1.1 	A bill for an act
1.2 	relating to state government; making changes to health and human services; 
1.3 	amending provisions related to licensing, the Minnesota family investment 
1.4 	program, child care, adult supports; fraud prevention, state-operated services, 
1.5 	the Minnesota sex offender program, the Department of Health, health care 
1.6 	programs, chemical and mental health; continuing care programs, and public 
1.7 	health; establishing the State-County Results, Accountability, and Service 
1.8 	Delivery Redesign; making technical changes; making forecast adjustments; 
1.9 	requiring reports; establishing and increasing fees; appropriating money;
1.10 	amending Minnesota Statutes 2008, sections 60A.092, subdivision 2; 62D.03, 
1.11 	subdivision 4; 62D.05, subdivision 3; 62J.495; 62J.496; 62J.497, subdivisions 
1.12 	1, 2, by adding subdivisions; 62J.692, subdivision 7; 103I.208, subdivision 
1.13 	2; 119B.09, subdivision 7; 119B.13, subdivision 6; 119B.21, subdivisions 5, 
1.14 	10; 119B.231, subdivisions 2, 3, 4; 144.0724, subdivisions 2, 4, 8, by adding 
1.15 	subdivisions; 144.121, subdivisions 1a, 1b; 144.122; 144.1222, subdivision 
1.16 	1a; 144.125, subdivision 1; 144.226, subdivision 4; 144.72, subdivisions 1, 3; 
1.17 	144.9501, subdivisions 22b, 26a, by adding subdivisions; 144.9505, subdivisions 
1.18 	1g, 4; 144.9508, subdivisions 2, 3, 4; 144.9512, subdivision 2; 144.966, by 
1.19 	adding a subdivision; 144.97, subdivisions 2, 4, 6, by adding subdivisions; 
1.20 	144.98, subdivisions 1, 2, 3, by adding subdivisions; 144.99, subdivision 
1.21 	1; 144A.073, by adding a subdivision; 144A.44, subdivision 2; 144A.46, 
1.22 	subdivision 1; 145A.17, by adding a subdivision; 148.6445, by adding a 
1.23 	subdivision; 148D.180, subdivisions 1, 2, 3, 5; 148E.180, subdivisions 1, 2, 3, 5; 
1.24 	152.126, subdivisions 1, 2, 6; 153A.17; 157.15, by adding a subdivision; 157.16; 
1.25 	157.22; 176.011, subdivision 9; 245.462, subdivision 18; 245.470, subdivision 
1.26 	1; 245.4871, subdivision 27; 245.488, subdivision 1; 245A.03, by adding a 
1.27 	subdivision; 245A.10, subdivisions 2, 3; 245A.11, subdivision 2a, by adding 
1.28 	subdivisions; 245A.16, subdivisions 1, 3; 245C.03, subdivision 2; 245C.04, 
1.29 	subdivisions 1, 3; 245C.05, subdivision 4, by adding a subdivision; 245C.08, 
1.30 	subdivision 2; 245C.10, subdivision 3, by adding subdivisions; 245C.17, by 
1.31 	adding a subdivision; 245C.20; 245C.21, subdivision 1a; 245C.23, subdivision 2; 
1.32 	246.50, subdivision 5, by adding subdivisions; 246.51, by adding subdivisions; 
1.33 	246.511; 246.52; 246.54, subdivision 2; 246B.01, by adding subdivisions; 
1.34 	252.025, subdivision 7; 252.46, by adding a subdivision; 252.50, subdivision 1; 
1.35 	254A.02, by adding a subdivision; 254A.16, by adding a subdivision; 254B.03, 
1.36 	subdivisions 1, 3, by adding a subdivision; 254B.05, subdivision 1; 254B.09, 
1.37 	subdivision 2; 256.01, subdivision 2b, by adding subdivisions; 256.045, 
1.38 	subdivision 3; 256.476, subdivisions 5, 11; 256.962, subdivisions 2, 6; 256.969, 
1.39 	subdivisions 2b, 3a, by adding subdivisions; 256.975, subdivision 7; 256.983, 
2.1 	subdivision 1; 256B.04, subdivision 16; 256B.055, subdivisions 7, 12; 256B.056, 
2.2 	subdivisions 3c, 3d; 256B.057, by adding a subdivision; 256B.0575; 256B.0595, 
2.3 	subdivisions 1, 2; 256B.06, subdivisions 4, 5; 256B.0621, subdivision 2; 
2.4 	256B.0622, subdivision 2; 256B.0623, subdivision 5; 256B.0624, subdivisions 
2.5 	5, 8; 256B.0625, subdivisions 3, 3c, 6a, 7, 9, 11, 13, 13e, 13h, 17, 17a, 19a, 
2.6 	19c, 26, 42, 47, by adding subdivisions; 256B.0641, subdivision 3; 256B.0651; 
2.7 	256B.0652; 256B.0653; 256B.0654; 256B.0655, subdivisions 1b, 4; 256B.0657, 
2.8 	subdivisions 2, 6, 8, by adding a subdivision; 256B.08, by adding a subdivision; 
2.9 	256B.0911, subdivisions 1, 1a, 3, 3a, 3b, 3c, 4a, 5, 6, 7, by adding subdivisions; 
2.10 	256B.0913, subdivision 4; 256B.0915, subdivisions 3a, 3e, 3h, 5, by adding a 
2.11 	subdivision; 256B.0916, subdivision 2; 256B.0917, by adding a subdivision; 
2.12 	256B.092, subdivision 8a, by adding subdivisions; 256B.0943, subdivisions 1, 
2.13 	12; 256B.0944, by adding a subdivision; 256B.0947, subdivision 1; 256B.15, 
2.14 	subdivisions 1, 1a, 1h, 2, by adding subdivisions; 256B.199; 256B.37, 
2.15 	subdivisions 1, 5; 256B.434, subdivision 4, by adding a subdivision; 256B.437, 
2.16 	subdivision 6; 256B.441, subdivisions 55, 58, by adding a subdivision; 256B.49, 
2.17 	subdivisions 12, 13, 14, 17, by adding subdivisions; 256B.501, subdivision 
2.18 	4a; 256B.5011, subdivision 2; 256B.5012, by adding a subdivision; 256B.69, 
2.19 	subdivisions 5a, 5c, 5f, 23; 256B.76, subdivision 1; 256D.03, subdivision 4; 
2.20 	256D.44, subdivision 5; 256G.02, subdivision 6; 256I.03, subdivision 7; 256I.05, 
2.21 	subdivisions 1a, 7c; 256J.08, subdivision 73a; 256J.24, subdivision 5; 256J.425, 
2.22 	subdivisions 2, 3; 256J.45, subdivision 3; 256J.49, subdivisions 1, 4; 256J.521, 
2.23 	subdivision 2; 256J.545; 256J.561, subdivisions 2, 3; 256J.57, subdivision 
2.24 	1; 256J.575, subdivisions 3, 4, 6, 7; 256J.621; 256J.626, subdivision 7; 
2.25 	256J.95, subdivisions 3, 11, 12, 13; 256L.03, by adding a subdivision; 256L.04, 
2.26 	subdivisions 1, 7a, 10a, by adding a subdivision; 256L.05, subdivisions 1, 3, 3a, 
2.27 	by adding a subdivision; 256L.07, subdivisions 1, 2, 3, by adding a subdivision; 
2.28 	256L.11, subdivision 1; 256L.15, subdivisions 2, 3; 256L.17, subdivisions 3, 5; 
2.29 	259.67, by adding a subdivision; 270A.09, by adding a subