary and provided in the recipient's home residence except as allowed under section 
197.13 	256B.0625, subdivision 6a.
197.14 	(b) Skilled nurse visits include face-to-face and telehomecare visits with a limit of 
197.15 	up to two visits per day per recipient. All visits must be based on assessed needs.
197.16 	(c) Telehomecare skilled nurse visits are allowed when the recipient's health status 
197.17 	can be accurately measured and assessed without a need for a face-to-face, hands-on 
197.18 	encounter. All telehomecare skilled nurse visits must have authorization and are paid at 
197.19 	the same allowable rates as face-to-face skilled nurse visits.
197.20 	(d) The provision of telehomecare must be made via live, two-way interactive 
197.21 	audiovisual technology and may be augmented by utilizing store-and-forward 
197.22 	technologies. Individually identifiable patient data obtained through real-time or 
197.23 	store-and-forward technology must be maintained as health records according to sections 
197.24 	144.291 to 144.298. If the video is used for research, training, or other purposes unrelated 
197.25 	to the care of the patient, the identity of the patient must be concealed.
197.26 	(e) Authorization for skilled nurse visits must be completed under section 
197.27 	256B.0652. A total of nine face-to-face skilled nurses visits per calendar year do not 
197.28 	require authorization. All telehomecare skilled nurse visits require authorization.
197.29 		Subd. 5.Home care therapies. (a) Home care therapies include the following: 
197.30 	physical therapy, occupational therapy, respiratory therapy, and speech and language 
197.31 	pathology therapy services.
197.32 	(b) Home care therapies must be:
197.33 	(1) provided in the recipient's residence after it has been determined the recipient is 
197.34 	unable to access outpatient therapy;
197.35 	(2) prescribed, ordered, or referred by a physician and documented in a plan of care 
197.36 	and reviewed, according to Minnesota Rules, part 9505.0390;
198.1 	(3) assessed by an appropriate therapist; and
198.2 	(4) provided by a Medicare-certified home health agency enrolled as a Medicaid 
198.3 	provider agency.
198.4 	(c) Restorative and specialized maintenance therapies must be provided according to 
198.5 	Minnesota Rules, part 9505.0390. Physical and occupational therapy assistants may be 
198.6 	used as allowed under Minnesota Rules, part 9505.0390, subpart 1, item B.
198.7 	(d) For both physical and occupational therapies, the therapist and the therapist's 
198.8 	assistant may not both bill for services provided to a recipient on the same day.
198.9 		Subd. 6.Noncovered home health agency services. The following are not eligible 
198.10 	for payment under medical assistance as a home health agency service:
198.11 	(1) telehomecare skilled nurses services that is communication between the home 
198.12 	care nurse and recipient that consists solely of a telephone conversation, facsimile, 
198.13 	electronic mail, or a consultation between two health care practitioners;
198.14 	(2) the following skilled nurse visits:
198.15 	(i) for the purpose of monitoring medication compliance with an established 
198.16 	medication program for a recipient;
198.17 	(ii) administering or assisting with medication administration, including injections, 
198.18 	prefilling syringes for injections, or oral medication setup of an adult recipient, when, 
198.19 	as determined and documented by the registered nurse, the need can be met by an 
198.20 	available pharmacy or the recipient or a family member is physically and mentally able 
198.21 	to self-administer or prefill a medication;
198.22 	(iii) services done for the sole purpose of supervision of the home health aide or 
198.23 	personal care assistant;
198.24 	(iv) services done for the sole purpose to train other home health agency workers;
198.25 	(v) services done for the sole purpose of blood samples or lab draw or Synagis 
198.26 	injections when the recipient is able to access these services outside the home; and
198.27 	(vi) Medicare evaluation or administrative nursing visits required by Medicare;
198.28 	(3) home health aide visits when the following activities are the sole purpose for the 
198.29 	visit: companionship, socialization, household tasks, transportation, and education; and
198.30 	(4) home care therapies provided in other settings such as a clinic, day program, or as 
198.31 	an inpatient or when the recipient can access therapy outside of the recipient's residence.

198.32 	Sec. 27. Minnesota Statutes 2008, section 256B.0654, is amended to read:
198.33 	256B.0654 PRIVATE DUTY NURSING.
198.34 		Subdivision 1.Definitions. (a) "Assessment" means a review and evaluation of a 
198.35 	recipient's need for home care services conducted in person. Assessments for private duty 
199.1 	nursing shall be conducted by a registered private duty nurse. Assessments for medical 
199.2 	assistance home care services for developmental disabilities and alternative care services 
199.3 	for developmentally disabled home and community-based waivered recipients may be 
199.4 	conducted by the county public health nurse to ensure coordination and avoid duplication.
199.5 	(b) (a) "Complex and regular private duty nursing care" means:
199.6 	(1) complex care is private duty nursing services provided to recipients who are 
199.7 	ventilator dependent or for whom a physician has certified that were it not for private 
199.8 	duty nursing the recipient would meet meets the criteria for inpatient hospital intensive 
199.9 	care unit (ICU) level of care; and
199.10 	(2) regular care is private duty nursing provided to all other recipients.
199.11 	(b) "Private duty nursing" means ongoing professional nursing services by a 
199.12 	registered or licensed practical nurse including assessment, professional nursing tasks, and 
199.13 	education, based on an assessment and physician orders to maintain or restore optimal 
199.14 	health of the recipient.
199.15 	(c) "Private duty nursing agency" means a medical assistance enrolled provider 
199.16 	licensed under chapter 144A to provide private duty nursing services.
199.17 	(d) "Regular private duty nursing" means nursing services provided to a recipient 
199.18 	who is considered stable and not at an inpatient hospital intensive care unit level of care, 
199.19 	but may have episodes of instability that are not life threatening.
199.20 	(e) "Shared private duty nursing" means the provision of nursing services by a 
199.21 	private duty nurse to two recipients at the same time and in the same setting.
199.22 		Subd. 2.Authorization; private duty nursing services. (a) All private duty 
199.23 	nursing services shall be prior authorized by the commissioner or the commissioner's 
199.24 	designee. Prior Authorization for private duty nursing services shall be based on 
199.25 	medical necessity and cost-effectiveness when compared with alternative care options. 
199.26 	The commissioner may authorize medically necessary private duty nursing services in 
199.27 	quarter-hour units when:
199.28 	(1) the recipient requires more individual and continuous care than can be provided 
199.29 	during a skilled nurse visit; or
199.30 	(2) the cares are outside of the scope of services that can be provided by a home 
199.31 	health aide or personal care assistant.
199.32 	(b) The commissioner may authorize:
199.33 	(1) up to two times the average amount of direct care hours provided in nursing 
199.34 	facilities statewide for case mix classification "K" as established by the annual cost report 
199.35 	submitted to the department by nursing facilities in May 1992;
200.1 	(2) private duty nursing in combination with other home care services up to the total 
200.2 	cost allowed under section 256B.0655, subdivision 4;
200.3 	(3) up to 16 hours per day if the recipient requires more nursing than the maximum 
200.4 	number of direct care hours as established in clause (1) and the recipient meets the hospital 
200.5 	admission criteria established under Minnesota Rules, parts 9505.0501 to 9505.0540.
200.6 	(c) The commissioner may authorize up to 16 hours per day of medically necessary 
200.7 	private duty nursing services or up to 24 hours per day of medically necessary private duty 
200.8 	nursing services until such time as the commissioner is able to make a determination of 
200.9 	eligibility for recipients who are cooperatively applying for home care services under 
200.10 	the community alternative care program developed under section 256B.49, or until it is 
200.11 	determined by the appropriate regulatory agency that a health benefit plan is or is not 
200.12 	required to pay for appropriate medically necessary health care services. Recipients 
200.13 	or their representatives must cooperatively assist the commissioner in obtaining this 
200.14 	determination. Recipients who are eligible for the community alternative care program 
200.15 	may not receive more hours of nursing under this section and sections 256B.0651, 
200.16 	256B.0653, 256B.0655, and256B.0656, and 256B.0659 than would otherwise be 
200.17 	authorized under section 256B.49.
200.18 		Subd. 2a.Private duty nursing services. (a) Private duty nursing services must 
200.19 	be used:
200.20 	(1) in the recipient's home or outside the home when normal life activities require;
200.21 	(2) when the recipient requires more individual and continuous care than can be 
200.22 	provided during a skilled nurse visit; and
200.23 	(3) when the care required is outside of the scope of services that can be provided by 
200.24 	a home health aide or personal care assistant.
200.25 	(b) Private duty nursing services must be:
200.26 	(1) assessed by a registered nurse on a form approved by the commissioner;
200.27 	(2) ordered by a physician and documented in a plan of care that is reviewed by the 
200.28 	physician at least once every 60 days; and
200.29 	(3) authorized by the commissioner under section 256B.0652.
200.30 		Subd. 2b.Noncovered private duty nursing services. Private duty nursing 
200.31 	services do not cover the following:
200.32 	(1) nursing services by a nurse who is the foster care provider of a person who has 
200.33 	not reached 18 years of age unless allowed under subdivision 4;
200.34 	(2) nursing services to more than two persons receiving shared private duty nursing 
200.35 	services from a private duty nurse in a single setting; and
201.1 	(3) nursing services provided by a registered nurse or licensed practical nurse who is 
201.2 	the recipient's legal guardian or related to the recipient as spouse, parent, family foster 
201.3 	parent, or child, whether by blood, marriage, or adoption except as specified in section 
201.4 	256B.0652, subdivision 4.
201.5 		Subd. 3.Shared private duty nursing care option. (a) Medical assistance 
201.6 	payments for shared private duty nursing services by a private duty nurse shall be limited 
201.7 	according to this subdivision. For the purposes of this section and sections 256B.0651, 
201.8 	256B.0653, 256B.0655, and 256B.0656, "private duty nursing agency" means an agency 
201.9 	licensed under chapter 144A to provide private duty nursing services. Unless otherwise 
201.10 	provided in this subdivision, all other statutory and regulatory provisions relating to 
201.11 	private duty nursing services apply to shared private duty nursing services. Nothing in 
201.12 	this subdivision shall be construed to reduce the total number of private duty nursing 
201.13 	hours authorized for an individual recipient.
201.14 	(b) Recipients of private duty nursing services may share nursing staff and the 
201.15 	commissioner shall provide a rate methodology for shared private duty nursing. For two 
201.16 	persons sharing nursing care, the rate paid to a provider shall not exceed 1.5 times the 
201.17 	regular private duty nursing rates paid for serving a single individual by a registered nurse 
201.18 	or licensed practical nurse. These rates apply only to situations in which both recipients 
201.19 	are present and receive shared private duty nursing care on the date for which the service 
201.20 	is billed. No more than two persons may receive shared private duty nursing services 
201.21 	from a private duty nurse in a single setting.
201.22 	(c) (b) Shared private duty nursing care is the provision of nursing services by a 
201.23 	private duty nurse to two medical assistance eligible recipients at the same time and in 
201.24 	the same setting. This subdivision does not apply when a private duty nurse is caring for 
201.25 	multiple recipients in more than one setting.
201.26 	(c) For the purposes of this subdivision, "setting" means:
201.27 	(1) the home residence or foster care home of one of the individual recipients as 
201.28 	defined in section 256B.0651; or
201.29 	(2) a child care program licensed under chapter 245A or operated by a local school 
201.30 	district or private school; or
201.31 	(3) an adult day care service licensed under chapter 245A; or
201.32 	(4) outside the home residence or foster care home of one of the recipients when 
201.33 	normal life activities take the recipients outside the home.
201.34 	This subdivision does not apply when a private duty nurse is caring for multiple 
201.35 	recipients in more than one setting.
202.1 	(d) The private duty nursing agency must offer the recipient the option of shared or 
202.2 	one-on-one private duty nursing services. The recipient may withdraw from participating 
202.3 	in a shared service arrangement at any time.
202.4 	(d) (e) The recipient or the recipient's legal representative, and the recipient's 
202.5 	physician, in conjunction with the home health care private duty nursing agency, shall 
202.6 	determine:
202.7 	(1) whether shared private duty nursing care is an appropriate option based on the 
202.8 	individual needs and preferences of the recipient; and
202.9 	(2) the amount of shared private duty nursing services authorized as part of the 
202.10 	overall authorization of nursing services.
202.11 	(e) (f) The recipient or the recipient's legal representative, in conjunction with the 
202.12 	private duty nursing agency, shall approve the setting, grouping, and arrangement of 
202.13 	shared private duty nursing care based on the individual needs and preferences of the 
202.14 	recipients. Decisions on the selection of recipients to share services must be based on the 
202.15 	ages of the recipients, compatibility, and coordination of their care needs.
202.16 	(f) (g) The following items must be considered by the recipient or the recipient's 
202.17 	legal representative and the private duty nursing agency, and documented in the recipient's 
202.18 	health service record:
202.19 	(1) the additional training needed by the private duty nurse to provide care to 
202.20 	two recipients in the same setting and to ensure that the needs of the recipients are met 
202.21 	appropriately and safely;
202.22 	(2) the setting in which the shared private duty nursing care will be provided;
202.23 	(3) the ongoing monitoring and evaluation of the effectiveness and appropriateness 
202.24 	of the service and process used to make changes in service or setting;
202.25 	(4) a contingency plan which accounts for absence of the recipient in a shared private 
202.26 	duty nursing setting due to illness or other circumstances;
202.27 	(5) staffing backup contingencies in the event of employee illness or absence; and
202.28 	(6) arrangements for additional assistance to respond to urgent or emergency care 
202.29 	needs of the recipients.
202.30 	(g) The provider must offer the recipient or responsible party the option of shared or 
202.31 	one-on-one private duty nursing services. The recipient or responsible party can withdraw 
202.32 	from participating in a shared service arrangement at any time.
202.33 	(h) The private duty nursing agency must document the following in the 
202.34 	health service record for each individual recipient sharing private duty nursing care
202.35 	The documentation for shared private duty nursing must be on a form approved by 
203.1 	the commissioner for each individual recipient sharing private duty nursing. The 
203.2 	documentation must be part of the recipient's health service record and include:
203.3 	(1) permission by the recipient or the recipient's legal representative for the 
203.4 	maximum number of shared nursing care hours per week chosen by the recipient and 
203.5 	permission for shared private duty nursing services provided in and outside the recipient's 
203.6 	home residence;
203.7 	(2) permission by the recipient or the recipient's legal representative for shared 
203.8 	private duty nursing services provided outside the recipient's residence;
203.9 	(3) permission by the recipient or the recipient's legal representative for others to 
203.10 	receive shared private duty nursing services in the recipient's residence;
203.11 	(4) (2) revocation by the recipient or the recipient's legal representative of for the 
203.12 	shared private duty nursing care authorization, or the shared care to be provided to others in 
203.13 	the recipient's residence, or the shared private duty nursing services to be provided outside
203.14 	permission, or services provided to others in and outside the recipient's residence; and
203.15 	(5) (3) daily documentation of the shared private duty nursing services provided by 
203.16 	each identified private duty nurse, including:
203.17 	(i) the names of each recipient receiving shared private duty nursing services 
203.18 	together;
203.19 	(ii) the setting for the shared services, including the starting and ending times that 
203.20 	the recipient received shared private duty nursing care; and
203.21 	(iii) notes by the private duty nurse regarding changes in the recipient's condition, 
203.22 	problems that may arise from the sharing of private duty nursing services, and scheduling 
203.23 	and care issues.
203.24 	(i) Unless otherwise provided in this subdivision, all other statutory and regulatory 
203.25 	provisions relating to private duty nursing services apply to shared private duty nursing 
203.26 	services.
203.27 	Nothing in this subdivision shall be construed to reduce the total number of private 
203.28 	duty nursing hours authorized for an individual recipient under subdivision 2.
203.29 	(i) The commissioner shall provide a rate methodology for shared private duty 
203.30 	nursing. For two persons sharing nursing care, the rate paid to a provider must not exceed 
203.31 	1.5 times the regular private duty nursing rates paid for serving a single individual by a 
203.32 	registered nurse or licensed practical nurse. These rates apply only to situations in which 
203.33 	both recipients are present and receive shared private duty nursing care on the date for 
203.34 	which the service is billed.
203.35 		Subd. 4.Hardship criteria; private duty nursing. (a) Payment is allowed for 
203.36 	extraordinary services that require specialized nursing skills and are provided by parents 
204.1 	of minor children, family foster parents, spouses, and legal guardians who are providing 
204.2 	private duty nursing care under the following conditions:
204.3 	(1) the provision of these services is not legally required of the parents, family 
204.4 	foster parents, spouses, or legal guardians;
204.5 	(2) the services are necessary to prevent hospitalization of the recipient; and
204.6 	(3) the recipient is eligible for state plan home care or a home and community-based 
204.7 	waiver and one of the following hardship criteria are met:
204.8 	(i) the parent, spouse, or legal guardian resigns from a part-time or full-time job to 
204.9 	provide nursing care for the recipient; or
204.10 	(ii) the parent, spouse, or legal guardian goes from a full-time to a part-time job with 
204.11 	less compensation to provide nursing care for the recipient; or
204.12 	(iii) the parent, spouse, or legal guardian takes a leave of absence without pay to 
204.13 	provide nursing care for the recipient; or
204.14 	(iv) because of labor conditions, special language needs, or intermittent hours of 
204.15 	care needed, the parent, spouse, or legal guardian is needed in order to provide adequate 
204.16 	private duty nursing services to meet the medical needs of the recipient.
204.17 	(b) Private duty nursing may be provided by a parent, spouse, family foster parent,
204.18 	or legal guardian who is a nurse licensed in Minnesota. Private duty nursing services 
204.19 	provided by a parent, spouse, family foster parent, or legal guardian cannot be used in 
204.20 	lieu of nursing services covered and available under liable third-party payors, including 
204.21 	Medicare. The private duty nursing provided by a parent, family foster parent, spouse, or 
204.22 	legal guardian must be included in the service plan. Authorized skilled nursing services
204.23 	for a single recipient or recipients with the same residence and provided by the parent, 
204.24 	family foster parent, spouse, or legal guardian may not exceed 50 percent of the total 
204.25 	approved nursing hours, or eight hours per day, whichever is less, up to a maximum of 
204.26 	40 hours per week. A parent or parents, family foster parents, spouse, or legal guardian 
204.27 	shall not provide more than 40 hours of services in a seven-day period. For parents, 
204.28 	family foster parents, and legal guardians, 40 hours is the total amount allowed regardless 
204.29 	of the number of children or adults who receive services. Nothing in this subdivision 
204.30 	precludes the parent's, family foster parents', spouse's, or legal guardian's obligation of 
204.31 	assuming the nonreimbursed family responsibilities of emergency backup caregiver and 
204.32 	primary caregiver.
204.33 	(c) A parent, family foster parent,  or a spouse may not be paid to provide private 
204.34 	duty nursing care if:
204.35 	(1) the parent or spouse fails to pass a criminal background check according to 
204.36 	chapter 245C, or if;
205.1 	(2) it has been determined by the home health care agency, the case manager, or the 
205.2 	physician that the private duty nursing care provided by the parent, family foster parents, 
205.3 	spouse, or legal guardian is unsafe; or
205.4 	(3) the parent, family foster parents, spouse, or legal guardian do not follow 
205.5 	physician orders.
205.6 	(d) For purposes of this section, "assessment" means a review and evaluation of a 
205.7 	recipient's need for home care services conducted in person. Assessments for private duty 
205.8 	nursing must be conducted by a registered nurse.

205.9 	Sec. 28. Minnesota Statutes 2008, section 256B.0655, subdivision 1b, is amended to 
205.10 	read:
205.11 		Subd. 1b.Assessment. "Assessment" means a review and evaluation of a recipient's 
205.12 	need for home care services conducted in person. Assessments for personal care assistant 
205.13 	services shall be conducted by the county public health nurse or a certified public 
205.14 	health nurse under contract with the county. A face-to-face An in-person assessment 
205.15 	must include: documentation of health status, determination of need, evaluation of 
205.16 	service effectiveness, identification of appropriate services, service plan development 
205.17 	or modification, coordination of services, referrals and follow-up to appropriate payers 
205.18 	and community resources, completion of required reports, recommendation of service 
205.19 	authorization, and consumer education. Once the need for personal care assistant 
205.20 	services is determined under this section or sections 256B.0651, 256B.0653, 256B.0654, 
205.21 	and 256B.0656, the county public health nurse or certified public health nurse under 
205.22 	contract with the county is responsible for communicating this recommendation to the 
205.23 	commissioner and the recipient. A face-to-face assessment for personal care assistant 
205.24 	services is conducted on those recipients who have never had a county public health 
205.25 	nurse assessment. A face-to-face An in-person assessment must occur at least annually or 
205.26 	when there is a significant change in the recipient's condition or when there is a change 
205.27 	in the need for personal care assistant services. A service update may substitute for 
205.28 	the annual face-to-face assessment when there is not a significant change in recipient 
205.29 	condition or a change in the need for personal care assistant service. A service update 
205.30 	may be completed by telephone, used when there is no need for an increase in personal 
205.31 	care assistant services, and used for two consecutive assessments if followed by a 
205.32 	face-to-face assessment. A service update must be completed on a form approved by the 
205.33 	commissioner. A service update or review for temporary increase includes a review of 
205.34 	initial baseline data, evaluation of service effectiveness, redetermination of service need, 
205.35 	modification of service plan and appropriate referrals, update of initial forms, obtaining 
206.1 	service authorization, and on going consumer education. Assessments must be completed 
206.2 	on forms provided by the commissioner within 30 days of a request for home care services 
206.3 	by a recipient or responsible party or personal care provider agency.

206.4 	Sec. 29. Minnesota Statutes 2008, section 256B.0655, subdivision 4, is amended to 
206.5 	read:
206.6 		Subd. 4.Prior Authorization; personal care assistance and qualified 
206.7 	professional. The commissioner, or the commissioner's designee, shall review the 
206.8 	assessment, service update, request for temporary services, request for flexible use option, 
206.9 	service plan, and any additional information that is submitted. The commissioner shall, 
206.10 	within 30 days after receiving a complete request, assessment, and service plan, authorize 
206.11 	home care services as follows:
206.12 	(1) (a) All personal care assistant services and, supervision by a qualified 
206.13 	professional, if requested by the recipient, and additional services beyond the limits 
206.14 	established in section 256B.0652, subdivision 11, must be prior authorized by the 
206.15 	commissioner or the commissioner's designee before services begin except for the 
206.16 	assessments established in section sections256B.0651, subdivision 11, and 256B.0655, 
206.17 	subdivision 1b. The authorization for personal care assistance and qualified professional 
206.18 	services under section 256B.0659 must be completed within 30 calendar days after 
206.19 	receiving a complete request.
206.20 	(b) The amount of personal care assistant services authorized must be based on 
206.21 	the recipient's home care rating. The home care rating shall be determined by the 
206.22 	commissioner or the commissioner's designee based on information submitted to the 
206.23 	commissioner identifying the following:
206.24 	A child may not be found to be dependent in an activity of daily living if because 
206.25 	of the child's age an adult would either perform the activity for the child or assist the 
206.26 	child with the activity and the amount of assistance needed is similar to the assistance 
206.27 	appropriate for a typical child of the same age. Based on medical necessity, the 
206.28 	commissioner may authorize:
206.29 	(A) up to two times the average number of direct care hours provided in nursing 
206.30 	facilities for the recipient's comparable case mix level; or
206.31 	(B) up to three times the average number of direct care hours provided in nursing 
206.32 	facilities for recipients who have complex medical needs or are dependent in at least seven 
206.33 	activities of daily living and need physical assistance with eating or have a neurological 
206.34 	diagnosis; or
207.1 	(C) up to 60 percent of the average reimbursement rate, as of July 1, 1991, for care 
207.2 	provided in a regional treatment center for recipients who have Level I behavior, plus any 
207.3 	inflation adjustment as provided by the legislature for personal care service; or
207.4 	(D) up to the amount the commissioner would pay, as of July 1, 1991, plus any 
207.5 	inflation adjustment provided for home care services, for care provided in a regional 
207.6 	treatment center for recipients referred to the commissioner by a regional treatment center 
207.7 	preadmission evaluation team. For purposes of this clause, home care services means 
207.8 	all services provided in the home or community that would be included in the payment 
207.9 	to a regional treatment center; or
207.10 	(E) up to the amount medical assistance would reimburse for facility care for 
207.11 	recipients referred to the commissioner by a preadmission screening team established 
207.12 	under section 256B.0911 or 256B.092; and
207.13 	(F) a reasonable amount of time for the provision of supervision by a qualified 
207.14 	professional of personal care assistant services, if a qualified professional is requested by 
207.15 	the recipient or responsible party.
207.16 	(2) The number of direct care hours shall be determined according to the annual cost 
207.17 	report submitted to the department by nursing facilities. The average number of direct care 
207.18 	hours, as established by May 1, 1992, shall be calculated and incorporated into the home 
207.19 	care limits on July 1, 1992. These limits shall be calculated to the nearest quarter hour.
207.20 	(3) The home care rating shall be determined by the commissioner or the 
207.21 	commissioner's designee based on information submitted to the commissioner by the 
207.22 	county public health nurse on forms specified by the commissioner. The home care rating 
207.23 	shall be a combination of current assessment tools developed under sections 256B.0911
207.24 	and 256B.501 with an addition for seizure activity that will assess the frequency and 
207.25 	severity of seizure activity and with adjustments, additions, and clarifications that are 
207.26 	necessary to reflect the needs and conditions of recipients who need home care including 
207.27 	children and adults under 65 years of age. The commissioner shall establish these forms 
207.28 	and protocols under this section and sections 256B.0651, 256B.0653, 256B.0654, and 
207.29 	256B.0656 and shall use an advisory group, including representatives of recipients, 
207.30 	providers, and counties, for consultation in establishing and revising the forms and 
207.31 	protocols.
207.32 	(4) A recipient shall qualify as having complex medical needs if the care required is 
207.33 	difficult to perform and because of recipient's medical condition requires more time than 
207.34 	community-based standards allow or requires more skill than would ordinarily be required 
207.35 	and the recipient needs or has one or more of the following:
207.36 	(A) daily tube feedings;
208.1 	(B) daily parenteral therapy;
208.2 	(C) wound or decubiti care;
208.3 	(D) postural drainage, percussion, nebulizer treatments, suctioning, tracheotomy 
208.4 	care, oxygen, mechanical ventilation;
208.5 	(E) catheterization;
208.6 	(F) ostomy care;
208.7 	(G) quadriplegia; or
208.8 	(H) other comparable medical conditions or treatments the commissioner determines 
208.9 	would otherwise require institutional care.
208.10 	(5) A recipient shall qualify as having Level I behavior if there is reasonable 
208.11 	supporting evidence that the recipient exhibits, or that without supervision, observation, or 
208.12 	redirection would exhibit, one or more of the following behaviors that cause, or have the 
208.13 	potential to cause:
208.14 	(A) injury to the recipient's own body;
208.15 	(B) physical injury to other people; or
208.16 	(C) destruction of property.
208.17 	(6) Time authorized for personal care relating to Level I behavior in paragraph 
208.18 	(5), clauses (A) to (C), shall be based on the predictability, frequency, and amount of 
208.19 	intervention required.
208.20 	(7) A recipient shall qualify as having Level II behavior if the recipient exhibits on a 
208.21 	daily basis one or more of the following behaviors that interfere with the completion of 
208.22 	personal care assistant services under subdivision 2, paragraph (a):
208.23 	(A) unusual or repetitive habits;
208.24 	(B) withdrawn behavior; or
208.25 	(C) offensive behavior.
208.26 	(8) A recipient with a home care rating of Level II behavior in paragraph (7), clauses 
208.27 	(A) to (C), shall be rated as comparable to a recipient with complex medical needs under 
208.28 	paragraph (4). If a recipient has both complex medical needs and Level II behavior, the 
208.29 	home care rating shall be the next complex category up to the maximum rating under 
208.30 	paragraph (1), clause (B).
208.31 	(1) total number of dependencies of activities of daily living as defined in section 
208.32 	256B.0659;
208.33 	(2) number of complex health-related functions as defined in section 256B.0659; and
208.34 	(3) number of behavior criteria as defined in section 256B.0659.
208.35 	(c) The methodology to determine total time for personal care assistance services is 
208.36 	based on the median paid units per day for each home care rating from fiscal year 2007 
209.1 	data. Each home care rating has a base level of hours assigned. Additional time is added 
209.2 	through the assessment and identification of the following:
209.3 	(1) 30 additional minutes per day for a dependency in each critical activity of daily 
209.4 	living as defined in section 256B.0659;
209.5 	(2) 30 additional minutes per day for each complex health-related need as defined in 
209.6 	section 256B.0659; and
209.7 	(3) 30 additional minutes per day for each behavior criteria as defined in section 
209.8 	256B.0659.
209.9 	(d) A limit of 96 units of qualified professional supervision may be authorized for 
209.10 	each recipient receiving personal care assistance services. A request to the commissioner 
209.11 	to exceed this total in a calendar year must be requested by the personal care provider 
209.12 	agency on a form approved by the commissioner.

209.13 	Sec. 30. Minnesota Statutes 2008, section 256B.0657, subdivision 8, is amended to 
209.14 	read:
209.15 		Subd. 8.Self-directed budget requirements. The budget for the provision of the 
209.16 	self-directed service option shall be equal to the greater of either established based on:
209.17 	(1) the annual amount of personal care assistant services under section 256B.0655
209.18 	that the recipient has used in the most recent 12-month period assessed personal care 
209.19 	assistance units, not to exceed the maximum number of personal care assistance units 
209.20 	available, as determined by section 256B.0655; or 
209.21 	(2) the amount determined using the consumer support grant methodology under 
209.22 	section 256.476, subdivision 11, except that the budget amount shall include the federal 
209.23 	and nonfederal share of the average service costs. the personal care assistance unit rate:
209.24 	(i) with a reduction to the unit rate to pay for a program administrator as defined in 
209.25 	subdivision 10; and
209.26 	(ii) an additional adjustment to the unit rate as needed to ensure cost neutrality for 
209.27 	the state.

209.28 	Sec. 31. Minnesota Statutes 2008, section 256B.0657, is amended by adding a 
209.29 	subdivision to read:
209.30 		Subd. 12.Enrollment and evaluation. Enrollment in the self-directed supports 
209.31 	option is available to current personal care assistance recipients upon annual personal care 
209.32 	assistance reassessment, with a maximum enrollment of 1,000 people in the first fiscal 
209.33 	year of implementation and an additional 1,000 people in the second fiscal year.  The 
209.34 	commissioner shall evaluate the self-directed supports option during the first two years of 
210.1 	implementation and make any necessary changes prior to the option becoming available 
210.2 	statewide.

210.3 	Sec. 32. [256B.0659] PERSONAL CARE ASSISTANCE PROGRAM.
210.4 		Subdivision 1.Definitions. (a) For the purposes of this section, the terms defined in 
210.5 	paragraphs (b) to (p) have the meanings given unless otherwise provided in text.
210.6 	(b) "Activities of daily living" means grooming, dressing, bathing, transferring, 
210.7 	mobility, positioning, eating, and toileting.
210.8 	(c) "Behavior" means categories to determine the home care rating and is based on 
210.9 	the criteria found in this section. Level I behavior means physical aggression to self or 
210.10 	others and destruction of property.
210.11 	(d) "Complex health-related needs" means a category to determine the home care 
210.12 	rating and is based on the criteria found in this section.
210.13 	(e) "Critical activities of daily living" means transferring, mobility, eating, and 
210.14 	toileting.
210.15 	(f) "Dependency in activities of daily living" means a person requires assistance to 
210.16 	begin or complete one or more of the activities of daily living.
210.17 	(g) "Health-related functions" means functions that can be delegated or assigned 
210.18 	by a licensed health care professional under state law to be performed by a personal 
210.19 	care assistant.
210.20 	(h) "Instrumental activities of daily living" means activities to include meal planning 
210.21 	and preparation; basic assistance with paying bills; shopping for food, clothing, and 
210.22 	other essential items; performing household tasks integral to the personal care assistance 
210.23 	services; communication by telephone and other media; and traveling, including to 
210.24 	medical appointments, and participating in the community.
210.25 	(i) " Managing employee" has the same definition as described in Code of Federal 
210.26 	Regulations, title 42, section 455.
210.27 	(j) "Qualified professional" means a professional providing supervision of personal 
210.28 	care assistance services and staff as defined in section 256B.0625, subdivision 19c.
210.29 	(k) "Personal care assistance provider agency" means a medical assistance enrolled 
210.30 	provider that provides or assists with providing personal care assistance services and 
210.31 	includes personal care assistance provider organizations, personal care assistance choice 
210.32 	agency, class A licensed nursing agency, and Medicare-certified home health agency.
210.33 	(l) "Personal care assistant" means an individual employed by a personal care 
210.34 	assistance agency that provides personal care assistance services.
211.1 	(m) "Personal care assistance care plan" means a written description of personal 
211.2 	care assistance services developed by the personal care assistance provider according 
211.3 	to the service plan.
211.4 	(n) "Responsible party" means an individual who is capable of providing the support 
211.5 	necessary to assist the recipient to live in the community.
211.6 	(o) "Self-administered medication" means medication taken orally, by injection or 
211.7 	insertion, or applied topically without the need for assistance.
211.8 	(p) "Service plan" means a written summary of the assessment and description of the 
211.9 	services needed by the recipient.
211.10 		Subd. 2.Personal care assistance services; covered services. (a) The personal 
211.11 	care assistance services eligible for payment include services and supports furnished 
211.12 	to an individual, as needed, to assist in:
211.13 	(1) activities of daily living;
211.14 	(2) health-related procedures and tasks;
211.15 	(3) assistance with behavior needs; and
211.16 	(4) instrumental activities of daily living.
211.17 	(b) Activities of daily living include the following covered services:
211.18 	(1) dressing, including assistance with choosing, application, and changing of 
211.19 	clothing and application of special appliances, wraps, or clothing;
211.20 	(2) grooming, including assistance with basic hair care, oral care, shaving, applying 
211.21 	cosmetics and deodorant, and care of eyeglasses and hearing aids. Nail care is included, 
211.22 	except for recipients who are diabetic or have poor circulation;
211.23 	(3) bathing, including assistance with basic personal hygiene and skin care;
211.24 	(4) eating, including assistance with hand washing and application of orthotics 
211.25 	required for eating, transfers, and feeding;
211.26 	(5) transfers, including assistance with transferring the recipient from one seating or 
211.27 	reclining area to another;
211.28 	(6) mobility, including assistance with ambulation, including use of a wheelchair. 
211.29 	Mobility does not include providing transportation for a recipient;
211.30 	(7) positioning, including assistance with positioning or turning a recipient for 
211.31 	necessary care and comfort; and
211.32 	(8) toileting, including assistance with helping recipient with bowel or bladder 
211.33 	elimination and care including transfers, mobility, positioning, feminine hygiene, use of 
211.34 	toileting equipment or supplies, cleansing the perineal area, inspection of the skin, and 
211.35 	adjusting clothing.
211.36 	(c) Health-related procedures or tasks include the following covered services:
212.1 	(1) range of motion and passive exercise to maintain a recipient's optimal level of 
212.2 	strength and muscle functioning;
212.3 	(2) assistance with self-administered medication as defined by this section, including 
212.4 	reminders to take medication, bringing medication to the recipient, and assistance with 
212.5 	opening medication under the direction of the recipient or responsible party;
212.6 	(3) interventions for seizure disorders, including monitoring and observation; and
212.7 	(4) other activities considered within the scope of the personal care service and 
212.8 	meeting the definition of health-related procedures or tasks under this section.
212.9 	(d) A personal care assistant may perform health-related procedures and tasks 
212.10 	associated with the complex health-related needs of a recipient if the tasks meet the 
212.11 	definition of health-related procedures and tasks under this section and the personal care 
212.12 	assistant is trained by a qualified professional and demonstrates competency to safely 
212.13 	complete the task. Delegation of health-related procedures and tasks and all training must 
212.14 	be documented in the personal care assistance care plan and the recipient's and personal 
212.15 	care assistant's files.
212.16 	(e) For a personal care assistant to provide the health-related procedures and tasks of 
212.17 	tracheostomy suctioning and services to recipients on ventilator support there must be:
212.18 	(1) delegation and training by a registered nurse, certified or licensed respiratory 
212.19 	therapist, or a physician;
212.20 	(2) utilization of clean rather than sterile procedure;
212.21 	(3) specialized training about the health-related functions and equipment, including 
212.22 	ventilator operation and maintenance;
212.23 	(4) individualized training regarding the needs of the recipient; and
212.24 	(5) supervision by a qualified professional who is a registered nurse.
212.25 	(f) A personal care assistant may observe and redirect the recipient for episodes 
212.26 	where there is a need for redirection due to behaviors. Training of the personal care 
212.27 	assistant must occur based on the needs of the recipient, the personal care assistance care 
212.28 	plan, and any other support services provided.
212.29 		Subd. 3.Noncovered personal care assistance services. (a) Personal care 
212.30 	assistance services are not eligible for medical assistance payment under this section 
212.31 	when provided:
212.32 	(1) by the recipient's spouse, parent of a recipient under the age of 18, paid legal 
212.33 	guardian, licensed foster provider, except as allowed under section 256B.0651, subdivision 
212.34 	9, or responsible party;
212.35 	(2) in lieu of other staffing options in a residential or child care setting;
212.36 	(3) solely as a child care or babysitting service; or
213.1 	(4) without authorization by the commissioner or the commissioner's designee.
213.2 	(b) The following personal care services are not eligible for medical assistance 
213.3 	payment under this section when provided in residential settings:
213.4 	(1) when the provider of home care services who is not related by blood, marriage, 
213.5 	or adoption owns or otherwise controls the living arrangement, including licensed or 
213.6 	unlicensed services; or
213.7 	(2) when personal care assistance services are the responsibility of a residential or 
213.8 	program license holder under the terms of a service agreement and administrative rules.
213.9 	(c) Other specific tasks not covered under paragraph (a) or (b) that are not eligible 
213.10 	for medical assistance reimbursement for personal care assistance services under this 
213.11 	section include:
213.12 	(1) sterile procedures;
213.13 	(2) injections of fluids and medications into veins, muscles, or skin;
213.14 	(3) home maintenance or chore services;
213.15 	(4) homemaker services not an integral part of assessed personal care assistance 
213.16 	services needed by a recipient;
213.17 	(5) application of restraints or implementation of procedures under section 245.825;
213.18 	(6) instrumental activities of daily living for children under the age of 18; and
213.19 	(7) assessments for personal care assistance services by personal care assistance 
213.20 	provider agencies or by independently enrolled registered nurses.
213.21 		Subd. 4.Assessment for personal care assistance services. (a) An assessment 
213.22 	as defined in section 256B.0655, subdivision 1b, must be completed for personal care 
213.23 	assistance services.
213.24 	(b) The following conditions apply to the assessment:
213.25 	(1) a person must be assessed as dependent in an activity of daily living based 
213.26 	on the person's need, on a daily basis, for:
213.27 	(i) cueing or supervision to complete the task; or
213.28 	(ii) hands-on assistance to complete the task; and
213.29 	(2) a child may not be found to be dependent in an activity of daily living if because 
213.30 	of the child's age an adult would either perform the activity for the child or assist the child 
213.31 	with the activity. Assistance needed is the assistance appropriate for a typical child of 
213.32 	the same age.
213.33 	(c) Assessment for complex health-related needs must meet the criteria in this 
213.34 	paragraph. During the assessment process, a recipient qualifies as having complex 
213.35 	health-related functions if the recipient has one or more of the interventions that are 
214.1 	ordered by a physician, specified in a personal care assistance care plan, and found in 
214.2 	the following:
214.3 	(1) tube feedings requiring:
214.4 	(i) a gastro/jejunostomy tube; or
214.5 	(ii) continuous tube feeding lasting longer than 12 hours per day;
214.6 	(2) wounds described as:
214.7 	(i) stage III or stage IV;
214.8 	(ii) multiple wounds;
214.9 	(iii) requiring sterile or clean dressing changes or a wound vac; or
214.10 	(iv) open lesions such as burns, fistulas, tube sites, or ostomy sites that require 
214.11 	specialized care;
214.12 	(3) parenteral therapy described as:
214.13 	(i) IV therapy more than two times per week lasting longer than four hours for 
214.14 	each treatment; or
214.15 	(ii) total parenteral nutrition (TPN) daily;
214.16 	(4) respiratory interventions including:
214.17 	(i) oxygen required more than eight hours per day;
214.18 	(ii) respiratory vest more than one time per day;
214.19 	(iii) bronchial drainage treatments more than two times per day;
214.20 	(iv) sterile or clean suctioning more than six times per day;
214.21 	(v) dependence on another to apply respiratory ventilation augmentation devises 
214.22 	such as BiPAP and CPAP; and
214.23 	(vi) ventilator dependence under section 256B.0652;
214.24 	(5) insertion and maintenance of catheter including:
214.25 	(i) sterile catheter changes more than one time per month;
214.26 	(ii) clean self-catheterization more than six times per day; or
214.27 	(iii) bladder irrigations;
214.28 	(6) bowel program more than two times per week requiring more than 30 minutes to 
214.29 	perform each time;
214.30 	(7) neurological intervention including:
214.31 	(i) seizures more than two times per week and requiring significant physical 
214.32 	assistance to maintain safety; or
214.33 	(ii) swallowing disorders diagnosed by a physician and requiring specialized 
214.34 	assistance from another on a daily basis; and
214.35 	(8) other congenital or acquired diseases creating a need for significantly increased 
214.36 	direct hands-on assistance and interventions in six to eight activities of daily living.
215.1 	(d) An assessment of behaviors must meet the criteria in this paragraph. A recipient 
215.2 	qualifies as having a need for assistance due to behaviors if the recipient's behavior requires 
215.3 	assistance at least four times per week and shows one or more of the following behaviors:
215.4 	(1) physical aggression towards self, others, or property that requires immediate 
215.5 	response of another;
215.6 	(2) increased vulnerability due to cognitive deficits or socially inappropriate 
215.7 	behavior; or
215.8 	(3) verbally aggressive and resistive to care.
215.9 		Subd. 5.Service and support planning and referral. (a) The assessor, with the 
215.10 	recipient or responsible party, shall review the assessment information and determine 
215.11 	referrals for other payers, services, and community supports as appropriate.
215.12 	(b) The recipient must be referred for evaluation, services, or supports that are 
215.13 	appropriate to help meet the recipient's needs including, but not limited to, the following 
215.14 	circumstances:
215.15 	(1) when there is another payer who is responsible to provide the service to meet 
215.16 	the recipient's needs;
215.17 	(2) when the recipient qualifies for assistance due to mental illness or behaviors 
215.18 	under this section, a referral for a mental health diagnostic and functional assessment 
215.19 	must be completed, or referral must be made for other specific mental health services 
215.20 	or community services;
215.21 	(3) when the recipient is eligible for medical assistance and meets medical assistance 
215.22 	eligibility for a home health aide or skilled nurse visit;
215.23 	(4) when the recipient would benefit from an evaluation for another service; and
215.24 	(5) when there is a more appropriate service to meet the assessed needs.
215.25 	(c) The reimbursement rates for public health nurse visits that relate to the provision 
215.26 	of personal care assistance services under this section and section 256B.0625, subdivision 
215.27 	19a, are:
215.28 	(1) $210.50 for a face-to-face assessment visit;
215.29 	(2) $105.25 for each service update; and
215.30 	(3) $105.25 for each request for a temporary service increase.
215.31 	(d) The rates specified in paragraph (c) must be adjusted to reflect provider rate 
215.32 	increases for personal care assistance services that are approved by the legislature for the 
215.33 	fiscal year ending June 30, 2000, and subsequent fiscal years. Any requirements applied 
215.34 	by the legislature to provider rate increases for personal care assistance services also 
215.35 	apply to adjustments under this paragraph.
216.1 	(e) Effective July 1, 2008, the payment rate for an assessment under this section and 
216.2 	section 256B.0651 shall be reduced by 25 percent when the assessment is not completed 
216.3 	on time and the service agreement documentation is not submitted in time to continue 
216.4 	services. The commissioner shall reduce the amount of the claim for those assessments 
216.5 	that are not submitted on time.
216.6 		Subd. 6.Service plan. The service plan must be completed by the assessor with the 
216.7 	recipient and responsible party on a form determined by the commissioner and include 
216.8 	a summary of the assessment with a description of the need, authorized amount, and 
216.9 	expected outcomes and goals of personal care assistance services. The recipient and 
216.10 	the provider chosen by the recipient or responsible party must be given a copy of the 
216.11 	completed service plan within ten working days. The recipient or responsible party must 
216.12 	be given information by the assessor about the options in the personal care assistance 
216.13 	program to allow for review and decision making.
216.14 		Subd. 7.Personal care assistance care plan. (a) Each recipient must have a current 
216.15 	personal care assistance care plan based on the service plan in subdivision 21 that is 
216.16 	developed by the qualified professional with the recipient and responsible party. A copy of 
216.17 	the most current personal care assistance care plan is required to be in the recipient's home 
216.18 	and in the recipient's file at the provider agency.
216.19 	(b) The personal care assistance care plan must have the following components:
216.20 	(1) start and end date of the care plan;
216.21 	(2) recipient demographic information, including name and telephone number;
216.22 	(3) emergency numbers, procedures, and a description of measures to address 
216.23 	identified safety and vulnerability issues, including a backup staffing plan; 
216.24 	(4) name of responsible party and instructions for contact;
216.25 	(5) description of the recipient's individualized needs for assistance with activities of 
216.26 	daily living, instrumental activities of daily living, health-related tasks, and behaviors; and
216.27 	(6) dated signatures of recipient or responsible party and qualified professional.
216.28 	(c) The personal care assistance care plan must have instructions and comments 
216.29 	about the recipient's needs for assistance and any special instructions or procedures 
216.30 	required. The month-to-month plan for the use of personal care assistance services is part 
216.31 	of the personal care assistance care plan. The personal care assistance care plan must 
216.32 	be completed within the first week after start of services with a personal care provider 
216.33 	agency and must be updated as needed when there is a change in need for personal care 
216.34 	assistance services. A new personal care assistance care plan is required annually at the 
216.35 	time of the reassessment.
217.1 		Subd. 8.Communication with recipient's physician. The personal care assistance 
217.2 	program requires communication with the recipient's physician about a recipient's assessed 
217.3 	needs for personal care assistance services. The commissioner shall work with the state 
217.4 	medical director to develop options for communication with the recipient's physician.
217.5 		Subd. 9.Responsible party; generally. (a) "Responsible party" means an 
217.6 	individual who is capable of providing the support necessary to assist the recipient to live 
217.7 	in the community.
217.8 	(b) A responsible party must be 18 years of age, actively participate in planning and 
217.9 	directing of personal care assistance services, and attend all assessments for the recipient.
217.10 	(c) A responsible party must not be the:
217.11 	(1) personal care assistant;
217.12 	(2) home care provider agency owner or staff; or
217.13 	(3) county staff acting as part of employment.
217.14 	(d) A licensed family foster parent who lives with the recipient may be the 
217.15 	responsible party as long as the family foster parent meets the other responsible party 
217.16 	requirements. 
217.17 	(e) A responsible party is required when:
217.18 	(1) the person is a minor according to section 524.5-102, subdivision 10;
217.19 	(2) the person is an incapacitated adult according to section 524.5-102, subdivision 
217.20 	6, resulting in a court-appointed guardian; or
217.21 	(3) the assessment according to section 256B.0911 determines that the recipient is in 
217.22 	need of a responsible party to direct the recipient's care.
217.23 	(f) There may be two persons designated as the responsible party for reasons such 
217.24 	as divided households and court-ordered custodies. Each person named as responsible 
217.25 	party must meet the program criteria and responsibilities.
217.26 	(g) The recipient or the recipient's legal representative shall appoint a responsible 
217.27 	party if necessary to direct and supervise the care provided to the recipient. The 
217.28 	responsible party must be identified at the time of assessment and listed on the recipient's 
217.29 	service agreement and personal care assistance care plan.
217.30 		Subd. 10.Responsible party; duties; delegation. (a) A responsible party with a 
217.31 	personal care assistance provider agency shall enter into a written agreement, on a form 
217.32 	determined by the commissioner, to perform the following duties: 
217.33 	(1) be available while care is provided in a method agreed upon by the individual 
217.34 	or the individual's legal representative and documented in the recipient's personal care 
217.35 	assistance care plan;
218.1 	(2) monitor personal care assistance services to ensure the recipient's personal care 
218.2 	assistance care plan is being followed; and
218.3 	(3) review and sign personal care assistance time sheets after services are provided 
218.4 	to provide verification that personal care assistance services were provided.
218.5 	Failure to provide the support required by the recipient must result in a referral to the 
218.6 	county common entry point.
218.7 	(b) Responsible parties who are parents of minors or guardians of minors or 
218.8 	incapacitated persons may delegate the responsibility to another adult who is not the 
218.9 	personal care assistant during a temporary absence of at least 24 hours but not more 
218.10 	than six months. The person delegated as a responsible party must be able to meet the 
218.11 	definition of the responsible party, except that the delegated responsible party is required 
218.12 	to reside with the recipient only while serving as the responsible party. The responsible 
218.13 	party must ensure that the delegate performs the functions of the responsible party, is 
218.14 	identified at the time of the assessment, and is listed on the personal care assistance 
218.15 	care plan. The responsible party must communicate to the personal care assistance 
218.16 	provider agency about the need for a delegate responsible party, including the name of the 
218.17 	delegated responsible party, dates the delegated responsible party will be acting as the 
218.18 	responsible party, and contact numbers.
218.19 		Subd. 11.Personal care assistant; requirements. (a) A personal care assistant 
218.20 	must meet the following requirements:
218.21 	(1) be at least 18 years of age and if 16 or 17 years of age only if:
218.22 	(i) supervised by a qualified professional every 60 days; and
218.23 	(ii) employed by only one personal care assistance provider agency responsible 
218.24 	for compliance with current labor laws;
218.25 	(2) be employed by a personal care assistance provider agency;
218.26 	(3) enroll with the department as a non-pay-to provider after clearing a background 
218.27 	study. Before a personal care assistant provides services, the personal care assistance 
218.28 	provider agency must initiate a background study on the personal care assistant under 
218.29 	chapter 245C, and the personal care assistance provider agency must have received a 
218.30 	notice from the commissioner that the personal care assistant is:
218.31 	(i) not disqualified under section 245C.14; or
218.32 	(ii) is disqualified, but the personal care assistant has received a set aside of the 
218.33 	disqualification under section 245C.22;
218.34 	(4) be able to effectively communicate with the recipient and personal care 
218.35 	assistance provider agency;
219.1 	(5) be able to provide covered personal care assistance services according to the 
219.2 	recipient's personal care assistance care plan, respond appropriately to recipient needs, 
219.3 	and report changes in the recipient's condition to the supervising qualified professional 
219.4 	or physician;
219.5 	(6) not be a consumer of personal care assistance services;
219.6 	(7) maintain daily written records including, but not limited to, time sheets under 
219.7 	subdivision 12;
219.8 	(8) complete standardized training as determined or approved by the commissioner 
219.9 	before completing enrollment. Personal care assistant training must include successful 
219.10 	completion of the following training components: basic first aid, vulnerable adult, child 
219.11 	maltreatment, OSHA universal precautions, basic roles and responsibilities of personal 
219.12 	care assistants including information about assistance with lifting and transfers for 
219.13 	recipients, orientation to positive behavior practices, emergency preparedness, fraud 
219.14 	issues, and completion of time sheets.Upon completion of the training components, the 
219.15 	personal care assistant must demonstrate the competency to provide assistance to the 
219.16 	recipient. Personal care assistant training and orientation must be completed within the 
219.17 	first seven days after the services begin and be directed to the needs of the recipient and 
219.18 	the recipient's personal care assistance care plan; and
219.19 	(9) be limited to providing and being paid for no more than 310 hours per month of 
219.20 	personal care assistance services that is determined by the commissioner regardless of 
219.21 	the number of recipients being served or the number of personal care assistance provider 
219.22 	agencies enrolled with.
219.23 	(b) A legal guardian may be a personal care assistant if the guardian is not being paid 
219.24 	for the guardian services and meets the criteria for personal care assistants in paragraph (a).
219.25 	(c) Persons who do not qualify as a personal care assistant include parents and 
219.26 	stepparents of minors, spouses, paid legal guardians, foster care providers, except as 
219.27 	otherwise allowed in section 256B.0625, subdivision 19a, or staff of a residential setting.
219.28 		Subd. 12.Documentation of personal care assistance services provided. (a) 
219.29 	Personal care assistance services for a recipient must be documented daily by each personal 
219.30 	care assistant, on a time sheet form approved by the commissioner. All documentation 
219.31 	may be Web-based, electronic, or paper documentation. The completed form must be 
219.32 	submitted on a monthly basis to the provider and kept in the recipient's health record.
219.33 	(b) The activity documentation must correspond to the personal care assistance care 
219.34 	plan and be reviewed by the qualified professional.
220.1 	(c) The personal care assistant time sheet must be on a form approved by the 
220.2 	commissioner documenting time the personal care assistant provides services in the home. 
220.3 	The following criteria must be included in the time sheet:
220.4 	(1) full name of personal care assistant and individual provider number;
220.5 	(2) provider name and telephone numbers;
220.6 	(3) full name of recipient;
220.7 	(4) consecutive dates, including month, day, and year, and arrival and departure 
220.8 	time with a.m. or p.m. notations;
220.9 	(5) signatures of recipient or the responsible party;
220.10 	(6) personal signature of the personal care assistant;
220.11 	(7) any shared care provided, if applicable;
220.12 	(8) a statement that it is a federal crime to provide false information on personal 
220.13 	care service billings for medical assistance payments; and
220.14 	(9) dates and location of recipient stays in a hospital, care facility, or incarceration.
220.15 		Subd. 13.Qualified professional; qualifications. (a) The qualified professional 
220.16 	must be employed by a personal care assistance provider agency and meet the definition 
220.17 	under section 256B.0625, subdivision 19c. Before a qualified professional provides 
220.18 	services, the personal care assistance provider agency must initiate a background study on 
220.19 	the qualified professional under chapter 245C, and the personal care assistance provider 
220.20 	agency must have received a notice from the commissioner that the qualified professional:
220.21 	(1) is not disqualified under section 245C.14; or
220.22 	(2) is disqualified, but the qualified professional has received a set aside of the 
220.23 	disqualification under section 245C.22.
220.24 	(b) The qualified professional shall perform the duties of training, supervision, and 
220.25 	evaluation of the personal care assistance staff and evaluation of the effectiveness of 
220.26 	personal care assistance services. The qualified professional shall:
220.27 	(1) develop and monitor with the recipient a personal care assistance care plan based 
220.28 	on the service plan and individualized needs of the recipient;
220.29 	(2) develop and monitor with the recipient a monthly plan for the use of personal 
220.30 	care assistance services;
220.31 	(3) review documentation of personal care assistance services provided;
220.32 	(4) provide training and ensure competency for the personal care assistant in the 
220.33 	individual needs of the recipient; and
220.34 	(5) document all training, communication, evaluations, and needed actions to 
220.35 	improve performance of the personal care assistants.
221.1 	(c) The qualified professional shall complete the provider training with basic 
221.2 	information about the personal care assistance program approved by the commissioner 
221.3 	within six months of the date hired by a personal care assistance provider agency. 
221.4 	Qualified professionals who have completed the required trainings as an employee with a 
221.5 	personal care assistance provider agency do not need to repeat the required trainings if they 
221.6 	are hired by another agency, if they have completed the training within the last three years.
221.7 		Subd. 14.Qualified professional; duties. (a) All personal care assistants must 
221.8 	be supervised by a qualified professional or in a joint supervision relationship with the 
221.9 	recipient or the responsible party.
221.10 	(b) Through direct training, observation, return demonstrations, and consultation 
221.11 	with the staff and the recipient, the qualified professional must ensure and document 
221.12 	that the personal care assistant is:
221.13 	(1) capable of providing the required personal care assistance services;
221.14 	(2) knowledgeable about the plan of personal care assistance services before services 
221.15 	are performed; and
221.16 	(3) able to identify conditions that should be immediately brought to the attention of 
221.17 	the qualified professional.
221.18 	(c) The qualified professional shall evaluate the personal care assistant within the 
221.19 	first 14 days of starting to provide services for a recipient, except for those providing 
221.20 	services under the personal care assistant choice option under subdivision 19. The 
221.21 	qualified professional shall evaluate the personal care assistance services for a recipient 
221.22 	through direct observation of a personal care assistant's work:
221.23 	(1) at least every 90 days thereafter for the first year of a recipient's services; and
221.24 	(2) every 120 days after the first year of a recipient's service, or whenever needed for 
221.25 	response to a recipient's request for increased supervision of the personal care assistance 
221.26 	staff.
221.27 	(d) Communication with the recipient is a part of the evaluation process of the 
221.28 	personal care assistance staff.
221.29 	(e) At each supervisory visit, the qualified professional shall evaluate personal care 
221.30 	assistance services including the following information:
221.31 	(1) satisfaction level of the recipient with personal care assistance services;
221.32 	(2) review of the month-to-month plan for use of personal care assistance services;
221.33 	(3) review of documentation of personal care assistance services provided;
221.34 	(4) whether the personal care assistance services are meeting the goals of the service 
221.35 	as stated in the personal care assistance care plan and service plan;
222.1 	(5) a written record of the results of the evaluation and actions taken to correct any 
222.2 	deficiencies in the work of a personal care assistant; and
222.3 	(6) revision of the personal care assistance care plan as necessary in consultation 
222.4 	with the recipient or responsible party, to meet the needs of the recipient.
222.5 	(f) The qualified professional shall complete the required documentation in the 
222.6 	agency recipient and employee files and the recipient's home, including the following 
222.7 	documentation:
222.8 	(1) the personal care assistance care plan based on the service plan and individualized 
222.9 	needs of the recipient;
222.10 	(2) a month-to-month plan for use of personal care assistance services;
222.11 	(3) changes in need of the recipient requiring a change to the level of service and the 
222.12 	personal care assistance care plan;
222.13 	(4) evaluation results of supervision visits and identified issues with personal care 
222.14 	assistance staff with actions taken;
222.15 	(5) all communication with the recipient and personal care assistance staff; and
222.16 	(6) hands-on training or individualized training for the care of the recipient.
222.17 	(g) The documentation in paragraph (f) must be completed on agency forms.
222.18 	(h) The services that are not eligible for payment as qualified professional services 
222.19 	include:
222.20 	(1) direct professional nursing tasks that could be assessed and authorized as skilled 
222.21 	nursing tasks;
222.22 	(2) supervision of personal care assistance completed by telephone;
222.23 	(3) agency administrative activities;
222.24 	(4) training other than the individualized training required to provide care for a 
222.25 	recipient; and
222.26 	(5) any other activity that is not described in this section.
222.27 		Subd. 15.Flexible use. (a) "Flexible use" means the scheduled use of authorized 
222.28 	hours of personal care assistance services, which vary within a service authorization 
222.29 	period covering no more than six months, in order to more effectively meet the needs and 
222.30 	schedule of the recipient. Each 12-month service agreement is divided into two six-month 
222.31 	authorization date spans. No more than 75 percent of the total authorized units for a 
222.32 	12-month service agreement may be used in a six-month date span.
222.33 	(b) Authorization of flexible use occurs during the authorization process under 
222.34 	section 256B.0652. The flexible use of authorized hours does not increase the total 
222.35 	amount of authorized hours available to a recipient. The commissioner shall not authorize 
222.36 	additional personal care assistance services to supplement a service authorization that 
223.1 	is exhausted before the end date under a flexible service use plan, unless the assessor 
223.2 	determines a change in condition and a need for increased services is established. 
223.3 	Authorized hours not used within the six-month period must not be carried over to another 
223.4 	time period.
223.5 	(c) A recipient who has terminated personal care assistance services before the end 
223.6 	of the 12-month authorization period must not receive additional hours upon reapplying 
223.7 	during the same 12-month authorization period, except if a change in condition is 
223.8 	documented. Services must be prorated for the remainder of the 12-month authorization 
223.9 	period based on the first six-month assessment.
223.10 	(d) The recipient, responsible party, and qualified professional must develop a 
223.11 	written month-to-month plan of the projected use of personal care assistance services that 
223.12 	is part of the personal care assistance care plan and ensures:
223.13 	(1) that the health and safety needs of the recipient are met throughout both date 
223.14 	spans of the authorization period; and
223.15 	(2) that the total authorized amount of personal care assistance services for each date 
223.16 	span must not be used before the end of each date span in the authorization period.
223.17 	(e) The personal care assistance provider agency shall monitor the use of personal 
223.18 	care assistance services to ensure health and safety needs of the recipient are met 
223.19 	throughout both date spans of the authorization period. The commissioner or the 
223.20 	commissioner's designee shall provide written notice to the provider and the recipient or 
223.21 	responsible party when a recipient is at risk of exceeding the personal care assistance 
223.22 	services prior to the end of the six-month period.
223.23 	(f) Misuse and abuse of the flexible use of personal care assistance services resulting 
223.24 	in the overuse of units in a manner where the recipient will not have enough units to meet 
223.25 	their needs for assistance and ensure health and safety for the entire six-month date span 
223.26 	may lead to an action by the commissioner. The commissioner may take action including, 
223.27 	but not limited to: (1) restricting recipients to service authorizations of no more than one 
223.28 	month in duration; (2) requiring the recipient to have a responsible party; and (3) requiring 
223.29 	a qualified professional to monitor and report services on a monthly basis.
223.30 		Subd. 16.Shared services. (a) Medical assistance payments for shared personal 
223.31 	care assistance services are limited according to this subdivision.
223.32 	(b) Shared service is the provision of personal care assistance services by a personal 
223.33 	care assistant to two or three recipients, eligible for medical assistance, who voluntarily 
223.34 	enter into an agreement to receive services at the same time and in the same setting.
223.35 	(c) For the purposes of this subdivision, "setting" means:
224.1 	(1) the home residence or family foster care home of one or more of the individual 
224.2 	recipients; or
224.3 	(2) a child care program licensed under chapter 245A or operated by a local school 
224.4 	district or private school.
224.5 	(d) Shared personal care assistance services follow the same criteria for covered 
224.6 	services as subdivision 2.
224.7 	(e) Noncovered shared personal care assistance services include the following:
224.8 	(1) services for more than three recipients by one personal care assistant at one time;
224.9 	(2) staff requirements for child care programs under chapter 245C;
224.10 	(3) caring for multiple recipients in more than one setting;
224.11 	(4) additional units of personal care assistance based on the selection of the option; 
224.12 	and
224.13 	(5) use of more than one personal care assistance provider agency for the shared 
224.14 	care services.
224.15 	(f) The option of shared personal care assistance is elected by the recipient or the 
224.16 	responsible party with the assistance of the assessor. The option must be determined 
224.17 	appropriate based on the ages of the recipients, compatibility, and coordination of their 
224.18 	assessed care needs. The recipient or the responsible party, in conjunction with the 
224.19 	qualified professional, shall arrange the setting and grouping of shared services based 
224.20 	on the individual needs and preferences of the recipients. The personal care assistance 
224.21 	provider agency shall offer the recipient or the responsible party the option of shared or 
224.22 	one-on-one personal care assistance services or a combination of both. The recipient or 
224.23 	the responsible party may withdraw from participating in a shared services arrangement at 
224.24 	any time.
224.25 	(g) Authorization for the shared service option must be determined by the 
224.26 	commissioner based on the criteria that the shared service is appropriate to meet all of the 
224.27 	recipients' needs and their health and safety is maintained. The authorization of shared 
224.28 	services is part of the overall authorization of personal care assistance services. Nothing 
224.29 	in this subdivision must be construed to reduce the total number of hours authorized for 
224.30 	an individual recipient.
224.31 	(h) A personal care assistant providing shared personal care assistance services must:
224.32 	(1) receive training specific for each recipient served; and
224.33 	(2) follow all required documentation requirements for time and services provided.
224.34 	(i) A qualified professional shall:
224.35 	(1) evaluate the ability of the personal care assistant to provide services for all of 
224.36 	the recipients in a shared setting;
225.1 	(2) visit the shared setting as services are being provided at least once every six 
225.2 	months or whenever needed for response to a recipient's request for increased supervision 
225.3 	of the personal care assistance staff;
225.4 	(3) provide ongoing monitoring and evaluation of the effectiveness and 
225.5 	appropriateness of the shared services;
225.6 	(4) develop a contingency plan with each of the recipients which accounts for 
225.7 	absence of the recipient in a share services setting due to illness or other circumstances;
225.8 	(5) obtain permission from each of the recipients who are sharing a personal care 
225.9 	assistant for number of shared hours for services provided inside and outside the home 
225.10 	residence; and
225.11 	(6) document the training completed by the personal care assistants specific to the 
225.12 	shared setting and recipients sharing services.
225.13 		Subd. 17.Shared services; rates. The commissioner shall establish a rate system 
225.14 	for shared personal care assistance services. For two persons sharing services, the rate 
225.15 	paid to a provider must not exceed one and one-half times the rate paid for serving a single 
225.16 	individual, and for three persons sharing services, the rate paid to a provider must not 
225.17 	exceed twice the rate paid for serving a single individual. These rates apply only when all 
225.18 	of the criteria for the shared care personal care assistance service have been met.
225.19 		Subd. 18.Personal care assistance choice option; generally. (a) The 
225.20 	commissioner may allow a recipient of personal care assistance services to use a fiscal 
225.21 	intermediary to assist the recipient in paying and account for medically necessary covered 
225.22 	personal care assistance services. Unless otherwise provided in this section, all other 
225.23 	statutory and regulatory provisions relating to personal care assistance services apply to a 
225.24 	recipient using the personal care assistance choice option.
225.25 	(b) Personal care assistance choice is an option of the personal care assistance 
225.26 	program that allows the recipient who receives personal care assistance services to be 
225.27 	responsible for the hiring, training, scheduling, and termination of personal care assistants. 
225.28 	This program offers greater control and choice for the recipient in deciding who provides 
225.29 	the personal care assistance service and when the service is scheduled. The recipient or 
225.30 	the recipient's responsible party must choose a personal care assistance choice provider 
225.31 	agency as a fiscal intermediary. This personal care assistance choice provider agency 
225.32 	manages payroll, invoices the state, is responsible for all payroll related taxes and 
225.33 	insurance, and is responsible for providing the consumer training and support in managing 
225.34 	the recipient's personal care assistance services.
225.35 		Subd. 19.Personal care assistance choice option; qualifications; duties. (a) 
225.36 	Under personal care assistance choice, the recipient or responsible party shall:
226.1 	(1) recruit, hire, schedule, and terminate personal care assistants and a qualified 
226.2 	professional;
226.3 	(2) develop a personal care assistance care plan based on the assessed needs 
226.4 	and addressing the health and safety of the recipient with the assistance of a qualified 
226.5 	professional as needed;
226.6 	(3) orient and train the personal care assistant with assistance as needed from the 
226.7 	qualified professional;
226.8 	(4) supervise and evaluate the personal care assistant with the qualified professional, 
226.9 	who is required to visit at least every 180 days;
226.10 	(5) monitor and verify in writing and report to the personal care assistance choice 
226.11 	agency the number of hours worked by the personal care assistant and the qualified 
226.12 	professional;
226.13 	(6) engage in an annual face-to-face reassessment to determine continuing eligibility 
226.14 	and service authorization; and
226.15 	(7) use the same personal care assistance choice provider agency if shared personal 
226.16 	assistance care is being used.
226.17 	(b) The personal care assistance choice provider agency shall:
226.18 	(1) meet all personal care assistance provider agency standards;
226.19 	(2) enter into a written agreement with the recipient, responsible party, and personal 
226.20 	care assistants;
226.21 	(3) not be related as a parent, child, sibling, or spouse to the recipient, qualified 
226.22 	professional, or the personal care assistant; and
226.23 	(4) ensure arm's-length transactions without undue influence or coercion with the 
226.24 	recipient and personal care assistant.
226.25 	(c) The duties of the personal care assistance choice provider agency are to:
226.26 	(1) be the employer of the personal care assistant and the qualified professional for 
226.27 	employment law and related regulations including but not limited to purchasing and 
226.28 	maintaining workers' compensation, unemployment insurance, surety and fidelity bonds, 
226.29 	and liability insurance, and submit any or all necessary documentation including, but not 
226.30 	limited to, workers' compensation and unemployment insurance;
226.31 	(2) bill the medical assistance program for personal care assistance services and 
226.32 	qualified professional services;
226.33 	(3) request and complete background studies that comply with the requirements for 
226.34 	personal care assistants and qualified professionals;
226.35 	(4) pay the personal care assistant and qualified professional based on actual hours 
226.36 	of services provided;
227.1 	(5) withhold and pay all applicable federal and state taxes;
227.2 	(6) verify and keep records of hours worked by the personal care assistant and 
227.3 	qualified professional;
227.4 	(7) make the arrangements and pay taxes and other benefits, if any; and comply with 
227.5 	any legal requirements for a Minnesota employer;
227.6 	(8) enroll in the medical assistance program as a personal care assistance choice 
227.7 	agency; and
227.8 	(9) enter into a written agreement as specified in subdivision 20 before services 
227.9 	are provided.
227.10 		Subd. 20.Personal care assistance choice option; administration. (a) Before 
227.11 	services commence under the personal care assistance choice option, and annually 
227.12 	thereafter, the personal care assistance choice provider agency, recipient, or responsible 
227.13 	party, each personal care assistant, and the qualified professional shall enter into a written 
227.14 	agreement. The agreement must include at a minimum:
227.15 	(1) duties of the recipient, qualified professional, personal care assistant, and 
227.16 	personal care assistance choice provider agency;
227.17 	(2) salary and benefits for the personal care assistant and the qualified professional;
227.18 	(3) administrative fee of the personal care assistance choice provider agency and 
227.19 	services paid for with that fee, including background study fees;
227.20 	(4) grievance procedures to respond to complaints;
227.21 	(5) procedures for hiring and terminating the personal care assistant; and
227.22 	(6) documentation requirements including, but not limited to, time sheets, activity 
227.23 	records, and the personal care assistance care plan.
227.24 	(b) Except for the administrative fee of the personal care assistance choice provider 
227.25 	agency as reported on the written agreement, the remainder of the rates paid to the 
227.26 	personal care assistance choice provider agency must be used to pay for the salary and 
227.27 	benefits for the personal care assistant or the qualified professional. The personal care 
227.28 	assistance choice provider agency must provide a minimum of 75 percent of the revenue 
227.29 	generated by the medical assistance rate for personal care assistance for employee 
227.30 	personal care assistant wages and benefits.
227.31 	(c) The commissioner shall deny, revoke, or suspend the authorization to use the 
227.32 	personal care assistance choice option if:
227.33 	(1) it has been determined by the qualified professional or public health nurse that 
227.34 	the use of this option jeopardizes the recipient's health and safety;
227.35 	(2) the parties have failed to comply with the written agreement specified in 
227.36 	subdivision 20;
228.1 	(3) the use of the option has led to abusive or fraudulent billing for personal care 
228.2 	assistance services; or
228.3 	(4) the department terminates the personal care assistance choice option.
228.4 	(d) The recipient or responsible party may appeal the commissioner's decision in 
228.5 	paragraph (c) according to section 256.045. The denial, revocation, or suspension to 
228.6 	use the personal care assistance choice option must not affect the recipient's authorized 
228.7 	level of personal care assistance services.
228.8 		Subd. 21.Requirements for initial enrollment of personal care assistance 
228.9 	provider agencies. (a) All personal care assistance provider agencies must provide, at the 
228.10 	time of enrollment as a personal care assistance provider agency in a format determined 
228.11 	by the commissioner, information and documentation that includes, but is not limited to, 
228.12 	the following:
228.13 	(1) the personal care assistance provider agency's current contact information 
228.14 	including address, telephone number, and e-mail address;
228.15 	(2) proof of surety bond coverage in the amount of $50,000 or ten percent of the 
228.16 	provider's payments from Medicaid in the previous year, whichever is less;
228.17 	(3) proof of fidelity bond coverage in the amount of $20,000;
228.18 	(4) proof of workers' compensation insurance coverage;
228.19 	(5) a description of the personal care assistance provider agency's organization 
228.20 	identifying the names of all owners, managerial officials, staff, board of directors, and the 
228.21 	affiliations of the directors, owners, or staff to other service providers;
228.22 	(6) a copy of the personal care assistance provider agency's written policies and 
228.23 	procedures including: hiring of employees; training requirements; service delivery; 
228.24 	and employee and consumer safety including process for notification and resolution 
228.25 	of consumer grievances, identification and prevention of communicable diseases, and 
228.26 	employee misconduct;
228.27 	(7) copies of all other forms the personal care assistance provider agency uses in 
228.28 	the course of daily business including, but not limited to:
228.29 	(i) a copy of the personal care assistance provider agency's time sheet if the time 
228.30 	sheet varies from the standard time sheet for personal care assistance services approved 
228.31 	by the commissioner, and a letter requesting approval of the personal care assistance 
228.32 	provider agency's nonstandard time sheet;
228.33 	(ii) the personal care assistance provider agency's template for the personal care 
228.34 	assistance care plan; and
229.1 	(iii) the personal care assistance provider agency's template and the written 
229.2 	agreement in subdivision 20 for recipients using the personal care assistance choice 
229.3 	option, if applicable;
229.4 	(8) a list of all trainings and classes that the personal care assistance provider agency 
229.5 	requires of its staff providing personal care assistance services;
229.6 	(9) documentation that the personal care assistance provider agency and staff have 
229.7 	successfully completed all the training required by this section;
229.8 	(10) disclosure of ownership, leasing, or management of all residential properties 
229.9 	that is used or could be used for providing home care services;
229.10 	(11) documentation of the agency's marketing practices; and
229.11 	(12) documentation that the agency will provide 75 percent for the personal care 
229.12 	assistance choice provider agency and 65 percent for regular personal care assistance 
229.13 	agency, or revenue generated from the medical assistance rate paid for personal care 
229.14 	assistance services for employee personal care assistant wages and benefits.
229.15 	(b) Personal care assistance provider agencies shall provide the information specified 
229.16 	in paragraph (a) to the commissioner at the time the personal care assistance provider 
229.17 	agency enrolls as a vendor or upon request from the commissioner. The commissioner 
229.18 	shall collect the information specified in paragraph (a) from all personal care assistance 
229.19 	providers beginning upon enactment of this section.
229.20 	(c) All personal care assistance provider agencies shall complete mandatory training 
229.21 	as determined by the commissioner before enrollment as a provider. Personal care 
229.22 	assistance provider agencies are required to send all owners employed by the agency 
229.23 	and all other managerial officials to the initial and subsequent trainings. Personal care 
229.24 	assistance provider agency billing staff shall complete training about personal care 
229.25 	assistance program financial management. This training is effective upon enactment of 
229.26 	this section. Any personal care assistance provider agency enrolled before that date shall, 
229.27 	if it has not already, complete the provider training within 18 months of the effective 
229.28 	date of this section. Any new owners, new qualified professionals, and new managerial 
229.29 	officials are required to complete mandatory training as a requisite of hiring.
229.30 		Subd. 22.Annual review for personal care providers. (a) All personal care 
229.31 	assistance provider agencies shall resubmit, on an annual basis, the information specified 
229.32 	in subdivision 21, in a format determined by the commissioner, and provide a copy of the 
229.33 	personal care assistance provider agency's most current version of its grievance policies 
229.34 	and procedures along with a written record of grievances and resolutions of the grievances 
229.35 	that the personal care assistance provider agency has received in the previous year and any 
229.36 	other information requested by the commissioner.
230.1 	(b) The commissioner shall send annual review notification to personal care 
230.2 	assistance provider agencies 30 days prior to renewal. The notification must:
230.3 	(1) list the materials and information the personal care assistance provider agency is 
230.4 	required to submit;
230.5 	(2) provide instructions on submitting information to the commissioner; and
230.6 	(3) provide a due date by which the commissioner must receive the requested 
230.7 	information.
230.8 	Personal care assistance provider agencies shall submit required documentation for 
230.9 	annual review within 30 days of notification from the commissioner. If no documentation 
230.10 	is submitted, the personal care assistance provider agency enrollment number must be 
230.11 	terminated or suspended.
230.12 	(c) Personal care assistance provider agencies also currently licensed under 
230.13 	Minnesota Rules, part 4668.0012, as a class A provider or currently certified for 
230.14 	participation in Medicare as a home health agency under Code of Federal Regulations, 
230.15 	title 42, part 484, are deemed in compliance with the personal care assistance requirements 
230.16 	for enrollment, annual review process, and documentation.
230.17 		Subd. 23.Enrollment requirements following termination. (a) A terminated 
230.18 	personal care assistance provider agency, including all named individuals on the current 
230.19 	enrollment disclosure form and known or discovered affiliates of the personal care 
230.20 	assistance provider agency, is not eligible to enroll as a personal care assistance provider 
230.21 	agency for two years following the termination.
230.22 	(b) After the two-year period in paragraph (a), if the provider seeks to reenroll 
230.23 	as a personal care assistance provider agency, the personal care assistance provider 
230.24 	agency must be placed on a one-year probation period, beginning after completion of 
230.25 	the following:
230.26 	(1) the department's provider trainings under this section; and
230.27 	(2) initial enrollment requirements under subdivision 21.
230.28 	(c) During the probationary period the commissioner shall complete site visits and 
230.29 	request submission of documentation to review compliance with program policies.
230.30 		Subd. 24.Personal care assistance provider agency; general duties. A personal 
230.31 	care assistance provider agency shall:
230.32 	(1) enroll as a Medicaid provider meeting all provider standards, including 
230.33 	completion of the required provider training;
230.34 	(2) comply with general medical assistance coverage requirements;
230.35 	(3) demonstrate compliance with law and policies of the personal care assistance 
230.36 	program to be determined by the commissioner;
231.1 	(4) comply with background study requirements;
231.2 	(5) verify and keep records of hours worked by the personal care assistant and 
231.3 	qualified professional;
231.4 	(6) pay the personal care assistant or qualified professional based on actual hours of 
231.5 	services provided;
231.6 	(7) document that the agency uses a minimum of 75 percent of the revenue generated 
231.7 	from the medical assistance rate for personal care assistant services for employee personal 
231.8 	care assistant wages and benefits;
231.9 	(8) withhold and pay all applicable federal and state taxes;
231.10 	(9) make the arrangements and pay unemployment insurance, taxes, workers' 
231.11 	compensation, liability insurance, and other benefits, if any;
231.12 	(10) enter into a written agreement under subdivision 21 before services are 
231.13 	provided;
231.14 	(11) report suspected neglect and abuse to the common entry point according to 
231.15 	section 256B.0651;
231.16 	(12) provide the recipient with a copy of the home care bill of rights at start of 
231.17 	service; and
231.18 	(13) market agency services only through printed information in brochures and on 
231.19 	Web sites and not engage in any direct contact or marketing in person, by telephone, or 
231.20 	other electronic means to potential recipients, guardians, or family members.
231.21 		Subd. 25.Personal care assistance provider agency; background studies.
 231.22 	Personal care assistance provider agencies enrolled to provide personal care assistance 
231.23 	services under the medical assistance program shall comply with the following:
231.24 	(1) owners who have a five percent interest or more and all managerial officials are 
231.25 	subject to a background study as provided in chapter 245C. This applies to currently 
231.26 	enrolled personal care assistance provider agencies and those agencies seeking enrollment 
231.27 	as a personal care assistance provider agency. Managerial official has the same meaning 
231.28 	as Code of Federal Regulations, title 42, section 455. An organization is barred from 
231.29 	enrollment if:
231.30 	(i) the organization has not initiated background studies on owners and managerial 
231.31 	officials; or
231.32 	(ii) the organization has initiated background studies on owners and managerial 
231.33 	officials, but the commissioner has sent the organization a notice that an owner or 
231.34 	managerial official of the organization has been disqualified under section 245C.14, 
231.35 	and the owner or managerial official has not received a set aside of the disqualification 
231.36 	under section 245C.22;
232.1 	(2) a background study must be initiated and completed for all qualified 
232.2 	professionals; and
232.3 	(3) a background study must be initiated and completed for all personal care 
232.4 	assistants.
232.5 		Subd. 26.Personal care assistance provider agency; communicable disease 
232.6 	prevention. A personal care assistance provider agency shall establish and implement 
232.7 	policies and procedures for prevention, control, and investigation of infections and 
232.8 	communicable diseases according to current nationally recognized infection control 
232.9 	practices or guidelines established by the United States Centers for Disease Control and 
232.10 	Prevention, as well as applicable regulations of other federal or state agencies.
232.11 		Subd. 27.Personal care assistance provider agency; ventilator training. The 
232.12 	personal care assistance provider agency is required to provide training for the personal 
232.13 	care assistant responsible for working with a recipient who is ventilator dependent. All 
232.14 	training must be administered by a respiratory therapist, nurse, or physician. Qualified 
232.15 	professional supervision by a nurse must be completed and documented on file in the 
232.16 	personal care assistant's employment record and the recipient's health record. If offering 
232.17 	personal care services to a ventilator-dependent recipient, the personal care assistance 
232.18 	provider agency shall demonstrate the ability to:
232.19 	(1) train the personal care assistant;
232.20 	(2) supervise the personal care assistant in ventilator operation and maintenance; and
232.21 	(3) supervise the recipient and responsible party in ventilator operation and 
232.22 	maintenance.
232.23 		Subd. 28.Personal care assistance provider agency; required documentation.
 232.24 	Required documentation must be completed and kept in the personal care assistance 
232.25 	provider agency file or the recipient's home residence. The required documentation 
232.26 	consists of:
232.27 	(1) employee files, including:
232.28 	(i) applications for employment;
232.29 	(ii) background study requests and results;
232.30 	(iii) orientation records about the agency policies;
232.31 	(iv) trainings completed with demonstration of competence;
232.32 	(v) supervisory visits;
232.33 	(vi) evaluations of employment; and
232.34 	(vii) signature on fraud statement;
232.35 	(2) recipient files, including:
232.36 	(i) demographics;
233.1 	(ii) emergency contact information and emergency backup plan;
233.2 	(iii) personal care assistance service plan;
233.3 	(iv) personal care assistance care plan;
233.4 	(v) month-to-month service use plan;
233.5 	(vi) all communication records;
233.6 	(vii) start of service information, including the written agreement with recipient; and
233.7 	(viii) date the home care bill of rights was given to the recipient;
233.8 	(3) agency policy manual, including:
233.9 	(i) policies for employment and termination;
233.10 	(ii) grievance policies with resolution of consumer grievances;
233.11 	(iii) staff and consumer safety;
233.12 	(iv) staff misconduct; and
233.13 	(v) staff hiring, service delivery, staff and consumer safety, staff misconduct, and 
233.14 	resolution of consumer grievances; and
233.15 	(4) time sheets for each personal care assistant along with completed activity sheets 
233.16 	for each recipient served.
233.17 		Subd. 29.Transitional assistance. Notwithstanding any contrary provision in 
233.18 	this section, the commissioner, counties, and personal care assistance providers shall 
233.19 	work together to provide transitional assistance for recipients and families to come into 
233.20 	compliance with the requirements of this section, and ensure that personal care assistance 
233.21 	services are not provided by the housing provider. The commissioner and counties shall 
233.22 	provide this assistance until July 1, 2010.
233.23 		Subd. 30.Notice of service changes to recipients. All recipients who will be 
233.24 	affected by the changes in medical assistance home care services must be provided notice 
233.25 	of the changes at least 30 days before the effective date of the change. The notice shall 
233.26 	include how to get further information on the changes, how to get help to obtain other 
233.27 	services, a list of community resources, and appeal rights. Notwithstanding section 
233.28 	256.045, a recipient may request continued services pending appeal within the time period 
233.29 	allowed to request an appeal.

233.30 	Sec. 33. Minnesota Statutes 2008, section 256B.0911, subdivision 1, is amended to 
233.31 	read:
233.32 		Subdivision 1.Purpose and goal. (a) The purpose of long-term care consultation 
233.33 	services is to assist persons with long-term or chronic care needs in making long-term 
233.34 	care decisions and selecting options that meet their needs and reflect their preferences. 
233.35 	The availability of, and access to, information and other types of assistance, including 
234.1 	assessment and support planning, is also intended to prevent or delay certified nursing 
234.2 	facility placements and to provide transition assistance after admission. Further, the goal 
234.3 	of these services is to contain costs associated with unnecessary certified nursing facility 
234.4 	admissions. Long-term consultation services must be available to any person regardless 
234.5 	of public program eligibility. The commissionerscommissioner of human services and 
234.6 	health shall seek to maximize use of available federal and state funds and establish the 
234.7 	broadest program possible within the funding available.
234.8 	(b) These services must be coordinated with serviceslong-term care options 
234.9 	counseling provided under section 256.975, subdivision 7, and with services provided by 
234.10 	other public and private agencies in the communitysection 256.01, subdivision 24, for 
234.11 	telephone assistance and follow up and to offer a variety of cost-effective alternatives to 
234.12 	persons with disabilities and elderly persons. The county or tribal agency or managed 
234.13 	care plan providing long-term care consultation services shall encourage the use of 
234.14 	volunteers from families, religious organizations, social clubs, and similar civic and 
234.15 	service organizations to provide community-based services.

234.16 	Sec. 34. Minnesota Statutes 2008, section 256B.0911, subdivision 1a, is amended to 
234.17 	read:
234.18 		Subd. 1a.Definitions. For purposes of this section, the following definitions apply:
234.19 	(a) "Long-term care consultation services" means:
234.20 	(1) providing information and education to the general public regarding availability 
234.21 	of the services authorized under this section;
234.22 	(2) an intake process that provides access to the services described in this section;
234.23 	(3) assessment of the health, psychological, and social needs of referred individuals;
234.24 	(4)(1) assistance in identifying services needed to maintain an individual in the 
234.25 	least restrictivemost inclusive environment;
234.26 	(5)(2) providing recommendations on cost-effective community services that are 
234.27 	available to the individual;
234.28 	(6)(3) development of an individual's person-centered community support plan;
234.29 	(7)(4) providing information regarding eligibility for Minnesota health care 
234.30 	programs;
234.31 	(5) face-to-face long-term care consultation assessments, which may be completed 
234.32 	in a hospital, nursing facility, intermediate care facility for persons with developmental 
234.33 	disabilities (ICF/DDs), regional treatment centers, or the person's current or planned 
234.34 	residence;
235.1 	(8) preadmission(6) federally mandated screening to determine the need for 
235.2 	a nursing facilityinstitutional level of care under section 256B.0911, subdivision 4, 
235.3 	paragraph (a);
235.4 	(9) preliminary(7) determination of Minnesota health care programshome and 
235.5 	community-based waiver service eligibility including level of care determination for 
235.6 	individuals who need a nursing facilityan institutional level of care as defined under 
235.7 	section 144.0724, subdivision 11, or 256B.092, service eligibility including state plan 
235.8 	home care services identified in section 256B.0625, subdivisions 6, 7, and 19, paragraphs 
235.9 	(a) and (c), based on assessment and support plan development with appropriate referrals 
235.10 	for final determination;
235.11 	(10)(8) providing recommendations for nursing facility placement when there are 
235.12 	no cost-effective community services available; and
235.13 	(11)(9) assistance to transition people back to community settings after facility 
235.14 	admission.
235.15 	(b) "Long-term care options counseling" means the services provided by the linkage 
235.16 	lines as mandated by sections 256.01 and 256.975, subdivision 7.
235.17 	(b) (c) "Minnesota health care programs" means the medical assistance program 
235.18 	under chapter 256B and the alternative care program under section 256B.0913.
235.19 	(d) "Lead agencies" means counties or a collaboration of counties, tribes, and health 
235.20 	plans administering long-term care consultation assessment and support planning services.

235.21 	EFFECTIVE DATE. The amendment to paragraph (a), clause (7), replacing a 
235.22 	reference to nursing facility level of care with institutional level of care as defined under 
235.23 	Minnesota Statutes, section 144.0724, subdivision 11, or 256B.092, is effective July 1, 
235.24 	2011.

235.25 	Sec. 35. Minnesota Statutes 2008, section 256B.0911, is amended by adding a 
235.26 	subdivision to read:
235.27 		Subd. 2b.Certified assessors. (a) Beginning January 1, 2011, each lead agency 
235.28 	shall have certified assessors who have completed training and certification process 
235.29 	determined by the commissioner in subdivision 2c. Certified assessors shall demonstrate 
235.30 	best practices in assessment and support planning including person-centered planning 
235.31 	principals and have a common set of skills that must ensure consistency and equitable 
235.32 	access to services statewide.
235.33 	(b) Certified assessors are persons with a minimum of a bachelor's degree in social 
235.34 	work, nursing with a public health nursing certificate, or other closely related field with at 
235.35 	least one year of home and community-based experience or a two-year registered nursing 
236.1 	degree with at least three years of home and community-based experience that have 
236.2 	received training and certification specific to assessment and consultation for long-term 
236.3 	care services in the state.

236.4 	Sec. 36. Minnesota Statutes 2008, section 256B.0911, is amended by adding a 
236.5 	subdivision to read:
236.6 		Subd. 2c.Assessor training and certification. The commissioner shall develop 
236.7 	curriculum and a certification process to begin no later than January 1, 2010. All existing 
236.8 	lead agency staff designated to provide the services defined in subdivision 1a must be 
236.9 	certified by December 30, 2010. Each lead agency is required to ensure that they have 
236.10 	sufficient numbers of certified assessors to provide long-term consultation assessment and 
236.11 	support planning within the timelines and parameters of the service by January 1, 2011. 
236.12 	Certified assessors are required to be recertified every three years.

236.13 	Sec. 37. Minnesota Statutes 2008, section 256B.0911, subdivision 3, is amended to 
236.14 	read:
236.15 		Subd. 3.Long-term care consultation team. (a) Until January 1, 2011, a long-term 
236.16 	care consultation team shall be established by the county board of commissioners. Each 
236.17 	local consultation team shall consist of at least one social worker and at least one public 
236.18 	health nurse from their respective county agencies. The board may designate public 
236.19 	health or social services as the lead agency for long-term care consultation services. If a 
236.20 	county does not have a public health nurse available, it may request approval from the 
236.21 	commissioner to assign a county registered nurse with at least one year experience in 
236.22 	home care to participate on the team. Two or more counties may collaborate to establish 
236.23 	a joint local consultation team or teams.
236.24 	(b) The team is responsible for providing long-term care consultation services to 
236.25 	all persons located in the county who request the services, regardless of eligibility for 
236.26 	Minnesota health care programs.
236.27 	(c) The commissioner shall allow arrangements and make recommendations that 
236.28 	encourage counties to collaborate to establish joint local long-term care consultation 
236.29 	teams to ensure that long-term care consultations are done within the timelines and 
236.30 	parameters of the service. This includes integrated service models as required in section 
236.31 	256B.0911, subdivision 1, paragraph (b).

236.32 	Sec. 38. Minnesota Statutes 2008, section 256B.0911, subdivision 3a, is amended to 
236.33 	read:
237.1 		Subd. 3a.Assessment and support planning. (a) Persons requesting assessment, 
237.2 	services planning, or other assistance intended to support community-based living, 
237.3 	including persons who need assessment in order to determine personal care assistance 
237.4 	services, private duty nursing services, home health agency services, waiver or alternative 
237.5 	care program eligibility, must be visited by a long-term care consultation team  or after 
237.6 	January 1, 2011, a certified assessor within ten working15 calendar days after the date on 
237.7 	which an assessment was requested or recommended. Face-to-face assessments must be 
237.8 	conducted according to paragraphs (b) to (i) (k).
237.9 	(b) The county may utilize a team of either the social worker or public health nurse, 
237.10 	or both, after January 1, 2011, lead agencies shall use a certified assessor to conduct the 
237.11 	assessment in a face-to-face interview. The consultation team members must confer 
237.12 	regarding the most appropriate care for each individual screened or assessed.
237.13 	(c) The long-term care consultation team must assess the health and social needs of 
237.14 	the person assessment must be comprehensive and include a person-centered assessment 
237.15 	of the health, psychological, functional, environmental, and social needs of referred 
237.16 	individuals and provide information necessary to develop a support plan that meets the 
237.17 	consumers needs, using an assessment form provided by the commissioner.
237.18 	(d) The team must conduct the assessment must be conducted in a face-to-face 
237.19 	interview with the person being assessed and the person's legal representative, if applicable
237.20 	as required by legally executed documents, and other individuals as requested by the 
237.21 	person, who can provide information on the needs, strengths, and preferences of the 
237.22 	person necessary to develop a support plan that ensures the person's health and safety, but 
237.23 	who is not a provider of service or has any financial interest in the provision of services.
237.24 	(e) The team must provide the person, or the person's legal representative, must 
237.25 	be provided with written recommendations for facility- or community-based services. 
237.26 	The team must documentor institutional care that include documentation that the most 
237.27 	cost-effective alternatives available were offered to the individual. For purposes of 
237.28 	this requirement, "cost-effective alternatives" means community services and living 
237.29 	arrangements that cost the same as or less than nursing facility institutional care.
237.30 	(f) If the person chooses to use community-based services, the team must provide 
237.31 	the person or the person's legal representative must be provided with a written community 
237.32 	support plan, regardless of whether the individual is eligible for Minnesota health care 
237.33 	programs. TheA person may request assistance in developing a community support plan 
237.34 	 identifying community supports without participating in a complete assessment. Upon 
237.35 	a request for assistance identifying community support, the person must be transferred 
238.1 	or referred to the services available under sections 256.975, subdivision 7, and 256.01, 
238.2 	subdivision 24, for telephone assistance and follow up.
238.3 	(g) The person has the right to make the final decision between nursing 
238.4 	facility institutional placement and community placement after the screening team's 
238.5 	recommendation recommendations have been provided, except as provided in subdivision 
238.6 	4a, paragraph (c).
238.7 	(h) The team must give the person receiving assessment or support planning, or 
238.8 	the person's legal representative, materials, and forms supplied by the commissioner 
238.9 	containing the following information:
238.10 	(1) the need for and purpose of preadmission screening if the person selects nursing 
238.11 	facility placement;
238.12 	(2) the role of the long-term care consultation assessment and support planning in 
238.13 	waiver and alternative care program eligibility determination;
238.14 	(3) information about Minnesota health care programs;
238.15 	(4) the person's freedom to accept or reject the recommendations of the team;
238.16 	(5) the person's right to confidentiality under the Minnesota Government Data 
238.17 	Practices Act, chapter 13;
238.18 	(6) the long-term care consultant's decision regarding the person's need for nursing 
238.19 	facility institutional level of care as determined under criteria established in section 
238.20 	144.0724, subdivision 11, or 256B.092; and
238.21 	(7) the person's right to appeal the decision regarding the need for nursing facility 
238.22 	level of care or the county's final decisions regarding public programs eligibility according 
238.23 	to section 256.045, subdivision 3.
238.24 	(i) Face-to-face assessment completed as part of eligibility determination for 
238.25 	the alternative care, elderly waiver, community alternatives for disabled individuals, 
238.26 	community alternative care, and traumatic brain injury waiver programs under sections 
238.27 	256B.0915, 256B.0917, and 256B.49 is valid to establish service eligibility for no more 
238.28 	than 60 calendar days after the date of assessment. The effective eligibility start date 
238.29 	for these programs can never be prior to the date of assessment. If an assessment was 
238.30 	completed more than 60 days before the effective waiver or alternative care program 
238.31 	eligibility start date, assessment and support plan information must be updated in a 
238.32 	face-to-face visit and documented in the department's Medicaid Management Information 
238.33 	System (MMIS). The effective date of program eligibility in this case cannot be prior to 
238.34 	the date the updated assessment is completed.

238.35 	EFFECTIVE DATE. The amendment to paragraph (h), clause (6), is effective 
238.36 	July 1, 2011.

239.1 	Sec. 39. Minnesota Statutes 2008, section 256B.0911, subdivision 4a, is amended to 
239.2 	read:
239.3 		Subd. 4a.Preadmission screening activities related to nursing facility 
239.4 	admissions. (a) All applicants to Medicaid certified nursing facilities, including certified 
239.5 	boarding care facilities, must be screened prior to admission regardless of income, assets, 
239.6 	or funding sources for nursing facility care, except as described in subdivision 4b. The 
239.7 	purpose of the screening is to determine the need for nursing facility level of care as 
239.8 	described in paragraph (d) and to complete activities required under federal law related to 
239.9 	mental illness and developmental disability as outlined in paragraph (b).
239.10 	(b) A person who has a diagnosis or possible diagnosis of mental illness or 
239.11 	developmental disability must receive a preadmission screening before admission 
239.12 	regardless of the exemptions outlined in subdivision 4b, paragraph (b), to identify the need 
239.13 	for further evaluation and specialized services, unless the admission prior to screening is 
239.14 	authorized by the local mental health authority or the local developmental disabilities case 
239.15 	manager, or unless authorized by the county agency according to Public Law 101-508.
239.16 	The following criteria apply to the preadmission screening:
239.17 	(1) the county must use forms and criteria developed by the commissioner to identify 
239.18 	persons who require referral for further evaluation and determination of the need for 
239.19 	specialized services; and
239.20 	(2) the evaluation and determination of the need for specialized services must be 
239.21 	done by:
239.22 	(i) a qualified independent mental health professional, for persons with a primary or 
239.23 	secondary diagnosis of a serious mental illness; or
239.24 	(ii) a qualified developmental disability professional, for persons with a primary or 
239.25 	secondary diagnosis of developmental disability. For purposes of this requirement, a 
239.26 	qualified developmental disability professional must meet the standards for a qualified 
239.27 	developmental disability professional under Code of Federal Regulations, title 42, section 
239.28 	483.430.
239.29 	(c) The local county mental health authority or the state developmental disability 
239.30 	authority under Public Law Numbers 100-203 and 101-508 may prohibit admission to a 
239.31 	nursing facility if the individual does not meet the nursing facility level of care criteria or 
239.32 	needs specialized services as defined in Public Law Numbers 100-203 and 101-508. For 
239.33 	purposes of this section, "specialized services" for a person with developmental disability 
239.34 	means active treatment as that term is defined under Code of Federal Regulations, title 
239.35 	42, section 483.440 (a)(1).
240.1 	(d) The determination of the need for nursing facility level of care must be made 
240.2 	according to criteria established in section 144.0724, subdivision 11, and 256B.092, 
240.3 	using forms developed by the commissioner. In assessing a person's needs, consultation 
240.4 	team members shall have a physician available for consultation and shall consider the 
240.5 	assessment of the individual's attending physician, if any. The individual's physician must 
240.6 	be included if the physician chooses to participate. Other personnel may be included on 
240.7 	the team as deemed appropriate by the county.

240.8 	EFFECTIVE DATE. The section is effective July 1, 2011.

240.9 	Sec. 40. Minnesota Statutes 2008, section 256B.0911, subdivision 5, is amended to 
240.10 	read:
240.11 		Subd. 5.Administrative activity. The commissioner shall minimize the number 
240.12 	of forms required in the provision of long-term care consultation services and shall 
240.13 	limit the screening document to items necessary for community support plan approval, 
240.14 	reimbursement, program planning, evaluation, and policy development business processes 
240.15 	required to provide the services in this section and shall implement integrated solutions 
240.16 	to automate the business processes to the extent necessary for community support plan 
240.17 	approval, reimbursement, program planning, evaluation, and policy development.

240.18 	Sec. 41. Minnesota Statutes 2008, section 256B.0911, subdivision 6, is amended to 
240.19 	read:
240.20 		Subd. 6.Payment for long-term care consultation services. (a) The total payment 
240.21 	for each county must be paid monthly by certified nursing facilities in the county. The 
240.22 	monthly amount to be paid by each nursing facility for each fiscal year must be determined 
240.23 	by dividing the county's annual allocation for long-term care consultation services by 12 
240.24 	to determine the monthly payment and allocating the monthly payment to each nursing 
240.25 	facility based on the number of licensed beds in the nursing facility. Payments to counties 
240.26 	in which there is no certified nursing facility must be made by increasing the payment 
240.27 	rate of the two facilities located nearest to the county seat.
240.28 	(b) The commissioner shall include the total annual payment determined under 
240.29 	paragraph (a) for each nursing facility reimbursed under section 256B.431 or 256B.434
240.30 	according to section 256B.431, subdivision 2b, paragraph (g).
240.31 	(c) In the event of the layaway, delicensure and decertification, or removal from 
240.32 	layaway of 25 percent or more of the beds in a facility, the commissioner may adjust 
240.33 	the per diem payment amount in paragraph (b) and may adjust the monthly payment 
240.34 	amount in paragraph (a). The effective date of an adjustment made under this paragraph 
241.1 	shall be on or after the first day of the month following the effective date of the layaway, 
241.2 	delicensure and decertification, or removal from layaway.
241.3 	(d) Payments for long-term care consultation services are available to the county 
241.4 	or counties to cover staff salaries and expenses to provide the services described in 
241.5 	subdivision 1a. The county shall employ, or contract with other agencies to employ, within 
241.6 	the limits of available funding, sufficient personnel to provide long-term care consultation 
241.7 	services while meeting the state's long-term care outcomes and objectives as defined in 
241.8 	section 256B.0917, subdivision 1. The county shall be accountable for meeting local 
241.9 	objectives as approved by the commissioner in the biennial home and community-based 
241.10 	services quality assurance plan on a form provided by the commissioner.
241.11 	(e) Notwithstanding section 256B.0641, overpayments attributable to payment of the 
241.12 	screening costs under the medical assistance program may not be recovered from a facility.
241.13 	(f) The commissioner of human services shall amend the Minnesota medical 
241.14 	assistance plan to include reimbursement for the local consultation teams.
241.15 	(g) The county may bill, as case management services, assessments, support 
241.16 	planning, and follow-along provided to persons determined to be eligible for case 
241.17 	management under Minnesota health care programs. No individual or family member 
241.18 	shall be charged for an initial assessment or initial support plan development provided 
241.19 	under subdivision 3a or 3b.
241.20 	(h) The commissioner shall develop an alternative payment methodology for 
241.21 	long-term care consultation services that includes the funding available under this 
241.22 	subdivision, and sections 256B.092 and 256B.0655. In developing the new payment 
241.23 	methodology, the commissioner shall consider the maximization of federal funding for 
241.24 	this activity.

241.25 	Sec. 42. Minnesota Statutes 2008, section 256B.0911, subdivision 7, is amended to 
241.26 	read:
241.27 		Subd. 7.Reimbursement for certified nursing facilities. (a) Medical assistance 
241.28 	reimbursement for nursing facilities shall be authorized for a medical assistance recipient 
241.29 	only if a preadmission screening has been conducted prior to admission or the county has 
241.30 	authorized an exemption. Medical assistance reimbursement for nursing facilities shall 
241.31 	not be provided for any recipient who the local screener has determined does not meet the 
241.32 	level of care criteria for nursing facility placement in section 144.0724, subdivision 11, or, 
241.33 	if indicated, has not had a level II OBRA evaluation as required under the federal Omnibus 
241.34 	Budget Reconciliation Act of 1987 completed unless an admission for a recipient with 
241.35 	mental illness is approved by the local mental health authority or an admission for a 
242.1 	recipient with developmental disability is approved by the state developmental disability 
242.2 	authority.
242.3 	(b) The nursing facility must not bill a person who is not a medical assistance 
242.4 	recipient for resident days that preceded the date of completion of screening activities as 
242.5 	required under subdivisions 4a, 4b, and 4c. The nursing facility must include unreimbursed 
242.6 	resident days in the nursing facility resident day totals reported to the commissioner.

242.7 	EFFECTIVE DATE. The section is effective July 1, 2011.

242.8 	Sec. 43. Minnesota Statutes 2008, section 256B.0913, subdivision 4, is amended to 
242.9 	read:
242.10 		Subd. 4.Eligibility for funding for services for nonmedical assistance recipients.
 242.11 	(a) Funding for services under the alternative care program is available to persons who 
242.12 	meet the following criteria:
242.13 	(1) the person has been determined by a community assessment under section 
242.14 	256B.0911 to be a person who would require the level of care provided in a nursing 
242.15 	facility according to the criteria established in section 144.0724, subdivision 11, but for 
242.16 	the provision of services under the alternative care program;
242.17 	(2) the person is age 65 or older;
242.18 	(3) the person would be eligible for medical assistance within 135 days of admission 
242.19 	to a nursing facility;
242.20 	(4) the person is not ineligible for the payment of long-term care services by the 
242.21 	medical assistance program due to an asset transfer penalty under section 256B.0595 or 
242.22 	equity interest in the home exceeding $500,000 as stated in section 256B.056;
242.23 	(5) the person needs long-term care services that are not funded through other state 
242.24 	or federal funding;
242.25 	(6) the monthly cost of the alternative care services funded by the program for 
242.26 	this person does not exceed 75 percent of the monthly limit described under section 
242.27 	256B.0915, subdivision 3a. This monthly limit does not prohibit the alternative care 
242.28 	client from payment for additional services, but in no case may the cost of additional 
242.29 	services purchased under this section exceed the difference between the client's monthly 
242.30 	service limit defined under section 256B.0915, subdivision 3, and the alternative care 
242.31 	program monthly service limit defined in this paragraph. If care-related supplies and 
242.32 	equipment or environmental modifications and adaptations are or will be purchased for 
242.33 	an alternative care services recipient, the costs may be prorated on a monthly basis for 
242.34 	up to 12 consecutive months beginning with the month of purchase. If the monthly cost 
242.35 	of a recipient's other alternative care services exceeds the monthly limit established in 
243.1 	this paragraph, the annual cost of the alternative care services shall be determined. In this 
243.2 	event, the annual cost of alternative care services shall not exceed 12 times the monthly 
243.3 	limit described in this paragraph; and
243.4 	(7) the person is making timely payments of the assessed monthly fee.
243.5 	A person is ineligible if payment of the fee is over 60 days past due, unless the person 
243.6 	agrees to:
243.7 	(i) the appointment of a representative payee;
243.8 	(ii) automatic payment from a financial account;
243.9 	(iii) the establishment of greater family involvement in the financial management of 
243.10 	payments; or
243.11 	(iv) another method acceptable to the lead agency to ensure prompt fee payments.
243.12 	The lead agency may extend the client's eligibility as necessary while making 
243.13 	arrangements to facilitate payment of past-due amounts and future premium payments. 
243.14 	Following disenrollment due to nonpayment of a monthly fee, eligibility shall not be 
243.15 	reinstated for a period of 30 days.
243.16 	(b) Alternative care funding under this subdivision is not available for a person 
243.17 	who is a medical assistance recipient or who would be eligible for medical assistance 
243.18 	without a spenddown or waiver obligation. A person whose initial application for medical 
243.19 	assistance and the elderly waiver program is being processed may be served under the 
243.20 	alternative care program for a period up to 60 days. If the individual is found to be eligible 
243.21 	for medical assistance, medical assistance must be billed for services payable under the 
243.22 	federally approved elderly waiver plan and delivered from the date the individual was 
243.23 	found eligible for the federally approved elderly waiver plan. Notwithstanding this 
243.24 	provision, alternative care funds may not be used to pay for any service the cost of which: 
243.25 	(i) is payable by medical assistance; (ii) is used by a recipient to meet a waiver obligation; 
243.26 	or (iii) is used to pay a medical assistance income spenddown for a person who is eligible 
243.27 	to participate in the federally approved elderly waiver program under the special income 
243.28 	standard provision.
243.29 	(c) Alternative care funding is not available for a person who resides in a licensed 
243.30 	nursing home, certified boarding care home, hospital, or intermediate care facility, except 
243.31 	for case management services which are provided in support of the discharge planning 
243.32 	process for a nursing home resident or certified boarding care home resident to assist with 
243.33 	a relocation process to a community-based setting.
243.34 	(d) Alternative care funding is not available for a person whose income is greater 
243.35 	than the maintenance needs allowance under section 256B.0915, subdivision 1d, but equal 
243.36 	to or less than 120 percent of the federal poverty guideline effective July 1 in the fiscal 
244.1 	year for which alternative care eligibility is determined, who would be eligible for the 
244.2 	elderly waiver with a waiver obligation.

244.3 	EFFECTIVE DATE. The section is effective July 1, 2011.

244.4 	Sec. 44. Minnesota Statutes 2008, section 256B.0915, subdivision 3e, is amended to 
244.5 	read:
244.6 		Subd. 3e.Customized living service rate. (a) Payment for customized living 
244.7 	services shall be a monthly rate negotiated and authorized by the lead agency within the 
244.8 	parameters established by the commissioner. The payment agreement must delineate the 
244.9 	services that have been customized for each recipient and specify the amount of each 
244.10 	component service included in the recipient's customized living service to be provided
244.11 	plan. The lead agency shall ensure that there is a documented need for allwithin the 
244.12 	parameters established by the commissioner for all component customized living services 
244.13 	authorized. Customized living services must not include rent or raw food costs.
244.14 	(b) The negotiated payment rate must be based on the amount of component services 
244.15 	to be provided utilizing component rates established by the commissioner. Counties and 
244.16 	tribes shall use tools issued by the commissioner to develop and document customized 
244.17 	living service plans and rates.
244.18 	Negotiated (c) Component service rates must not exceed payment rates for 
244.19 	comparable elderly waiver or medical assistance services and must reflect economies of 
244.20 	scale. Customized living services must not include rent or raw food costs.
244.21 	(b)(d) The individualized monthly negotiated authorized payment for the 
244.22 	customized living services service plan shall not exceed the nonfederal share, in effect 
244.23 	on July 1 of the state fiscal year for which the rate limit is being calculated, 50 percent
244.24 	of the greater of either the statewide or any of the geographic groups' weighted average 
244.25 	monthly nursing facility rate of the case mix resident class to which the elderly waiver 
244.26 	eligible client would be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, 
244.27 	less the maintenance needs allowance as described in subdivision 1d, paragraph (a), until 
244.28 	the July 1 of the state fiscal year in which the resident assessment system as described 
244.29 	in section 256B.438 for nursing home rate determination is implemented. Effective on 
244.30 	July 1 of the state fiscal year in which the resident assessment system as described in 
244.31 	section 256B.438 for nursing home rate determination is implemented and July 1 of each 
244.32 	subsequent state fiscal year, the individualized monthly negotiated authorized payment 
244.33 	for the services described in this clause shall not exceed the limit described in this clause
244.34 	which was in effect on June 30 of the previous state fiscal year and which has been 
244.35 	adjusted by the greater of any legislatively adopted home and community-based services 
245.1 	cost-of-living percentage increase or any legislatively adopted statewide percent rate 
245.2 	increase for nursing facilities updated annually based on legislatively adopted changes to 
245.3 	all service rate maximums for home and community-based service providers.
245.4 	(c)(e) Customized living services are delivered by a provider licensed by the 
245.5 	Department of Health as a class A or class F home care provider and provided in a 
245.6 	building that is registered as a housing with services establishment under chapter 144D.

245.7 	Sec. 45. Minnesota Statutes 2008, section 256B.0915, subdivision 3h, is amended to 
245.8 	read:
245.9 		Subd. 3h.Service rate limits; 24-hour customized living services. (a) The 
245.10 	payment rates for 24-hour customized living services isare a monthly rate negotiated and
245.11 	authorized by the lead agency within the parameters established by the commissioner 
245.12 	of human services. The payment agreement must delineate the services that have been 
245.13 	customized for each recipient and specify the amount of each component service included 
245.14 	in each recipient's customized living service to be provided plan. The lead agency 
245.15 	shall ensure that there is a documented need within the parameters established by the 
245.16 	commissioner for all component customized living services authorized. The lead agency 
245.17 	shall not authorize 24-hour customized living services unless there is a documented need 
245.18 	for 24-hour supervision.
245.19 	(b) For purposes of this section, "24-hour supervision" means that the recipient 
245.20 	requires assistance due to needs related to one or more of the following:
245.21 	(1) intermittent assistance with toileting or transferring;
245.22 	(2) cognitive or behavioral issues;
245.23 	(3) a medical condition that requires clinical monitoring; or
245.24 	(4) other conditions or needs as defined by the commissioner of human services. 
245.25 	The lead agency shall ensure that the frequency and mode of supervision of the recipient 
245.26 	and the qualifications of staff providing supervision are described and meet the needs of 
245.27 	the recipient. Customized living services must not include rent or raw food costs.
245.28 	(c) The negotiated payment rate for 24-hour customized living services must be 
245.29 	based on the amount of component services to be provided utilizing component rates 
245.30 	established by the commissioner. Counties and tribes will use tools issued by the 
245.31 	commissioner to develop and document customized living plans and authorize rates.
245.32 	Negotiated (d) Component service rates must not exceed payment rates for 
245.33 	comparable elderly waiver or medical assistance services and must reflect economies 
245.34 	of scale.
246.1 	(e) The individually negotiated authorized 24-hour customized living payments, 
246.2 	in combination with the payment for other elderly waiver services, including case 
246.3 	management, must not exceed the recipient's community budget cap specified in 
246.4 	subdivision 3a. Customized living services must not include rent or raw food costs.
246.5 	(f) The individually authorized 24-hour customized living payment rates shall not 
246.6 	exceed the 95 percentile of statewide monthly authorizations for 24-hour customized 
246.7 	living services in effect and in the Medicaid management information systems on March 
246.8 	31, 2009, for each case mix resident class under Minnesota Rules, parts 9549.0050 
246.9 	to 9549.0059, to which elderly waiver service clients are assigned. When there are 
246.10 	fewer than 50 authorizations in effect in the case mix resident class, the commissioner 
246.11 	shall multiply the calculated service payment rate maximum for the A classification by 
246.12 	the standard weight for that classification under Minnesota Rules, parts 9549.0050 to 
246.13 	9549.0059, to determine the applicable payment rate maximum. Service payment rate 
246.14 	maximums shall be updated annually based on legislatively adopted changes to all service 
246.15 	rates for home and community-based service providers.
246.16 	(g) Notwithstanding the requirements of paragraphs (d) and (f), the commissioner 
246.17 	may establish alternative payment rate systems for 24-hour customized living services in 
246.18 	housing with services establishments which are freestanding buildings with a capacity of 
246.19 	16 or fewer, by applying a single hourly rate for covered component services provided 
246.20 	in either:
246.21 	(1) licensed corporate adult foster homes; or
246.22 	(2) specialized dementia care units which meet the requirements of section 144D.065 
246.23 	and in which:
246.24 	(i) each resident is offered the option of having their own apartment; or
246.25 	(ii) the units are licensed as board and lodge establishments with maximum capacity 
246.26 	of eight residents, and which meet the requirements of Minnesota Rules, part 9555.6205, 
246.27 	subparts 1, 2, 3, and 4, item A.

246.28 	Sec. 46. Minnesota Statutes 2008, section 256B.0915, subdivision 5, is amended to 
246.29 	read:
246.30 		Subd. 5.Assessments and reassessments for waiver clients. (a) Each client 
246.31 	shall receive an initial assessment of strengths, informal supports, and need for services 
246.32 	in accordance with section 256B.0911, subdivisions 3, 3a, and 3b. A reassessment of a 
246.33 	client served under the elderly waiver must be conducted at least every 12 months and at 
246.34 	other times when the case manager determines that there has been significant change in 
246.35 	the client's functioning. This may include instances where the client is discharged from 
247.1 	the hospital. There must be a determination that the client requires nursing facility level of 
247.2 	care as defined in section 144.0724, subdivision 11, at initial and subsequent assessments 
247.3 	to initiate and maintain participation in the waiver program.
247.4 	(b) Regardless of other assessments identified in section 144.0724, subdivision 
247.5 	4, as appropriate to determine nursing facility level of care for purposes of medical 
247.6 	assistance payment for nursing facility services, only face-to-face assessments conducted 
247.7 	according to section 256B.0911, subdivisions 3a and 3b, that result in a nursing facility 
247.8 	level of care determination will be accepted for purposes of initial and ongoing access to 
247.9 	waiver service payment.

247.10 	EFFECTIVE DATE. The section is effective July 1, 2011.

247.11 	Sec. 47. Minnesota Statutes 2008, section 256B.0915, is amended by adding a 
247.12 	subdivision to read:
247.13 		Subd. 10.Waiver payment rates; managed care organizations. The 
247.14 	commissioner shall adjust the elderly waiver capitation payment rates for managed care 
247.15 	organizations paid under section 256B.69, subdivisions 6a and 23, to reflect the maximum 
247.16 	service rate limits for customized living services and 24-hour customized living services 
247.17 	under subdivisions 3e and 3h for the contract period beginning October 1, 2009. Medical 
247.18 	assistance rates paid to customized living providers by managed care organizations 
247.19 	under this section shall not exceed the maximum service rate limits determined by the 
247.20 	commissioner under subdivisions 3e and 3h.

247.21 	Sec. 48. Minnesota Statutes 2008, section 256B.0916, subdivision 2, is amended to 
247.22 	read:
247.23 		Subd. 2.Distribution of funds; partnerships. (a) Beginning with fiscal year 2000, 
247.24 	the commissioner shall distribute all funding available for home and community-based 
247.25 	waiver services for persons with developmental disabilities to individual counties or to 
247.26 	groups of counties that form partnerships to jointly plan, administer, and authorize funding 
247.27 	for eligible individuals. The commissioner shall encourage counties to form partnerships 
247.28 	that have a sufficient number of recipients and funding to adequately manage the risk 
247.29 	and maximize use of available resources.
247.30 	(b) Counties must submit a request for funds and a plan for administering the 
247.31 	program as required by the commissioner. The plan must identify the number of clients to 
247.32 	be served, their ages, and their priority listing based on:
247.33 	(1) requirements in Minnesota Rules, part 9525.1880; and
248.1 	(2) unstable living situations due to the age or incapacity of the primary caregiver;
248.2 	statewide priorities identified in section 256B.092, subdivision 12.
248.3 	(3) the need for services to avoid out-of-home placement of children;
248.4 	(4) the need to serve persons affected by private sector ICF/MR closures; and
248.5 	(5) the need to serve persons whose consumer support grant exception amount 
248.6 	was eliminated in 2004.
248.7 	The plan must also identify changes made to improve services to eligible persons and to 
248.8 	improve program management.
248.9 	(c) In allocating resources to counties, priority must be given to groups of counties 
248.10 	that form partnerships to jointly plan, administer, and authorize funding for eligible 
248.11 	individuals and to counties determined by the commissioner to have sufficient waiver 
248.12 	capacity to maximize resource use.
248.13 	(d) Within 30 days after receiving the county request for funds and plans, the 
248.14 	commissioner shall provide a written response to the plan that includes the level of 
248.15 	resources available to serve additional persons.
248.16 	(e) Counties are eligible to receive medical assistance administrative reimbursement 
248.17 	for administrative costs under criteria established by the commissioner.

248.18 	Sec. 49. Minnesota Statutes 2008, section 256B.0917, is amended by adding a 
248.19 	subdivision to read:
248.20 		Subd. 14.Essential community supports grants. (a) The purpose of the essential 
248.21 	community supports grant program is to provide targeted services to persons 65 years and 
248.22 	older who need essential community support, but whose needs do not meet the level of 
248.23 	care required for nursing facility placement under section 144.0724, subdivision 11.
248.24 	(b) Within the limits of the appropriation and not to exceed $400 per person per 
248.25 	month, funding must be available to a person who:
248.26 	(1) is age 65 or older;
248.27 	(2) is not eligible for medical assistance;
248.28 	(3) would otherwise be financially eligible for the alternative care program under 
248.29 	section 256B.0913, subdivision 4;
248.30 	(4) has received a community assessment under section 256B.0911, subdivision 3a 
248.31 	or 3b, and does not require the level of care provided in a nursing facility;
248.32 	(5) has a community support plan; and
248.33 	(6) has been determined by a community assessment under section 256B.0911, 
248.34 	subdivision 3a or 3b, to be a person who would require provision of at least one of the 
249.1 	following services, as defined in the approved elderly waiver plan, in order to maintain 
249.2 	their community residence:
249.3 	(i) caregiver support;
249.4 	(ii) homemaker;
249.5 	(iii) chore; or
249.6 	(iv) a personal emergency response device or system.
249.7 	(c) The person receiving any of the essential community supports in this subdivision 
249.8 	must also receive service coordination as part of their community support plan.
249.9 	(d) A person who has been determined to be eligible for an essential community 
249.10 	support grant must be reassessed at least annually and continue to meet the criteria in 
249.11 	paragraph (b) to remain eligible for an essential community support grant.
249.12 	(e) The commissioner shall allocate grants to counties and tribes under contract with 
249.13 	the department based upon the historic use of the medical assistance elderly waiver and 
249.14 	alternative care grant programs and other criteria as determined by the commissioner.

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

249.16 	Sec. 50. Minnesota Statutes 2008, section 256B.092, subdivision 8a, is amended to 
249.17 	read:
249.18 		Subd. 8a.County concurrence. (a) If the county of financial responsibility wishes 
249.19 	to place a person in another county for services, the county of financial responsibility shall 
249.20 	seek concurrence from the proposed county of service and the placement shall be made 
249.21 	cooperatively between the two counties. Arrangements shall be made between the two 
249.22 	counties for ongoing social service, including annual reviews of the person's individual 
249.23 	service plan. The county where services are provided may not make changes in the 
249.24 	person's service plan without approval by the county of financial responsibility.
249.25 	(b) When a person has been screened and authorized for services in an intermediate 
249.26 	care facility for persons with developmental disabilities or for home and community-based 
249.27 	services for persons with developmental disabilities, the case manager shall assist that 
249.28 	person in identifying a service provider who is able to meet the needs of the person 
249.29 	according to the person's individual service plan. If the identified service is to be provided 
249.30 	in a county other than the county of financial responsibility, the county of financial 
249.31 	responsibility shall request concurrence of the county where the person is requesting to 
249.32 	receive the identified services. The county of service may refuse to concur if:
249.33 	(1) it can demonstrate that the provider is unable to provide the services identified in 
249.34 	the person's individual service plan as services that are needed and are to be provided; or
250.1 	(2) in the case of an intermediate care facility for persons with developmental 
250.2 	disabilities, there has been no authorization for admission by the admission review team 
250.3 	as required in section 256B.0926; or.
250.4 	(3) in the case of home and community-based services for persons with 
250.5 	developmental disabilities, the county of service can demonstrate that the prospective 
250.6 	provider has failed to substantially comply with the terms of a past contract or has had a 
250.7 	prior contract terminated within the last 12 months for failure to provide adequate services, 
250.8 	or has received a notice of intent to terminate the contract.
250.9 	(c) The county of service shall notify the county of financial responsibility of 
250.10 	concurrence or refusal to concur no later than 20 working days following receipt of the 
250.11 	written request. Unless other mutually acceptable arrangements are made by the involved 
250.12 	county agencies, the county of financial responsibility is responsible for costs of social 
250.13 	services and the costs associated with the development and maintenance of the placement. 
250.14 	The county of service may request that the county of financial responsibility purchase 
250.15 	case management services from the county of service or from a contracted provider 
250.16 	of case management when the county of financial responsibility is not providing case 
250.17 	management as defined in this section and rules adopted under this section, unless other 
250.18 	mutually acceptable arrangements are made by the involved county agencies. Standards 
250.19 	for payment limits under this section may be established by the commissioner. Financial 
250.20 	disputes between counties shall be resolved as provided in section 256G.09.

250.21 	Sec. 51. Minnesota Statutes 2008, section 256B.092, is amended by adding a 
250.22 	subdivision to read:
250.23 		Subd. 11.Residential support services. (a) Upon federal approval, there is 
250.24 	established a new service called residential support that is available on the CAC, CADI, 
250.25 	DD, and TBI waivers. Existing waiver service descriptions must be modified to the extent 
250.26 	necessary to ensure there is no duplication between other services. Residential support 
250.27 	services must be provided by vendors licensed under category community residential 
250.28 	setting as defined in section 245A.11, subdivision 8.
250.29 	(b) Residential support services must meet the following criteria:
250.30 	(1) providers of residential support services must own or control the residential site;
250.31 	(2) the residential site must not be the primary residence of the license holder;
250.32 	(3) the residential site must have a designated program supervisor responsible for 
250.33 	program oversight, development, and implementation of policies and procedures;
250.34 	(4) the provider of residential support services must provide supervision, training, 
250.35 	and assistance as described in the person's community support plan; and
251.1 	(5) the provider of residential support services must meet the requirements of 
251.2 	licensure and additional requirements of the person's community support plan.
251.3 	(c) Providers of residential support services that meet the definition in paragraph (a) 
251.4 	must be registered using a process determined by the commissioner beginning July 1, 2009.

251.5 	Sec. 52. Minnesota Statutes 2008, section 256B.092, is amended by adding a 
251.6 	subdivision to read:
251.7 		Subd. 12.Waivered services statewide priorities. (a) The commissioner shall 
251.8 	establish statewide priorities for individuals on the waiting list for developmental 
251.9 	disabilities (DD) waiver services, as of January 1, 2010. The statewide priorities must 
251.10 	include, but are not limited to, individuals who continue to have a need for waiver services 
251.11 	after they have maximized the use of state plan services and other funding resources, 
251.12 	including natural supports, prior to accessing waiver services, and who meet at least one 
251.13 	of the following criteria:
251.14 	(1) have unstable living situations due to the age, incapacity, or sudden loss of 
251.15 	the primary caregivers;
251.16 	(2) are moving from an institution due to bed closures;
251.17 	(3) experience a sudden closure of their current living arrangement;
251.18 	(4) require protection from confirmed abuse, neglect, or exploitation;
251.19 	(5) experience a sudden change in need that can  no longer be met through state plan 
251.20 	services or other funding resources alone; or
251.21 	(6) meet other priorities established by the department.
251.22 	(b) When allocating resources to lead agencies, the commissioner shall take into 
251.23 	consideration the number of individuals waiting who meet statewide priorities.
251.24 	(c) The commissioner shall evaluate the impact of the use of statewide priorities and 
251.25 	provide recommendations to the legislature on whether to continue the use of statewide 
251.26 	priorities in the November 1, 2011, annual report required by the commissioner in sections 
251.27 	256B.0916, subdivision 7, and 256B.49, subdivision 21.

251.28 	Sec. 53. Minnesota Statutes 2008, section 256B.37, subdivision 1, is amended to read:
251.29 		Subdivision 1.Subrogation. Upon furnishing medical assistance or alternative 
251.30 	care services under section 256B.0913 to any person who has private accident or health 
251.31 	care coverage, or receives or has a right to receive health or medical care from any 
251.32 	type of organization or entity, or has a cause of action arising out of an occurrence that 
251.33 	necessitated the payment of medical assistance, the state agency or the state agency's agent 
251.34 	shall be subrogated, to the extent of the cost of medical care furnished, to any rights the 
252.1 	person may have under the terms of the coverage, or against the organization or entity 
252.2 	providing or liable to provide health or medical care, or under the cause of action.
252.3 	The right of subrogation created in this section includes all portions of the cause 
252.4 	of action, notwithstanding any settlement allocation or apportionment that purports to 
252.5 	dispose of portions of the cause of action not subject to subrogation.

252.6 	Sec. 54. Minnesota Statutes 2008, section 256B.37, subdivision 5, is amended to read:
252.7 		Subd. 5.Private benefits to be used first. Private accident and health care coverage 
252.8 	including Medicare for medical services is primary coverage and must be exhausted before 
252.9 	medical assistance is or alternative care services are paid for medical services including 
252.10 	home health care, personal care assistant services, hospice, supplies and equipment, or 
252.11 	services covered under a Centers for Medicare and Medicaid Services waiver. When a 
252.12 	person who is otherwise eligible for medical assistance has private accident or health care 
252.13 	coverage, including Medicare or a prepaid health plan, the private health care benefits 
252.14 	available to the person must be used first and to the fullest extent.

252.15 	Sec. 55. Minnesota Statutes 2008, section 256B.437, subdivision 6, is amended to read:
252.16 		Subd. 6.Planned closure rate adjustment. (a) The commissioner of human 
252.17 	services shall calculate the amount of the planned closure rate adjustment available under 
252.18 	subdivision 3, paragraph (b), for up to 5,140 beds according to clauses (1) to (4):
252.19 	(1) the amount available is the net reduction of nursing facility beds multiplied 
252.20 	by $2,080;
252.21 	(2) the total number of beds in the nursing facility or facilities receiving the planned 
252.22 	closure rate adjustment must be identified;
252.23 	(3) capacity days are determined by multiplying the number determined under 
252.24 	clause (2) by 365; and
252.25 	(4) the planned closure rate adjustment is the amount available in clause (1), divided 
252.26 	by capacity days determined under clause (3).
252.27 	(b) A planned closure rate adjustment under this section is effective on the first day 
252.28 	of the month following completion of closure of the facility designated for closure in the 
252.29 	application and becomes part of the nursing facility's total operating payment rate.
252.30 	(c) Applicants may use the planned closure rate adjustment to allow for a property 
252.31 	payment for a new nursing facility or an addition to an existing nursing facility or as an 
252.32 	operating payment rate adjustment. Applications approved under this subdivision are 
252.33 	exempt from other requirements for moratorium exceptions under section 144A.073, 
252.34 	subdivisions 2 and 3.
253.1 	(d) Upon the request of a closing facility, the commissioner must allow the facility a 
253.2 	closure rate adjustment as provided under section 144A.161, subdivision 10.
253.3 	(e) A facility that has received a planned closure rate adjustment may reassign it 
253.4 	to another facility that is under the same ownership at any time within three years of its 
253.5 	effective date. The amount of the adjustment shall be computed according to paragraph (a).
253.6 	(f) If the per bed dollar amount specified in paragraph (a), clause (1), is increased, 
253.7 	the commissioner shall recalculate planned closure rate adjustments for facilities that 
253.8 	delicense beds under this section on or after July 1, 2001, to reflect the increase in the per 
253.9 	bed dollar amount. The recalculated planned closure rate adjustment shall be effective 
253.10 	from the date the per bed dollar amount is increased.
253.11 	(g) For planned closures approved after June 30, 2009, the commissioner of human 
253.12 	services shall calculate the amount of the planned closure rate adjustment available under 
253.13 	subdivision 3, paragraph (b), according to paragraph (a), clauses (1) to (4).

253.14 	Sec. 56. Minnesota Statutes 2008, section 256B.441, is amended by adding a 
253.15 	subdivision to read:
253.16 		Subd. 24a.Medicare costs. For purposes of computing rates under this section for 
253.17 	rate years beginning on or after October 1, 2009, "Medicare costs" means 70.4 percent of 
253.18 	Medicare Part A and Part B revenues received during the reporting year.

253.19 	Sec. 57. Minnesota Statutes 2008, section 256B.441, subdivision 48, is amended to 
253.20 	read:
253.21 		Subd. 48.Calculation of operating per diems. The direct care per diem for 
253.22 	each facility shall be the facility's direct care costs divided by its standardized days. 
253.23 	The other care-related per diem shall be the sum of the facility's activities costs, other 
253.24 	direct care costs, raw food costs, therapy costs, and social services costs, divided by the 
253.25 	facility's resident days. The other operating per diem shall be the sum of the facility's 
253.26 	administrative costs, dietary costs, housekeeping costs, laundry costs, and maintenance 
253.27 	and plant operations costs divided by the facility's resident days. For rate years beginning 
253.28 	on or after October 1, 2009, the calculations of the direct care per diem, other care-related 
253.29 	per diem, and other operating per diem shall:
253.30 	(1) have allowable costs reduced by Medicare costs as defined in subdivision 24a. 
253.31 	The Medicare costs must be allocated between direct care, other care-related, and other 
253.32 	operating based on a ratio of allowable expenses from the cost report; and
253.33 	(2) have resident days and standardized days computed without using days paid 
253.34 	by Medicare.

254.1 	Sec. 58. Minnesota Statutes 2008, section 256B.441, subdivision 55, is amended to 
254.2 	read:
254.3 		Subd. 55.Phase-in of rebased operating payment rates.  (a) For the rate years 
254.4 	beginning October 1, 2008, to October 1, 2015, the operating payment rate calculated 
254.5 	under this section shall be phased in by blending the operating rate with the operating 
254.6 	payment rate determined under section 256B.434. For purposes of this subdivision, the 
254.7 	rate to be used that is determined under section 256B.434 shall not include the portion of 
254.8 	the operating payment rate related to performance-based incentive payments under section 
254.9 	256B.434, subdivision 4, paragraph (d). For the rate year beginning October 1, 2008, the 
254.10 	operating payment rate for each facility shall be 13 percent of the operating payment rate 
254.11 	from this section, and 87 percent of the operating payment rate from section 256B.434. 
254.12 	For the rate year period beginning October 1, 2009, through September 30, 2013, the 
254.13 	operating payment rate for each facility shall be 14 percent of the operating payment rate 
254.14 	from this section, and 86 percent of the operating payment rate from section 256B.434. 
254.15 	For the rate year beginning October 1, 2010, the operating payment rate for each facility 
254.16 	shall be 14 percent of the operating payment rate from this section, and 86 percent of the 
254.17 	operating payment rate from section 256B.434. For the rate year beginning October 1, 
254.18 	2011, the operating payment rate for each facility shall be 31 percent of the operating 
254.19 	payment rate from this section, and 69 percent of the operating payment rate from section 
254.20 	256B.434. For the rate year beginning October 1, 2012, the operating payment rate for 
254.21 	each facility shall be 48 percent of the operating payment rate from this section, and 52 
254.22 	percent of the operating payment rate from section 256B.434. For the rate year beginning 
254.23 	October 1, 2013, the operating payment rate for each facility shall be 65 percent of the 
254.24 	operating payment rate from this section, and 35 percent of the operating payment rate 
254.25 	from section 256B.434. For the rate year beginning October 1, 2014, the operating 
254.26 	payment rate for each facility shall be 82 percent of the operating payment rate from this 
254.27 	section, and 18 percent of the operating payment rate from section 256B.434. For the rate 
254.28 	year beginning October 1, 2015, the operating payment rate for each facility shall be the 
254.29 	operating payment rate determined under this section. The blending of operating payment 
254.30 	rates under this section shall be performed separately for each RUG's class.
254.31 	(b) For the rate year beginning October 1, 2008, the commissioner shall apply limits 
254.32 	to the operating payment rate increases under paragraph (a) by creating a minimum 
254.33 	percentage increase and a maximum percentage increase.
254.34 	(1) Each nursing facility that receives a blended October 1, 2008, operating payment 
254.35 	rate increase under paragraph (a) of less than one percent, when compared to its operating 
255.1 	payment rate on September 30, 2008, computed using rates with RUG's weight of 1.00, 
255.2 	shall receive a rate adjustment of one percent.
255.3 	(2) The commissioner shall determine a maximum percentage increase that will 
255.4 	result in savings equal to the cost of allowing the minimum increase in clause (1). Nursing 
255.5 	facilities with a blended October 1, 2008, operating payment rate increase under paragraph 
255.6 	(a) greater than the maximum percentage increase determined by the commissioner, when 
255.7 	compared to its operating payment rate on September 30, 2008, computed using rates with 
255.8 	a RUG's weight of 1.00, shall receive the maximum percentage increase.
255.9 	(3) Nursing facilities with a blended October 1, 2008, operating payment rate 
255.10 	increase under paragraph (a) greater than one percent and less than the maximum 
255.11 	percentage increase determined by the commissioner, when compared to its operating 
255.12 	payment rate on September 30, 2008, computed using rates with a RUG's weight of 1.00, 
255.13 	shall receive the blended October 1, 2008, operating payment rate increase determined 
255.14 	under paragraph (a).
255.15 	(4) The October 1, 2009, through October 1, 2015, operating payment rate for 
255.16 	facilities receiving the maximum percentage increase determined in clause (2) shall be 
255.17 	the amount determined under paragraph (a) less the difference between the amount 
255.18 	determined under paragraph (a) for October 1, 2008, and the amount allowed under clause 
255.19 	(2). This rate restriction does not apply to rate increases provided in any other section.
255.20 	(c) A portion of the funds received under this subdivision that are in excess of 
255.21 	operating payment rates that a facility would have received under section 256B.434, as 
255.22 	determined in accordance with clauses (1) to (3), shall be subject to the requirements in 
255.23 	section 256B.434, subdivision 19, paragraphs (b) to (h).
255.24 	(1) Determine the amount of additional funding available to a facility, which shall be 
255.25 	equal to total medical assistance resident days from the most recent reporting year times 
255.26 	the difference between the blended rate determined in paragraph (a) for the rate year being 
255.27 	computed and the blended rate for the prior year.
255.28 	(2) Determine the portion of all operating costs, for the most recent reporting year, 
255.29 	that are compensation related. If this value exceeds 75 percent, use 75 percent.
255.30 	(3) Subtract the amount determined in clause (2) from 75 percent.
255.31 	(4) The portion of the fund received under this subdivision that shall be subject to 
255.32 	the requirements in section 256B.434, subdivision 19, paragraphs (b) to (h), shall equal 
255.33 	the amount determined in clause (1) times the amount determined in clause (3).

255.34 	Sec. 59. Minnesota Statutes 2008, section 256B.441, is amended by adding a 
255.35 	subdivision to read:
256.1 		Subd. 59.Single-bed payments for medical assistance recipients. Effective 
256.2 	October 1, 2009, the amount paid for a private room under Minnesota Rules, part 
256.3 	9549.0070, subpart 3, is reduced from 115 percent to 111.5 percent.

256.4 	Sec. 60. Minnesota Statutes 2008, section 256B.49, is amended by adding a 
256.5 	subdivision to read:
256.6 		Subd. 11a.Waivered services waiting list. (a) The commissioner shall establish 
256.7 	statewide priorities for individuals on the waiting list for CAC, CADI, and TBI waiver 
256.8 	services, as of January 1, 2010. The statewide priorities must include, but are not limited 
256.9 	to, individuals who continue to have a need for waiver services after they have maximized 
256.10 	the use of state plan services and other funding resources, including natural supports, prior 
256.11 	to accessing waiver services, and who meet at least one of the following criteria:
256.12 	(1) have unstable living situations due to the age, incapacity, or sudden loss of 
256.13 	the primary caregivers;
256.14 	(2) are moving from an institution due to bed closures;
256.15 	(3) experience a sudden closure of their current living arrangement;
256.16 	(4) require protection from confirmed abuse, neglect, or exploitation;
256.17 	(5) experience a sudden change in need that can  no longer be met through state plan 
256.18 	services or other funding resources alone; or
256.19 	(6) meet other priorities established by the department.
256.20 	(b) When allocating resources to lead agencies, the commissioner shall take into 
256.21 	consideration the number of individuals waiting who meet statewide priorities.
256.22 	(c) The commissioner shall evaluate the impact of the use of statewide priorities and 
256.23 	provide recommendations to the legislature on whether to continue the use of statewide 
256.24 	priorities in the November 1, 2011, annual report required by the commissioner in sections 
256.25 	256B.0916, subdivision 7, and 256B.49, subdivision 21.

256.26 	Sec. 61. Minnesota Statutes 2008, section 256B.49, subdivision 12, is amended to read:
256.27 		Subd. 12.Informed choice. Persons who are determined likely to require the 
256.28 	level of care provided in a nursing facility as determined under sections 256B.0911 and 
256.29 	144.0724, subdivision 11, or hospital shall be informed of the home and community-based 
256.30 	support alternatives to the provision of inpatient hospital services or nursing facility 
256.31 	services. Each person must be given the choice of either institutional or home and 
256.32 	community-based services using the provisions described in section 256B.77, subdivision 
256.33 	2, paragraph (p).

256.34 	EFFECTIVE DATE. The section is effective July 1, 2011.

257.1 	Sec. 62. Minnesota Statutes 2008, section 256B.49, subdivision 13, is amended to read:
257.2 		Subd. 13.Case management. (a) Each recipient of a home and community-based 
257.3 	waiver shall be provided case management services by qualified vendors as described 
257.4 	in the federally approved waiver application. The case management service activities 
257.5 	provided will include:
257.6 	(1) assessing the needs of the individual within 20 working days of a recipient's 
257.7 	request;
257.8 	(2) developing the written individual service plan within ten working days after the 
257.9 	assessment is completed;
257.10 	(3) informing the recipient or the recipient's legal guardian or conservator of service 
257.11 	options;
257.12 	(4) assisting the recipient in the identification of potential service providers;
257.13 	(5) assisting the recipient to access services;
257.14 	(6) coordinating, evaluating, and monitoring of the services identified in the service 
257.15 	plan;
257.16 	(7) completing the annual reviews of the service plan; and
257.17 	(8) informing the recipient or legal representative of the right to have assessments 
257.18 	completed and service plans developed within specified time periods, and to appeal county 
257.19 	action or inaction under section 256.045, subdivision 3, including the determination of 
257.20 	nursing facility level of care. 
257.21 	(b) The case manager may delegate certain aspects of the case management service 
257.22 	activities to another individual provided there is oversight by the case manager. The case 
257.23 	manager may not delegate those aspects which require professional judgment including 
257.24 	assessments, reassessments, and care plan development.

257.25 	Sec. 63. Minnesota Statutes 2008, section 256B.49, subdivision 14, is amended to read:
257.26 		Subd. 14.Assessment and reassessment. (a) Assessments of each recipient's 
257.27 	strengths, informal support systems, and need for services shall be completed within 
257.28 	20 working days of the recipient's request. Reassessment of each recipient's strengths, 
257.29 	support systems, and need for services shall be conducted at least every 12 months and at 
257.30 	other times when there has been a significant change in the recipient's functioning.
257.31 	(b) There must be a determination that the client requires a hospital level of care or a 
257.32 	nursing facility level of care as defined in section 144.0724, subdivision 11, at initial and 
257.33 	subsequent assessments to initiate and maintain participation in the waiver program.
257.34 	(c) Regardless of other assessments identified in section 144.0724, subdivision 4, as 
257.35 	appropriate to determine nursing facility level of care for purposes of medical assistance 
258.1 	payment for nursing facility services, only face-to-face assessments conducted according 
258.2 	to section 256B.0911, subdivisions 3a, 3b, and 4d, that result in a hospital level of care 
258.3 	determination or a nursing facility level of care determination must be accepted for 
258.4 	purposes of initial and ongoing access to waiver services payment.
258.5 	(d) Persons with developmental disabilities who apply for services under the nursing 
258.6 	facility level waiver programs shall be screened for the appropriate level of care according 
258.7 	to section 256B.092.
258.8 	(c)(e) Recipients who are found eligible for home and community-based services 
258.9 	under this section before their 65th birthday may remain eligible for these services after 
258.10 	their 65th birthday if they continue to meet all other eligibility factors.

258.11 	EFFECTIVE DATE. The section is effective July 1, 2011.

258.12 	Sec. 64. Minnesota Statutes 2008, section 256B.49, is amended by adding a 
258.13 	subdivision to read:
258.14 		Subd. 22.Residential support services. For the purposes of this section, the 
258.15 	provisions of section 256B.092, subdivision 11, are controlling.

258.16 	Sec. 65. [256B.4912] HOME AND COMMUNITY-BASED WAIVERS; 
258.17 	PROVIDERS AND PAYMENT.
258.18 		Subdivision 1.Provider qualifications. For the home and community-based 
258.19 	waivers providing services to seniors and individuals with disabilities, the commissioner 
258.20 	shall establish:
258.21 	(1) agreements with enrolled waiver service providers to ensure providers meet 
258.22 	qualifications defined in the waiver plans;
258.23 	(2) regular reviews of provider qualifications; and
258.24 	(3) processes to gather the necessary information to determine provider 
258.25 	qualifications.
258.26 	By July 2010, staff that provide direct contact, as defined in section 245C.02, subdivision 
258.27 	11, that are employees of waiver service providers must meet the requirements of chapter 
258.28 	245C prior to providing waiver services and as part of ongoing enrollment. Upon federal 
258.29 	approval, this requirement must also apply to consumer-directed community supports.
258.30 		Subd. 2.Rate-setting methodologies. The commissioner shall establish 
258.31 	statewide rate-setting methodologies that meet federal waiver requirements for home 
258.32 	and community-based waiver services for individuals with disabilities. The rate-setting 
258.33 	methodologies must utilize person-centered methods that result in quality of life beyond 
259.1 	custodial care, promote individual choice and service stability, are understandable to 
259.2 	families and nonfinancial county staff, are equitable across the state, are transparent and 
259.3 	available to the public, and are flexible to adapt to recipients' individual service needs. The 
259.4 	methodologies must involve a uniform process of structuring rates for each service and 
259.5 	must promote quality and participant choice.  The rate-setting methodologies developed 
259.6 	under this section must be codified in statute before implementation.

259.7 	Sec. 66. Minnesota Statutes 2008, section 256B.5011, subdivision 2, is amended to 
259.8 	read:
259.9 		Subd. 2.Contract provisions. (a) The service contract with each intermediate 
259.10 	care facility must include provisions for:
259.11 	(1) modifying payments when significant changes occur in the needs of the 
259.12 	consumers;
259.13 	(2) the establishment and use of a quality improvement plan. Using criteria and 
259.14 	options for performance measures developed by the commissioner, each intermediate care 
259.15 	facility must identify a minimum of one performance measure on which to focus its efforts 
259.16 	for quality improvement during the contract period;
259.17 	(3) appropriate and necessary statistical information required by the commissioner;
259.18 	(4) annual aggregate facility financial information; and
259.19 	(5) (4) additional requirements for intermediate care facilities not meeting the 
259.20 	standards set forth in the service contract.
259.21 	(b) The commissioner of human services and the commissioner of health, in 
259.22 	consultation with representatives from counties, advocacy organizations, and the provider 
259.23 	community, shall review the consolidated standards under chapter 245B and the supervised 
259.24 	living facility rule under Minnesota Rules, chapter 4665, to determine what provisions 
259.25 	in Minnesota Rules, chapter 4665, may be waived by the commissioner of health for 
259.26 	intermediate care facilities in order to enable facilities to implement the performance 
259.27 	measures in their contract and provide quality services to residents without a duplication 
259.28 	of or increase in regulatory requirements.

259.29 	Sec. 67. Minnesota Statutes 2008, section 256B.5012, is amended by adding a 
259.30 	subdivision to read:
259.31 		Subd. 8.ICF/MR rate decreases effective July 1, 2009. The commissioner shall 
259.32 	decrease each facility reimbursed under this section operating payment adjustments 
259.33 	equal to 3.0 percent of the operating payment rates in effect on June 30, 2009. For each 
259.34 	facility, the commissioner shall implement the rate reduction, based on occupied beds, 
260.1 	using the percentage specified in this subdivision multiplied by the total payment rate, 
260.2 	including the variable rate but excluding the property-related payment rate, in effect on 
260.3 	the preceding date. The total rate reduction shall include the adjustment provided in 
260.4 	section 256B.502, subdivision 7.

260.5 	Sec. 68. Minnesota Statutes 2008, section 256B.5013, subdivision 1, is amended to 
260.6 	read:
260.7 		Subdivision 1.Variable rate adjustments. (a) For rate years beginning on or after 
260.8 	October 1, 2000, when there is a documented increase in the needs of a current ICF/MR 
260.9 	recipient, the county of financial responsibility may recommend a variable rate to enable 
260.10 	the facility to meet the individual's increased needs. Variable rate adjustments made under 
260.11 	this subdivision replace payments for persons with special needs under section 256B.501, 
260.12 	subdivision 8, and payments for persons with special needs for crisis intervention services 
260.13 	under section 256B.501, subdivision 8a. Effective July 1, 2003, facilities with a base rate 
260.14 	above the 50th percentile of the statewide average reimbursement rate for a Class A 
260.15 	facility or Class B facility, whichever matches the facility licensure, are not eligible for a 
260.16 	variable rate adjustment. Variable rate adjustments may not exceed a 12-month period, 
260.17 	except when approved for purposes established in paragraph (b), clause (1). Variable rate 
260.18 	adjustments approved solely on the basis of changes on a developmental disabilities 
260.19 	screening document will end June 30, 2002. 
260.20 	(b) A variable rate may be recommended by the county of financial responsibility 
260.21 	for increased needs in the following situations:
260.22 	(1) a need for resources due to an individual's full or partial retirement from 
260.23 	participation in a day training and habilitation service when the individual: (i) has reached 
260.24 	the age of 65 or has a change in health condition that makes it difficult for the person 
260.25 	to participate in day training and habilitation services over an extended period of time 
260.26 	because it is medically contraindicated; and (ii) has expressed a desire for change through 
260.27 	the developmental disability screening process under section 256B.092; 
260.28 	(2) a need for additional resources for intensive short-term programming which is 
260.29 	necessary prior to an individual's discharge to a less restrictive, more integrated setting;
260.30 	(3) a demonstrated medical need that significantly impacts the type or amount of 
260.31 	services needed by the individual; or
260.32 	(4) a demonstrated behavioral need that significantly impacts the type or amount of 
260.33 	services needed by the individual.
261.1 	(c) The county of financial responsibility must justify the purpose, the projected 
261.2 	length of time, and the additional funding needed for the facility to meet the needs of 
261.3 	the individual.
261.4 	(d) The facility shall provide a quarterly report to the county case manager on 
261.5 	the use of the variable rate funds and the status of the individual on whose behalf the 
261.6 	funds were approved. The county case manager will forward the facility's report with a 
261.7 	recommendation to the commissioner to approve or disapprove a continuation of the 
261.8 	variable rate.
261.9 	(e) Funds made available through the variable rate process that are not used by 
261.10 	the facility to meet the needs of the individual for whom they were approved shall be 
261.11 	returned to the state.

261.12 	Sec. 69. Minnesota Statutes 2008, section 256B.69, subdivision 5a, is amended to read:
261.13 		Subd. 5a.Managed care contracts. (a) Managed care contracts under this section 
261.14 	and sections 256L.12 and 256D.03, shall be entered into or renewed on a calendar year 
261.15 	basis beginning January 1, 1996. Managed care contracts which were in effect on June 
261.16 	30, 1995, and set to renew on July 1, 1995, shall be renewed for the period July 1, 1995 
261.17 	through December 31, 1995 at the same terms that were in effect on June 30, 1995. The 
261.18 	commissioner may issue separate contracts with requirements specific to services to 
261.19 	medical assistance recipients age 65 and older.
261.20 	(b) A prepaid health plan providing covered health services for eligible persons 
261.21 	pursuant to chapters 256B, 256D, and 256L, is responsible for complying with the terms 
261.22 	of its contract with the commissioner. Requirements applicable to managed care programs 
261.23 	under chapters 256B, 256D, and 256L, established after the effective date of a contract 
261.24 	with the commissioner take effect when the contract is next issued or renewed.
261.25 	(c) Effective for services rendered on or after January 1, 2003, the commissioner 
261.26 	shall withhold five percent of managed care plan payments under this section for the 
261.27 	prepaid medical assistance and general assistance medical care programs pending 
261.28 	completion of performance targets. Each performance target must be quantifiable, 
261.29 	objective, measurable, and reasonably attainable, except in the case of a performance 
261.30 	target based on a federal or state law or rule. Criteria for assessment of each performance 
261.31 	target must be outlined in writing prior to the contract effective date. The managed 
261.32 	care plan must demonstrate, to the commissioner's satisfaction, that the data submitted 
261.33 	regarding attainment of the performance target is accurate. The commissioner shall 
261.34 	periodically change the administrative measures used as performance targets in order 
261.35 	to improve plan performance across a broader range of administrative services. The 
262.1 	performance targets must include measurement of plan efforts to contain spending 
262.2 	on health care services and administrative activities. The commissioner may adopt 
262.3 	plan-specific performance targets that take into account factors affecting only one plan, 
262.4 	including characteristics of the plan's enrollee population. The withheld funds must be 
262.5 	returned no sooner than July of the following year if performance targets in the contract 
262.6 	are achieved. The commissioner may exclude special demonstration projects under 
262.7 	subdivision 23. A managed care plan or a county-based purchasing plan under section 
262.8 	256B.692 may include as admitted assets under section 62D.044 any amount withheld 
262.9 	under this paragraph that is reasonably expected to be returned.
262.10 	(d)(1) Effective for services rendered on or after January 1, 2009, the commissioner 
262.11 	shall withhold three percent of managed care plan payments under this section for the 
262.12 	prepaid medical assistance and general assistance medical care programs. The withheld 
262.13 	funds must be returned no sooner than July 1 and no later than July 31 of the following 
262.14 	year. The commissioner may exclude special demonstration projects under subdivision 23.
262.15 	(2) A managed care plan or a county-based purchasing plan under section 256B.692 
262.16 	may include as admitted assets under section 62D.044 any amount withheld under 
262.17 	this paragraph. The return of the withhold under this paragraph is not subject to the 
262.18 	requirements of paragraph (c).
262.19 	(e) Effective for services provided on or after January 1, 2010, the commissioner 
262.20 	shall require that managed care plans use the fee-for-service medical assistance assessment 
262.21 	and authorization processes, forms, timelines, standards, documentation, and data 
262.22 	reporting requirements, protocols, billing processes, and policies for all personal care 
262.23 	assistance services under section 256B.0659.

262.24 	Sec. 70. Minnesota Statutes 2008, section 256D.44, subdivision 5, is amended to read:
262.25 		Subd. 5.Special needs. In addition to the state standards of assistance established in 
262.26 	subdivisions 1 to 4, payments are allowed for the following special needs of recipients of 
262.27 	Minnesota supplemental aid who are not residents of a nursing home, a regional treatment 
262.28 	center, or a group residential housing facility.
262.29 	(a) The county agency shall pay a monthly allowance for medically prescribed 
262.30 	diets if the cost of those additional dietary needs cannot be met through some other 
262.31 	maintenance benefit. The need for special diets or dietary items must be prescribed by 
262.32 	a licensed physician. Costs for special diets shall be determined as percentages of the 
262.33 	allotment for a one-person household under the thrifty food plan as defined by the United 
262.34 	States Department of Agriculture. The types of diets and the percentages of the thrifty 
262.35 	food plan that are covered are as follows:
263.1 	(1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;
263.2 	(2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent 
263.3 	of thrifty food plan;
263.4 	(3) controlled protein diet, less than 40 grams and requires special products, 125 
263.5 	percent of thrifty food plan;
263.6 	(4) low cholesterol diet, 25 percent of thrifty food plan;
263.7 	(5) high residue diet, 20 percent of thrifty food plan;
263.8 	(6) pregnancy and lactation diet, 35 percent of thrifty food plan;
263.9 	(7) gluten-free diet, 25 percent of thrifty food plan;
263.10 	(8) lactose-free diet, 25 percent of thrifty food plan;
263.11 	(9) antidumping diet, 15 percent of thrifty food plan;
263.12 	(10) hypoglycemic diet, 15 percent of thrifty food plan; or
263.13 	(11) ketogenic diet, 25 percent of thrifty food plan.
263.14 	(b) Payment for nonrecurring special needs must be allowed for necessary home 
263.15 	repairs or necessary repairs or replacement of household furniture and appliances using 
263.16 	the payment standard of the AFDC program in effect on July 16, 1996, for these expenses, 
263.17 	as long as other funding sources are not available.
263.18 	(c) A fee for guardian or conservator service is allowed at a reasonable rate 
263.19 	negotiated by the county or approved by the court. This rate shall not exceed five percent 
263.20 	of the assistance unit's gross monthly income up to a maximum of $100 per month. If the 
263.21 	guardian or conservator is a member of the county agency staff, no fee is allowed.
263.22 	(d) The county agency shall continue to pay a monthly allowance of $68 for 
263.23 	restaurant meals for a person who was receiving a restaurant meal allowance on June 1, 
263.24 	1990, and who eats two or more meals in a restaurant daily. The allowance must continue 
263.25 	until the person has not received Minnesota supplemental aid for one full calendar month 
263.26 	or until the person's living arrangement changes and the person no longer meets the criteria 
263.27 	for the restaurant meal allowance, whichever occurs first.
263.28 	(e) A fee of ten percent of the recipient's gross income or $25, whichever is less, 
263.29 	is allowed for representative payee services provided by an agency that meets the 
263.30 	requirements under SSI regulations to charge a fee for representative payee services. This 
263.31 	special need is available to all recipients of Minnesota supplemental aid regardless of 
263.32 	their living arrangement.
263.33 	(f)(1) Notwithstanding the language in this subdivision, an amount equal to the 
263.34 	maximum allotment authorized by the federal Food Stamp Program for a single individual 
263.35 	which is in effect on the first day of July of each year will be added to the standards of 
263.36 	assistance established in subdivisions 1 to 4 for adults under the age of 65 who qualify 
264.1 	as shelter needy and are: (i) relocating from an institution, or an adult mental health 
264.2 	residential treatment program under section 256B.0622; (ii) eligible for the self-directed 
264.3 	supports option as defined under section 256B.0657, subdivision 2; or (iii) home and 
264.4 	community-based waiver recipients living in their own home or rented or leased apartment 
264.5 	which is not owned, operated, or controlled by a provider of service not related by blood 
264.6 	or marriage.
264.7 	(2) Notwithstanding subdivision 3, paragraph (c), an individual eligible for the 
264.8 	shelter needy benefit under this paragraph is considered a household of one. An eligible 
264.9 	individual who receives this benefit prior to age 65 may continue to receive the benefit 
264.10 	after the age of 65.
264.11 	(3) "Shelter needy" means that the assistance unit incurs monthly shelter costs that 
264.12 	exceed 40 percent of the assistance unit's gross income before the application of this 
264.13 	special needs standard. "Gross income" for the purposes of this section is the applicant's or 
264.14 	recipient's income as defined in section 256D.35, subdivision 10, or the standard specified 
264.15 	in subdivision 3, paragraph (a) or (b), whichever is greater. A recipient of a federal or 
264.16 	state housing subsidy, that limits shelter costs to a percentage of gross income, shall not be 
264.17 	considered shelter needy for purposes of this paragraph.
264.18 	(g) Notwithstanding this subdivision, recipients of home and community-based 
264.19 	services may relocate to services without 24-hour supervision and receive the equivalent 
264.20 	of the recipient's group residential housing allocation in Minnesota supplemental 
264.21 	assistance shelter needy funding if the cost of the services and housing is equal to or less 
264.22 	than provided to the recipient in home and community-based services and the relocation is 
264.23 	the recipient's choice and is approved by the recipient or guardian.
264.24 	(h) To access housing and services as provided in paragraph (g), the recipient may 
264.25 	choose housing that may or may not be owned, operated, or controlled by the recipient's 
264.26 	service provider.
264.27 	(i) The provisions in paragraphs (g) and (h) are effective to June 30, 2011. The 
264.28 	commissioner shall assess the development of publicly owned housing, other housing 
264.29 	alternatives, and whether a public equity housing fund may be established that would 
264.30 	maintain the state's interest, to the extent paid from group residential housing and 
264.31 	Minnesota supplemental aid shelter needy funds in provider-owned housing so that when 
264.32 	sold, the state would recover its share for a public equity fund to be used for future public 
264.33 	needs under this chapter. The commissioner shall report findings and recommendations to 
264.34 	the legislative committees and budget divisions with jurisdiction over health and human 
264.35 	services policy and financing by January 15, 2012. 
265.1 	(j) In selecting prospective services needed by recipients for whom home and 
265.2 	community-based services have been authorized, the recipient and the recipient's guardian 
265.3 	shall first consider alternatives to home and community-based services. Minnesota 
265.4 	supplemental aid shelter needy funding for recipients who utilize Minnesota supplemental 
265.5 	aid shelter needy funding as provided in this section shall remain permanent unless the 
265.6 	recipient with the recipient's guardian later chooses to access home and community-based 
265.7 	services.

265.8 	Sec. 71. Minnesota Statutes 2008, section 626.556, subdivision 3c, is amended to read:
265.9 		Subd. 3c.Local welfare agency, Department of Human Services or Department 
265.10 	of Health responsible for assessing or investigating reports of maltreatment. (a) 
265.11 	The county local welfare agency is the agency responsible for assessing or investigating 
265.12 	allegations of maltreatment in child foster care, family child care, and legally unlicensed 
265.13 	child care and in, juvenile correctional facilities licensed under section 241.021 located 
265.14 	in the local welfare agency's county, and unlicensed personal care assistance provider 
265.15 	organizations providing services and receiving reimbursements under chapter 256B. 
265.16 	(b) The Department of Human Services is the agency responsible for assessing or 
265.17 	investigating allegations of maltreatment in facilities licensed under chapters 245A and 
265.18 	245B, except for child foster care and family child care.
265.19 	(c) The Department of Health is the agency responsible for assessing or investigating 
265.20 	allegations of child maltreatment in facilities licensed under sections  144.50 to  144.58 and 
265.21 	144A.46, and in unlicensed home health care. 
265.22 	(d) The commissioners of human services, public safety, and education must 
265.23 	jointly submit a written report by January 15, 2007, to the education policy and finance 
265.24 	committees of the legislature recommending the most efficient and effective allocation 
265.25 	of agency responsibility for assessing or investigating reports of maltreatment and must 
265.26 	specifically address allegations of maltreatment that currently are not the responsibility 
265.27 	of a designated agency. 

265.28 	Sec. 72. Minnesota Statutes 2008, section 626.5572, subdivision 13, is amended to 
265.29 	read:
265.30 		Subd. 13.Lead agency. "Lead agency" is the primary administrative agency 
265.31 	responsible for investigating reports made under section 626.557.  
265.32 	(a) The Department of Health is the lead agency for the facilities which are licensed 
265.33 	or are required to be licensed as hospitals, home care providers, nursing homes, residential 
265.34 	care homes, or boarding care homes.
266.1 	(b) The Department of Human Services is the lead agency for the programs licensed 
266.2 	or required to be licensed as adult day care, adult foster care, programs for people with 
266.3 	developmental disabilities, mental health programs, or chemical health programs, or 
266.4 	personal care provider organizations.
266.5 	(c) The county social service agency or its designee is the lead agency for all other 
266.6 	reports, including personal care provider organizations under section 256B.0659.

266.7 	Sec. 73. COMMISSIONER TO REPORT ON PERSONAL CARE ASSISTANCE 
266.8 	PROGRAM.
 266.9 	The commissioner of human services must report to the legislative committees 
266.10 	with jurisdiction over health and human services policy and finance by January 1, 2010, 
266.11 	on the training developed and delivered for all types of participants in the personal 
266.12 	care assistance program, audit and financial integrity measures and results, information 
266.13 	developed for consumers and responsible parties, available demographic, health care 
266.14 	service use, and housing information about individuals who no longer qualify for personal 
266.15 	care assistance, and quality assurance measures and results.

266.16 	Sec. 74. COLA COMPENSATION REQUIREMENTS.
 266.17 	Effective July 1, 2009, providers who received rate increases under Laws 2007, 
266.18 	chapter 147, article 7, section 71, as amended by Laws 2008, chapter 363, article 15, 
266.19 	section 17, and Minnesota Statutes, section 256B.5012, subdivision 7, for state fiscal years 
266.20 	2008 and 2009 are no longer required to continue or retain employee compensation or 
266.21 	wage-related increases required by those sections.

266.22 	Sec. 75. PROVIDER RATE AND GRANT REDUCTIONS.
 266.23 	(a) The commissioner of human services shall decrease grants, allocations, 
266.24 	reimbursement rates, or rate limits, as applicable, by 3.0 percent effective July 1, 2009, for 
266.25 	services rendered on or after that date. County or tribal contracts for services specified 
266.26 	in this section must be amended to pass through these rate reductions within 60 days of 
266.27 	the effective date of the decrease and must be retroactive from the effective date of the 
266.28 	rate decrease.
266.29 	(b) The annual rate decreases described in this section must be provided to:
266.30 	(1) home and community-based waivered services for persons with developmental 
266.31 	disabilities or related conditions, including consumer-directed community supports, under 
266.32 	Minnesota Statutes, section 256B.501;
267.1 	(2) home and community-based waivered services for the elderly, including 
267.2 	consumer-directed community supports, under Minnesota Statutes, section 256B.0915;
267.3 	(3) waivered services under community alternatives for disabled individuals, 
267.4 	including consumer-directed community supports, under Minnesota Statutes, section 
267.5 	256B.49;
267.6 	(4) community alternative care waivered services, including consumer-directed 
267.7 	community supports, under Minnesota Statutes, section 256B.49;
267.8 	(5) traumatic brain injury waivered services, including consumer-directed 
267.9 	community supports, under Minnesota Statutes, section 256B.49;
267.10 	(6) nursing services and home health services under Minnesota Statutes, section 
267.11 	256B.0625, subdivision 6a;
267.12 	(7) personal care services and qualified professional supervision of personal care 
267.13 	services under Minnesota Statutes, section 256B.0625, subdivisions 6a and 19a;
267.14 	(8) private duty nursing services under Minnesota Statutes, section 256B.0625, 
267.15 	subdivision 7;
267.16 	(9) day training and habilitation services for adults with developmental disabilities 
267.17 	or related conditions under Minnesota Statutes, sections 252.40 to 252.46, including the 
267.18 	additional cost of rate adjustments on day training and habilitation services, provided as a 
267.19 	social service under Minnesota Statutes, section 256M.60;
267.20 	(10) alternative care services under Minnesota Statutes, section 256B.0913;
267.21 	(11) the group residential housing supplementary service rate under Minnesota 
267.22 	Statutes, section 256I.05, subdivision 1a;
267.23 	(12) semi-independent living services (SILS) under Minnesota Statutes, section 
267.24 	252.275, including SILS funding under county social services grants formerly funded 
267.25 	under Minnesota Statutes, chapter 256I;
267.26 	(13) community support services for deaf and hard-of-hearing adults with mental 
267.27 	illness who use or wish to use sign language as their primary means of communication 
267.28 	under Minnesota Statutes, section 256.01, subdivision 2; and deaf and hard-of-hearing 
267.29 	grants under Minnesota Statutes, sections 256C.233 and 256C.25; Laws 1985, chapter 9; 
267.30 	and Laws 1997, First Special Session chapter 5, section 20;
267.31 	(14) consumer support grants under Minnesota Statutes, section 256.476;
267.32 	(15) family support grants under Minnesota Statutes, section 252.32;
267.33 	(16) aging grants under Minnesota Statutes, sections 256.975 to 256.977, 256B.0917, 
267.34 	and 256B.0928;
267.35 	(17) disability linkage line grants under Minnesota Statutes, section 256.01, 
267.36 	subdivision 24; and
268.1 	(18) housing access grants under Minnesota Statutes, section 256B.0658.
268.2 	(c) A managed care plan receiving state payments for the services in this section 
268.3 	must include these decreases in their payments to providers effective on January 1 
268.4 	following the effective date of the rate decrease.

268.5 	Sec. 76. RECOMMENDATIONS FOR PERSONAL CARE ASSISTANCE 
268.6 	SERVICES CHANGES AND CONSULTATION WITH STAKEHOLDERS.
 268.7 	The commissioner shall consult with representatives of interested stakeholders 
268.8 	beginning in July 2009 to examine and develop recommendations for the personal care 
268.9 	assistance services program, including recommendations to streamline the home care 
268.10 	ratings and assignment of units of service to eligible recipients. The recommendations 
268.11 	shall include proposed changes, alternative services, and costs for those whose services 
268.12 	will change, as well as personal care assistance program data for public reporting. 
268.13 	The recommendations are to result in a reduction of spending growth as authorized 
268.14 	by the legislature in personal care assistance services beginning January 1, 2011. The 
268.15 	recommendations shall be provided to the chairs and ranking minority members of the 
268.16 	legislative committees having jurisdiction over health and human services by January 
268.17 	15, 2010.

268.18 	Sec. 77. ESTABLISHING A SINGLE SET OF STANDARDS.
 268.19 	(a) The commissioner of human services shall consult with disability service 
268.20 	providers, advocates, counties, and consumer families to develop a single set of standards 
268.21 	governing services for people with disabilities receiving services under the home and 
268.22 	community-based waiver services program to replace all or portions of existing laws and 
268.23 	rules including, but not limited to, data practices, licensure of facilities and providers, 
268.24 	background studies, reporting of maltreatment of minors, reporting of maltreatment of 
268.25 	vulnerable adults, and the psychotropic medication checklist. The standards must:
268.26 	(1) enable optimum consumer choice;
268.27 	(2) be consumer driven;
268.28 	(3) link services to individual needs and life goals;
268.29 	(4) be based on quality assurance and individual outcomes; 
268.30 	(5) utilize the people closest to the recipient, who may include family, friends, and 
268.31 	health and service providers, in conjunction with the recipient's risk management plan to 
268.32 	assist the recipient or the recipient's guardian in making decisions that meet the recipient's 
268.33 	needs in a cost-effective manner and assure the recipient's health and safety;
268.34 	(6) utilize person-centered planning; and
269.1 	(7) maximize federal financial participation.
269.2 	(b) The commissioner may consult with existing stakeholder groups convened under 
269.3 	the commissioner's authority, including the home and community-based expert services 
269.4 	panel established by the commissioner in 2008, to meet all or some of the requirements 
269.5 	of this section.
269.6 	(c) The commissioner shall provide the reports and plans required by this section to 
269.7 	the legislative committees and budget divisions with jurisdiction over health and human 
269.8 	services policy and finance by January 15, 2012.

269.9 	Sec. 78. COMMON SERVICE MENU FOR HOME AND COMMUNITY-BASED 
269.10 	WAIVER PROGRAMS.
 269.11 	The commissioner of human services shall confer with representatives of recipients, 
269.12 	advocacy groups, counties, providers, and health plans to develop and update a common 
269.13 	service menu for home and community-based waiver programs. The commissioner may 
269.14 	consult with existing stakeholder groups convened under the commissioner's authority to 
269.15 	meet all or some of the requirements of this section.

269.16 	Sec. 79. INTERMEDIATE CARE FACILITIES FOR PERSONS WITH 
269.17 	DEVELOPMENTAL DISABILITIES REPORT.
 269.18 	The commissioner of human services shall consult with providers and advocates of 
269.19 	intermediate care facilities for persons with developmental disabilities to monitor progress 
269.20 	made in response to the commissioner's December 15, 2008, report to the legislature 
269.21 	regarding intermediate care facilities for persons with developmental disabilities.

269.22 	Sec. 80. HOUSING OPTIONS.
 269.23 	The commissioner of human services, in consultation with the commissioner of 
269.24 	administration and the Minnesota Housing Finance Agency, and representatives of 
269.25 	counties, residents' advocacy groups, consumers of housing services, and provider 
269.26 	agencies shall explore ways to maximize the availability and affordability of housing 
269.27 	choices available to persons with disabilities or who need care assistance due to other 
269.28 	health challenges. A goal shall also be to minimize state physical plant costs in order to 
269.29 	serve more persons with appropriate program and care support. Consideration shall be 
269.30 	given to:
269.31 	(1) improved access to rent subsidies;
269.32 	(2) use of cooperatives, land trusts, and other limited equity ownership models;
270.1 	(3) the desirability of the state acquiring an ownership interest or promoting the 
270.2 	use of publicly owned housing;
270.3 	(4) promoting more choices in the market for accessible housing that meets the 
270.4 	needs of persons with physical challenges; and
270.5 	(5) what consumer ownership models, if any, are appropriate.
270.6 	The commissioner shall provide a written report on the findings of the evaluation of 
270.7 	housing options to the chairs and ranking minority members of the house of representatives 
270.8 	and senate standing committees with jurisdiction over health and human services policy 
270.9 	and funding by December 15, 2010. This report shall replace the November 1, 2010, 
270.10 	annual report by the commissioner required in Minnesota Statutes, sections 256B.0916, 
270.11 	subdivision 7, and 256B.49, subdivision 21

270.12 	Sec. 81. REVISOR'S INSTRUCTION.
 270.13 		Subdivision 1.Renumbering of Minnesota Statutes, section 256B.0652, 
270.14 	authorization and review of home care services. (a) The revisor of statutes shall 
270.15 	renumber each section of Minnesota Statutes listed in column A with the number in 
270.16 	column B.

270.17	Column A
	Column B
	
270.18	256B.0652, subdivision 3
	256B.0652, subdivision 14
	
270.19	256B.0651, subdivision 6, paragraph (a)
	256B.0652, subdivision 3
	
270.20	256B.0651, subdivision 6, paragraph (b)
	256B.0652, subdivision 4
	
270.21	256B.0651, subdivision 6, paragraph (c)
	256B.0652, subdivision 7
	
270.22	256B.0651, subdivision 7, paragraph (a)
	256B.0652, subdivision 8
	
270.23	256B.0651, subdivision 7, paragraph (b)
	256B.0652, subdivision 14
	
270.24	256B.0651, subdivision 8
	256B.0652, subdivision 9
	
270.25	256B.0651, subdivision 9
	256B.0652, subdivision 10
	
270.26	256B.0651, subdivision 11
	256B.0652, subdivision 11
	
270.27	256B.0654, subdivision 2
	256B.0652, subdivision 5
	
270.28	256B.0655, subdivision 4
	256B.0652, subdivision 6
	
270.29 	(b) The revisor of statutes shall make necessary cross-reference changes in statutes 
270.30 	and rules consistent with the renumbering in paragraph (a). The Department of Human 
270.31 	Services shall assist the revisor with any cross-reference changes. The revisor may make 
270.32 	changes necessary to correct the punctuation, grammar, or structure of the remaining text 
270.33 	to conform with the intent of the renumbering in paragraph (a).
270.34 		Subd. 2.Renumbering personal care assistance services. The revisor of statutes 
270.35 	shall replace any reference to Minnesota Statutes, section 256B.0655 with section 
270.36 	256B.0659, wherever it appears in statutes or rules. The revisor shall correct any cross 
270.37 	reference changes that are necessary as a result of this section. The Department of Human 
271.1 	Services shall assist the revisor in making these changes, and if necessary, shall draft a 
271.2 	corrections bill with changes for introduction in the 2010 legislative session. The revisor 
271.3 	may make changes to punctuation, grammar, or sentence structure to preserve the integrity 
271.4 	of statutes and effectuate the intention of this section.

271.5 	Sec. 82.  REPEALER.
 271.6 	(a) Minnesota Statutes 2008, sections 256B.0655, subdivisions 1, 1a, 1c, 1d, 1e, 
271.7 	1f, 1g, 1h, 1i, 2, 3, 5, 6, 7, 8, 9, 10, 11, 12, and 13; and 256B.071, subdivisions 1, 2, 3, 
271.8 	and 4, are repealed.
271.9 	(b) Laws 1988, chapter 689, section 251, is repealed effective July 1, 2009.
271.10 	(c) Minnesota Statutes 2008, sections 256B.19, subdivision 1d; and 256B.431, 
271.11 	subdivision 23, are repealed effective May 1, 2009.

271.12 	ARTICLE 10
271.13 	STATE-COUNTY RESULTS, ACCOUNTABILITY, AND SERVICE 
271.14 	DELIVERY REFORM ACT

271.15 	Section 1. [402A.01] CITATION.
271.16 	Sections 402A.01 to 402A.50 may be cited as the "State-County Results, 
271.17 	Accountability, and Service Delivery Reform Act."

271.18 	Sec. 2. [402A.10] DEFINITIONS.
271.19 		Subdivision 1.Terms defined. For the purposes of this chapter, the terms defined in 
271.20 	this subdivision have the meanings given.
271.21 		Subd. 2.Commissioner. "Commissioner" means the commissioner of human 
271.22 	services.
271.23 		Subd. 3.Council. "Council" means the Council on State-County Results, 
271.24 	Accountability, and Service Delivery Redesign established in section 402A.40.
271.25 		Subd. 4.Essential human services programs. "Essential human services 
271.26 	programs" means assistance and services to recipients or potential recipients of public 
271.27 	welfare and other services delivered by counties that are mandated in state law that are 
271.28 	to be available in all counties of the state.
271.29 		Subd. 5.Redesign. "Redesign" means the State-County Results, Accountability, 
271.30 	and Service Delivery Redesign under this chapter.
271.31 		Subd. 6.Service delivery authority. "Service delivery authority" means a single 
271.32 	county, or group of counties operating by execution of a joint powers agreement under 
272.1 	section 471.59 or other contractual agreement, that has voluntarily chosen by resolution of 
272.2 	the county board of commissioners to participate in the redesign under this chapter.
272.3 		Subd. 7.Steering committee. "Steering committee" means the Steering Committee 
272.4 	on Performance and Outcome Reforms.

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

272.6 	Sec. 3. [402A.15] STEERING COMMITTEE ON PERFORMANCE AND 
272.7 	OUTCOME REFORMS.
272.8 		Subdivision 1.Duties. (a) The Steering Committee on Performance and Outcome 
272.9 	Reforms shall develop a uniform process to establish and review performance and 
272.10 	outcome standards for essential human services programs, and to develop appropriate 
272.11 	reporting measures and a uniform accountability process for responding to a county's 
272.12 	or human service authority's failure to make adequate progress on achieving outcome 
272.13 	goals.  The accountability process shall focus on the performance measures rather than 
272.14 	inflexible implementation requirements.
272.15 	(b) The steering committee shall:
272.16 	(1) by November 1, 2009, establish an agreed upon list of essential services;
272.17 	(2) by January 10, 2010, develop and recommend to the legislature a uniform, 
272.18 	graduated process for responding to a county's failure to make adequate progress on 
272.19 	achieving outcome goals, including recommendations for the specific measures and 
272.20 	penalties to be imposed; and
272.21 	(3) by December 15, 2009, establish a three-year schedule of ongoing program 
272.22 	reviews to evaluate and establish outcome goals, modify the reporting system, and review 
272.23 	the distribution of state and federal funds for those services, taking into consideration 
272.24 	program demand and the unique differences of local areas in geography and the 
272.25 	populations served. Priority shall be given to services with the greatest variation in 
272.26 	availability and greatest administrative demands. The schedule shall be published on the 
272.27 	agency Web site and reported to the legislative committees with jurisdiction over health 
272.28 	and human services.
272.29 	(c) As far as possible, the outcome goals, reporting system, and distribution formulas 
272.30 	shall be consistent across program areas. The development of outcome goals shall 
272.31 	consider the manner in which achievement of these goals will be reported. An estimate 
272.32 	of increased or decreased state and local administrative costs in collecting and reporting 
272.33 	outcomes shall be included when outcome goals are established.  The steering committee 
272.34 	shall take into consideration that the goal of implementing changes to program monitoring 
272.35 	and reporting the progress toward achieving outcomes is to significantly minimize the 
273.1 	cost of administrative requirements and to allow funds freed by reduced administrative 
273.2 	expenditures to be used to provide additional services, allow flexibility in service design 
273.3 	and management, and focus energies on achieving program and client outcomes.
273.4 	(d) In making its recommendations, the steering committee shall consider input from 
273.5 	the council established in section 402A.40. The steering committee shall review the 
273.6 	measurable goals established under section 402A.30, subdivision 2, paragraph (b), and 
273.7 	consider whether they may be applied as statewide performance outcomes.
273.8 	(e) The steering committee shall form work groups that include persons who provide 
273.9 	or receive essential services and representatives of organizations who advocate on behalf 
273.10 	of those persons.
273.11 	(f) By January 15 of each year starting January 15, 2010, the steering committee 
273.12 	shall report to the legislative committees with jurisdiction over health and human services 
273.13 	its recommendations for outcome goals, a reporting system, and funding distribution 
273.14 	formulas. The steering committee shall also identify statutory provisions, administrative 
273.15 	rules and requirements, and reports that should be repealed or eliminated.  In addition, the 
273.16 	commissioner shall post quarterly  updates on the progress of the steering committee on 
273.17 	the department Web site.
273.18 	(g) The commissioner shall publish instructional bulletins in a timely manner that 
273.19 	contain the outcome goals and reporting requirements adopted by the legislature. The 
273.20 	commissioner shall initiate state plan amendments necessary to implement provisions of 
273.21 	this section in a timely manner.
273.22 		Subd. 2.Composition. (a) The steering committee shall include:
273.23 	(1) the commissioner of human services, or designee;
273.24 	(2) three county commissioners, representative of rural, suburban, and urban 
273.25 	counties, selected by the Association of Minnesota Counties;
273.26 	(3) three county directors of human services, representative of rural, suburban, 
273.27 	and urban counties, selected by the Minnesota Association of County Social Service 
273.28 	Administrators; and
273.29 	(4) five clients or client advocates representing different populations receiving 
273.30 	services from the Department of Human Services, who are appointed by the commissioner.
273.31 	(b) The commissioner, or designee, and a county commissioner shall serve as 
273.32 	cochairs of the committee. The committee shall be convened within 60 days of final 
273.33 	enactment of this legislation.
273.34 	(c) State agency staff shall serve as informational resources and staff to the steering 
273.35 	committee. Statewide county associations shall assemble county program data as required.
274.1 	(d) To promote information sharing and coordination between the steering committee 
274.2 	and council, one of the county representatives from paragraph (a), clause (2), and one of the 
274.3 	county representatives from paragraph (a), clause (3), must also serve as a representative 
274.4 	on the council under section 402A.40, subdivision 1, paragraph (b), clause (5) or (6).

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

274.6 	Sec. 4. [402A.20] STATE-COUNTY RESULTS, ACCOUNTABILITY, AND 
274.7 	SERVICE DELIVERY REDESIGN.
274.8 	The State-County Results, Accountability, and Service Delivery Redesign is 
274.9 	established to authorize implementation of methods and procedures for administering 
274.10 	assistance and services to recipients or potential recipients of public welfare and other 
274.11 	services delivered by counties which encourage greater transparency, more effective 
274.12 	governance, and innovation through the use of flexibility and performance measurement.

274.13 	Sec. 5. [402A.30] DESIGNATION OF SERVICE DELIVERY AUTHORITY.
274.14 		Subdivision 1.Establishment. A county or consortium of counties may establish 
274.15 	a service delivery authority to  redesign the delivery of some or all essential services, 
274.16 	or other services as appropriate.
274.17 		Subd. 2.New state-county governance framework. (a) Upon recommendation 
274.18 	of the council and approval of the commissioner, a single county with a population over 
274.19 	55,000, or two or more counties meeting the criteria in subdivision 4 may, by resolution of 
274.20 	their county boards of commissioners, establish a service delivery authority having the 
274.21 	composition, powers, and duties agreed upon. These counties may, by agreement entered 
274.22 	into through action of their bodies, jointly or cooperatively exercise any power common to 
274.23 	the contracting parties in carrying out their duties under current law, including, but not 
274.24 	limited to, chapters 245 to 267, 393, and 402. Participating county boards shall establish 
274.25 	acceptable ways of apportioning the cost of the services.
274.26 	(b) To establish a service delivery authority, each participating county and the 
274.27 	state must enter into the following binding agreements to establish a joint state-county 
274.28 	governance framework:
274.29 	(1) a governance agreement which defines the scope of essential services or other 
274.30 	services over which the service delivery authority has jurisdiction, and the respective 
274.31 	authority, powers, roles, and responsibilities of the state and service delivery authorities. 
274.32 	Each service delivery authority shall designate a single administrative structure to oversee 
274.33 	the delivery of services over which the service delivery authority has jurisdiction. As part 
274.34 	of the governance agreement, the service delivery authority shall be held accountable for 
275.1 	achieving measurable goals as defined in the performance agreement under clause (2). The 
275.2 	state and participating counties shall identify in the agreement the waivers from statutory 
275.3 	requirements that are needed to ensure greater local control and flexibility to determine the 
275.4 	most cost-effective means of achieving specified measurable goals. The commissioner 
275.5 	shall grant the identified waivers, subject to clause (2). The governance agreement shall 
275.6 	set forth the terms under which a county may withdraw from participation;
275.7 	(2) a performance agreement which defines measurable goals in key operational areas 
275.8 	that the service delivery authority is expected to achieve. This agreement must identify 
275.9 	the dependencies and other requirements necessary for the service delivery authority to 
275.10 	achieve the measurable goals as defined in the performance agreement. The dependencies 
275.11 	and requirements may include, but are not limited to, specific resource commitments of 
275.12 	the state and the service delivery authority, and funding or expenditure flexibility.
275.13 	The performance goals must, at a minimum, satisfy performance outcomes 
275.14 	recommended by the steering committee and enacted into law; and
275.15 	(3) a service level agreement which specifies the expectations and responsibilities 
275.16 	of the state and the service delivery authority regarding administrative and information 
275.17 	technology support necessary to achieve the measurable goals specified in the performance 
275.18 	agreement under clause (2). The service level agreement shall set forth a reasonable level 
275.19 	of targeted reductions in overhead and administrative costs for each county participating 
275.20 	in the service delivery authority.
275.21 	(c) After January 1, 2010, each county board in Minnesota shall vote to determine 
275.22 	whether the county intends to participate in a service delivery authority under this chapter. 
275.23 	Counties may withdraw from participation as set forth in the governance agreement, but 
275.24 	no county may withdraw except under the following conditions:
275.25 	(1) the county shall submit written notification to the council after August 1 in the 
275.26 	preceding calendar year in which the county wishes to withdraw; and
275.27 	(2) if a county wishing to withdraw has received an appropriation from the state for 
275.28 	costs related to the county's participation in the redesign, those funds must be repaid. If a 
275.29 	county withdraws after participating in the redesign for:
275.30 	(i) one year or less, the county must repay 75 percent of the money appropriated;
275.31 	(ii) more than one year but less than two years, the county must repay 50 percent of 
275.32 	the money appropriated;
275.33 	(iii) two years or more but less than three years, the county must repay 25 percent of 
275.34 	the money appropriated; or
275.35 	(iv) three years or more, the county is not required to repay the appropriation.
275.36 	The commissioner may waive the repayment requirement in clause (2).
276.1 	(d) Nothing in this chapter precludes local governments from utilizing sections 
276.2 	465.81 and 465.82 to establish procedures for local governments to merge, with the 
276.3 	consent of the voters. Any agreement under subdivision 2, paragraph (b), must be 
276.4 	governed by this chapter. Nothing in this chapter limits the authority of a county board 
276.5 	to enter into contractual agreements for services not covered by the provisions of the 
276.6 	redesign with other agencies or with other units of government.
276.7 		Subd. 3.Duties. (a) The service delivery authority shall:
276.8 	(1) carry out the responsibilities required of local agencies under chapter 393 and 
276.9 	human service boards under chapter 402;
276.10 	(2) manage the public resources devoted to human services and other public services 
276.11 	delivered or purchased by the counties that are subsidized or regulated by the Department 
276.12 	of Human Services under chapter 245 or 267;
276.13 	(3) employ staff to assist in carrying out the redesign;
276.14 	(4) develop and maintain a continuity of operations plan to ensure the continued 
276.15 	operation or resumption of essential human services functions in the event of any business 
276.16 	interruption according to local, state, and federal emergency planning requirements;
276.17 	(5) receive and expend funds received for the redesign;
276.18 	(6) plan and deliver services directly or through contract with other governmental 
276.19 	or nongovernmental providers;
276.20 	(7) rent, purchase, sell, and otherwise dispose of real and personal property as 
276.21 	necessary to carry out the redesign; and
276.22 	(8) carry out any other service designated as a responsibility of a county.
276.23 	(b) Each service delivery authority certified under subdivision 4 shall designate a 
276.24 	single administrative structure that has the powers and duties assigned to the service 
276.25 	delivery authority.
276.26 		Subd. 4.Certification of service delivery authority. The council shall recommend 
276.27 	certification of a county or consortium of counties as a service delivery authority to the 
276.28 	commissioner of human services if: 
276.29 	(1) the conditions in subdivision 2, paragraphs (a) and (b), are met; and
276.30 	(2) the county or consortium of counties are:
276.31 	(i) a single county with a population of 55,000 or more;
276.32 	(ii) a consortium of counties with a total combined population of 55,000 or more and 
276.33 	the counties comprising the consortium are in reasonable geographic proximity; 
276.34 	(iii) four or more counties in reasonable geographic proximity without regard to 
276.35 	population; or
277.1 	(iv) a single county or consortium of counties meeting the criteria for exemption 
277.2 	from minimum population standards in this subdivision and subdivision 6.
277.3 		Subd. 5.Single county service delivery authority. For counties with populations 
277.4 	over 55,000, the board of county commissioners may be the service delivery authority 
277.5 	and retain existing authority under law. Counties with populations over 55,000 that serve 
277.6 	as their own service delivery authority may enter into shared services arrangements with 
277.7 	other service delivery authorities or smaller counties. These shared services arrangements 
277.8 	may include, but are not limited to, human services, corrections, public health, veterans 
277.9 	planning, human resources, program development and operations, training, technical 
277.10 	systems, joint purchasing, and consultative services or direct services to transient, special 
277.11 	needs, or low-incidence populations.
277.12 		Subd. 6.Exemption. The council may recommend that the commissioner of 
277.13 	human services exempt a single county or multicounty service delivery authority from the 
277.14 	minimum population standard in this subdivision if that service delivery authority can 
277.15 	demonstrate that it can otherwise meet the requirements of this chapter.
277.16 		Subd. 7.Commissioner remedies. The commissioner may submit to the council 
277.17 	a recommendation of remedies for performance improvement for any service delivery 
277.18 	authority not meeting the measurable goals agreed upon in performance agreements 
277.19 	under subdivision 2, paragraph (b). This provision does not preclude other powers of the 
277.20 	commissioner of human services to remedy county performance issues in a county or 
277.21 	counties not certified as a service delivery authority.

277.22 	Sec. 6. [402A.40] COUNCIL.
277.23 		Subdivision 1.Council. (a) A State-County Results, Accountability, and Service 
277.24 	Delivery Redesign Council is established. The council is responsible for review of the 
277.25 	redesign and must be convened by the commissioner of human services. Appointed council 
277.26 	members must be appointed by their respective agencies, associations, or governmental 
277.27 	units by November 1, 2009. The council shall be cochaired by the commissioner of human 
277.28 	services, or designee, and a county representative from paragraph (b), clause (5) or (6), 
277.29 	appointed by the Association of Minnesota Counties. Recommendations of the council 
277.30 	must be approved by a majority of the council members. The provisions of section 15.059 
277.31 	do not apply to this council, and this council does not expire.
277.32 	(b) The council must consist of the following members:
277.33 	(1) one representative from the governor's office;
277.34 	(2) from the house of representatives, one member of the majority party and one 
277.35 	member of the minority party, appointed by the speaker of the house;
278.1 	(3) from the senate, one member of the majority party and one member of the 
278.2 	minority party, appointed by the senate majority leader;
278.3 	(4) the commissioner of human services, or designee, and two employees from 
278.4 	the department;
278.5 	(5) two county commissioners appointed by the Association of Minnesota Counties;
278.6 	(6) two county representatives appointed by the Minnesota Association of County 
278.7 	Social Service Administrators; 
278.8 	(7) one representative appointed by AFSCME; and
278.9 	(8) one representative appointed by the Teamsters.
278.10 	(c) Administrative support to the council may be provided by the Association of 
278.11 	Minnesota Counties and affiliates.
278.12 	(d) Member agencies and associations are responsible for initial and subsequent 
278.13 	appointments to the council.
278.14 		Subd. 2.Council duties. (a) The council shall:
278.15 	(1) provide oversight of administration of the redesign;
278.16 	(2) recommend the approval of waivers from statutory requirements, administrative 
278.17 	rules, and standards necessary to achieve the requirements of the agreements under 
278.18 	section 402A.30, subdivision 2, paragraph (b), to the commissioner of human services 
278.19 	or other appropriate entity, for counties certified as service delivery authorities under 
278.20 	section 402A.30;
278.21 	(3) recommend approval of the agreements in section 402A.30, subdivision 2, 
278.22 	paragraph (b), to the commissioner of human services and ensure the consistency of the 
278.23 	agreements with the performance standards recommended by the steering committee and 
278.24 	enacted  by the legislature;
278.25 	(4) recommend certification of a county or consortium of counties as a service 
278.26 	delivery authority to the commissioner of human services;
278.27 	(5) recommend approval of shared services arrangements under section 402A.30, 
278.28 	subdivision 5;
278.29 	(6) establish a process to take public input on a proposed service delivery authority 
278.30 	and the governance framework; 
278.31 	(7) form work groups as necessary to carry out the duties of the council under the 
278.32 	redesign; and
278.33 	(8) establish a process for the mediation of conflicts among participating counties or 
278.34 	between participating counties and the commissioner of human services.
278.35 	(b) In order to carry out the provisions of the redesign, and to effectuate the 
278.36 	agreements established under section 402A.30, subdivision 2, paragraph (b), the 
279.1 	commissioner of human services shall exercise authority under section 256.01, subdivision 
279.2 	2, paragraph (l), including seeking all necessary waivers. The commissioner of human 
279.3 	services has authority to approve shared service arrangements as defined in section 
279.4 	402A.30, subdivision 5.

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

279.6 	Sec. 7. [402A.50]; PRIVATE SECTOR FUNDING.
279.7 	The council may support stakeholder agencies, if not otherwise prohibited by law, to 
279.8 	separately or jointly seek and receive funds to provide expert technical assistance to the 
279.9 	council, the council's work group, and any sub-work groups for executing the provisions 
279.10 	of the redesign. 

279.11 	Sec. 8. APPROPRIATION.
 279.12 	$350,000 is appropriated for the biennium beginning July 1, 2009, from the general 
279.13 	fund to the Council on State-County Results, Accountability, and Service Delivery 
279.14 	Redesign, for the purposes of the State-County Results, Accountability, and Service 
279.15 	Delivery Reform Act under Minnesota Statutes, sections 402A.01 to 402A.50. The 
279.16 	council shall establish a methodology for distributing funds to certified service delivery 
279.17 	authorities for the purposes of carrying out the requirements of the redesign.

279.18 	ARTICLE 11
279.19 	PUBLIC HEALTH

279.20 	Section 1. Minnesota Statutes 2008, section 103I.208, subdivision 2, is amended to 
279.21 	read:
279.22 		Subd. 2.Permit fee. The permit fee to be paid by a property owner is:
279.23 	(1) for a water supply well that is not in use under a maintenance permit, $175 
279.24 	annually;
279.25 	(2) for construction of a monitoring well, $215, which includes the state core 
279.26 	function fee;
279.27 	(3) for a monitoring well that is unsealed under a maintenance permit, $175 annually;
279.28 	(4) for a monitoring well owned by a federal agency, state agency, or local unit of 
279.29 	government that is unsealed under a maintenance permit, $50 annually. "Local unit of 
279.30 	government" means a statutory or home rule charter city, town, county, or soil and water 
279.31 	conservation district, watershed district, an organization formed for the joint exercise of 
279.32 	powers under section 471.59, a board of health or community health board, or other 
280.1 	special purpose district or authority with local jurisdiction in water and related land 
280.2 	resources management;
280.3 	(5) for monitoring wells used as a leak detection device at a single motor fuel retail 
280.4 	outlet, a single petroleum bulk storage site excluding tank farms, or a single agricultural 
280.5 	chemical facility site, the construction permit fee is $215, which includes the state core 
280.6 	function fee, per site regardless of the number of wells constructed on the site, and 
280.7 	the annual fee for a maintenance permit for unsealed monitoring wells is $175 per site 
280.8 	regardless of the number of monitoring wells located on site;
280.9 	(5) (6) for a groundwater thermal exchange device, in addition to the notification fee 
280.10 	for water supply wells, $215, which includes the state core function fee;
280.11 	(6) (7) for a vertical heat exchanger with less than ten tons of heating/cooling 
280.12 	capacity, $215;
280.13 	(8) for a vertical heat exchanger with ten to 50 tons of heating/cooling capacity, $425;
280.14 	(9) for a vertical heat exchanger with greater than 50 tons of heating/cooling 
280.15 	capacity, $650;
280.16 	(7) (10) for a dewatering well that is unsealed under a maintenance permit, $175 
280.17 	annually for each dewatering well, except a dewatering project comprising more than five 
280.18 	dewatering wells shall be issued a single permit for $875 annually for dewatering wells 
280.19 	recorded on the permit; and
280.20 	(8) (11) for an elevator boring, $215 for each boring.

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

280.26	(1)
	medical or veterinary equipment
		$
	53100
	
280.27	(2)
	dental x-ray equipment
		$
	3340
	
280.28	(3)
	accelerator
		$
	66
	
280.29	(4)
	radiation therapy equipment
		$
	66
	
280.30
280.31	(5)(3)
	x-ray equipment not used on 
humans or animals
		$
	53100
	
280.32
280.33
280.34	(6)(4)
	devices with sources of ionizing 
radiation not used on humans or 
animals
		$
	53100
	
280.35 	(b) A facility with radiation therapy and accelerator equipment must pay an annual 
280.36 	registration fee of $500. A facility with an industrial accelerator must pay an annual 
280.37 	registration fee of $150.
281.1 	(c) Electron microscopy equipment is exempt from the registration fee requirements 
281.2 	of this section.

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

281.8 	Sec. 4. Minnesota Statutes 2008, section 144.1222, subdivision 1a, is amended to read:
281.9 		Subd. 1a. Fees. All plans and specifications for public pool and spa construction, 
281.10 	installation, or alteration or requests for a variance that are submitted to the commissioner 
281.11 	according to Minnesota Rules, part 4717.3975, shall be accompanied by the appropriate 
281.12 	fees. All public pool construction plans submitted for review after January 1, 2009, 
281.13 	must be certified by a professional engineer registered in the state of Minnesota. If the 
281.14 	commissioner determines, upon review of the plans, that inadequate fees were paid, the 
281.15 	necessary additional fees shall be paid before plan approval. For purposes of determining 
281.16 	fees, a project is defined as a proposal to construct or install a public pool, spa, special 
281.17 	purpose pool, or wading pool and all associated water treatment equipment and drains, 
281.18 	gutters, decks, water recreation features, spray pads, and those design and safety features 
281.19 	that are within five feet of any pool or spa. The commissioner shall charge the following 
281.20 	fees for plan review and inspection of public pools and spas and for requests for variance 
281.21 	from the public pool and spa rules: 
281.22 	(1) each pool, $800 $1,500; 
281.23 	(2) each spa pool, $500 $800; 
281.24 	(3) each slide, $400 $600; 
281.25 	(4) projects valued at $250,000 or more, the greater of the sum of the fees in clauses 
281.26 	(1), (2), and (3) or 0.5 percent of the documented estimated project cost to a maximum 
281.27 	fee of $10,000 $15,000; 
281.28 	(5) alterations to an existing pool without changing the size or configuration of 
281.29 	the pool, $400 $600; 
281.30 	(6) removal or replacement of pool disinfection equipment only, $75 $100; and 
281.31 	(7) request for variance from the public pool and spa rules, $500. 

281.32 	Sec. 5. Minnesota Statutes 2008, section 144.125, subdivision 1, is amended to read:
282.1 		Subdivision 1.Duty to perform testing. It is the duty of (1) the administrative 
282.2 	officer or other person in charge of each institution caring for infants 28 days or less of age, 
282.3 	(2) the person required in pursuance of the provisions of section 144.215, to register the 
282.4 	birth of a child, or (3) the nurse midwife or midwife in attendance at the birth, to arrange 
282.5 	to have administered to every infant or child in its care tests for heritable and congenital 
282.6 	disorders according to subdivision 2 and rules prescribed by the state commissioner of 
282.7 	health. Testing and the recording and reporting of test results shall be performed at the 
282.8 	times and in the manner prescribed by the commissioner of health. The commissioner shall 
282.9 	charge a fee so that the total of fees collected will approximate the costs of conducting the 
282.10 	tests and implementing and maintaining a system to follow-up infants with heritable or 
282.11 	congenital disorders, including hearing loss detected through the early hearing detection 
282.12 	and intervention program under section 144.966. The fee is $101 $105 per specimen. 
282.13 	Costs associated with capital expenditures and the development of new procedures may be 
282.14 	prorated over a three-year period when calculating the amount of the fees. 

282.15 	EFFECTIVE DATE. This section is effective July 1, 2010.

282.16 	Sec. 6. Minnesota Statutes 2008, section 144.72, subdivision 1, is amended to read:
282.17 		Subdivision 1.Permits License required. The state commissioner of health is 
282.18 	authorized to issue permits for the operation of youth camps which are required to obtain 
282.19 	the permits a license according to chapter 157.

282.20 	Sec. 7. Minnesota Statutes 2008, section 144.72, subdivision 3, is amended to read:
282.21 		Subd. 3.Issuance of permits license. If the commissioner should determine from 
282.22 	the application that the health and safety of the persons using the camp will be properly 
282.23 	safeguarded, the commissioner may, prior to actual inspection of the camp, issue the 
282.24 	permit license in writing. No fee shall be charged for the permit. The permit license shall 
282.25 	be posted in a conspicuous place on the premises occupied by the camp.

282.26 	Sec. 8. Minnesota Statutes 2008, section 144.9501, is amended by adding a subdivision 
282.27 	to read:
282.28 		Subd. 8a.Disclosure pamphlet. "Disclosure pamphlet" means the EPA pamphlet 
282.29 	titled "Renovate Right: Important Lead Hazard Information for Families, Child Care 
282.30 	Providers and Schools" developed under section 406(a) of the Toxic Substance Control 
282.31 	Act.

283.1 	Sec. 9. Minnesota Statutes 2008, section 144.9501, subdivision 22b, is amended to 
283.2 	read:
283.3 		Subd. 22b.Lead sampling technician. "Lead sampling technician" means an 
283.4 	individual who performs clearance inspections for nonabatement or nonorder lead hazard 
283.5 	reduction renovation sites, and lead dust sampling in other settings, or visual assessment 
283.6 	for deteriorated paint for nonabatement sites, and who is registered with the commissioner 
283.7 	under section 144.9505. 

283.8 	Sec. 10. Minnesota Statutes 2008, section 144.9501, subdivision 26a, is amended to 
283.9 	read:
283.10 		Subd. 26a.Regulated lead work. (a) "Regulated lead work" means:
283.11 	(1) abatement;
283.12 	(2) interim controls;
283.13 	(3) a clearance inspection;
283.14 	(4) a lead hazard screen;
283.15 	(5) a lead inspection;
283.16 	(6) a lead risk assessment;
283.17 	(7) lead project designer services;
283.18 	(8) lead sampling technician services; or
283.19 	(9) swab team services.;
283.20 	(10) renovation activities; or
283.21 	(11) activities performed to comply with lead orders issued by a board of health.
283.22 	(b) Regulated lead work does not include abatement, interim controls, swab team 
283.23 	services, or renovation activities that disturb painted surfaces that total no more than:
283.24 	(1) activities such as remodeling, renovation, installation, rehabilitation, or 
283.25 	landscaping activities, the primary intent of which is to remodel, repair, or restore a 
283.26 	structure or dwelling, rather than to permanently eliminate lead hazards, even though these 
283.27 	activities may incidentally result in a reduction in lead hazards; or
283.28 	(2) interim control activities that are not performed as a result of a lead order and 
283.29 	that do not disturb painted surfaces that total more than:
283.30 	(i) (1) 20 square feet (two square meters) on exterior surfaces; or
283.31 	(ii) two (2) six square feet (0.2 0.6 square meters) in an interior room; or.
283.32 	(iii) ten percent of the total surface area on an interior or exterior type of component 
283.33 	with a small surface area.

284.1 	Sec. 11. Minnesota Statutes 2008, section 144.9501, is amended by adding a 
284.2 	subdivision to read:
284.3 		Subd. 26b.Renovation. "Renovation" means the modification of any affected 
284.4 	property that results in the disturbance of painted surfaces, unless that activity is performed 
284.5 	as an abatement. A renovation performed for the purpose of converting a building or part 
284.6 	of a building into an affected property is a renovation under this subdivision.

284.7 	Sec. 12. Minnesota Statutes 2008, section 144.9505, subdivision 1g, is amended to 
284.8 	read:
284.9 		Subd. 1g.Certified lead firm. A person within the state intending to directly 
284.10 	perform or cause to be performed through subcontracting or similar delegation any 
284.11 	regulated lead work shall first obtain certification from the commissioner A person who 
284.12 	employs individuals to perform regulated lead work outside of the person's property must 
284.13 	obtain certification as a lead firm. The certificate must be in writing, contain an expiration 
284.14 	date, be signed by the commissioner, and give the name and address of the person to 
284.15 	whom it is issued. The certification fee is $100, is nonrefundable, and must be submitted 
284.16 	with each application. The certificate or a copy of the certificate must be readily available 
284.17 	at the worksite for review by the contracting entity, the commissioner, and other public 
284.18 	health officials charged with the health, safety, and welfare of the state's citizens.

284.19 	Sec. 13. Minnesota Statutes 2008, section 144.9505, subdivision 4, is amended to read:
284.20 		Subd. 4.Notice of regulated lead work. (a) At least five working days before 
284.21 	starting work at each regulated lead worksite, the person performing the regulated lead 
284.22 	work shall give written notice to the commissioner and the appropriate board of health.
284.23 	(b) This provision does not apply to lead hazard screen, lead inspection, lead risk 
284.24 	assessment, lead sampling technician, renovation, or lead project design activities.

284.25 	Sec. 14. Minnesota Statutes 2008, section 144.9508, subdivision 2, is amended to read:
284.26 		Subd. 2.Regulated lead work standards and methods. (a) The commissioner 
284.27 	shall adopt rules establishing regulated lead work standards and methods in accordance 
284.28 	with the provisions of this section, for lead in paint, dust, drinking water, and soil in 
284.29 	a manner that protects public health and the environment for all residences, including 
284.30 	residences also used for a commercial purpose, child care facilities, playgrounds, and 
284.31 	schools.
284.32 	(b) In the rules required by this section, the commissioner shall require lead hazard 
284.33 	reduction of intact paint only if the commissioner finds that the intact paint is on a 
285.1 	chewable or lead-dust producing surface that is a known source of actual lead exposure to 
285.2 	a specific individual. The commissioner shall prohibit methods that disperse lead dust into 
285.3 	the air that could accumulate to a level that would exceed the lead dust standard specified 
285.4 	under this section. The commissioner shall work cooperatively with the commissioner 
285.5 	of administration to determine which lead hazard reduction methods adopted under this 
285.6 	section may be used for lead-safe practices including prohibited practices, preparation, 
285.7 	disposal, and cleanup. The commissioner shall work cooperatively with the commissioner 
285.8 	of the Pollution Control Agency to develop disposal procedures. In adopting rules under 
285.9 	this section, the commissioner shall require the best available technology for regulated 
285.10 	lead work methods, paint stabilization, and repainting.
285.11 	(c) The commissioner of health shall adopt regulated lead work standards and 
285.12 	methods for lead in bare soil in a manner to protect public health and the environment. 
285.13 	The commissioner shall adopt a maximum standard of 100 parts of lead per million in 
285.14 	bare soil. The commissioner shall set a soil replacement standard not to exceed 25 parts 
285.15 	of lead per million. Soil lead hazard reduction methods shall focus on erosion control 
285.16 	and covering of bare soil.
285.17 	(d) The commissioner shall adopt regulated lead work standards and methods for 
285.18 	lead in dust in a manner to protect the public health and environment. Dust standards 
285.19 	shall use a weight of lead per area measure and include dust on the floor, on the window 
285.20 	sills, and on window wells. Lead hazard reduction methods for dust shall focus on dust 
285.21 	removal and other practices which minimize the formation of lead dust from paint, soil, or 
285.22 	other sources.
285.23 	(e) The commissioner shall adopt lead hazard reduction standards and methods for 
285.24 	lead in drinking water both at the tap and public water supply system or private well 
285.25 	in a manner to protect the public health and the environment. The commissioner may 
285.26 	adopt the rules for controlling lead in drinking water as contained in Code of Federal 
285.27 	Regulations, title 40, part 141. Drinking water lead hazard reduction methods may include 
285.28 	an educational approach of minimizing lead exposure from lead in drinking water.
285.29 	(f) The commissioner of the Pollution Control Agency shall adopt rules to ensure that 
285.30 	removal of exterior lead-based coatings from residences and steel structures by abrasive 
285.31 	blasting methods is conducted in a manner that protects health and the environment.
285.32 	(g) All regulated lead work standards shall provide reasonable margins of safety that 
285.33 	are consistent with more than a summary review of scientific evidence and an emphasis on 
285.34 	overprotection rather than underprotection when the scientific evidence is ambiguous.
285.35 	(h) No unit of local government shall have an ordinance or regulation governing 
285.36 	regulated lead work standards or methods for lead in paint, dust, drinking water, or soil 
286.1 	that require a different regulated lead work standard or method than the standards or 
286.2 	methods established under this section.
286.3 	(i) Notwithstanding paragraph (h), the commissioner may approve the use by a unit 
286.4 	of local government of an innovative lead hazard reduction method which is consistent 
286.5 	in approach with methods established under this section.
286.6 	(j) The commissioner shall adopt rules for issuing lead orders required under section 
286.7 	144.9504, rules for notification of abatement or interim control activities requirements, 
286.8 	and other rules necessary to implement sections 144.9501 to 144.9512. 
286.9 	(k) The commissioners shall adopt rules consistent with section 402(c)(3) of the 
286.10 	Toxic Substances Control Act to ensure that renovation in a pre-1978 affected property 
286.11 	where a child or pregnant female resides is conducted in a manner that protects health 
286.12 	and the environment.
286.13 	(l) The commissioner shall adopt rules consistent with sections 406(a) and 406(b) of 
286.14 	the Toxic Substances Control Act.

286.15 	Sec. 15. Minnesota Statutes 2008, section 144.9508, subdivision 3, is amended to read:
286.16 		Subd. 3.Licensure and certification. The commissioner shall adopt rules to 
286.17 	license lead supervisors, lead workers, lead project designers, lead inspectors, and lead 
286.18 	risk assessors, and lead sampling technicians. The commissioner shall also adopt rules 
286.19 	requiring certification of firms that perform regulated lead work and rules requiring 
286.20 	registration of lead sampling technicians. The commissioner shall require periodic renewal 
286.21 	of licenses, and certificates, and registrations and shall establish the renewal periods.

286.22 	Sec. 16. Minnesota Statutes 2008, section 144.9508, subdivision 4, is amended to read:
286.23 		Subd. 4.Lead training course. The commissioner shall establish by rule 
286.24 	requirements for training course providers and the renewal period for each lead-related 
286.25 	training course required for certification or licensure. The commissioner shall establish 
286.26 	criteria in rules for the content and presentation of training courses intended to qualify 
286.27 	trainees for licensure under subdivision 3. The commissioner shall establish criteria 
286.28 	in rules for the content and presentation of training courses for lead interim control 
286.29 	workers renovation and lead sampling technicians. Training course permit fees shall be 
286.30 	nonrefundable and must be submitted with each application in the amount of $500 for an 
286.31 	initial training course, $250 for renewal of a permit for an initial training course, $250 for 
286.32 	a refresher training course, and $125 for renewal of a permit of a refresher training course.

286.33 	Sec. 17. Minnesota Statutes 2008, section 144.9512, subdivision 2, is amended to read:
287.1 		Subd. 2.Grants; administration. Within the limits of the available appropriation, 
287.2 	the commissioner shall make grants to a nonprofit organization currently operating the 
287.3 	CLEARCorps lead hazard reduction project organizations to train workers to provide lead 
287.4 	screening, education, outreach, and swab team services for residential property. Projects 
287.5 	that provide Americorps funding or positions, or leverage matching funds, as part of the 
287.6 	delivery of the services must be given priority for the grant funds.

287.7 	Sec. 18. Minnesota Statutes 2008, section 144.966, is amended by adding a subdivision 
287.8 	to read:
287.9 		Subd. 3a.Support services to families. The commissioner shall contract with 
287.10 	a nonprofit organization to provide support and assistance to families with children 
287.11 	who are deaf or have a hearing loss. The family support provided must include direct 
287.12 	parent-to-parent assistance and information on communication, educational, and medical 
287.13 	options. The commissioner shall give preference to a nonprofit organization that has the 
287.14 	ability to provide these services throughout the state.

287.15 	Sec. 19. Minnesota Statutes 2008, section 144.97, subdivision 2, is amended to read:
287.16 		Subd. 2.Certification Accreditation. "Certification" means written 
287.17 	acknowledgment of a laboratory's demonstrated capability to perform tests for a specific 
287.18 	purpose "Accreditation" means written acknowledgment that a laboratory has the 
287.19 	policies, procedures, equipment, and practices to produce reliable data in the analysis of 
287.20 	environmental samples.

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

287.22 	Sec. 20. Minnesota Statutes 2008, section 144.97, subdivision 4, is amended to read:
287.23 		Subd. 4.ContractCommercial laboratory. "Contract Commercial laboratory" 
287.24 	means a laboratory that performs tests on samples on a contract or fee-for-service basis.

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

287.26 	Sec. 21. Minnesota Statutes 2008, section 144.97, is amended by adding a subdivision 
287.27 	to read:
287.28 		Subd. 5a.Field of testing. "Field of testing" means the combination of analyte, 
287.29 	method, matrix, and test category for which a laboratory may hold accreditation.

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

288.1 	Sec. 22. Minnesota Statutes 2008, section 144.97, subdivision 6, is amended to read:
288.2 		Subd. 6.Laboratory. "Laboratory" means the state, a person, corporation, or other 
288.3 	entity, including governmental, that examines, analyzes, or tests samples in a specified 
288.4 	physical location.

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

288.6 	Sec. 23. Minnesota Statutes 2008, section 144.97, is amended by adding a subdivision 
288.7 	to read:
288.8 		Subd. 8.Test category. "Test category" means the combination of program and 
288.9 	category as provided by section 144.98, subdivisions 3, paragraph (b), clauses (1) to (10), 
288.10 	and 3a, paragraph (a), clauses (1) to (5).

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

288.12 	Sec. 24. Minnesota Statutes 2008, section 144.98, subdivision 1, is amended to read:
288.13 		Subdivision 1.Authorization. The commissioner of health may certify shall 
288.14 	accredit environmental laboratories that test environmental samples according to national 
288.15 	standards developed using a consensus process as established by Circular A-119, 
288.16 	published by the United States Office of Management and Budget.

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

288.18 	Sec. 25. Minnesota Statutes 2008, section 144.98, subdivision 2, is amended to read:
288.19 		Subd. 2.Rules and standards. The commissioner may adopt rules to implement 
288.20 	this section, including: carry out the commissioner's responsibilities under the national 
288.21 	standards specified in subdivisions 1 and 2a.
288.22 	(1) procedures, requirements, and fee adjustments for laboratory certification, 
288.23 	including provisional status and recertification;
288.24 	(2) standards and fees for certificate approval, suspension, and revocation;
288.25 	(3) standards for environmental samples;
288.26 	(4) analysis methods that assure reliable test results;
288.27 	(5) laboratory quality assurance, including internal quality control, proficiency 
288.28 	testing, and personnel training; and
288.29 	(6) criteria for recognition of certification programs of other states and the federal 
288.30 	government.

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

289.1 	Sec. 26. Minnesota Statutes 2008, section 144.98, is amended by adding a subdivision 
289.2 	to read:
289.3 		Subd. 2a.Standards. The commissioner shall accredit laboratories according to 
289.4 	the most current environmental laboratory accreditation standards under subdivision 1 
289.5 	and as accepted by the accreditation bodies recognized by the National Environmental 
289.6 	Laboratory Accreditation Program (NELAP) of the NELAC Institute.

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

289.8 	Sec. 27. Minnesota Statutes 2008, section 144.98, subdivision 3, is amended to read:
289.9 		Subd. 3.Annual fees. (a) An application for certification accreditation under 
289.10 	subdivision 1 6 must be accompanied by the biennial fee annual fees specified in this 
289.11 	subdivision. The fees are for annual fees include:
289.12 	(1) base certification accreditation fee, $1,600 $1,500;
289.13 	(2) sample preparation techniques fees fee, $100 $200 per technique; and
289.14 	(3) an administrative fee for laboratories located outside this state, $3,750; and
289.15 	(4) test category certification fees:.

289.16	Test Category
	Certification Fee
	
289.17	Clean water program bacteriology
	$800
	
289.18	Safe drinking water program bacteriology
	$800
	
289.19	Clean water program inorganic chemistry
	$800
	
289.20	Safe drinking water program inorganic chemistry
	$800
	
289.21	Clean water program chemistry metals
	$1,200
	
289.22	Safe drinking water program chemistry metals
	$1,200
	
289.23	Resource conservation and recovery program chemistry metals
	$1,200
	
289.24	Clean water program volatile organic compounds
	$1,500
	
289.25	Safe drinking water program volatile organic compounds
	$1,500
	
289.26
289.27	Resource conservation and recovery program volatile organic 
compounds
	$1,500
	
289.28	Underground storage tank program volatile organic compounds
	$1,500
	
289.29	Clean water program other organic compounds
	$1,500
	
289.30	Safe drinking water program other organic compounds
	$1,500
	
289.31	Resource conservation and recovery program other organic compounds
	$1,500
	
289.32	Clean water program radiochemistry
	$2,500
	
289.33	Safe drinking water program radiochemistry
	$2,500
	
289.34	Resource conservation and recovery program agricultural contaminants
	$2,500
	
289.35	Resource conservation and recovery program emerging contaminants
	$2,500
	
289.36 	(b) Laboratories located outside of this state that require an on-site inspection shall be 
289.37 	assessed an additional $3,750 fee. For the programs in subdivision 3a, the commissioner 
289.38 	may accredit laboratories for fields of testing under the categories listed in clauses (1) to 
290.1 	(10) upon completion of the application requirements provided by subdivision 6 and 
290.2 	receipt of the fees for each category under each program that accreditation is requested. 
290.3 	The categories offered and related fees include:
290.4 	(1) microbiology, $450;
290.5 	(2) inorganics, $450;
290.6 	(3) metals, $1,000;
290.7 	(4) volatile organics, $1,300;
290.8 	(5) other organics, $1,300;
290.9 	(6) radiochemistry, $1,500;
290.10 	(7) emerging contaminants, $1,500;
290.11 	(8) agricultural contaminants, $1,250;
290.12 	(9) toxicity (bioassay), $1,000; and
290.13 	(10) physical characterization, $250.
290.14 	(c) The total biennial certification annual fee includes the base fee, the sample 
290.15 	preparation techniques fees, the test category fees per program, and, when applicable, the 
290.16 	on-site inspection fee an administrative fee for out-of-state laboratories.
290.17 	(d) Fees must be set so that the total fees support the laboratory certification program. 
290.18 	Direct costs of the certification service include program administration, inspections, the 
290.19 	agency's general support costs, and attorney general costs attributable to the fee function.
290.20 	(e) A change fee shall be assessed if a laboratory requests additional analytes 
290.21 	or methods at any time other than when applying for or renewing its certification. The 
290.22 	change fee is equal to the test category certification fee for the analyte.
290.23 	(f) A variance fee shall be assessed if a laboratory requests and is granted a variance 
290.24 	from a rule adopted under this section. The variance fee is $500 per variance.
290.25 	(g) Refunds or credits shall not be made for analytes or methods requested but 
290.26 	not approved.
290.27 	(h) Certification of a laboratory shall not be awarded until all fees are paid.

290.28 	Sec. 28. Minnesota Statutes 2008, section 144.98, is amended by adding a subdivision 
290.29 	to read:
290.30 		Subd. 3a.Available programs, categories, and analytes. (a) The commissioner 
290.31 	shall accredit laboratories that test samples under the following programs:
290.32 	(1) the clean water program, such as compliance monitoring under the federal Clean 
290.33 	Water Act, and ambient monitoring of surface and groundwater, or analysis of biological 
290.34 	tissue;
291.1 	(2) the safe drinking water program, including compliance monitoring under the 
291.2 	federal Safe Drinking Water Act, and the state requirements for monitoring private wells;
291.3 	(3) the resource conservation and recovery program, including federal and state 
291.4 	requirements for monitoring solid and hazardous wastes, biological tissue, leachates, and 
291.5 	groundwater monitoring wells not intended as drinking water sources;
291.6 	(4) the underground storage tank program; and
291.7 	(5) the clean air program, including air and emissions testing under the federal Clean 
291.8 	Air Act, and state and federal requirements for vapor intrusion monitoring.
291.9 	(b) The commissioner shall maintain and publish a list of analytes available for 
291.10 	accreditation. The list must be reviewed at least once every six months and the changes 
291.11 	published in the State Register and posted on the program's Web site. The commissioner 
291.12 	shall publish the notification of changes and review comments on the changes no less than 
291.13 	30 days from the date the list is published.

291.14 	Sec. 29. Minnesota Statutes 2008, section 144.98, is amended by adding a subdivision 
291.15 	to read:
291.16 		Subd. 3b.Additional fees. (a) Laboratories located outside of this state that require 
291.17 	an on-site assessment more frequent than once every two years must pay an additional 
291.18 	assessed fee of $3,000 per assessment for each additional on-site assessment conducted. 
291.19 	The laboratory must pay the fee within 15 business days of receiving the commissioner's 
291.20 	notification that an on-site assessment is required. The commissioner may conduct 
291.21 	additional on-site assessments to determine a laboratory's continued compliance with 
291.22 	the standards provided in subdivision 2a.
291.23 	(b) A late fee of $200 shall be added to the annual fee for accredited laboratories 
291.24 	submitting renewal applications to the commissioner after November 1.
291.25 	(c) A change fee shall be assessed if a laboratory requests additional fields of testing 
291.26 	at any time other than when initially applying for or renewing its accreditation. A change 
291.27 	fee does not apply for applications to add fields of testing for new analytes in response 
291.28 	to the published notice under subdivision 3a, paragraph (b), if the laboratory holds valid 
291.29 	accreditation for the changed test category and applies for additional analytes within the 
291.30 	same test category. The change fee is equal to the applicable test category fee for the 
291.31 	field of testing requested. An application that requests accreditation of multiple fields of 
291.32 	testing within a test category requires a single payment of the applicable test category fee 
291.33 	per application submitted.
291.34 	(d) A variance fee shall be assessed if a laboratory requests a variance from a 
291.35 	standard provided in subdivision 2a. The variance fee is $500 per variance.
292.1 	(e) The commissioner shall assess a fee for changes to laboratory information 
292.2 	regarding ownership, name, address, or personnel. Laboratories must submit changes 
292.3 	through the application process under subdivision 6. The information update fee is $250 
292.4 	per application.
292.5 	(f) Fees must be set so that the total fees support the laboratory accreditation 
292.6 	program. Direct costs of the accreditation service include program administration, 
292.7 	assessments, the agency's general support costs, and attorney general costs attributable 
292.8 	to the fee function.

292.9 	Sec. 30. Minnesota Statutes 2008, section 144.98, is amended by adding a subdivision 
292.10 	to read:
292.11 		Subd. 3c.Refunds and nonpayment. Refunds or credits shall not be made for 
292.12 	applications received but not approved. Accreditation of a laboratory shall not be awarded 
292.13 	until all fees are paid.

292.14 	Sec. 31. Minnesota Statutes 2008, section 144.98, is amended by adding a subdivision 
292.15 	to read:
292.16 		Subd. 6.Application. (a) Laboratories seeking accreditation must apply on a form 
292.17 	provided by the commissioner, include the laboratory's procedures and quality manual, 
292.18 	and pay the applicable fees.
292.19 	(b) Laboratories may be fixed-base or mobile. The commissioner shall accredit 
292.20 	mobile laboratories individually and require a vehicle identification number, license 
292.21 	plate number, or other uniquely identifying information in addition to the application 
292.22 	requirements of paragraph (a).
292.23 	(c) Laboratories maintained on separate properties, even though operated under the 
292.24 	same management or ownership, must apply separately. Laboratories with more than one 
292.25 	building on the same or adjoining properties do not need to submit a separate application.
292.26 	(d) The commissioner may accredit laboratories located out-of-state. Accreditation 
292.27 	for out-of-state laboratories may be obtained directly from the commissioner following 
292.28 	the requirements in paragraph (a), or out-of-state laboratories may be accredited through 
292.29 	a reciprocal agreement if the laboratory:
292.30 	(1) is accredited by a NELAP-recognized accreditation body for those fields of 
292.31 	testing in which the laboratory requests accreditation from the commissioner;
292.32 	(2) submits an application and documentation according to this subdivision; and
293.1 	(3) submits a current copy of the laboratory's unexpired accreditation from a 
293.2 	NELAP-recognized accreditation body showing the fields of accreditation for which the 
293.3 	laboratory is currently accredited.
293.4 	(e) Under the conflict of interest determinations provided in section 43A.38, 
293.5 	subdivision 6, clause (a), the commissioner shall not accredit governmental laboratories 
293.6 	operated by agencies of the executive branch of the state. If accreditation is required, 
293.7 	laboratories operated by agencies of the executive branch of the state must apply for 
293.8 	accreditation through any other NELAP-recognized accreditation body.

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

293.10 	Sec. 32. Minnesota Statutes 2008, section 144.98, is amended by adding a subdivision 
293.11 	to read:
293.12 		Subd. 6a.Implementation and effective date. All laboratories must comply with 
293.13 	standards under this section by July 1, 2009. Fees under subdivisions 3 and 3b apply to 
293.14 	applications received and accreditations issued after June 30, 2009. Accreditations issued 
293.15 	on or before June 30, 2009, shall expire upon their current expiration date.

293.16 	Sec. 33. Minnesota Statutes 2008, section 144.98, is amended by adding a subdivision 
293.17 	to read:
293.18 		Subd. 7.Initial accreditation and annual accreditation renewal. (a) The 
293.19 	commissioner shall issue or renew accreditation after receipt of the completed application 
293.20 	and documentation required in this section, provided the laboratory maintains compliance 
293.21 	with the standards specified in subdivision 2a, and attests to the compliance on the 
293.22 	application form.
293.23 	(b) The commissioner shall prorate the fees in subdivision 3 for laboratories 
293.24 	applying for accreditation after December 31. The fees are prorated on a quarterly basis 
293.25 	beginning with the quarter in which the commissioner receives the completed application 
293.26 	from the laboratory.
293.27 	(c) Applications for renewal of accreditation must be received by November 1 and 
293.28 	no earlier than October 1 of each year. The commissioner shall send annual renewal 
293.29 	notices to laboratories 90 days before expiration. Failure to receive a renewal notice does 
293.30 	not exempt laboratories from meeting the annual November 1 renewal date.
293.31 	(d) The commissioner shall issue all accreditations for the calendar year for which 
293.32 	the application is made, and the accreditation shall expire on December 31 of that year.
293.33 	(e) The accreditation of any laboratory that fails to submit a renewal application 
293.34 	and fees to the commissioner expires automatically on December 31 without notice or 
294.1 	further proceeding. Any person who operates a laboratory as accredited after expiration of 
294.2 	accreditation or without having submitted an application and paid the fees is in violation 
294.3 	of the provisions of this section and is subject to enforcement action under sections 
294.4 	144.989 to 144.993, the Health Enforcement Consolidation Act. A laboratory with expired 
294.5 	accreditation may reapply under subdivision 6.

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

294.7 	Sec. 34. Minnesota Statutes 2008, section 144.99, subdivision 1, is amended to read:
294.8 		Subdivision 1.Remedies available. The provisions of chapters 103I and 157 and 
294.9 	sections 115.71 to 115.77; 144.12, subdivision 1, paragraphs (1), (2), (5), (6), (10), (12), 
294.10 	(13), (14), and (15); 144.1201 to 144.1204; 144.121; 144.1222; 144.35; 144.381 to 
294.11 	144.385; 144.411 to 144.417; 144.495; 144.71 to 144.74; 144.9501 to 144.9512; 144.97; 
294.12 	144.98;144.992; 326.70 to 326.785; 327.10 to 327.131; and 327.14 to 327.28 and all 
294.13 	rules, orders, stipulation agreements, settlements, compliance agreements, licenses, 
294.14 	registrations, certificates, and permits adopted or issued by the department or under any 
294.15 	other law now in force or later enacted for the preservation of public health may, in 
294.16 	addition to provisions in other statutes, be enforced under this section. 

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

294.18 	Sec. 35. Minnesota Statutes 2008, section 157.15, is amended by adding a subdivision 
294.19 	to read:
294.20 		Subd. 20.Youth camp. "Youth camp" has the meaning given in section 144.71, 
294.21 	subdivision 2.

294.22 	Sec. 36. Minnesota Statutes 2008, section 157.16, is amended to read:
294.23 	157.16 LICENSES REQUIRED; FEES. 
294.24 		Subdivision 1. License required annually. A license is required annually for every 
294.25 	person, firm, or corporation engaged in the business of conducting a food and beverage 
294.26 	service establishment, for-profit youth camp, hotel, motel, lodging establishment, public 
294.27 	pool, or resort. Any person wishing to operate a place of business licensed in this 
294.28 	section shall first make application, pay the required fee specified in this section, and 
294.29 	receive approval for operation, including plan review approval. Seasonal and temporary 
294.30 	food stands and Special event food stands are not required to submit plans. Nonprofit 
294.31 	organizations operating a special event food stand with multiple locations at an annual 
294.32 	one-day event shall be issued only one license. Application shall be made on forms 
295.1 	provided by the commissioner and shall require the applicant to state the full name and 
295.2 	address of the owner of the building, structure, or enclosure, the lessee and manager of the 
295.3 	food and beverage service establishment, hotel, motel, lodging establishment, public pool, 
295.4 	or resort; the name under which the business is to be conducted; and any other information 
295.5 	as may be required by the commissioner to complete the application for license. 
295.6 		Subd. 2. License renewal. Initial and renewal licenses for all food and beverage 
295.7 	service establishments, for-profit youth camps, hotels, motels, lodging establishments, 
295.8 	public pools, and resorts shall be issued for the calendar year for which application is 
295.9 	made and shall expire on December 31 of such year on an annual basis. Any person 
295.10 	who operates a place of business after the expiration date of a license or without having 
295.11 	submitted an application and paid the fee shall be deemed to have violated the provisions 
295.12 	of this chapter and shall be subject to enforcement action, as provided in the Health 
295.13 	Enforcement Consolidation Act, sections 144.989 to 144.993. In addition, a penalty of 
295.14 	$50 $60 shall be added to the total of the license fee for any food and beverage service 
295.15 	establishment operating without a license as a mobile food unit, a seasonal temporary 
295.16 	or seasonal permanent food stand, or a special event food stand, and a penalty of $100
295.17 	$120 shall be added to the total of the license fee for all restaurants, food carts, hotels, 
295.18 	motels, lodging establishments, for-profit youth camps, public pools, and resorts operating 
295.19 	without a license for a period of up to 30 days. A late fee of $300 $360 shall be added to 
295.20 	the license fee for establishments operating more than 30 days without a license. 
295.21 		Subd. 2a. Food manager certification. An applicant for certification or certification 
295.22 	renewal as a food manager must submit to the commissioner a $28 $35 nonrefundable 
295.23 	certification fee payable to the Department of Health. The commissioner shall issue a 
295.24 	duplicate certificate to replace a lost, destroyed, or mutilated certificate if the applicant 
295.25 	submits a completed application on a form provided by the commissioner for a duplicate 
295.26 	certificate and pays $20 to the department for the cost of duplication.
295.27 		Subd. 3. Establishment fees; definitions. (a) The following fees are required for 
295.28 	food and beverage service establishments, for-profit youth camps, hotels, motels, lodging 
295.29 	establishments, public pools, and resorts licensed under this chapter. Food and beverage 
295.30 	service establishments must pay the highest applicable fee under paragraph (d), clause 
295.31 	(1), (2), (3), or (4), and establishments serving alcohol must pay the highest applicable 
295.32 	fee under paragraph (d), clause (6) or (7). The license fee for new operators previously 
295.33 	licensed under this chapter for the same calendar year is one-half of the appropriate annual 
295.34 	license fee, plus any penalty that may be required. The license fee for operators opening 
295.35 	on or after October 1 is one-half of the appropriate annual license fee, plus any penalty 
295.36 	that may be required. 
296.1 	(b) All food and beverage service establishments, except special event food stands, 
296.2 	and all hotels, motels, lodging establishments, public pools, and resorts shall pay an 
296.3 	annual base fee of $150. 
296.4 	(c) A special event food stand shall pay a flat fee of $40 $50 annually. "Special event 
296.5 	food stand" means a fee category where food is prepared or served in conjunction with 
296.6 	celebrations, county fairs, or special events from a special event food stand as defined 
296.7 	in section 157.15. 
296.8 	(d) In addition to the base fee in paragraph (b), each food and beverage service 
296.9 	establishment, other than a special event food stand, and each hotel, motel, lodging 
296.10 	establishment, public pool, and resort shall pay an additional annual fee for each fee 
296.11 	category, additional food service, or required additional inspection specified in this 
296.12 	paragraph: 
296.13 	(1) Limited food menu selection, $50 $60. "Limited food menu selection" means a 
296.14 	fee category that provides one or more of the following: 
296.15 	(i) prepackaged food that receives heat treatment and is served in the package; 
296.16 	(ii) frozen pizza that is heated and served; 
296.17 	(iii) a continental breakfast such as rolls, coffee, juice, milk, and cold cereal; 
296.18 	(iv) soft drinks, coffee, or nonalcoholic beverages; or 
296.19 	(v) cleaning for eating, drinking, or cooking utensils, when the only food served 
296.20 	is prepared off site. 
296.21 	(2) Small establishment, including boarding establishments, $100 $120. "Small 
296.22 	establishment" means a fee category that has no salad bar and meets one or more of 
296.23 	the following: 
296.24 	(i) possesses food service equipment that consists of no more than a deep fat fryer, a 
296.25 	grill, two hot holding containers, and one or more microwave ovens; 
296.26 	(ii) serves dipped ice cream or soft serve frozen desserts; 
296.27 	(iii) serves breakfast in an owner-occupied bed and breakfast establishment; 
296.28 	(iv) is a boarding establishment; or 
296.29 	(v) meets the equipment criteria in clause (3), item (i) or (ii), and has a maximum 
296.30 	patron seating capacity of not more than 50. 
296.31 	(3) Medium establishment, $260 $310. "Medium establishment" means a fee 
296.32 	category that meets one or more of the following: 
296.33 	(i) possesses food service equipment that includes a range, oven, steam table, salad 
296.34 	bar, or salad preparation area; 
296.35 	(ii) possesses food service equipment that includes more than one deep fat fryer, 
296.36 	one grill, or two hot holding containers; or 
297.1 	(iii) is an establishment where food is prepared at one location and served at one or 
297.2 	more separate locations. 
297.3 	Establishments meeting criteria in clause (2), item (v), are not included in this fee 
297.4 	category. 
297.5 	(4) Large establishment, $460 $540. "Large establishment" means either: 
297.6 	(i) a fee category that (A) meets the criteria in clause (3), items (i) or (ii), for a 
297.7 	medium establishment, (B) seats more than 175 people, and (C) offers the full menu 
297.8 	selection an average of five or more days a week during the weeks of operation; or 
297.9 	(ii) a fee category that (A) meets the criteria in clause (3), item (iii), for a medium 
297.10 	establishment, and (B) prepares and serves 500 or more meals per day. 
297.11 	(5) Other food and beverage service, including food carts, mobile food units, 
297.12 	seasonal temporary food stands, and seasonal permanent food stands, $50 $60. 
297.13 	(6) Beer or wine table service, $50 $60. "Beer or wine table service" means a fee 
297.14 	category where the only alcoholic beverage service is beer or wine, served to customers 
297.15 	seated at tables. 
297.16 	(7) Alcoholic beverage service, other than beer or wine table service, $135 $165. 
297.17 	"Alcohol beverage service, other than beer or wine table service" means a fee 
297.18 	category where alcoholic mixed drinks are served or where beer or wine are served from 
297.19 	a bar. 
297.20 	(8) Lodging per sleeping accommodation unit, $8 $10, including hotels, motels, 
297.21 	lodging establishments, and resorts, up to a maximum of $800 $1,000. "Lodging per 
297.22 	sleeping accommodation unit" means a fee category including the number of guest rooms, 
297.23 	cottages, or other rental units of a hotel, motel, lodging establishment, or resort; or the 
297.24 	number of beds in a dormitory. 
297.25 	(9) First public pool, $180 $325; each additional public pool, $100 $175. "Public 
297.26 	pool" means a fee category that has the meaning given in section 144.1222, subdivision 4. 
297.27 	(10) First spa, $110 $175; each additional spa, $50 $100. "Spa pool" means a fee 
297.28 	category that has the meaning given in Minnesota Rules, part 4717.0250, subpart 9. 
297.29 	(11) Private sewer or water, $50 $60. "Individual private water" means a fee 
297.30 	category with a water supply other than a community public water supply as defined in 
297.31 	Minnesota Rules, chapter 4720. "Individual private sewer" means a fee category with an 
297.32 	individual sewage treatment system which uses subsurface treatment and disposal. 
297.33 	(12) Additional food service, $130 $150. "Additional food service" means a location 
297.34 	at a food service establishment, other than the primary food preparation and service area, 
297.35 	used to prepare or serve food to the public. 
298.1 	(13) Additional inspection fee, $300 $360. "Additional inspection fee" means a 
298.2 	fee to conduct the second inspection each year for elementary and secondary education 
298.3 	facility school lunch programs when required by the Richard B. Russell National School 
298.4 	Lunch Act. 
298.5 	(e) A fee of $350 for review of the construction plans must accompany the initial 
298.6 	license application for restaurants, hotels, motels, lodging establishments, or resorts with 
298.7 	five or more sleeping units., seasonal food stands, and mobile food units. The fee for 
298.8 	this construction plan review is as follows:

298.9	Service Area
	Type
	Fee
	
298.10	Food
	limited food menu
	$275
	
298.11		small establishment
	$400
	
298.12		medium establishment
	$450
	
298.13		large food establishment
	$500
	
298.14		additional food service
	$150
	
298.15	Transient food service
	food cart
	$250
	
298.16		seasonal permanent food stand
	$250
	
298.17		seasonal temporary food stand
	$250
	
298.18		mobile food unit
	$350
	
298.19	Alcohol
	beer or wine table service
	$150
	
298.20		alcohol service from bar
	$250
	
298.21	Lodging
	less than 25 rooms
	$375
	
298.22		25 to less than 100 rooms
	$400
	
298.23		100 rooms or more
	$500
	
298.24		less than five cabins
	$350
	
298.25		five to less than ten cabins
	$400
	
298.26		ten cabins or more
	$450
	
298.27 	(f) When existing food and beverage service establishments, hotels, motels, lodging 
298.28 	establishments, or resorts, seasonal food stands, and mobile food units are extensively 
298.29 	remodeled, a fee of $250 must be submitted with the remodeling plans. A fee of $250 
298.30 	must be submitted for new construction or remodeling for a restaurant with a limited food 
298.31 	menu selection, a seasonal permanent food stand, a mobile food unit, or a food cart, or for 
298.32 	a hotel, motel, resort, or lodging establishment addition of less than five sleeping units.
298.33 	The fee for this construction plan review is as follows:

298.34	Service Area
	Type
	Fee
	
298.35	Food
	limited food menu
	$250
	
298.36		small establishment
	$300
	
298.37		medium establishment
	$350
	
298.38		large food establishment
	$400
	
298.39		additional food service
	$150
	
298.40	Transient food service
	food cart
	$250
	
299.1		seasonal permanent food stand
	$250
	
299.2		seasonal temporary food stand
	$250
	
299.3		mobile food unit
	$250
	
299.4	Alcohol
	beer or wine table service
	$150
	
299.5		alcohol service from bar
	$250
	
299.6	Lodging
	less than 25 rooms
	$250
	
299.7		25 to less than 100 rooms
	$300
	
299.8		100 rooms or more
	$450
	
299.9		less than five cabins
	$250
	
299.10		five to less than ten cabins
	$350
	
299.11		ten cabins or more
	$400
	
299.12 	(g) Seasonal temporary food stands and Special event food stands are not required to 
299.13 	submit construction or remodeling plans for review. 
299.14 	(h) For-profit youth camp fee, $500.
299.15 		Subd. 3a. Statewide hospitality fee. Every person, firm, or corporation that 
299.16 	operates a licensed boarding establishment, food and beverage service establishment, 
299.17 	seasonal temporary or permanent food stand, special event food stand, mobile food unit, 
299.18 	food cart, resort, hotel, motel, or lodging establishment in Minnesota must submit to the 
299.19 	commissioner a $35 annual statewide hospitality fee for each licensed activity. The fee 
299.20 	for establishments licensed by the Department of Health is required at the same time the 
299.21 	licensure fee is due. For establishments licensed by local governments, the fee is due by 
299.22 	July 1 of each year. 
299.23 		Subd. 4. Posting requirements. Every food and beverage service establishment,
299.24 	for-profit youth camp, hotel, motel, lodging establishment, public pool, or resort must have 
299.25 	the license posted in a conspicuous place at the establishment. Mobile food units, food 
299.26 	carts, and seasonal temporary food stands shall be issued decals with the initial license and 
299.27 	each calendar year with license renewals. The current license year decal must be placed on 
299.28 	the unit or stand in a location determined by the commissioner. Decals are not transferable.

299.29 	Sec. 37. Minnesota Statutes 2008, section 157.22, is amended to read:
299.30 	157.22 EXEMPTIONS.
299.31 	This chapter shall not be construed to does not apply to:
299.32 	(1) interstate carriers under the supervision of the United States Department of 
299.33 	Health and Human Services;
299.34 	(2) any building constructed and primarily used for religious worship;
299.35 	(3) any building owned, operated, and used by a college or university in accordance 
299.36 	with health regulations promulgated by the college or university under chapter 14;
300.1 	(4) any person, firm, or corporation whose principal mode of business is licensed 
300.2 	under sections 28A.04 and 28A.05, is exempt at that premises from licensure as a food 
300.3 	or beverage establishment; provided that the holding of any license pursuant to sections 
300.4 	28A.04 and 28A.05 shall not exempt any person, firm, or corporation from the applicable 
300.5 	provisions of this chapter or the rules of the state commissioner of health relating to 
300.6 	food and beverage service establishments;
300.7 	(5) family day care homes and group family day care homes governed by sections 
300.8 	245A.01 to 245A.16;
300.9 	(6) nonprofit senior citizen centers for the sale of home-baked goods;
300.10 	(7) fraternal or patriotic organizations that are tax exempt under section 501(c)(3), 
300.11 	501(c)(4), 501(c)(6), 501(c)(7), 501(c)(10), or 501(c)(19) of the Internal Revenue Code of 
300.12 	1986, or organizations related to or affiliated with such fraternal or patriotic organizations. 
300.13 	Such organizations may organize events at which home-prepared food is donated by 
300.14 	organization members for sale at the events, provided:
300.15 	(i) the event is not a circus, carnival, or fair;
300.16 	(ii) the organization controls the admission of persons to the event, the event agenda, 
300.17 	or both; and
300.18 	(iii) the organization's licensed kitchen is not used in any manner for the event;
300.19 	(8) food not prepared at an establishment and brought in by individuals attending a 
300.20 	potluck event for consumption at the potluck event. An organization sponsoring a potluck 
300.21 	event under this clause may advertise the potluck event to the public through any means. 
300.22 	Individuals who are not members of an organization sponsoring a potluck event under this 
300.23 	clause may attend the potluck event and consume the food at the event. Licensed food 
300.24 	establishments other than schools cannot be sponsors of potluck events. A school may 
300.25 	sponsor and hold potluck events in areas of the school other than the school's kitchen, 
300.26 	provided that the school's kitchen is not used in any manner for the potluck event. For 
300.27 	purposes of this clause, "school" means a public school as defined in section 120A.05, 
300.28 	subdivisions 9, 11, 13, and 17, or a nonpublic school, church, or religious organization 
300.29 	at which a child is provided with instruction in compliance with sections 120A.22 and 
300.30 	120A.24. Potluck event food shall not be brought into a licensed food establishment 
300.31 	kitchen; and
300.32 	(9) a home school in which a child is provided instruction at home; and
300.33 	(10) concession stands operated in conjunction with school-sponsored events on 
300.34 	school property are exempt from the 21-day restriction.

301.1 	Sec. 38. Minnesota Statutes 2008, section 327.14, is amended by adding a subdivision 
301.2 	to read:
301.3 		Subd. 9.Special event recreational camping area. "Special event recreational 
301.4 	camping area" means a recreational camping area which operates no more than two times 
301.5 	annually and for no more than 14 consecutive days.

301.6 	Sec. 39. Minnesota Statutes 2008, section 327.15, is amended to read:
301.7 	327.15 LICENSE REQUIRED; RENEWAL; PLANS FOR EXPANSIONFEES.
301.8 		Subdivision 1.License required; plan review. No person, firm or corporation shall 
301.9 	establish, maintain, conduct or operate a manufactured home park or recreational camping 
301.10 	area within this state without first obtaining a an annual license therefor from the state 
301.11 	Department of Health. Any person wishing to obtain a license shall first make application, 
301.12 	pay the required fee specified in this section, and receive approval for operation, including 
301.13 	plan review approval. Application shall be made on forms provided by the commissioner 
301.14 	and shall require the applicant to state the full name and address of the owner of the 
301.15 	manufactured home park or recreational camping area, the name under which the business 
301.16 	is to be conducted, and any other information as may be required by the commissioner 
301.17 	to complete the application for license. Any person, firm, or corporation desiring to 
301.18 	operate either a manufactured home park or a recreational camping area on the same site 
301.19 	in connection with the other, need only obtain one license. A license shall expire and be 
301.20 	renewed as prescribed by the commissioner pursuant to section 144.122. The license shall 
301.21 	state the number of manufactured home sites and recreational camping sites allowed 
301.22 	according to state commissioner of health approval. No renewal license shall be issued if 
301.23 	the number of sites specified in the application exceeds those of the original application
301.24 	The number of licensed sites shall not be increased unless the plans for expansion or 
301.25 	the construction for expansion are submitted and the expansion first approved by the 
301.26 	Department of Health. Any manufactured home park or recreational camping area located 
301.27 	in more than one municipality shall be dealt with as two separate manufactured home 
301.28 	parks or camping areas. The license shall be conspicuously displayed in the office of the 
301.29 	manufactured home park or camping area. The license is not transferable as to person 
301.30 	or place. 
301.31 		Subd. 2.License renewal. Initial and renewal licenses for all manufactured home 
301.32 	parks and recreational camping areas shall be issued annually and shall have an expiration 
301.33 	date included on the license. Any person who operates a manufactured home park or 
301.34 	recreational camping area after the expiration date of a license or without having submitted 
301.35 	an application and paid the fee shall be deemed to have violated the provisions of this 
302.1 	chapter and shall be subject to enforcement action, as provided in the Health Enforcement 
302.2 	Consolidation Act, sections 144.989 to 144.993. In addition, a penalty of $120 shall 
302.3 	be added to the total of the license fee for any manufactured home park or recreational 
302.4 	camping area operating without a license for a period of up to 30 days. A late fee of $360 
302.5 	shall be added to the license fee for any manufactured home park or recreational camping 
302.6 	area operating more than 30 days without a license.
302.7 		Subd. 3.Fees; manufactured home parks; recreational camping areas. (a) The 
302.8 	following fees are required for manufactured home parks and recreational camping areas 
302.9 	licensed under this chapter. Recreational camping areas and manufactured home parks 
302.10 	must pay the highest applicable fee under paragraph (c). The license fee for new operators 
302.11 	of a manufactured home park or recreational camping area previously licensed under this 
302.12 	chapter for the same calendar year is one-half of the appropriate annual license fee, plus 
302.13 	any penalty that may be required. The license fee for operators opening on or after October 
302.14 	1 is one-half of the appropriate annual license fee, plus any penalty that may be required.
302.15 	(b) All manufactured home parks and recreational camping areas, except special 
302.16 	event recreational camping areas, shall pay an annual base fee of $150 plus $4 for each 
302.17 	licensed site, except that any operator of a manufactured home park or recreational 
302.18 	camping area who is licensed under section 157.16 for the same location shall not be 
302.19 	required to pay the base fee.
302.20 	(c) In addition to the fee in paragraph (b), each manufactured home park or 
302.21 	recreational camping area shall pay an additional annual fee for each fee category 
302.22 	specified in this paragraph:
302.23 	(1) manufactured home parks and recreational camping areas with public swimming 
302.24 	pools and spas shall pay the appropriate fees specified in section 157.16; and
302.25 	(2) individual private sewer or water, $60. "Individual private water" means a fee 
302.26 	category with a water supply other than a community public water supply as defined in 
302.27 	Minnesota Rules, chapter 4720. "Individual private sewer" means a fee category with an 
302.28 	individual sewage treatment system which uses subsurface treatment and disposal.
302.29 	(d) The following fees must accompany a plan review application for initial 
302.30 	construction of a manufactured home park or recreational camping area for initial 
302.31 	construction of:
302.32 	(1) less than 25 sites, $375;
302.33 	(2) 25 to less than 100 sites, $400; and
302.34 	(3) 100 or more sites, $500.
302.35 	(e) The following fees must accompany a plan review application when an existing 
302.36 	manufactured home park or recreational camping area is expanded for expansion of:
303.1 	(1) less than 25 sites, $250;
303.2 	(2) 25 but less than 100 sites, $300; and
303.3 	(3) 100 or more sites, $450.
303.4 		Subd. 4.Fees; special event recreational camping areas. (a) The following fees 
303.5 	are required for special event recreational camping areas licensed under this chapter.
303.6 	(b) All special event recreational camping areas shall pay an annual fee of $150 plus 
303.7 	$1 for each licensed site.
303.8 	(c) A special event recreational camping area shall pay a late fee of $360 for failing 
303.9 	to obtain a license prior to operating.
303.10 	(d) The following fees must accompany a plan review application for initial 
303.11 	construction of a special event recreational camping area for initial construction of:
303.12 	(1) less than 25 special event recreational camping sites, $375;
303.13 	(2) 25 to less than 100 sites, $400; and
303.14 	(3) 100 or more sites, $500.
303.15 	(e) The following fees must accompany a plan review application for expansion of a 
303.16 	special event recreational camping area for expansion of:
303.17 	(1) less than 25 sites, $250;
303.18 	(2) 25 but less than 100 sites, $300; and
303.19 	(3) 100 or more sites, $450.

303.20 	Sec. 40. Minnesota Statutes 2008, section 327.16, is amended to read:
303.21 	327.16 LICENSE PLAN REVIEW APPLICATION.
303.22 		Subdivision 1.Made to state Department of Health. The plan review application 
303.23 	for license to operate and maintain a manufactured home park or recreational camping 
303.24 	area shall be made to the state Department of Health, at such office and in such manner 
303.25 	as may be prescribed by that department.
303.26 		Subd. 2.Contents. The applicant for a primary license or annual license shall make 
303.27 	application in writing plan review application shall be made upon a form provided by the 
303.28 	state Department of Health setting forth:
303.29 	(1) The full name and address of the applicant or applicants, or names and addresses 
303.30 	of the partners if the applicant is a partnership, or the names and addresses of the officers 
303.31 	if the applicant is a corporation.
303.32 	(2) A legal description of the site, lot, field, or tract of land upon which the applicant 
303.33 	proposes to operate and maintain a manufactured home park or recreational camping area.
303.34 	(3) The proposed and existing facilities on and about the site, lot, field, or tract of 
303.35 	land for the proposed construction or alteration and maintaining of a sanitary community 
304.1 	building for toilets, urinals, sinks, wash basins, slop-sinks, showers, drains, laundry 
304.2 	facilities, source of water supply, sewage, garbage and waste disposal; except that no 
304.3 	toilet facilities shall be required in any manufactured home park which permits only 
304.4 	manufactured homes equipped with toilet facilities discharging to water carried sewage 
304.5 	disposal systems; and method of fire and storm protection.
304.6 	(4) The proposed method of lighting the structures and site, lot, field, or tract of land 
304.7 	upon which the manufactured home park or recreational camping area is to be located.
304.8 	(5) The calendar months of the year which the applicant will operate the 
304.9 	manufactured home park or recreational camping area.
304.10 	(6) Plans and drawings for new construction or alteration, including buildings, wells, 
304.11 	plumbing and sewage disposal systems.
304.12 		Subd. 3.Fees; Approval. The application for the primary license plan review shall 
304.13 	be submitted with all plans and specifications enumerated in subdivision 2, and payment 
304.14 	of a fee in an amount prescribed by the state commissioner of health pursuant to section 
304.15 	144.122 and shall be accompanied by an approved zoning permit from the municipality or 
304.16 	county wherein the park is to be located, or a statement from the municipality or county 
304.17 	that it does not require an approved zoning permit. The fee for the annual license shall be 
304.18 	in an amount prescribed by the state commissioner of health pursuant to section 144.122. 
304.19 	All license fees paid to the commissioner of health shall be turned over to the state 
304.20 	treasury. The fee submitted for the primary license plan review shall be retained by the 
304.21 	state even though the proposed project is not approved and a license is denied. 
304.22 	When construction has been completed in accordance with approved plans and 
304.23 	specifications the state commissioner of health shall promptly cause the manufactured 
304.24 	home park or recreational camping area and appurtenances thereto to be inspected. When 
304.25 	the inspection and report has been made and the state commissioner of health finds that 
304.26 	all requirements of sections 327.10, 327.11, 327.14 to 327.28, and such conditions of 
304.27 	health and safety as the state commissioner of health may require, have been met by 
304.28 	the applicant, the state commissioner of health shall forthwith issue the primary license 
304.29 	in the name of the state. 
304.30 		Subd. 4.Sanitary facilities Compliance with current state law. During the 
304.31 	pendency of the application for such primary license any change in the sanitary or safety 
304.32 	facilities of the intended manufactured home park or recreational camping area shall be 
304.33 	immediately reported in writing to the state Department of Health through the office 
304.34 	through which the application was made. If no objection is made by the state Department 
304.35 	of Health to such change in such sanitary or safety facilities within 60 days of the date 
304.36 	such change is reported, it shall be deemed to have the approval of the state Department of 
305.1 	Health. Any manufactured home park or recreational camping area must be constructed 
305.2 	and operated according to all applicable state electrical, fire, plumbing, and building codes.
305.3 		Subd. 5.Permit. When the plans and specifications have been approved, the state 
305.4 	Department of Health shall issue an approval report permitting the applicant to construct 
305.5 	or make alterations upon a manufactured home park or recreational camping area and the 
305.6 	appurtenances thereto according to the plans and specifications presented.
305.7 	Such approval does not relieve the applicant from securing building permits in 
305.8 	municipalities that require permits or from complying with any other municipal ordinance 
305.9 	or ordinances, applicable thereto, not in conflict with this statute.
305.10 		Subd. 6.Denial of construction. If the application to construct or make alterations 
305.11 	upon a manufactured home park or recreational camping area and the appurtenances 
305.12 	thereto or a primary license to operate and maintain the same is denied by the state 
305.13 	commissioner of health, the commissioner shall so state in writing giving the reason 
305.14 	or reasons for denying the application. If the objections can be corrected the applicant 
305.15 	may amend the application and resubmit it for approval, and if denied the applicant may 
305.16 	appeal from the decision of the state commissioner of health as provided in section 
305.17 	144.99, subdivision 10. 

305.18 	Sec. 41. Minnesota Statutes 2008, section 327.20, subdivision 1, is amended to read:
305.19 		Subdivision 1.Rules. No domestic animals or house pets of occupants of 
305.20 	manufactured home parks or recreational camping areas shall be allowed to run at large, 
305.21 	or commit any nuisances within the limits of a manufactured home park or recreational 
305.22 	camping area. Each manufactured home park or recreational camping area licensed under 
305.23 	the provisions of sections 327.10, 327.11, and327.14 to 327.28 shall, among other things, 
305.24 	provide for the following, in the manner hereinafter specified: 
305.25 	(1) A responsible attendant or caretaker shall be in charge of every manufactured 
305.26 	home park or recreational camping area at all times, who shall maintain the park or 
305.27 	area, and its facilities and equipment in a clean, orderly and sanitary condition. In any 
305.28 	manufactured home park containing more than 50 lots, the attendant, caretaker, or other 
305.29 	responsible park employee, shall be readily available at all times in case of emergency.
305.30 	(2) All manufactured home parks shall be well drained and be located so that the 
305.31 	drainage of the park area will not endanger any water supply. No wastewater from 
305.32 	manufactured homes or recreational camping vehicles shall be deposited on the surface of 
305.33 	the ground. All sewage and other water carried wastes shall be discharged into a municipal 
305.34 	sewage system whenever available. When a municipal sewage system is not available, a 
305.35 	sewage disposal system acceptable to the state commissioner of health shall be provided.
306.1 	(3) No manufactured home shall be located closer than three feet to the side lot lines 
306.2 	of a manufactured home park, if the abutting property is improved property, or closer than 
306.3 	ten feet to a public street or alley. Each individual site shall abut or face on a driveway 
306.4 	or clear unoccupied space of not less than 16 feet in width, which space shall have 
306.5 	unobstructed access to a public highway or alley. There shall be an open space of at least 
306.6 	ten feet between the sides of adjacent manufactured homes including their attachments 
306.7 	and at least three feet between manufactured homes when parked end to end. The space 
306.8 	between manufactured homes may be used for the parking of motor vehicles and other 
306.9 	property, if the vehicle or other property is parked at least ten feet from the nearest 
306.10 	adjacent manufactured home position. The requirements of this paragraph shall not apply 
306.11 	to recreational camping areas and variances may be granted by the state commissioner 
306.12 	of health in manufactured home parks when the variance is applied for in writing and in 
306.13 	the opinion of the commissioner the variance will not endanger the health, safety, and 
306.14 	welfare of manufactured home park occupants.
306.15 	(4) An adequate supply of water of safe, sanitary quality shall be furnished at each 
306.16 	manufactured home park or recreational camping area. The source of the water supply 
306.17 	shall first be approved by the state Department of Health.
306.18 	(5) All plumbing shall be installed in accordance with the rules of the state 
306.19 	commissioner of labor and industry and the provisions of the Minnesota Plumbing Code.
306.20 	(6) In the case of a manufactured home park with less than ten manufactured homes, 
306.21 	a plan for the sheltering or the safe evacuation to a safe place of shelter of the residents of 
306.22 	the park in times of severe weather conditions, such as tornadoes, high winds, and floods. 
306.23 	The shelter or evacuation plan shall be developed with the assistance and approval of 
306.24 	the municipality where the park is located and shall be posted at conspicuous locations 
306.25 	throughout the park. The park owner shall provide each resident with a copy of the 
306.26 	approved shelter or evacuation plan, as provided by section 327C.01, subdivision 1c. 
306.27 	Nothing in this paragraph requires the Department of Health to review or approve any 
306.28 	shelter or evacuation plan developed by a park. Failure of a municipality to approve a plan 
306.29 	submitted by a park shall not be grounds for action against the park by the Department of 
306.30 	Health if the park has made a good faith effort to develop the plan and obtain municipal 
306.31 	approval. 
306.32 	(7) A manufactured home park with ten or more manufactured homes, licensed prior 
306.33 	to March 1, 1988, shall provide a safe place of shelter for park residents or a plan for the 
306.34 	evacuation of park residents to a safe place of shelter within a reasonable distance of the 
306.35 	park for use by park residents in times of severe weather, including tornadoes and high 
306.36 	winds. The shelter or evacuation plan must be approved by the municipality by March 1, 
307.1 	1989. The municipality may require the park owner to construct a shelter if it determines 
307.2 	that a safe place of shelter is not available within a reasonable distance from the park. A 
307.3 	copy of the municipal approval and the plan shall be submitted by the park owner to the 
307.4 	Department of Health. The park owner shall provide each resident with a copy of the 
307.5 	approved shelter or evacuation plan, as provided by section 327C.01, subdivision 1c. 
307.6 	(8) A manufactured home park with ten or more manufactured homes, receiving 
307.7 	a primary an initial license after March 1, 1988, must provide the type of shelter required 
307.8 	by section 327.205, except that for manufactured home parks established as temporary, 
307.9 	emergency housing in a disaster area declared by the President of the United States or 
307.10 	the governor, an approved evacuation plan may be provided in lieu of a shelter for a 
307.11 	period not exceeding 18 months. 
307.12 	(9) For the purposes of this subdivision, "park owner" and "resident" have the 
307.13 	meaning meanings given them in section 327C.01. 

307.14 	Sec. 42. Minnesota Statutes 2008, section 327.20, is amended by adding a subdivision 
307.15 	to read:
307.16 		Subd. 4.Special event recreational camping areas. Each special event camping 
307.17 	area licensed under sections 327.10, 327.11, and 327.14 to 327.28 is subject to this section.
307.18 	(1) Recreational camping vehicles and tents, including attachments, must be 
307.19 	separated from each other and other structures by at least seven feet.
307.20 	(2) A minimum area of 300 square feet per site must be provided and the total 
307.21 	number of sites must not exceed one site for every 300 square feet of usable land area.
307.22 	(3) Each site must abut or face a driveway or clear unoccupied space of at least 16 
307.23 	feet in width, which space must have unobstructed access to a public roadway.
307.24 	(4) If no approved on-site water supply system is available, hauled water may be 
307.25 	used, provided that persons using hauled water comply with Minnesota Rules, parts 
307.26 	4720.4000 to 4720.4600.
307.27 	(5) Nonburied sewer lines may be permitted provided they are of approved materials, 
307.28 	watertight, and properly maintained.
307.29 	(6) If a sanitary dumping station is not provided on-site, arrangements must be 
307.30 	made with a licensed sewage pumper to service recreational camping vehicle holding 
307.31 	tanks as needed.
307.32 	(7) Toilet facilities must be provided consisting of toilets connected to an approved 
307.33 	sewage disposal system, portable toilets, or approved, properly constructed privies.
307.34 	(8) Toilets must be provided in the ratio of one toilet for each sex for each 150 sites.
307.35 	(9) Toilets must be not more than 400 feet from any site.
308.1 	(10) If a central building or buildings are provided with running water, then toilets 
308.2 	and handwashing lavatories must be provided in the building or buildings that meet the 
308.3 	requirements of this subdivision.
308.4 	(11) Showers, if provided, must be provided in the ratio of one shower for each sex 
308.5 	for each 250 sites. Showerheads must be provided, where running water is available, for 
308.6 	each camping event exceeding two nights.
308.7 	(12) Central toilet and shower buildings, if provided, must be constructed with 
308.8 	adequate heating, ventilation, and lighting, and floors of impervious material sloped 
308.9 	to drain. Walls must be of a washable material. Permanent facilities must meet the 
308.10 	requirements of the Americans with Disabilities Act.
308.11 	(13) An adequate number of durable, covered, watertight containers must be 
308.12 	provided for all garbage and refuse. Garbage and refuse must be collected as often as 
308.13 	necessary to prevent nuisance conditions.
308.14 	(14) Campgrounds must be located in areas free of poison ivy or other noxious 
308.15 	weeds considered detrimental to health. Sites must not be located in areas of tall grass or 
308.16 	weeds and sites must be adequately drained.
308.17 	(15) Campsites for recreational vehicles may not be located on inclines of greater 
308.18 	than eight percent grade or one inch drop per lineal foot.
308.19 	(16) A responsible attendant or caretaker must be available on-site at all times during 
308.20 	the operation of any special event recreational camping area that has 50 or more sites.

308.21 	Sec. 43. MINNESOTA COLORECTAL CANCER PREVENTION ACT.
 308.22 		Subdivision 1.Purpose. Colon cancer is one of Minnesota's leading causes of 
308.23 	death and one of the most preventable forms of cancer. The Minnesota Colorectal 
308.24 	Cancer Prevention Act creates a demonstration project and public-private partnership 
308.25 	that leverages business, nonprofit, and government sectors to reduce the incidence of 
308.26 	colon cancer, reduce future health care expenditures, and address health disparities by 
308.27 	emphasizing prevention in a manner consistent with Minnesota's health care reform goals.
308.28 		Subd. 2.Establishment. The commissioner of health shall award grants to 
308.29 	Hennepin County Medical Center and MeritCare Bemidji for a colorectal screening 
308.30 	demonstration project to provide screening to uninsured and underinsured women and 
308.31 	men.
308.32 		Subd. 3.Eligibility. To be eligible for colorectal screening under this demonstration 
308.33 	project, an applicant must:
308.34 	(1) be at least 50 years of age, or under the age of 50 and at high risk for colon cancer;
309.1 	(2) be uninsured, or if insured, has coverage that does not cover the full cost of 
309.2 	colorectal cancer screenings;
309.3 	(3) not eligible for medical assistance, general assistance medical care, or 
309.4 	MinnesotaCare programs; and
309.5 	(4) have a gross family income at or below 250 percent of the federal poverty level.
309.6 		Subd. 4.Services. Services provided under this project shall include:
309.7 	(1) colorectal cancer screening, according to standard practices of medicine, or 
309.8 	guidelines provided by the Institute for Clinical Systems Improvement or the American 
309.9 	Cancer Society;
309.10 	(2) follow-up services for abnormal tests; and
309.11 	(3) diagnostic services to determine the extent and proper course of treatment.
309.12 		Subd. 5.Project evaluation. The commissioner of health, in consultation with the 
309.13 	University of Minnesota School of Public Health, shall evaluate the demonstration project 
309.14 	and make recommendations for increasing the number of persons in Minnesota who 
309.15 	receive recommended colon cancer screening. The commissioner of health shall submit 
309.16 	the evaluation and recommendations to the legislature by January 1, 2011.

309.17 	Sec. 44. WOMEN'S HEART HEALTH PILOT PROJECT.
 309.18 		Subdivision 1.Establishment. The commissioner of health shall develop and 
309.19 	implement a women's heart health pilot project to provide heart disease risk screening 
309.20 	to uninsured and underinsured women, who are low-income, American Indian, or other 
309.21 	minority.
309.22 		Subd. 2.Services. Under this project, the commissioner must contract with health 
309.23 	care clinics to provide heart disease risk screenings to eligible women. The clinics may 
309.24 	also provide follow-up services to women found to be at risk for heart disease.
309.25 		Subd. 3.Eligibility. To be eligible for screening under this program, an applicant 
309.26 	must:
309.27 	(1) be between the ages of 40 and 64 years;
309.28 	(2) receive breast and cervical cancer screening services under the Department of 
309.29 	Health's Sage program;
309.30 	(3) be uninsured, or have insurance that does not cover heart disease risk screenings; 
309.31 	and
309.32 	(4) have a gross family income at or below 150 percent of the federal poverty level.

309.33 	Sec. 45. EXPOSURE LEVELS STUDY.
 310.1 	The commissioner of health shall work with appropriate local, state, and federal 
310.2 	agencies to determine whether the levels of exposure to pentachlorophenol (PCP) in 
310.3 	Minneapolis neighborhoods where utility poles treated with PCP or creosote, probable 
310.4 	human carcinogens, are installed, exceed human health risk limits or maximum 
310.5 	contaminant levels for residents, utility workers, and others who handle the treated poles.

310.6 	Sec. 46. FEASIBILITY PILOT PROJECT FOR CANCER SURVEILLANCE.
 310.7 	The commissioner of health must provide a grant to the Hennepin County Medical 
310.8 	Center for a one-year feasibility pilot project to collect occupational history and residential 
310.9 	history data from newly diagnosed cancer patients at the Hennepin County Medical 
310.10 	Center's Cancer Center. Funding for this grant shall come from the Department of Health's 
310.11 	current resources for the Chronic Disease and Environmental Epidemiology Section. The 
310.12 	grant shall cover the cost of one full-time equivalent position at the Hennepin County 
310.13 	Medical Center. The grant must be sufficient to cover the responsibilities associated with 
310.14 	carrying out the feasibility pilot project.
310.15 	Under this pilot project, Hennepin County Medical Center will design an expansion 
310.16 	of its existing cancer registry to include the collection of additional data, including the 
310.17 	cancer patient's occupational history, residential history, and military service history. 
310.18 	Patient consent is required for collection of these additional data. The data collection 
310.19 	expansion may also include the cancer patient's possible toxic environmental exposure 
310.20 	history, if known. The purpose of this pilot project is to determine the following:
310.21 	(1) the feasibility of collecting these data on a statewide scale; 
310.22 	(2) the potential design of a self-administered patient questionnaire template; and 
310.23 	(3) necessary qualifications for staff who will collect these data. 
310.24 	Hennepin County Medical Center must report the results of this pilot project to the 
310.25 	legislature by October 1, 2010.

310.26 	Sec. 47. SMOKING CESSATION.
 310.27 	The commissioner of health must prioritize smoking prevention and smoking 
310.28 	cessation activities in low-income, indigenous, and minority communities in their 
310.29 	collaborations with the ClearWay organization.

310.30 	Sec. 48. MEDICAL RESPONSE UNIT REIMBURSEMENT PILOT PROGRAM.
 310.31 	(a) The Department of Public Safety or its contract designee shall collaborate 
310.32 	with the Minnesota Ambulance Association to create the parameters of the medical 
311.1 	response unit reimbursement pilot program, including determining criteria for baseline 
311.2 	data reporting.
311.3 	(b) In conducting the pilot program, the Department of Public Safety must consult 
311.4 	with the Minnesota Ambulance Association, Minnesota Fire Chiefs Association, 
311.5 	Emergency Services Regulatory Board, and the Minnesota Council of Health Plans to:
311.6 	(1) identify no more than five medical response units registered as medical response 
311.7 	units with the Minnesota Emergency Medical Services Regulatory Board according to 
311.8 	Minnesota Statutes, chapter 144E, to participate in the program;
311.9 	(2) outline and develop criteria for reimbursement;
311.10 	(3) determine the amount of reimbursement for each unit response; and
311.11 	(4) collect program data to be analyzed for a final report.
311.12 	(c) Further criteria for the medical response unit reimbursement pilot program 
311.13 	shall include:
311.14 	(1) the pilot program will expire on December 31, 2010, or when the appropriation 
311.15 	is extended, whichever occurs first;
311.16 	(2) a report shall be made to the legislature by March 1, 2011, by the Department 
311.17 	of Public Safety or its contractor as to the effectiveness and value of this reimbursement 
311.18 	pilot program to the emergency medical services delivery system, any actual or potential 
311.19 	savings to the health care system, and impact on patient outcomes;
311.20 	(3) participating medical response units must adhere to the requirements of this 
311.21 	pilot program outlined in an agreement between the Department of Public Safety and 
311.22 	the medical response unit, including but not limited to, requirements relating to data 
311.23 	collection, response criteria, and patient outcomes and disposition;
311.24 	(4) individual entities licensed to provide ambulance care under Minnesota Statutes, 
311.25 	chapter 144E, are not eligible for participation in this pilot program;
311.26 	(5) if a participating medical response unit withdraws from the pilot program, the 
311.27 	Department of Public Safety in consultation with the Minnesota Ambulance Association 
311.28 	may choose another pilot site if funding is available;
311.29 	(6) medical response units must coordinate their operations under this pilot project 
311.30 	with the ambulance service or services licensed to provide care in their first response 
311.31 	geographic areas;
311.32 	(7) licensed ambulance services that participate with the medical response unit in 
311.33 	the pilot program assume no financial or legal liability for the actions of the participating 
311.34 	medical response unit; and
312.1 	(8) the Department of Public Safety and its pilot program partners have no ongoing 
312.2 	responsibility to reimburse medical response units beyond the parameters of the pilot 
312.3 	program.

312.4 	Sec. 49. REPEALER.
 312.5 	(a) Minnesota Statutes 2008, sections 103I.112; 144.9501, subdivision 17b; and 
312.6 	327.14, subdivisions 5 and 6, are repealed.
312.7 	(b) Minnesota Rules, part 4626.2015, subpart 9, is repealed.

312.8 	ARTICLE 12
312.9 	HEALTH-RELATED FEES

312.10 	Section 1. Minnesota Statutes 2008, section 148.108, is amended to read:
312.11 	148.108 FEES.
312.12 		Subdivision 1.Fees. In addition to the fees established in Minnesota Rules, chapter 
312.13 	2500, and according to sections 148.05, 148.06, 148.07, and 148.10, subdivisions 2 and 3, 
312.14 	the board is authorized to charge the fees in this section.
312.15 		Subd. 2.Annual renewal of inactive acupuncture registration License and 
312.16 	registration fees. The annual renewal of an inactive acupuncture registration fee is $25.
312.17 	License and registration fees are as follows:
312.18 	(1) for a license application fee, $300;
312.19 	(2) for a license active renewal fee, $220;
312.20 	(3) for a license inactive renewal fee, $165;
312.21 	(4) for an acupuncture initial registration fee, $125;
312.22 	(5) for an acupuncture active registration renewal fee, $75;
312.23 	(6) for an acupuncture registration reinstatement fee, $50;
312.24 	(7) for an acupuncture inactive registration renewal fee, $25;
312.25 	(8) for an animal chiropractic registration fee, $125;
312.26 	(9) for an animal chiropractic active registration renewal fee, $75; and
312.27 	(10) for an animal chiropractic inactive registration renewal fee, $25.
312.28 		Subd. 3.Acupuncture reinstatement. The acupuncture reinstatement fee is $50.

312.29 	Sec. 2. Minnesota Statutes 2008, section 148D.180, subdivision 1, is amended to read:
312.30 		Subdivision 1.Application fees. Application fees for licensure are as follows:
312.31 	(1) for a licensed social worker, $45;
312.32 	(2) for a licensed graduate social worker, $45;
312.33 	(3) for a licensed independent social worker, $90 $45;
313.1 	(4) for a licensed independent clinical social worker, $90 $45;
313.2 	(5) for a temporary license, $50; and
313.3 	(6) for a licensure by endorsement, $150 $85.
313.4 	The fee for criminal background checks is the fee charged by the Bureau of Criminal 
313.5 	Apprehension. The criminal background check fee must be included with the application 
313.6 	fee as required pursuant to section 148D.055.

313.7 	Sec. 3. Minnesota Statutes 2008, section 148D.180, subdivision 2, is amended to read:
313.8 		Subd. 2.License fees. License fees are as follows:
313.9 	(1) for a licensed social worker, $115.20 $81;
313.10 	(2) for a licensed graduate social worker, $201.60 $144;
313.11 	(3) for a licensed independent social worker, $302.40 $216;
313.12 	(4) for a licensed independent clinical social worker, $331.20 $238.50;
313.13 	(5) for an emeritus license, $43.20; and
313.14 	(6) for a temporary leave fee, the same as the renewal fee specified in subdivision 3.
313.15 	If the licensee's initial license term is less or more than 24 months, the required 
313.16 	license fees must be prorated proportionately.

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

313.23 	Sec. 5. Minnesota Statutes 2008, section 148D.180, subdivision 5, is amended to read:
313.24 		Subd. 5.Late fees. Late fees are as follows:
313.25 	(1) renewal late fee, one-half one-fourth of the renewal fee specified in subdivision 
313.26 	3; and
313.27 	(2) supervision plan late fee, $40.

313.28 	Sec. 6. Minnesota Statutes 2008, section 148E.180, subdivision 1, is amended to read:
313.29 		Subdivision 1.Application fees. Application fees for licensure are as follows:
313.30 	(1) for a licensed social worker, $45;
313.31 	(2) for a licensed graduate social worker, $45;
313.32 	(3) for a licensed independent social worker, $90 $45;
314.1 	(4) for a licensed independent clinical social worker, $90 $45;
314.2 	(5) for a temporary license, $50; and
314.3 	(6) for a licensure by endorsement, $150 $85.
314.4 	The fee for criminal background checks is the fee charged by the Bureau of Criminal 
314.5 	Apprehension. The criminal background check fee must be included with the application 
314.6 	fee as required according to section 148E.055.

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

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

314.23 	Sec. 9. Minnesota Statutes 2008, section 148E.180, subdivision 5, is amended to read:
314.24 		Subd. 5.Late fees. Late fees are as follows:
314.25 	(1) renewal late fee, one-half one-fourth of the renewal fee specified in subdivision 
314.26 	3; and
314.27 	(2) supervision plan late fee, $40.

314.28 	Sec. 10. Minnesota Statutes 2008, section 153A.17, is amended to read:
314.29 	153A.17 EXPENSES; FEES.
314.30 	(a) The expenses for administering the certification requirements including the 
314.31 	complaint handling system for certified hearing aid dispensers in sections 153A.14 and 
314.32 	153A.15 and the Consumer Information Center under section 153A.18 must be paid 
315.1 	from initial application and examination fees, renewal fees, penalties, and fines. All 
315.2 	fees are nonrefundable.
315.3 	(b) The certificate application fee is $350, the examination fee is $250 for the 
315.4 	written portion and $250 for the practical portion each time one or the other is taken, 
315.5 	and the trainee application fee is $200. The penalty fee for late submission of a renewal 
315.6 	application is $200. The fee for verification of certification to other jurisdictions or entities 
315.7 	is $25. All fees are nonrefundable.
315.8 	(c) All fees, penalties, and fines received must be deposited in the state government 
315.9 	special revenue fund. The commissioner may prorate the certification fee for new 
315.10 	applicants based on the number of quarters remaining in the annual certification period.  
315.11 	(d) The fees charged by the commissioner must reflect the actual costs of 
315.12 	administering the program under paragraph (a). Fees must not be increased to cover the 
315.13 	costs associated with investigating allegations against uncertified hearing aid dispensers.

315.14 	Sec. 11. [156.011] LICENSE, APPLICATION, AND EXAMINATION FEES.
315.15 		Subdivision 1.Application fee. A person applying for a license to practice 
315.16 	veterinary medicine in Minnesota or applying for a permit to take the national veterinary 
315.17 	medical examination must pay a $60 nonrefundable application fee to the board. Persons 
315.18 	submitting concurrent applications for licensure and a national examination permit shall 
315.19 	pay only one application fee.
315.20 		Subd. 2.Examination fees. (a) An applicant for veterinary licensure in Minnesota 
315.21 	must successfully pass the Minnesota Veterinary Jurisprudence Examination. The fee for 
315.22 	this examination is $60, payable to the board.
315.23 	(b) An applicant participating in the national veterinary licensing examination must 
315.24 	complete a separate application for the national examination and submit the application 
315.25 	to the board for approval. Payment for the national examination must be made by the 
315.26 	applicant to the national board examination committee.

315.27 	Sec. 12. [156.012] INITIAL AND RENEWAL FEE.
315.28 		Subdivision 1.Required for licensure. A person now licensed to practice 
315.29 	veterinary medicine in this state, or who becomes licensed by the Board of Veterinary 
315.30 	Medicine to engage in the practice, shall pay an initial fee or a biennial license renewal 
315.31 	fee if the person wishes to practice veterinary medicine in the coming two-year period 
315.32 	or remain licensed as a veterinarian. A licensure period begins on March 1 and expires 
315.33 	the last day of February two years later. A licensee with an even-numbered license shall 
316.1 	renew by March 1 of even-numbered years and a licensee with an odd-numbered license 
316.2 	shall renew by March 1 of odd-numbered years.
316.3 		Subd. 2.Amount. The initial licensure fee and the biennial renewal fee is $280 
316.4 	and must be paid to the executive director of the board. By January 1 of the first year 
316.5 	for which the biennial renewal fee is due, the board shall issue a renewal application to 
316.6 	a current licensee to the last address maintained in the board file. Failure to receive this 
316.7 	notice does not relieve the licensee of the obligation to pay renewal fees so that they are 
316.8 	received by the board on or before the renewal date of March 1.
316.9 	Initial licenses issued after the start of the licensure renewal period are valid only 
316.10 	until the end of the period.
316.11 		Subd. 3.Date due. A licensee must apply for a renewal license on or before March 
316.12 	1 of the first year of the biennial license renewal period. A renewal license is valid 
316.13 	from March 1 through the last day of February of the last year of the two-year license 
316.14 	renewal period. An application postmarked no later than the last day of February must be 
316.15 	considered to have been received on March 1.
316.16 		Subd. 4.Late renewal penalty. An applicant for renewal must pay a late renewal 
316.17 	penalty of $140 in addition to the renewal fee if the application for renewal is received 
316.18 	after March 1 of the licensure renewal period. A renewed license issued after March 1 of 
316.19 	the licensure renewal period is valid only to the end of the period regardless of when the 
316.20 	renewal fee is received.
316.21 		Subd. 5.Reinstatement fee. An applicant for license renewal whose license 
316.22 	has previously been suspended by official board action for nonrenewal must pay a 
316.23 	reinstatement fee of $60 in addition to the $280 renewal fee and the $140 late renewal 
316.24 	penalty.
316.25 		Subd. 6.Penalty for failure to pay. Within 30 days after the renewal date, a 
316.26 	licensee who has not renewed the license must be notified by letter sent to the last known 
316.27 	address of the licensee in the file of the board that the renewal is overdue and that failure 
316.28 	to pay the current fee and current late fee within 60 days after the renewal date will result 
316.29 	in suspension of the license. A second notice must be sent by registered or certified mail at 
316.30 	least seven days before a board meeting occurring 60 days or more after the renewal date 
316.31 	to a licensee who has not paid the renewal fee and late fee.
316.32 		Subd. 7.Suspension. The board, by means of a roll call vote, shall suspend the 
316.33 	license of a licensee whose license renewal is at least 60 days overdue and to whom 
316.34 	notification has been sent as provided in Minnesota Rules, part 9100.0500, subpart 5. 
316.35 	Failure of a licensee to receive notification is not grounds for later challenge by the 
316.36 	licensee of the suspension. The former licensee must be notified by registered or certified 
317.1 	letter within seven days of the board action. The suspended status placed on a license may 
317.2 	be removed only on payment of renewal fees and late penalty fees for each licensure 
317.3 	period or part of a period that the license was not renewed. A licensee who fails to renew a 
317.4 	license for five years or more must meet the criteria of section 156.071 for relicensure.
317.5 		Subd. 8.Inactive license. (a) A person holding a current active license to practice 
317.6 	veterinary medicine in Minnesota may, at the time of the person's next biennial license 
317.7 	renewal date, renew the license as an inactive license at one-half the renewal fee of an 
317.8 	active license. The license may be continued in an inactive status by renewal on a biennial 
317.9 	basis at one-half the regular license fee.
317.10 	(b) A person holding an inactive license is not permitted to practice veterinary 
317.11 	medicine in Minnesota and remains under the disciplinary authority of the board.
317.12 	(c) A person may convert a current inactive license to an active license upon 
317.13 	application to and approval by the board. The application must include:
317.14 	(1) documentation of licensure in good standing and of having met continuing 
317.15 	education requirements of current state of practice, or documentation of having met 
317.16 	Minnesota continuing education requirements retroactive to the date of licensure 
317.17 	inactivation;
317.18 	(2) certification by the applicant that the applicant is not currently under disciplinary 
317.19 	orders or investigation for acts that could result in disciplinary action in any other 
317.20 	jurisdiction; and
317.21 	(3) payment of a fee equal to the full difference between an inactive and active 
317.22 	license if converting during the first year of the biennial license cycle or payment of a fee 
317.23 	equal to one-half the difference between an inactive and an active license if converting 
317.24 	during the second year of the license cycle.
317.25 	(d) Deadline for renewal of an inactive license is March 1 of the first year of the 
317.26 	biennial license renewal period. A late renewal penalty of one-half the inactive renewal 
317.27 	fee must be paid if renewal is received after March 1.

317.28 	Sec. 13. Minnesota Statutes 2008, section 156.015, is amended to read:
317.29 	156.015 MISCELLANEOUS FEES.
317.30 		Subdivision 1.Verification of licensure. The board may charge a fee of $25 per 
317.31 	license verification to a licensee for verification of licensure status provided to other 
317.32 	veterinary licensing boards.
317.33 		Subd. 2.Continuing education review. The board may charge a fee of $50 per 
317.34 	submission to a sponsor for review and approval of individual continuing education 
317.35 	seminars, courses, wet labs, and lectures. This fee does not apply to continuing education 
318.1 	sponsors that already meet the criteria for preapproval under Minnesota Rules, part 
318.2 	9100.1000, subpart 3, item A.
318.3 		Subd. 3.Temporary license fee. A person meeting the requirements for issuance 
318.4 	of a temporary permit to practice veterinary medicine under section 156.073, pending 
318.5 	examination, who desires a temporary permit shall pay a fee of $60 to the board.
318.6 		Subd. 4.Duplicate license. A person requesting issuance of a duplicate or 
318.7 	replacement license shall pay a fee of $15 to the board.
318.8 		Subd. 5.Mailing examination and reference materials. An applicant who resides 
318.9 	outside the Twin Cities metropolitan area may request to take the Minnesota Veterinary 
318.10 	Jurisprudence Examination by mail. The fee for mailing the examination and reference 
318.11 	materials is $15.

318.12 	Sec. 14.  REPEALER.
 318.13 	(a) Minnesota Rules, parts 9100.0400, subparts 1 and 3; 9100.0500; and 9100.0600,
318.14 	are repealed.
318.15 	(b) Minnesota Statutes 2008, section 148D.180, subdivision 8, is repealed.

318.16 	ARTICLE 13
318.17 	HEALTH APPROPRIATIONS

318.18	Section 1. HEALTH APPROPRIATION.
 	
318.19 	The sums shown in the columns marked "Appropriations" are appropriated to the 
318.20 	agencies and for the purposes specified in this article. The appropriations are from the 
318.21 	general fund, or another named fund, and are available for the fiscal years indicated 
318.22 	for each purpose. The figures "2010" and "2011" used in this article mean that the 
318.23 	appropriations listed under them are available for the fiscal year ending June 30, 2010, or 
318.24 	June 30, 2011, respectively. "The first year" is fiscal year 2010. "The second year" is fiscal 
318.25 	year 2011. "The biennium" is fiscal years 2010 and 2011. Appropriations for the fiscal 
318.26 	year ending June 30, 2009, are effective the day following final enactment.

318.27				APPROPRIATIONS
	
318.28				Available for the Year
	
318.29				Ending June 30
	
318.30					2010
		2011

318.31	Sec. 2. COMMISSIONER OF HEALTH

318.32	Subdivision 1.Total Appropriation
 	$
	103,645,000
	$
	 98,574,000

319.1	Appropriations by Fund
	
319.2		2010
	2011
	
319.3	General
	60,670,000
	55,310,000
	
319.4
319.5	State Government 
Special Revenue
	 31,531,000
	31,242,000
	
319.6	Federal TANF
	11,733,000
	11,733,000

319.7
319.8	Subd. 2.Community and Family Health 
Promotion

319.9	Appropriations by Fund
	
319.10	General
	43,701,000
	38,441,000
	
319.11
319.12	State Government 
Special Revenue
	1,033,000
	 1,322,000
	
319.13	Federal TANF
	11,733,000
	11,733,000
	
319.14 	Support Services for Families With 
319.15 	Children Who are Deaf or Have Hearing 
319.16 	Loss. Of the state government special 
319.17 	revenue fund amount, $18,000 in fiscal year 
319.18 	2010 and $271,000 in fiscal year 2011 is for 
319.19 	support services to families with children 
319.20 	who are deaf or have hearing loss. Of this 
319.21 	amount, in fiscal year 2011, $198,000 is for 
319.22 	grants and the balance is for administrative 
319.23 	costs. Base funding in fiscal years 2012 and 
319.24 	2013 is $288,000 each year. Of this amount, 
319.25 	$215,000 each year is for grants and the 
319.26 	balance is for administrative costs.
319.27 	Funding Usage. Up to 75 percent of the 
319.28 	fiscal year 2012 appropriation for local public 
319.29 	health grants may be used to fund calendar 
319.30 	year 2011 allocations for this program. The 
319.31 	general fund reduction of $5,060,000 in 
319.32 	fiscal year 2011 for local public health grants 
319.33 	is onetime and the base funding for local 
319.34 	public health grants for fiscal year 2012 is 
319.35 	increased by $5,060,000.
319.36 	Grants Reduction. Effective July 1, 
319.37 	2009, base-level funding for general fund 
320.1 	community and family health grants issued 
320.2 	under this paragraph shall be reduced by 2.55 
320.3 	percent at the allotment level. Effective July 
320.4 	1, 2011, base-level funding for general fund 
320.5 	community and family health grants issued 
320.6 	under this paragraph shall be reduced by 5.5 
320.7 	percent at the allotment level.
320.8 	Colorectal Screening. $100,000 in 
320.9 	fiscal year 2010 is for grants to the 
320.10 	Hennepin County Medical Center and 
320.11 	MeritCare Bemidji for colorectal screening 
320.12 	demonstration projects.
320.13 	Women's Heart Health Pilot Project.
320.14 	$100,000 in fiscal year 2010 is for the 
320.15 	women's heart health pilot project. This is a 
320.16 	onetime appropriation and is available until 
320.17 	expended.
320.18 	TANF Appropriations. (1) $1,156,000 of 
320.19 	the TANF funds are appropriated each year to 
320.20 	the commissioner for family planning grants 
320.21 	under Minnesota Statutes, section 145.925.
320.22 	(2) $3,579,000 of the TANF funds are 
320.23 	appropriated each year to the commissioner 
320.24 	for home visiting and nutritional services 
320.25 	listed under Minnesota Statutes, section 
320.26 	145.882, subdivision 7, clauses (6) and (7). 
320.27 	Funds must be distributed to community 
320.28 	health boards according to Minnesota 
320.29 	Statutes, section 145A.131, subdivision 1.
320.30 	(3) $2,000,000 of the TANF funds are 
320.31 	appropriated each year to the commissioner 
320.32 	for decreasing racial and ethnic disparities 
320.33 	in infant mortality rates under Minnesota 
320.34 	Statutes, section 145.928, subdivision 7.
321.1 	(4) $4,998,000 of the TANF funds are 
321.2 	appropriated each year to the commissioner 
321.3 	for the family home visiting grant program 
321.4 	according to Minnesota Statutes, section 
321.5 	145A.17. $4,000,000 of the funding must 
321.6 	be distributed to community health boards 
321.7 	according to Minnesota Statutes, section 
321.8 	145A.131, subdivision 1. $998,000 of 
321.9 	the funding must be distributed to tribal 
321.10 	governments according to Minnesota 
321.11 	Statutes, section 145A.14, subdivision 2a. 
321.12 	The commissioner may use five percent of 
321.13 	the funds appropriated each fiscal year to 
321.14 	conduct the ongoing evaluations required 
321.15 	under Minnesota Statutes, section 145A.17, 
321.16 	subdivision 7, and may use ten percent of 
321.17 	the funds appropriated each fiscal year to 
321.18 	provide training and technical assistance as 
321.19 	required under Minnesota Statutes, section 
321.20 	145A.17, subdivisions 4 and 5.
321.21 	TANF Carryforward. Any unexpended 
321.22 	balance of the TANF appropriation in the 
321.23 	first year of the biennium does not cancel but 
321.24 	is available for the second year.

321.25	Subd. 3.Policy, Quality, and Compliance
 		100,000
		0
	
321.26 	Rural Pharmacy Planning. $100,000 in 
321.27 	fiscal year 2010 is for the rural pharmacy 
321.28 	planning and transition grant program under 
321.29 	Minnesota Statutes, section 144.1476. The 
321.30 	appropriation is available until expended.

321.31	Subd. 4.Health Protection

321.32	Appropriations by Fund
	
321.33	General
	9,679,000
	9,679,000
	
321.34
321.35	State Government 
Special Revenue
	30,209,000
	30,209,000
	
322.1 	Grants Reduction. Effective July 1, 
322.2 	2009, base-level funding for general fund 
322.3 	health protection grants issued under this 
322.4 	paragraph shall be reduced by 2.55 percent 
322.5 	at the allotment level. Effective July 1, 
322.6 	2011, base-level funding for general fund 
322.7 	health protection grants issued under this 
322.8 	paragraph shall be reduced by 5.5 percent at 
322.9 	the allotment level.
322.10 	Session Laws Adjustment. (a) $163,000 
322.11 	each year is for the lead abatement grant 
322.12 	program. This adjustment is onetime.
322.13 	(b) $100,000 each year is for emergency 
322.14 	preparedness and response activities. This 
322.15 	adjustment is onetime. Of this amount, 
322.16 	$50,000 each year is for tuberculosis 
322.17 	prevention and control.

322.18	Subd. 5.Administrative Support Services
 		7,190,000
		7,190,000

322.19	Sec. 3. HEALTH-RELATED BOARDS

322.20	Subdivision 1.Total Appropriation 
 	$
	14,753,000
	$
	15,036,000
	
322.21 	This appropriation is from the state 
322.22 	government special revenue fund.
322.23 	Transfer From Special Revenue Fund.
322.24 	During the fiscal year beginning July 1, 2011, 
322.25 	the commissioner of finance shall transfer 
322.26 	$10,000,000 from the state government 
322.27 	special revenue fund to the general fund. The 
322.28 	boards must allocate this reduction to boards 
322.29 	carrying a positive balance as of July 1, 2011.
322.30 	The amounts that may be spent for each 
322.31 	purpose are specified in the following 
322.32 	subdivisions.

322.33	Subd. 2.Board of Chiropractic Examiners
 		492,000
		509,000

323.1	Subd. 3.Board of Dentistry
 		1,100,000
		1,136,000

323.2
323.3	Subd. 4.Board of Dietetic and Nutrition 
Practice
 		105,000
		105,000

323.4
323.5	Subd. 5.Board of Marriage and Family 
Therapy
 		159,000
		167,000

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

323.7	Subd. 7.Board of Nursing
 		3,368,000
		3,521,000

323.8
323.9	Subd. 8.Board of Nursing Home 
Administrators
 		1,358,000
		1,262,000
	
323.10 	Administrative Services Unit - Operating 
323.11 	Costs. Of this appropriation, $524,000 
323.12 	in fiscal year 2010 and $526,000 in 
323.13 	fiscal year 2011 are for operating costs 
323.14 	of the administrative services unit. The 
323.15 	administrative services unit may receive 
323.16 	and expend reimbursements for services 
323.17 	performed by other agencies.
323.18 	Administrative Services Unit - Retirement 
323.19 	Costs. Of this appropriation in fiscal year 
323.20 	2010, $201,000 is for onetime retirement 
323.21 	costs in the health-related boards. This 
323.22 	funding may be transferred to the health 
323.23 	boards incurring those costs for their 
323.24 	payment. These funds are available either 
323.25 	year of the biennium.
323.26 	Administrative Services Unit - Volunteer 
323.27 	Health Care Provider Program. Of this 
323.28 	appropriation, $79,000 in fiscal year 2010 
323.29 	and $89,000 in fiscal year 2011 are to pay 
323.30 	for medical professional liability coverage 
323.31 	required under Minnesota Statutes, section 
323.32 	214.40.
323.33 	Administrative Services Unit - Contested 
323.34 	Cases and Other Legal Proceedings. Of 
324.1 	this appropriation, $200,000 in fiscal year 
324.2 	2010 and $200,000 in fiscal year 2011 
324.3 	are for costs of contested case hearings 
324.4 	and other unanticipated costs of legal 
324.5 	proceedings involving health-related 
324.6 	boards funded under this section. Upon 
324.7 	certification of a health-related board to the 
324.8 	administrative services unit that the costs 
324.9 	will be incurred and that there is insufficient 
324.10 	money available to pay for the costs out of 
324.11 	money currently available to that board, the 
324.12 	administrative services unit is authorized 
324.13 	to transfer money from this appropriation 
324.14 	to the board for payment of those costs 
324.15 	with the approval of the commissioner of 
324.16 	finance. This appropriation does not cancel. 
324.17 	Any unencumbered and unspent balances 
324.18 	remain available for these expenditures in 
324.19 	subsequent fiscal years.

324.20	Subd. 9.Board of Optometry
 		105,000
		108,000

324.21	Subd. 10.Board of Pharmacy
 		1,509,000
		1,579,000

324.22	Subd. 11.Board of Physical Therapy
 		346,000
		356,000

324.23	Subd. 12.Board of Podiatry
 		61,000
		64,000

324.24	Subd. 13.Board of Psychology
 		876,000
		907,000

324.25	Subd. 14.Board of Social Work
 		958,000
		996,000

324.26	Subd. 15.Board of Veterinary Medicine
 		240,000
		250,000

324.27
324.28	Subd. 16.Board of Behavioral Health and 
Therapy
 		394,000
		394,000

324.29
324.30	Sec. 4. EMERGENCY MEDICAL SERVICES 
BOARD
 	$
	 4,024,000
	$
	4,054,000

324.31	Appropriations by Fund
	
324.32		2010
	2011
	
324.33	General
	 3,288,000
	3,288,000
	
325.1
325.2	State Government 
Special Revenue
	736,000
	766,000
	
325.3
325.4
325.5	Cooper/Sams 
Volunteer 
Ambulance Trust
	625,000
	0
	
325.6 	Longevity Award and Incentive Program.
325.7 	Of the general fund appropriation, $700,000 
325.8 	in fiscal year 2010 and $700,000 in fiscal 
325.9 	year 2011 are to the board for the ambulance 
325.10 	service personnel longevity award and 
325.11 	incentive program, under Minnesota Statutes, 
325.12 	section 144E.40.
325.13 	Transfer. In fiscal year 2010, $626,000 
325.14 	is transferred from the Cooper/Sams 
325.15 	volunteer ambulance trust, established under 
325.16 	Minnesota Statutes, section 144E.42, to the 
325.17 	general fund.
325.18 	Health Professional Services Program.
325.19 	$736,000 in fiscal year 2010 and $766,000 in 
325.20 	fiscal year 2011 from the state government 
325.21 	special revenue fund are for the health 
325.22 	professional services program.
325.23 	Regional Medical Services Program.(a) 
325.24 	$400,000 in the first year is transferred from 
325.25 	the Cooper/Sams volunteer ambulance trust 
325.26 	to the emergency medical services system 
325.27 	fund.
325.28 	(b) $400,000 in the first year from the 
325.29 	emergency medical services system fund is 
325.30 	for the regional emergency medical services 
325.31 	programs. This amount shall be distributed 
325.32 	equally to the eight emergency medical 
325.33 	service regions. Notwithstanding Minnesota 
325.34 	Statutes, section 144E.50, 100 percent of 
325.35 	the appropriation shall be passed on to the 
325.36 	emergency medical service regions.
326.1 	Comprehensive Advanced Life-Support 
326.2 	Educational (CALS) Program.$100,000 in 
326.3 	the first year from the Cooper/Sams volunteer 
326.4 	ambulance trust is for the comprehensive 
326.5 	advanced life-support educational (CALS) 
326.6 	program established under Minnesota 
326.7 	Statutes, section 144E.37. This appropriation 
326.8 	is to extend availability and affordability 
326.9 	of the CALS program for rural emergency 
326.10 	medical personnel and to assist hospital staff 
326.11 	in attaining the credentialing levels necessary 
326.12 	for implementation of the statewide trauma 
326.13 	system.
326.14 	Emergency Medical Services for Children 
326.15 	(EMS-C) Program.$25,000 in the first 
326.16 	year from the Cooper/Sams volunteer 
326.17 	ambulance trust is for the emergency medical 
326.18 	services for children (EMS-C) program. 
326.19 	This appropriation is to meet increased need 
326.20 	for medical training specific to pediatric 
326.21 	emergencies.

326.22
326.23	Sec. 5. DEPARTMENT OF VETERANS 
AFFAIRS
 	$
	200,000
	$
	0
	
326.24 	Veterans Paramedic Apprenticeship 
326.25 	Program. $200,000 in the first year is from 
326.26 	the Cooper/Sams volunteer ambulance trust 
326.27 	to the commissioner of veterans affairs 
326.28 	for a grant to the Minnesota Ambulance 
326.29 	Association to implement a veterans 
326.30 	paramedic apprenticeship program to 
326.31 	reintegrate returning military medics into 
326.32 	Minnesota's workforce in the field of 
326.33 	paramedic and emergency services, thereby 
326.34 	guaranteeing returning military medics 
326.35 	gainful employment with livable wages and 
327.1 	benefits. This appropriation is available until 
327.2 	expended.

327.3	Sec. 6. DEPARTMENT OF PUBLIC SAFETY
 	$
	250,000
	$
	0
	
327.4 	Medical Response Unit Reimbursement 
327.5 	Pilot Program. (a) $250,000 in the first 
327.6 	year is from the Cooper/Sams volunteer 
327.7 	ambulance trust to the Department of 
327.8 	Public Safety for a medical response unit 
327.9 	reimbursement pilot program. Of this 
327.10 	appropriation, $75,000 is for administrative 
327.11 	costs to the Department of Public Safety, 
327.12 	including providing contract staff support 
327.13 	and technical assistance to the pilot program 
327.14 	partners if necessary.
327.15 	(b) Of the amount in paragraph (a), $175,000 
327.16 	is to the Department of Public Safety 
327.17 	to be used to provide a predetermined 
327.18 	reimbursement amount to the participating 
327.19 	medical response units. The Department 
327.20 	of Public Safety or its contract designee 
327.21 	will develop an agreement with the medical 
327.22 	response units outlining reimbursement and 
327.23 	program requirements to include HIPAA 
327.24 	compliance while participating in the pilot 
327.25 	program.

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

327.27
327.28
327.29	Sec. 8. OMBUDSMAN FOR MENTAL 
HEALTH AND DEVELOPMENTAL 
DISABILITIES
 	$
	1,655,000
	$
	1,580,000

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

327.31 	Sec. 10. FEDERAL STIMULUS FUNDS; REPORT.
 328.1 	By February 15, 2010, the commissioner of health shall submit to the chairs and 
328.2 	ranking minority members of the house of representatives and senate committees with 
328.3 	jurisdiction over public health and public safety finance a report on how funds from the 
328.4 	American Recovery and Reinvestment Act of 2009 are used: (1) to support advancing 
328.5 	the objectives of the Minnesota Department of Health's Sexual Violence Prevention Plan; 
328.6 	and (2) to support any pilot programs that might demonstrate and evaluate how use of 
328.7 	community-based prevention grants might serve as a model for future investment of state 
328.8 	resources to help advance the department's Sexual Violence Prevention Plan.

328.9 	ARTICLE 14
328.10 	HUMAN SERVICES APPROPRIATIONS

328.11 	Section 1. EMERGENCY SERVICES SHELTER GRANTS FROM AMERICAN 
328.12 	RECOVERY AND REINVESTMENT ACT.
 328.13 	To the extent permitted under federal law, the commissioner of human services, when 
328.14 	determining the uses of the emergency services shelter grants provided under the American 
328.15 	Recovery and Reinvestment Act, shall give priority to programs that serve the following:
328.16 	(1) homeless youth;
328.17 	(2) American Indian women who are victims of trafficking; 
328.18 	(3) high-risk adult males considered to be very likely to enter or reenter state or 
328.19 	county correctional programs, or chemical and mental health programs;
328.20 	(4) battered women; and
328.21 	(5) families affected by foreclosure.

328.22	Sec. 2. HUMAN SERVICES APPROPRIATIONS.
 	
328.23 	The sums shown in the columns marked "Appropriations" are appropriated to the 
328.24 	agencies and for the purposes specified in this article. The appropriations are from the 
328.25 	general fund, or another named fund, and are available for the fiscal years indicated 
328.26 	for each purpose. The figures "2010" and "2011" used in this article mean that the 
328.27 	appropriations listed under them are available for the fiscal year ending June 30, 2010, or 
328.28 	June 30, 2011, respectively. "The first year" is fiscal year 2010. "The second year" is fiscal 
328.29 	year 2011. "The biennium" is fiscal years 2010 and 2011. Appropriations for the fiscal 
328.30 	year ending June 30, 2009, are effective the day following final enactment.

328.31				APPROPRIATIONS
	
328.32				Available for the Year
	
328.33				Ending June 30
	
328.34					2010
		2011

329.1	Sec. 3. HUMAN SERVICES

329.2	Subdivision 1.Total Appropriation
 	$
	15,993,000
	$
	14,990,000

329.3	Appropriations by Fund
	
329.4		2010
	2011
	
329.5	General
	10,993,000
	14,990,000
	
329.6
329.7
329.8	Federal Fiscal 
Stabilization 
Account
	5,000,000
	0

329.9329.10
	Subd. 2.Other Children and Economic 
Assistance Grants
 		15,993,000
		14,990,000
	
329.11 	Federal Funding. $5,000,000 in fiscal year 
329.12 	2010 is from the federal fiscal stabilization 
329.13 	account.
329.14 	Homeless and Runaway Youth. $238,000 
329.15 	in fiscal year 2010 is for the Runaway 
329.16 	and Homeless Youth Act under Minnesota 
329.17 	Statutes, section 256K.45. Funds shall be 
329.18 	spent in each area of the continuum of care 
329.19 	to ensure that programs are meeting the 
329.20 	greatest need. Any unexpended balance in 
329.21 	the first year is available in the second year. 
329.22 	Beginning July 1, 2011, the base is increased 
329.23 	by $119,000 each year.
329.24 	Foodshelf Programs. $275,000 in fiscal 
329.25 	year 2010 is for foodshelf programs under 
329.26 	Minnesota Statutes, section 256E.34. This 
329.27 	is a onetime appropriation and is available 
329.28 	until expended. This appropriation is to 
329.29 	complement the federal funding under the 
329.30 	American Recovery and Reinvestment Act.
329.31 	Supportive Housing Services. $1,500,000 
329.32 	each year is for supportive services under 
329.33 	Minnesota Statutes, section 256K.26. This is 
329.34 	a onetime appropriation. Beginning in fiscal 
329.35 	year 2012, the base is increased by $68,000 
329.36 	per year.
330.1 	Community Action Grants. Community 
330.2 	action grants are reduced one time by 
330.3 	$1,764,000 each year. This reduction is due 
330.4 	to the availability of federal funds under the 
330.5 	American Recovery and Reinvestment Act.

330.6 	ARTICLE 15
330.7 	HUMAN SERVICES FORECAST ADJUSTMENTS

330.8
330.9	Section 1. SUMMARY OF APPROPRIATIONS; DEPARTMENT OF HUMAN 
SERVICES FORECAST ADJUSTMENT.
 	
330.10 	The dollar amounts shown are added to or, if shown in parentheses, are subtracted 
330.11 	from the appropriations in Laws 2008, chapter 363, from the general fund, or any other 
330.12 	fund named, to the Department of Human Services for the purposes specified in this article, 
330.13 	to be available for the fiscal year indicated for each purpose. The figure "2009" used in 
330.14 	this article means that the appropriation or appropriations listed are available for the fiscal 
330.15 	year ending June 30, 2009. Supplemental appropriations and reductions to appropriations 
330.16 	for the fiscal year ending June 30, 2009, are effective the day following final enactment.

330.17
330.18	Sec. 2. COMMISSIONER OF HUMAN 
SERVICES

330.19	Subdivision 1.Total Appropriation
 			$
	(478,994,000)

330.20	Appropriations by Fund
	
330.21			2009
	
330.22	General
		(445,130,000)
	
330.23	Health Care Access
		(19,460,000)
	
330.24	Federal TANF
		(14,404,000)

330.25	Subd. 2.Revenue and Pass-Through

330.26	Federal TANF
		1,107,000

330.27
330.28	Subd. 3.Children and Economic Assistance 
Grants

330.29	General
		27,002,000
	
330.30	Federal TANF
		(16,211,000)
	
330.31	Total
		10,791,000
	
330.32 	The amounts that may be spent from this 
330.33 	appropriation for each purpose are as follows:

330.34	(a) MFIP/DWP Grants

331.1	General
		17,530,000
	
331.2	Federal TANF
		(16,211,000)

331.3	(b) MFIP Child Care Assistance Grants
				4,933,000

331.4	(c) General Assistance Grants
				1,458,000

331.5	(d) Minnesota Supplemental Aid Grants
				513,000

331.6	(e) Group Residential Housing Grants
				2,568,000

331.7	Subd. 4.Basic Health Care Grants

331.8	General
		(224,341,000)
	
331.9	Health Care Access
		(19,460,000)
	
331.10	Total
		(243,801,000)
	
331.11 	The amounts that may be spent from this 
331.12 	appropriation for each purpose are as follows:

331.13	(a) MinnesotaCare

331.14	 Health Care Access
		(19,460,000)

331.15
331.16	(b) MA Basic Health Care - Families and 
Children
				(100,055,000)

331.17
331.18	(c) MA Basic Health Care - Elderly and 
Disabled
				(136,795,000)

331.19	(d) General Assistance Medical Care
				12,539,000

331.20	Subd. 5.Continuing Care Grants
 				(247,791,000)
	
331.21 	The amounts that may be spent from this 
331.22 	appropriation for each purpose are as follows:

331.23	(a) MA Long-Term Care Facilities
				(59,204,000)

331.24	(b) MA Long-Term Care Waivers
				(168,927,000)

331.25	(c) Chemical Dependency Entitlement Grants
				(19,660,000)

331.26 	ARTICLE 16
331.27 	HEALTH AND HUMAN SERVICES APPROPRIATIONS

331.28	Section 1. SUMMARY OF APPROPRIATIONS.
 	
331.29 	The amounts shown in this section summarize direct appropriations by fund made 
331.30 	in this article.

332.1			2010
		2011
		Total
	
332.2	General
	$
	4,276,443,000
	$
	5,150,311,000
	$
	9,426,754,000
	
332.3
332.4	State Government Special 
Revenue
		15,488,000
		14,841,000
		30,329,000
	
332.5	Health Care Access
		463,239,000
		560,223,000
		1,023,462,000
	
332.6	Federal TANF
		276,848,000
		257,526,000
		534,374,000
	
332.7	Lottery Prize
		1,665,000
		1,665,000
		3,330,000
	
332.8	Federal Fund
		99,800,000
		0
		99,800,000
	
332.9	Total
	$
	5,133,483,000
	$
	5,984,566,000
	$
	11,118,049,000

332.10	Sec. 2. HEALTH AND HUMAN SERVICES APPROPRIATION.
 	
332.11 	The sums shown in the columns marked "Appropriations" are appropriated to the 
332.12 	agencies and for the purposes specified in this article. The appropriations are from the 
332.13 	general fund, or another named fund, and are available for the fiscal years indicated 
332.14 	for each purpose. The figures "2010" and "2011" used in this article mean that the 
332.15 	appropriations listed under them are available for the fiscal year ending June 30, 2010, or 
332.16 	June 30, 2011, respectively. "The first year" is fiscal year 2010. "The second year" is fiscal 
332.17 	year 2011. "The biennium" is fiscal years 2010 and 2011. Appropriations from the federal 
332.18 	fund are from money received under the American Reinvestment and Recovery Act of 
332.19 	2009, Public Law 111-5, unless otherwise specified. Appropriations for the fiscal year 
332.20 	ending June 30, 2009, are effective the day following final enactment.

332.21				APPROPRIATIONS
	
332.22				Available for the Year
	
332.23				Ending June 30
	
332.24					2010
		2011

332.25	Sec. 3. HUMAN SERVICES

332.26	Subdivision 1.Total Appropriation
 	$
	5,083,386,000
	$
	5,950,114,000

332.27	Appropriations by Fund
	
332.28		2010
	2011
	
332.29	General
	4,263,602,000
	5,141,510,000
	
332.30
332.31	State Government 
Special Revenue
	1,315,000
	565,000
	
332.32	Health Care Access
	450,156,000
	548,848,000
	
332.33	Federal TANF
	276,848,000
	257,526,000
	
332.34	Lottery Prize
	1,665,000
	1,665,000
	
332.35	Federal Fund
	89,800,000
	0
	
332.36 	Receipts for Systems Projects.
332.37 	Appropriations and federal receipts for 
333.1 	information systems projects for MAXIS, 
333.2 	PRISM, MMIS, and SSIS must be deposited 
333.3 	in the state system account authorized in 
333.4 	Minnesota Statutes, section 256.014. Money 
333.5 	appropriated for computer projects approved 
333.6 	by the Minnesota Office of Enterprise 
333.7 	Technology, funded by the legislature, and 
333.8 	approved by the commissioner of finance, 
333.9 	may be transferred from one project to 
333.10 	another and from development to operations 
333.11 	as the commissioner of human services 
333.12 	considers necessary. Any unexpended 
333.13 	balance in the appropriation for these 
333.14 	projects does not cancel but is available for 
333.15 	ongoing development and operations.
333.16 	Nonfederal Share Transfers. The 
333.17 	nonfederal share of activities for which 
333.18 	federal administrative reimbursement is 
333.19 	appropriated to the commissioner may be 
333.20 	transferred to the special revenue fund.
333.21 	TANF Maintenance of Effort.
333.22 	(a) In order to meet the basic maintenance 
333.23 	of effort (MOE) requirements of the TANF 
333.24 	block grant specified under Code of Federal 
333.25 	Regulations, title 45, section 263.1, the 
333.26 	commissioner may only report nonfederal 
333.27 	money expended for allowable activities 
333.28 	listed in the following clauses as TANF/MOE 
333.29 	expenditures:
333.30 	(1) MFIP cash, diversionary work program, 
333.31 	and food assistance benefits under Minnesota 
333.32 	Statutes, chapter 256J;
333.33 	(2) the child care assistance programs 
333.34 	under Minnesota Statutes, sections 119B.03 
333.35 	and 119B.05, and county child care 
334.1 	administrative costs under Minnesota 
334.2 	Statutes, section 119B.15;
334.3 	(3) state and county MFIP administrative 
334.4 	costs under Minnesota Statutes, chapters 
334.5 	256J and 256K;
334.6 	(4) state, county, and tribal MFIP 
334.7 	employment services under Minnesota 
334.8 	Statutes, chapters 256J and 256K;
334.9 	(5) expenditures made on behalf of 
334.10 	noncitizen MFIP recipients who qualify 
334.11 	for the medical assistance without federal 
334.12 	financial participation program under 
334.13 	Minnesota Statutes, section 256B.06, 
334.14 	subdivision 4, paragraphs (d), (e), and (j); 
334.15 	and
334.16 	(6) qualifying working family credit 
334.17 	expenditures under Minnesota Statutes, 
334.18 	section 290.0671.
334.19 	(b) The commissioner shall ensure that 
334.20 	sufficient qualified nonfederal expenditures 
334.21 	are made each year to meet the state's 
334.22 	TANF/MOE requirements. For the activities 
334.23 	listed in paragraph (a), clauses (2) to 
334.24 	(6), the commissioner may only report 
334.25 	expenditures that are excluded from the 
334.26 	definition of assistance under Code of 
334.27 	Federal Regulations, title 45, section 260.31.
334.28 	(c) For fiscal years beginning with state 
334.29 	fiscal year 2003, the commissioner shall 
334.30 	ensure that the maintenance of effort used 
334.31 	by the commissioner of finance for the 
334.32 	February and November forecasts required 
334.33 	under Minnesota Statutes, section 16A.103, 
334.34 	contains expenditures under paragraph (a), 
334.35 	clause (1), equal to at least 16 percent of 
335.1 	the total required under Code of Federal 
335.2 	Regulations, title 45, section 263.1.
335.3 	(d) For the federal fiscal year beginning 
335.4 	October 1, 2007, the commissioner may not 
335.5 	claim an amount of TANF/MOE in excess of 
335.6 	the 75 percent standard in Code of Federal 
335.7 	Regulations, title 45, section 263.1(a)(2), 
335.8 	except:
335.9 	(1) to the extent necessary to meet the 80 
335.10 	percent standard under Code of Federal 
335.11 	Regulations, title 45, section 263.1(a)(1), 
335.12 	if it is determined by the commissioner 
335.13 	that the state will not meet the TANF work 
335.14 	participation target rate for the current year;
335.15 	(2) to provide any additional amounts 
335.16 	under Code of Federal Regulations, title 45, 
335.17 	section 264.5, that relate to replacement of 
335.18 	TANF funds due to the operation of TANF 
335.19 	penalties; and
335.20 	(3) to provide any additional amounts that 
335.21 	may contribute to avoiding or reducing 
335.22 	TANF work participation penalties through 
335.23 	the operation of the excess MOE provisions 
335.24 	of Code of Federal Regulations, title 45, 
335.25 	section 261.43(a)(2).
335.26 	For the purposes of clauses (1) to (3), 
335.27 	the commissioner may supplement the 
335.28 	MOE claim with working family credit 
335.29 	expenditures to the extent such expenditures 
335.30 	or other qualified expenditures are otherwise 
335.31 	available after considering the expenditures 
335.32 	allowed in this section.
335.33 	(e) Minnesota Statutes, section 256.011, 
335.34 	subdivision 3, which requires that federal 
335.35 	grants or aids secured or obtained under that 
336.1 	subdivision be used to reduce any direct 
336.2 	appropriations provided by law, do not apply 
336.3 	if the grants or aids are federal TANF funds.
336.4 	(f) Notwithstanding any contrary provision 
336.5 	in this article, this provision expires June 30, 
336.6 	2013.
336.7 	Working Family Credit Expenditures as 
336.8 	TANF/MOE. The commissioner may claim 
336.9 	as TANF/MOE up to $6,707,000 per year for 
336.10 	fiscal year 2010 through fiscal year 2011.
336.11 	Working Family Credit Expenditures 
336.12 	to be Claimed for TANF/MOE. The 
336.13 	commissioner may count the following 
336.14 	amounts of working family credit expenditure 
336.15 	as TANF/MOE:
336.16 	(1) fiscal year 2010, $6,707,000;
336.17 	(2) fiscal year 2011, $32,387,000;
336.18 	(3) fiscal year 2012, $38,052,000; and
336.19 	(4) fiscal year 2013, $42,555,000.
336.20 	Notwithstanding any contrary provision in 
336.21 	this article, this rider expires June 30, 2013.
336.22 	TANF Transfer to Federal Child Care 
336.23 	and Development Fund. The following 
336.24 	TANF fund amounts are appropriated to the 
336.25 	commissioner for the purposes of MFIP and 
336.26 	transition year child care under Minnesota 
336.27 	Statutes, section 119B.05:
336.28 	(1) fiscal year 2010, $0;
336.29 	(2) fiscal year 2011, $25,680,000;
336.30 	(3) fiscal year 2012, $31,345,000; and
336.31 	(4) fiscal year 2013, $35,848,000.
336.32 	The commissioner shall authorize the 
336.33 	transfer of sufficient TANF funds to the 
337.1 	federal child care and development fund to 
337.2 	meet this appropriation and shall ensure that 
337.3 	all transferred funds are expended according 
337.4 	to federal child care and development fund 
337.5 	regulations. The transferred funds shall be 
337.6 	used to offset any general fund reductions to 
337.7 	MFIP child care in this article.
337.8 	Child Care and Development Fund 
337.9 	Unexpended Balance. The commissioner 
337.10 	shall determine the unexpended balance of 
337.11 	the federal Child Care and Development 
337.12 	Fund (CCDF) for the basic sliding fee child 
337.13 	care program by February 28, 2009. The 
337.14 	balance must first be used to fund programs 
337.15 	described in paragraph (b) and the remainder 
337.16 	must be available for the basic sliding fee 
337.17 	child care under Minnesota Statutes, section 
337.18 	119B.03.
337.19 	Food Stamps Employment and Training.
337.20 	Notwithstanding Minnesota Statutes, sections 
337.21 	256J.626 and 256D.051, subdivisions 1a, 6b, 
337.22 	and 6c, federal food stamps employment and 
337.23 	training funds received as reimbursement of 
337.24 	MFIP consolidated fund grant expenditures 
337.25 	and child care assistance program 
337.26 	expenditures for two-parent families must be 
337.27 	deposited in the general fund. The amount of 
337.28 	funds must be limited to $3,400,000 in fiscal 
337.29 	year 2010 and $4,400,000 in fiscal years 
337.30 	2011 through 2013, contingent on approval 
337.31 	by the federal Food and Nutrition Service. 
337.32 	Consistent with the receipt of these federal 
337.33 	funds, the commissioner may adjust the 
337.34 	level of working family credit expenditures 
337.35 	claimed as TANF maintenance of effort. 
338.1 	Notwithstanding any contrary provision in 
338.2 	this article, this rider expires June 30, 2013.
338.3 	Emergency Fund for the TANF Program.
338.4 	TANF Emergency Contingency funds 
338.5 	available under the American Recovery 
338.6 	and Reinvestment Act of 2009 (Public Law 
338.7 	111-5) are appropriated to the commissioner. 
338.8 	The commissioner must request TANF 
338.9 	Emergency Contingency funds from the 
338.10 	Secretary of the Department of Health 
338.11 	and Human Services to the extent the 
338.12 	commissioner meets or expects to meet the 
338.13 	requirements of section 403(c) of the Social 
338.14 	Security Act. The commissioner must seek 
338.15 	to maximize such grants. The funds received 
338.16 	must  be used as appropriated.

338.17	Subd. 2.Agency Management
 					
338.18 	The amounts that may be spent from the 
338.19 	appropriation for each purpose are as follows:

338.20	(a) Financial Operations

338.21	Appropriations by Fund
	
338.22	General
	3,380,000
	3,908,000
	
338.23	Health Care Access
	1,241,000
	1,016,000
	
338.24	Federal TANF
	122,000
	122,000

338.25	(b) Legal and Regulatory Operations

338.26	Appropriations by Fund
	
338.27	General
	13,710,000
	13,495,000
	
338.28
338.29	State Government 
Special Revenue
	440,000
	440,000
	
338.30	Health Care Access
	943,000
	943,000
	
338.31	Federal TANF
	100,000
	100,000
	
338.32 	Base Adjustment. The general fund base 
338.33 	is decreased $4,550,000 in fiscal year 2012 
338.34 	and $4,550,000 in fiscal year 2013. The state 
338.35 	government special revenue fund base is 
339.1 	increased $4,500,000 in fiscal year 2012 and 
339.2 	$4,500,000 in fiscal year 2013.

339.3	(c) Management Operations

339.4	Appropriations by Fund
	
339.5	General
	4,715,000
	4,715,000
	
339.6	Health Care Access
	242,000
	242,000

339.7	(d) Information Technology Operations

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

339.11
339.12	Subd. 3.Revenue and Pass-Through Revenue 
Expenditures
 		65,746,000
		92,748,000
	
339.13 	This appropriation is from the federal TANF 
339.14 	fund.

339.15
339.16	Subd. 4.Children and Economic Assistance 
Grants
 					
339.17 	The amounts that may be spent from this 
339.18 	appropriation for each purpose are as follows:

339.19	(a) MFIP/DWP Grants

339.20	Appropriations by Fund
	
339.21	General
	68,634,000
	98,587,000
	
339.22	Federal TANF
	96,333,000
	64,709,000

339.23	(b) Support Services Grants

339.24	Appropriations by Fund
	
339.25	General
	8,715,000
	8,715,000
	
339.26	Federal TANF
	113,711,000
	99,111,000
	
339.27 	MFIP Consolidated Fund. The MFIP 
339.28 	consolidated fund TANF appropriation is 
339.29 	reduced by $5,500,000 in fiscal year 2011.
339.30 	TANF Emergency Fund; Nonrecurrent 
339.31 	Short-Term Benefits. TANF Emergency 
339.32 	Contingency fund grants received due to 
339.33 	increases in expenditures for nonrecurrent 
339.34 	short-term benefits must be used to offset the 
340.1 	increase in these expenditures for counties 
340.2 	under the MFIP consolidated fund under 
340.3 	Minnesota Statutes, section 256J.626, 
340.4 	and the diversionary work program. The 
340.5 	commissioner shall develop procedures 
340.6 	to maximize reimbursement of these 
340.7 	expenditures over the TANF emergency fund 
340.8 	base year quarters.

340.9	(c) MFIP Child Care Assistance Grants
		0
		(25,680,000)
	
340.10 	ARRA Child Care and Development Block 
340.11 	Grant Funds. The funds available from the 
340.12 	child care development block grant under 
340.13 	the American Recovery and Reinvestment 
340.14 	Act of 2009 (ARRA) must be used for MFIP 
340.15 	child care to the extent that those funds are 
340.16 	not earmarked for quality expansion or to 
340.17 	improve the quality of infant and toddler 
340.18 	care.

340.19	(d) Child Care Development Grants
		4,000
		4,000

340.20	(e) Child Support Enforcement Grants
		3,705,000
		3,705,000

340.21	(f) Children's Services Grants

340.22	Appropriations by Fund
	
340.23	General
	47,533,000
	50,498,000
	
340.24	Federal TANF
	340,000
	240,000
	
340.25 	Base Adjustment. The general fund base is 
340.26 	increased by $3,094,000 in fiscal year 2012 
340.27 	and $18,907,000 in fiscal year 2013.
340.28 	Privatized Adoption Grants. Federal 
340.29 	reimbursement for privatized adoption grant 
340.30 	and foster care recruitment grant expenditures 
340.31 	is appropriated to the commissioner for 
340.32 	adoption grants and foster care and adoption 
340.33 	administrative purposes.
341.1 	Adoption Assistance Incentive Grants.
341.2 	Federal funds available during fiscal year 
341.3 	2010 and fiscal year 2011 for the adoption 
341.4 	incentive grants are appropriated to the 
341.5 	commissioner for these purposes.
341.6 	Adoption Assistance and Relative Custody 
341.7 	Assistance. The commissioner may transfer 
341.8 	unencumbered appropriation balances for 
341.9 	adoption assistance and relative custody 
341.10 	assistance between fiscal years and between 
341.11 	programs.

341.12	(g) Children and Community Services Grants
		67,604,000
		67,463,000
	
341.13 	Targeted Case Management Temporary 
341.14 	Funding Adjustment. The commissioner 
341.15 	shall recover from each county and tribe 
341.16 	receiving a targeted case management 
341.17 	temporary funding payment in fiscal year 
341.18 	2008 an amount equal to that payment. The 
341.19 	commissioner shall recover one-half of the 
341.20 	funds by February 1, 2010, and the remainder 
341.21 	by February 1, 2011. At the commissioner's 
341.22 	discretion and at the request of a county 
341.23 	or tribe, the commissioner may revise 
341.24 	the payment schedule, but full payment 
341.25 	must not be delayed beyond May 1, 2011. 
341.26 	The commissioner may use the recovery 
341.27 	procedure under Minnesota Statutes, section 
341.28 	256.017, to recover the funds. Recovered 
341.29 	funds must be deposited into the general 
341.30 	fund.

341.31	(h) General Assistance Grants
		49,315,000
		49,708,000
	
341.32 	General Assistance Standard. The 
341.33 	commissioner shall set the monthly standard 
341.34 	of assistance for general assistance units 
341.35 	consisting of an adult recipient who is 
342.1 	childless and unmarried or living apart 
342.2 	from parents or a legal guardian at $203. 
342.3 	The commissioner may reduce this amount 
342.4 	according to Laws 1997, chapter 85, article 
342.5 	3, section 54.
342.6 	Combining Emergency Assistance for 
342.7 	MSA and GA. The amount appropriated 
342.8 	for emergency general assistance funds is 
342.9 	limited to no more than $8,989,812 in fiscal 
342.10 	year 2010 and $8,989,812 in fiscal year 2011. 
342.11 	Funds to counties must be allocated by the 
342.12 	commissioner using the allocation method 
342.13 	specified in Minnesota Statutes, section 
342.14 	256D.06.

342.15	(i) Minnesota Supplemental Aid Grants
		32,830,000
		34,091,000

342.16	(j) Group Residential Housing Grants
		111,689,000
		113,937,000

342.17
342.18	(k) Other Children and Economic Assistance 
Grants
		285,000
		569,000

342.19	(l) Children's Mental Health Grants
		16,885,000
		16,882,000
	
342.20 	Funding Usage. Up to 75 percent of a fiscal 
342.21 	year's appropriation for children's mental 
342.22 	health grants may be used to fund allocations 
342.23 	in that portion of the fiscal year ending 
342.24 	December 31.

342.25
342.26	Subd. 5.Children and Economic Assistance 
Management
 					
342.27 	The amounts that may be spent from the 
342.28 	appropriation for each purpose are as follows:

342.29
342.30	(a) Children and Economic Assistance 
Administration

342.31	Appropriations by Fund
	
342.32	General
	10,218,000
	10,208,000
	
342.33	Federal TANF
	496,000
	496,000

342.34
342.35	(b) Children and Economic Assistance 
Operations

343.1	Appropriations by Fund
	
343.2	General
	33,773,000
	33,423,000
	
343.3	Health Care Access
	361,000
	361,000
	
343.4 	Financial Institution Data Match and 
343.5 	Payment of Fees. The commissioner is 
343.6 	authorized to allocate up to $310,000 each 
343.7 	year in fiscal years 2010 and 2011 from the 
343.8 	PRISM special revenue account to make 
343.9 	payments to financial institutions in exchange 
343.10 	for performing data matches between account 
343.11 	information held by financial institutions 
343.12 	and the public authority's database of child 
343.13 	support obligors as authorized by Minnesota 
343.14 	Statutes, section 13B.06, subdivision 7.

343.15	Subd. 6.Basic Health Care Grants
 					
343.16 	ARRA Food Support Administration.
343.17 	The funds available for food support 
343.18 	administration under American Recovery 
343.19 	and Reinvestment Act of 2009 must 
343.20 	be appropriated to the commissioner 
343.21 	for implementing the food support benefit 
343.22 	increases, increased eligibility determinations 
343.23 	and outreach. Of these funds, 20 percent 
343.24 	shall be allocated to the commissioner and 
343.25 	80 percent must be allocated to counties. 
343.26 	The commissioner shall reimburse counties 
343.27 	proportionate to their food support caseload 
343.28 	based on data for the most recent quarter 
343.29 	available. Tribal reimbursement must be 
343.30 	made from  the state portion based on a 
343.31 	caseload factor equivalent to that of a county.
343.32 	The amounts that may be spent from this 
343.33 	appropriation for each purpose are as follows:

343.34	(a) MinnesotaCare Grants
		414,258,000
		513,994,000
	
344.1 	This appropriation is from the health care 
344.2 	access fund.

344.3
344.4	(b) MA Basic Health Care Grants - Families 
and Children
		755,064,000
		1,002,267,000
	
344.5 	Medical Education Research Costs 
344.6 	(MERC). Of these funds, the commissioner 
344.7 	of human services shall transfer $38,000,000 
344.8 	in fiscal year 2010 to the medical education 
344.9 	research fund. These funds must restore the 
344.10 	fiscal year 2009 unallotment of the transfers 
344.11 	under Minnesota Statutes, section 256B.69, 
344.12 	subdivision 5c, paragraph (a), for the July 1, 
344.13 	2008, through June 30, 2009, period.
344.14 	Local Share Payment Modification 
344.15 	Required for ARRA Compliance.
344.16 	Effective retroactively from October 1, 2008, 
344.17 	to June 30, 2009, the state shall reduce 
344.18 	Hennepin County's monthly contribution to 
344.19 	the nonfederal share of medical assistance 
344.20 	costs to the percentage required on September 
344.21 	1, 2008, to meet federal requirements for 
344.22 	enhanced federal match under the American 
344.23 	Reinvestment and Recovery Act of 2009. 
344.24 	Notwithstanding the requirements of 
344.25 	Minnesota Statutes 2008, section 256B.19, 
344.26 	subdivision 1c, paragraph (d), for the period 
344.27 	beginning October 1, 2008, to June 30, 2009, 
344.28 	Hennepin County's monthly payment under 
344.29 	that provision is reduced to $434,688.
344.30 	Capitation Payments. Effective 
344.31 	retroactively from October 1, 2008, to 
344.32 	December 31, 2010, and notwithstanding 
344.33 	the requirements of Minnesota Statutes 
344.34 	2008, section 256B.19, subdivision 1c, 
344.35 	paragraph (c), the commissioner of human 
344.36 	services shall increase capitation payments 
345.1 	made to the Metropolitan Health Plan 
345.2 	under Minnesota Statutes 2008, section 
345.3 	256B.69, by $6,800,000 to recognize higher 
345.4 	than average medical education costs. The 
345.5 	increased amount includes federal matching 
345.6 	money.

345.7
345.8	(c) MA Basic Health Care Grants - Elderly and 
Disabled
		969,013,000
		1,177,139,000
	
345.9 	Minnesota Disability Health Options. 
345.10 	Notwithstanding Minnesota Statutes, section 
345.11 	256B.69, subdivision 5a, paragraph (b), 
345.12 	for the period beginning July 1, 2009, to 
345.13 	June 30, 2011, the monthly enrollment of 
345.14 	people receiving home and community-based 
345.15 	waivered services under Minnesota Disability 
345.16 	Health Options shall not exceed 1,000. If 
345.17 	the budget neutrality provision in Minnesota 
345.18 	Statutes, section 256B.69, subdivision 23, 
345.19 	paragraph (f), is reached prior to June 30, 
345.20 	2011, the commissioner may waive this 
345.21 	monthly enrollment requirement.

345.22	(d) General Assistance Medical Care Grants

345.23	Appropriations by Fund
	
345.24	General
	252,061,000
	380,555,000
	
345.25	Federal
	99,300,000
	0
	
345.26 	Use of Federal Funds. $99,300,000 in fiscal 
345.27 	year 2010 is appropriated from the fiscal 
345.28 	stabilization funds in the federal fund. This 
345.29 	is a onetime appropriation.

345.30	(e) Other Health Care Grants

345.31	Appropriations by Fund
	
345.32	General
	295,000
	295,000
	
345.33	Health Care Access
	940,000
	190,000

345.34	Subd. 7.Health Care Management
 					
346.1 	The amounts that may be spent from the 
346.2 	appropriation for each purpose are as follows:

346.3	(a) Health Care Administration

346.4	Appropriations by Fund
	
346.5	General
	7,779,000
	7,535,000
	
346.6	Health Care Access
	1,812,000
	906,000

346.7	(b) Health Care Operations

346.8	Appropriations by Fund
	
346.9	General
	19,902,000
	18,869,000
	
346.10	Health Care Access
	24,753,000
	25,578,000
	
346.11 	Base Adjustment. The health care access 
346.12 	fund base is decreased by $62,000 in fiscal 
346.13 	year 2012 and $149,000 in fiscal year 2013. 
346.14 	The general fund base is decreased by 
346.15 	$157,000 in fiscal year 2012 and $157,000 in 
346.16 	fiscal year 2013.

346.17	Subd. 8.Continuing Care Grants
 					
346.18 	The amounts that may be spent from the 
346.19 	appropriation for each purpose are as follows:

346.20	(a) Aging and Adult Services Grants

346.21	Appropriations by Fund
	
346.22	General
	13,186,000
	13,702,000
	
346.23	Federal
	500,000
	0
	
346.24 	Base Adjustment. The general fund base is 
346.25 	increased by $6,643,000 in fiscal year 2012 
346.26 	and $7,511,000 in fiscal year 2013.
346.27 	Information and Assistance 
346.28 	Reimbursement. Federal administrative 
346.29 	reimbursement obtained from information 
346.30 	and assistance services provided by the 
346.31 	Senior LinkAge or Disability Linkage lines 
346.32 	to people who are identified as eligible for 
346.33 	medical assistance shall be appropriated to 
346.34 	the commissioner for this activity.
347.1 	Community Service Development Grant 
347.2 	Reduction. Funding for community service 
347.3 	development grants must be reduced by 
347.4 	$240,000 per year for fiscal years 2010 and 
347.5 	2011. This reduction shall not adjust the base 
347.6 	appropriation.
347.7 	Senior Nutrition Use of Federal Funds.
347.8 	For fiscal year 2010, general fund grants 
347.9 	for home-delivered meals shall be reduced 
347.10 	by $250,000 and general fund grants for 
347.11 	congregate dining shall be reduced by 
347.12 	$250,000. The commissioner must replace 
347.13 	these general fund reductions with equal 
347.14 	amounts from federal funding for senior 
347.15 	nutrition from the American Recovery and 
347.16 	Reinvestment Act of 2009.

347.17	(b) Alternative Care Grants
		51,165,000
		50,976,000
	
347.18 	Base Adjustment. The general fund base is 
347.19 	decreased by $6,068,000 in fiscal year 2012 
347.20 	and $6,449,000 in fiscal year 2013.
347.21 	Alternative Care Transfer. Any money 
347.22 	allocated to the alternative care program that 
347.23 	is not spent for the purposes indicated does 
347.24 	not cancel but must be transferred to the 
347.25 	medical assistance account.

347.26
347.27	(c) Medical Assistance Grants; Long-Term 
Care Facilities.
		366,293,000
		426,549,000

347.28
347.29	(d) Medical Assistance Long-Term Care 
Waivers and Home Care Grants
		853,824,000
		1,054,067,000
	
347.30 	Manage Growth in TBI and CADI 
347.31 	Waivers. During the fiscal years beginning 
347.32 	on July 1, 2011, and July 1, 2012, the 
347.33 	commissioner shall allocate money for home 
347.34 	and community-based waiver programs 
347.35 	under Minnesota Statutes, section 256B.49, 
348.1 	to ensure a reduction in state spending that is 
348.2 	equivalent to limiting the caseload growth of 
348.3 	the TBI waiver to 12.5 allocations per month 
348.4 	each year of the biennium and the CADI 
348.5 	waiver to 95 allocations per month each year 
348.6 	of the biennium. Limits do not apply: (1) 
348.7 	when there is an approved plan for nursing 
348.8 	facility bed closures for individuals under 
348.9 	age 65 who require relocation due to the 
348.10 	bed closure; (2) to fiscal year 2009 waiver 
348.11 	allocations delayed due to unallotment; or (3) 
348.12 	to transfers authorized by the commissioner 
348.13 	from the personal care assistance program 
348.14 	of individuals having a home care rating 
348.15 	of "CS," "MT," or "HL." Priorities for the 
348.16 	allocation of funds must be for individuals 
348.17 	anticipated to be discharged from institutional 
348.18 	settings or who are at imminent risk of a 
348.19 	placement in an institutional setting.
348.20 	Manage Growth in DD Waiver. The 
348.21 	commissioner shall manage the growth in 
348.22 	the DD waiver by limiting the allocations 
348.23 	included in the February 2009 forecast to 15 
348.24 	additional diversion allocations each month 
348.25 	for the calendar years that begin on January 
348.26 	1, 2012, and January 1, 2013. Additional 
348.27 	allocations must be made available for 
348.28 	transfers authorized by the commissioner 
348.29 	from the personal care program of individuals 
348.30 	having a home care rating of "CS," "MT," 
348.31 	or "HL."
348.32 	Adjustment to Lead Agency Waiver 
348.33 	allocations. Prior to the availability of the 
348.34 	alternative license defined in Minnesota 
348.35 	Statutes, section 245A.11, subdivision 8, 
348.36 	the commissioner shall reduce lead agency 
349.1 	waiver allocations for the purposes of 
349.2 	implementing a moratorium on corporate 
349.3 	foster care.

349.4	(e) Mental Health Grants

349.5	Appropriations by Fund
	
349.6	General
	75,089,000
	77,539,000
	
349.7	Health Care Access
	750,000
	750,000
	
349.8	Lottery Prize
	1,508,000
	1,508,000
	
349.9 	Funding Usage. Up to 75 percent of a fiscal 
349.10 	year's appropriation for adult mental health 
349.11 	grants may be used to fund allocations in that 
349.12 	portion of the fiscal year ending December 
349.13 	31.
349.14 	Base Adjustment. The general fund base is 
349.15 	reduced by $525,000 in fiscal year 2012 and 
349.16 	$525,000 is fiscal year 2013.

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

349.18	(g) Chemical Dependency Entitlement Grants
		109,989,000
		120,133,000
	
349.19 	Payments for Substance Abuse Treatment.
349.20 	For services provided in fiscal years 2010 
349.21 	and 2011, county-negotiated rates and 
349.22 	provider claims to the consolidated chemical 
349.23 	dependency fund must not exceed rates 
349.24 	charged for services in excess of those 
349.25 	in effect on January 1, 2009. If statutes 
349.26 	authorize a cost-of-living adjustment 
349.27 	during fiscal years 2010 and 2011, then 
349.28 	notwithstanding any law to the contrary, 
349.29 	fiscal years 2010 and 2011 rates must 
349.30 	not exceed those in effect on January 2, 
349.31 	2009, plus any authorized cost-of-living 
349.32 	adjustments.
349.33 	Chemical Dependency Special Revenue 
349.34 	Account. For fiscal year 2010, $750,000 
350.1 	must be transferred from the consolidated 
350.2 	chemical dependency treatment fund 
350.3 	administrative account and deposited into the 
350.4 	general fund by September 1, 2010.

350.5
350.6	(h) Chemical Dependency Nonentitlement 
Grants
		1,729,000
		1,729,000

350.7	(i) Other Continuing Care Grants
		17,958,000
		11,941,000
	
350.8 	Base Adjustment. The general fund base is 
350.9 	increased $424,000 in fiscal year 2012 and 
350.10 	decreased $505,000 in fiscal year 2013.
350.11 	Other Continuing Care Grants; HIV 
350.12 	Grants. Money appropriated for the HIV 
350.13 	drug and insurance grant program in fiscal 
350.14 	year 2010 may be used in either year of the 
350.15 	biennium.

350.16	Subd. 9.Continuing Care Management

350.17	Appropriations by Fund
	
350.18	General
	21,775,000
	21,119,000
	
350.19
350.20	State Government 
Special Revenue
	875,000
	125,000
	
350.21	Lottery Prize
	157,000
	157,000
	
350.22 	County Maintenance of Effort. $350,000 in 
350.23 	fiscal year 2010 is from the general fund for 
350.24 	the State-County Results Accountability and 
350.25 	Service Delivery Reform under Minnesota 
350.26 	Statutes, chapter 402A.
350.27 	The general fund base is increased 
350.28 	$1,000,000 in fiscal year 2012 and $950,000 
350.29 	in fiscal year 2013.

350.30	Subd. 10.State-Operated Services
 		255,484,000
		262,881,000
	
350.31 	The amounts that may be spent from the 
350.32 	appropriation for each purpose are as follows:
350.33 	Transfer Authority Related to 
350.34 	State-Operated Services. Money 
351.1 	appropriated to finance state-operated 
351.2 	services may be transferred between the 
351.3 	fiscal years of the biennium with the approval 
351.4 	of the commissioner of finance.
351.5 	County Past Due Receivables. The 
351.6 	commissioner is authorized to withhold 
351.7 	county federal administrative reimbursement 
351.8 	when the county of financial responsibility 
351.9 	for cost-of-care payments due the state 
351.10 	under Minnesota Statutes, section 246.54 
351.11 	or 253B.045, is 90 days past due. The 
351.12 	commissioner shall deposit the withheld 
351.13 	federal administrative earnings for the county 
351.14 	into the general fund to settle the claims with 
351.15 	the county of financial responsibility. The 
351.16 	process for withholding funds is governed by 
351.17 	Minnesota Statutes, section 256.017.

351.18	(a) Adult Mental Health Services
		106,906,000
		111,643,000
	
351.19 	Appropriation Limitation. No part of 
351.20 	the appropriation in this article to the 
351.21 	commissioner for mental health treatment 
351.22 	services provided by state-operated services 
351.23 	shall be used for the Minnesota sex offender 
351.24 	program.
351.25 	Community Behavioral Health Hospitals.
351.26 	Under Minnesota Statutes, section 246.51, 
351.27 	subdivision 1, a determination order for the 
351.28 	clients served in a community behavioral 
351.29 	health hospital operated by the commissioner 
351.30 	of human services is only required when 
351.31 	a client's third-party coverage has been 
351.32 	exhausted.

351.33	(b) Minnesota Sex Offender Services
		64,843,000
		67,503,000

352.1
352.2
352.3	(c) Minnesota Security 
Hospital and METO 
Services
				83,735,000
		83,735,000
	
352.4 	Minnesota Security Hospital.  For the 
352.5 	purposes of enhancing the safety of 
352.6 	the public, improving supervision, and 
352.7 	enhancing community-based mental health 
352.8 	treatment, state-operated services may 
352.9 	establish additional community capacity 
352.10 	for providing treatment and supervision 
352.11 	of clients who have been ordered into a 
352.12 	less restrictive alternative of care from the 
352.13 	state-operated services transitional services 
352.14 	program consistent with Minnesota Statutes, 
352.15 	section 246.014.
352.16 	Base Adjustment. The general fund base is 
352.17 	increased by $18,000 in fiscal year 2012.

352.18	Sec. 4. COMMISSIONER OF HEALTH

352.19	Subdivision 1.Total Appropriation
 	$
	40,097,000
	$
	34,452,000

352.20	Appropriations by Fund
	
352.21		2010
	2011
	
352.22	General
	12,841,000
	8,801,000
	
352.23
352.24	State Government 
Special Revenue
	14,173,000
	14,276,000
	
352.25	Health Care Access
	13,083,000
	11,375,000

352.26	Subd. 2.Policy Quality and Compliance

352.27	Appropriations by Fund
	
352.28	General
	12,841,000
	8,801,000
	
352.29
352.30	State Government 
Special Revenue
	14,173,000
	14,276,000
	
352.31	Health Care Access
	13,083,000
	11,375,000
	
352.32 	Value-Based Insurance Designs. The 
352.33 	commissioner of health, in consultation 
352.34 	with the commissioner of human services, 
352.35 	commerce, and Minnesota management 
352.36 	and budget, shall study and report to the 
353.1 	legislature on value-based insurance designs 
353.2 	that vary enrollee cost-sharing based on 
353.3 	clinical or cost-effectiveness of services. 
353.4 	In performing this study, the commissioner 
353.5 	shall consult with and seek input from 
353.6 	health plans, health care providers, and 
353.7 	employers. The commissioner shall report to 
353.8 	the legislature by January 15, 2010.
353.9 	Health Information Technology. Of the 
353.10 	general fund appropriation, $4,000,000 is 
353.11 	to fund the revolving loan account under 
353.12 	Minnesota Statutes, section 62J.496.  This 
353.13 	appropriation must not be expended unless 
353.14 	it is matched with federal funding under the 
353.15 	federal Health Information Technology for 
353.16 	Economic and Clinical Health (HITECH) 
353.17 	Act. This appropriation must not be included 
353.18 	in the agency's base budget for the fiscal year 
353.19 	beginning July 1, 2012.
353.20 	Base Adjustment. The general fund 
353.21 	base is $8,801,000 in fiscal year 2012 and 
353.22 	$8,593,000 in fiscal year 2013. The health 
353.23 	care access fund base is $10,775,000 in fiscal 
353.24 	year 2012 and $6,641,000 in fiscal year 2013. 
353.25 	The state government special revenue fund 
353.26 	base is $14,234,000 for each of fiscal years 
353.27 	2012 and 2013.

353.28 	Sec. 5. Laws 2007, chapter 147, article 19, section 3, subdivision 4, as amended by 
353.29 	Laws 2008, chapter 277, article 5, section 1; and Laws 2008, chapter 363, article 18, 
353.30 	section 7, is amended to read:

353.31
353.32	Subd. 4. Children and Economic Assistance 
Grants
 					
353.33 	The amounts that may be spent from this 
353.34 	appropriation for each purpose are as follows: 

354.1	(a) MFIP/DWP Grants 

354.2	Appropriations by Fund 
	
354.3	General 
	62,069,000 
	62,405,000 
	
354.4	Federal TANF 
	75,904,000 
	80,841,000 

354.5	(b) Support Services Grants 

354.6	Appropriations by Fund 
	
354.7	General 
	8,715,000 
	8,715,000 
	
354.8	Federal TANF 
	113,429,000 
	115,902,000 
	
354.9 	TANF Prior Appropriation Cancellation.
354.10 	Notwithstanding Laws 2001, First Special 
354.11 	Session chapter 9, article 17, section 
354.12 	2, subdivision 11, paragraph (b), any 
354.13 	unexpended TANF funds appropriated to the 
354.14 	commissioner to contract with the Board of 
354.15 	Trustees of Minnesota State Colleges and 
354.16 	Universities, to provide tuition waivers to 
354.17 	employees of health care and human service 
354.18 	providers that are members of qualifying 
354.19 	consortia operating under Minnesota 
354.20 	Statutes, sections 116L.10 to 116L.15, must 
354.21 	cancel at the end of fiscal year 2007. 
354.22 	MFIP Pilot Program. Of the TANF 
354.23 	appropriation, $100,000 in fiscal year 2008 
354.24 	and $750,000 in fiscal year 2009 are for a 
354.25 	grant to the Stearns-Benton Employment and 
354.26 	Training Council for the Workforce U pilot 
354.27 	program. Base level funding for this program 
354.28 	shall be $750,000 in 2010 and $0 in 2011. 
354.29 	Supported Work. (1) Of the TANF 
354.30 	appropriation, $5,468,000 in fiscal year 2008 
354.31 	is for supported work for MFIP participants, 
354.32 	to be allocated to counties and tribes based 
354.33 	on the criteria under clauses (2) and (3), and 
354.34 	is available until expended. Paid transitional 
354.35 	work experience and other supported 
355.1 	employment under this rider provides 
355.2 	a continuum of employment assistance, 
355.3 	including outreach and recruitment, 
355.4 	program orientation and intake, testing and 
355.5 	assessment, job development and marketing, 
355.6 	preworksite training, supported worksite 
355.7 	experience, job coaching, and postplacement 
355.8 	follow-up, in addition to extensive case 
355.9 	management and referral services. * (The 
355.10 	preceding text "and $7,291,000 in fiscal 
355.11 	year 2009" was indicated as vetoed by the 
355.12 	governor.) 
355.13 	(2) A county or tribe is eligible to receive an 
355.14 	allocation under this rider if: 
355.15 	(i) the county or tribe is not meeting the 
355.16 	federal work participation rate; 
355.17 	(ii) the county or tribe has participants who 
355.18 	are required to perform work activities under 
355.19 	Minnesota Statutes, chapter 256J, but are not 
355.20 	meeting hourly work requirements; and 
355.21 	(iii) the county or tribe has assessed 
355.22 	participants who have completed six weeks 
355.23 	of job search or are required to perform 
355.24 	work activities and are not meeting the 
355.25 	hourly requirements, and the county or tribe 
355.26 	has determined that the participant would 
355.27 	benefit from working in a supported work 
355.28 	environment. 
355.29 	(3) A county or tribe may also be eligible for 
355.30 	funds in order to contract for supplemental 
355.31 	hours of paid work at the participant's child's 
355.32 	place of education, child care location, or the 
355.33 	child's physical or mental health treatment 
355.34 	facility or office. This grant to counties and 
355.35 	tribes is specifically for MFIP participants 
356.1 	who need to work up to five hours more 
356.2 	per week in order to meet the hourly work 
356.3 	requirement, and the participant's employer 
356.4 	cannot or will not offer more hours to the 
356.5 	participant. 
356.6 	Work Study. Of the TANF appropriation, 
356.7 	$750,000 each year are to the commissioner 
356.8 	to contract with the Minnesota Office of 
356.9 	Higher Education for the biennium beginning 
356.10 	July 1, 2007, for work study grants under 
356.11 	Minnesota Statutes, section 136A.233, 
356.12 	specifically for low-income individuals who 
356.13 	receive assistance under Minnesota Statutes, 
356.14 	chapter 256J, and for grants to opportunities 
356.15 	industrialization centers. * (The preceding 
356.16 	text beginning "Work Study. Of the TANF 
356.17 	appropriation," was indicated as vetoed 
356.18 	by the governor.) 
356.19 	Integrated Service Projects. $2,500,000 
356.20 	in fiscal year 2008 and $2,500,000 in fiscal 
356.21 	year 2009 are appropriated from the TANF 
356.22 	fund to the commissioner to continue to 
356.23 	fund the existing integrated services projects 
356.24 	for MFIP families, and if funding allows, 
356.25 	additional similar projects. 
356.26 	Base Adjustment. The TANF base for fiscal 
356.27 	year 2010 is $115,902,000 and for fiscal year 
356.28 	2011 is $115,152,000. 

356.29	(c) MFIP Child Care Assistance Grants 

356.30	General 
	74,654,000 
	71,951,000 

356.31
356.32	(d) Basic Sliding Fee Child Care Assistance 
Grants 

356.33	General 
	42,995,000 
	45,008,000 
	
357.1 	Base Adjustment. The general fund base 
357.2 	is $44,881,000 for fiscal year 2010 and 
357.3 	$44,852,000 for fiscal year 2011. 
357.4 	At-Home Infant Care Program. No 
357.5 	funding shall be allocated to or spent on 
357.6 	the at-home infant care program under 
357.7 	Minnesota Statutes, section 119B.035. 

357.8	(e) Child Care Development Grants 

357.9	General 
	4,390,000 
	6,390,000 
	
357.10 	Prekindergarten Exploratory Projects. Of 
357.11 	the general fund appropriation, $2,000,000 
357.12 	the first year and $4,000,000 the second 
357.13 	year are for grants to the city of St. Paul, 
357.14 	Hennepin County, and Blue Earth County to 
357.15 	establish scholarship demonstration projects 
357.16 	to be conducted in partnership with the 
357.17 	Minnesota Early Learning Foundation to 
357.18 	promote children's school readiness. This 
357.19 	appropriation is available until June 30, 2009. 
357.20 	Child Care Services Grants. Of this 
357.21 	appropriation, $250,000 each year are for 
357.22 	the purpose of providing child care services 
357.23 	grants under Minnesota Statutes, section 
357.24 	119B.21, subdivision 5. This appropriation 
357.25 	is for the 2008-2009 biennium only, and does 
357.26 	not increase the base funding. 
357.27 	Early Childhood Professional 
357.28 	Development System. Of this appropriation, 
357.29 	$250,000 each year are for purposes of the 
357.30 	early childhood professional development 
357.31 	system, which increases the quality and 
357.32 	continuum of professional development 
357.33 	opportunities for child care practitioners. 
357.34 	This appropriation is for the 2008-2009 
358.1 	biennium only, and does not increase the 
358.2 	base funding. 
358.3 	Base Adjustment. The general fund base 
358.4 	is $1,515,000 for each of fiscal years 2010 
358.5 	and 2011. 

358.6	(f) Child Support Enforcement Grants 

358.7	General 
	11,038,000 
	3,705,000 
	
358.8 	Child Support Enforcement. $7,333,000 
358.9 	for fiscal year 2008 is to make grants to 
358.10 	counties for child support enforcement 
358.11 	programs to make up for the loss under the 
358.12 	2005 federal Deficit Reduction Act of federal 
358.13 	matching funds for federal incentive funds 
358.14 	passed on to the counties by the state. 
358.15 	This appropriation is available until June 30, 
358.16 	2009. 

358.17	(g) Children's Services Grants 

358.18	Appropriations by Fund 
	
358.19	General 
	63,647,000 
	71,147,000 
	
358.20	Health Care Access 
	250,000 
	-0- 
	
358.21	TANF 
	240,000 
	340,000 
	
358.22 	Grants for Programs Serving Young 
358.23 	Parents. Of the TANF fund appropriation, 
358.24 	$140,000 each year is for a grant to a program 
358.25 	or programs that provide comprehensive 
358.26 	services through a private, nonprofit agency 
358.27 	to young parents in Hennepin County who 
358.28 	have dropped out of school and are receiving 
358.29 	public assistance. The program administrator 
358.30 	shall report annually to the commissioner on 
358.31 	skills development, education, job training, 
358.32 	and job placement outcomes for program 
358.33 	participants. 
359.1 	County Allocations for Rate Increases.
359.2 	County Children and Community Services 
359.3 	Act allocations shall be increased by 
359.4 	$197,000 effective October 1, 2007, and 
359.5 	$696,000 effective October 1, 2008, to help 
359.6 	counties pay for the rate adjustments to 
359.7 	day training and habilitation providers for 
359.8 	participants paid by county social service 
359.9 	funds. Notwithstanding the provisions of 
359.10 	Minnesota Statutes, section 256M.40, the 
359.11 	allocation to a county shall be based on 
359.12 	the county's proportion of social services 
359.13 	spending for day training and habilitation 
359.14 	services as determined in the most recent 
359.15 	social services expenditure and grant 
359.16 	reconciliation report. 
359.17 	Privatized Adoption Grants. Federal 
359.18 	reimbursement for privatized adoption grant 
359.19 	and foster care recruitment grant expenditures 
359.20 	is appropriated to the commissioner for 
359.21 	adoption grants and foster care and adoption 
359.22 	administrative purposes. 
359.23 	Adoption Assistance Incentive Grants.
359.24 	Federal funds available during fiscal year 
359.25 	2008 and fiscal year 2009 for the adoption 
359.26 	incentive grants are appropriated to the 
359.27 	commissioner for these purposes. 
359.28 	Adoption Assistance and Relative Custody 
359.29 	Assistance. The commissioner may transfer 
359.30 	unencumbered appropriation balances for 
359.31 	adoption assistance and relative custody 
359.32 	assistance between fiscal years and between 
359.33 	programs. 
359.34 	Children's Mental Health Grants. Of the 
359.35 	general fund appropriation, $5,913,000 in 
360.1 	fiscal year 2008 and $6,825,000 in fiscal year 
360.2 	2009 are for children's mental health grants. 
360.3 	The purpose of these grants is to increase and 
360.4 	maintain the state's children's mental health 
360.5 	service capacity, especially for school-based 
360.6 	mental health services. The commissioner 
360.7 	shall require grantees to utilize all available 
360.8 	third party reimbursement sources as a 
360.9 	condition of using state grant funds. At 
360.10 	least 15 percent of these funds shall be 
360.11 	used to encourage efficiencies through early 
360.12 	intervention services. At least another 15 
360.13 	percent shall be used to provide respite care 
360.14 	services for children with severe emotional 
360.15 	disturbance at risk of out-of-home placement. 
360.16 	Mental Health Crisis Services. Of the 
360.17 	general fund appropriation, $2,528,000 in 
360.18 	fiscal year 2008 and $2,850,000 in fiscal year 
360.19 	2009 are for statewide funding of children's 
360.20 	mental health crisis services. Providers must 
360.21 	utilize all available funding streams. 
360.22 	Children's Mental Health Evidence-Based 
360.23 	and Best Practices. Of the general fund 
360.24 	appropriation, $375,000 in fiscal year 2008 
360.25 	and $750,000 in fiscal year 2009 are for 
360.26 	children's mental health evidence-based and 
360.27 	best practices including, but not limited 
360.28 	to: Adolescent Integrated Dual Diagnosis 
360.29 	Treatment services; school-based mental 
360.30 	health services; co-location of mental 
360.31 	health and physical health care, and; the 
360.32 	use of technological resources to better 
360.33 	inform diagnosis and development of 
360.34 	treatment plan development by mental 
360.35 	health professionals. The commissioner 
360.36 	shall require grantees to utilize all available 
361.1 	third-party reimbursement sources as a 
361.2 	condition of using state grant funds. 
361.3 	Culturally Specific Mental Health 
361.4 	Treatment Grants. Of the general fund 
361.5 	appropriation, $75,000 in fiscal year 2008 
361.6 	and $300,000 in fiscal year 2009 are for 
361.7 	children's mental health grants to support 
361.8 	increased availability of mental health 
361.9 	services for persons from cultural and 
361.10 	ethnic minorities within the state. The 
361.11 	commissioner shall use at least 20 percent 
361.12 	of these funds to help members of cultural 
361.13 	and ethnic minority communities to become 
361.14 	qualified mental health professionals and 
361.15 	practitioners. The commissioner shall assist 
361.16 	grantees to meet third-party credentialing 
361.17 	requirements and require them to utilize all 
361.18 	available third-party reimbursement sources 
361.19 	as a condition of using state grant funds. 
361.20 	Mental Health Services for Children with 
361.21 	Special Treatment Needs. Of the general 
361.22 	fund appropriation, $50,000 in fiscal year 
361.23 	2008 and $200,000 in fiscal year 2009 are 
361.24 	for children's mental health grants to support 
361.25 	increased availability of mental health 
361.26 	services for children with special treatment 
361.27 	needs. These shall include, but not be limited 
361.28 	to: victims of trauma, including children 
361.29 	subjected to abuse or neglect, veterans and 
361.30 	their families, and refugee populations; 
361.31 	persons with complex treatment needs, such 
361.32 	as eating disorders; and those with low 
361.33 	incidence disorders. 
361.34 	MFIP and Children's Mental Health 
361.35 	Pilot Project. Of the TANF appropriation, 
362.1 	$100,000 in fiscal year 2008 and $200,000 
362.2 	in fiscal year 2009 are to fund the MFIP 
362.3 	and children's mental health pilot project. 
362.4 	Of these amounts, up to $100,000 may be 
362.5 	expended on evaluation of this pilot. 
362.6 	Prenatal Alcohol or Drug Use. Of the 
362.7 	general fund appropriation, $75,000 each 
362.8 	year is to award grants beginning July 1, 
362.9 	2007, to programs that provide services 
362.10 	under Minnesota Statutes, section 254A.171, 
362.11 	in Pine, Kanabec, and Carlton Counties. This 
362.12 	appropriation shall become part of the base 
362.13 	appropriation.
362.14 	Base Adjustment. The general fund base 
362.15 	is $62,572,000 in fiscal year 2010 and 
362.16 	$62,575,000 in fiscal year 2011.

362.17	(h) Children and Community Services Grants

362.18	General
	101,369,000 
	69,208,000 
	
362.19 	Base Adjustment. The general fund base 
362.20 	is $69,274,000 in each of fiscal years 2010 
362.21 	and 2011.
362.22 	Targeted Case Management Temporary 
362.23 	Funding. (a) Of the general fund 
362.24 	appropriation, $32,667,000 in fiscal year 
362.25 	2008 is transferred to the targeted case 
362.26 	management contingency reserve account in 
362.27 	the general fund to be allocated to counties 
362.28 	and tribes affected by reductions in targeted 
362.29 	case management federal Medicaid revenue 
362.30 	as a result of the provisions in the federal 
362.31 	Deficit Reduction Act of 2005, Public Law 
362.32 	109-171. 
362.33 	(b) Contingent upon (1) publication by the 
362.34 	federal Centers for Medicare and Medicaid 
363.1 	Services of final regulations implementing 
363.2 	the targeted case management provisions 
363.3 	of the federal Deficit Reduction Act of 
363.4 	2005, Public Law 109-171, or (2) the 
363.5 	issuance of a finding by the Centers for 
363.6 	Medicare and Medicaid Services of federal 
363.7 	Medicaid overpayments for targeted case 
363.8 	management expenditures, up to $32,667,000 
363.9 	is appropriated to the commissioner of human 
363.10 	services. Prior to distribution of funds, the 
363.11 	commissioner shall estimate and certify the 
363.12 	amount by which the federal regulations or 
363.13 	federal disallowance will reduce targeted 
363.14 	case management Medicaid revenue over the 
363.15 	2008-2009 biennium. 
363.16 	(c) Within 60 days of a contingency described 
363.17 	in paragraph (b), the commissioner shall 
363.18 	distribute the grants proportionate to each 
363.19 	affected county or tribe's targeted case 
363.20 	management federal earnings for calendar 
363.21 	year 2005, not to exceed the lower of (1) the 
363.22 	amount of the estimated reduction in federal 
363.23 	revenue or (2) $32,667,000. 
363.24 	(d) These funds are available in either year of 
363.25 	the biennium. Counties and tribes shall use 
363.26 	these funds to pay for social service-related 
363.27 	costs, but the funds are not subject to 
363.28 	provisions of the Children and Community 
363.29 	Services Act grant under Minnesota Statutes, 
363.30 	chapter 256M. 
363.31 	(e) This appropriation shall be available to 
363.32 	pay counties and tribes for expenses incurred 
363.33 	on or after July 1, 2007. The appropriation 
363.34 	shall be available until expended. 

363.35	(i) General Assistance Grants 

364.1	General 
	37,876,000 
	38,253,000 
	
364.2 	General Assistance Standard. The 
364.3 	commissioner shall set the monthly standard 
364.4 	of assistance for general assistance units 
364.5 	consisting of an adult recipient who is 
364.6 	childless and unmarried or living apart 
364.7 	from parents or a legal guardian at $203. 
364.8 	The commissioner may reduce this amount 
364.9 	according to Laws 1997, chapter 85, article 
364.10 	3, section 54. 
364.11 	Emergency General Assistance. The 
364.12 	amount appropriated for emergency general 
364.13 	assistance funds is limited to no more 
364.14 	than $7,889,812 in fiscal year 2008 and 
364.15 	$7,889,812 in fiscal year 2009. Funds 
364.16 	to counties must be allocated by the 
364.17 	commissioner using the allocation method 
364.18 	specified in Minnesota Statutes, section 
364.19 	256D.06. 

364.20	(j) Minnesota Supplemental Aid Grants 

364.21	General 
	30,505,000 
	30,812,000 
	
364.22 	Emergency Minnesota Supplemental 
364.23 	Aid Funds. The amount appropriated for 
364.24 	emergency Minnesota supplemental aid 
364.25 	funds is limited to no more than $1,100,000 
364.26 	in fiscal year 2008 and $1,100,000 in fiscal 
364.27 	year 2009. Funds to counties must be 
364.28 	allocated by the commissioner using the 
364.29 	allocation method specified in Minnesota 
364.30 	Statutes, section 256D.46. 

364.31	(k) Group Residential Housing Grants 

364.32	General 
	91,069,000 
	98,671,000 
	
364.33 	People Incorporated. Of the general fund 
364.34 	appropriation, $460,000 each year is to 
365.1 	augment community support and mental 
365.2 	health services provided to individuals 
365.3 	residing in facilities under Minnesota 
365.4 	Statutes, section 256I.05, subdivision 1m. 

365.5
365.6	(l) Other Children and Economic Assistance 
Grants 

365.7	General 
	20,183,000 
	16,333,000 
	
365.8	Federal TANF 
	1,500,000 
	1,500,000 
	
365.9 	Base Adjustment. The general fund base 
365.10 	shall be $16,033,000 in fiscal year 2010 and 
365.11 	$15,533,000 in fiscal year 2011. The TANF 
365.12 	base shall be $1,500,000 in fiscal year 2010 
365.13 	and $1,181,000 in fiscal year 2011. 
365.14 	Homeless and Runaway Youth. Of the 
365.15 	general fund appropriation, $500,000 each 
365.16 	year are for the Runaway and Homeless 
365.17 	Youth Act under Minnesota Statutes, section 
365.18 	256K.45. Funds shall be spent in each area 
365.19 	of the continuum of care to ensure that 
365.20 	programs are meeting the greatest need. This 
365.21 	is a onetime appropriation. 
365.22 	Long-Term Homelessness. Of the general 
365.23 	fund appropriation, $2,000,000 in fiscal year 
365.24 	2008 is for implementation of programs 
365.25 	to address long-term homelessness and is 
365.26 	available in either year of the biennium. This 
365.27 	is a onetime appropriation. 
365.28 	Minnesota Community Action Grants. (a) 
365.29 	Of the general fund appropriation, $250,000 
365.30 	each year is for the purposes of Minnesota 
365.31 	community action grants under Minnesota 
365.32 	Statutes, sections 256E.30 to 256E.32. This 
365.33 	is a onetime appropriation. 
365.34 	(b) Of the TANF appropriation, $1,500,000 
365.35 	each year is for community action agencies 
366.1 	for auto repairs, auto loans, and auto 
366.2 	purchase grants to individuals who are 
366.3 	eligible to receive benefits under Minnesota 
366.4 	Statutes, chapter 256J, or who have lost 
366.5 	eligibility for benefits under Minnesota 
366.6 	Statutes, chapter 256J, due to earnings in the 
366.7 	prior 12 months. Base level funding for this 
366.8 	activity shall be $1,500,000 in fiscal year 
366.9 	2010 and $1,181,000 in fiscal year 2011. * 
366.10 	(The preceding text beginning "(b) Of the 
366.11 	TANF appropriation," was indicated as 
366.12 	vetoed by the governor.) 
366.13 	(c) Money appropriated under paragraphs (a) 
366.14 	and (b) that is not spent in the first year does 
366.15 	not cancel but is available for the second 
366.16 	year.

366.17 	Sec. 6. EXPIRATION OF UNCODIFIED LANGUAGE.
 366.18 	All uncodified language contained in this article expires on June 30, 2011, unless a 
366.19 	different expiration date is explicit.

366.20 	Sec. 7. EFFECTIVE DATE.
 366.21 	The provisions in this article are effective July 1, 2009, unless a different effective 
366.22 	date is specified.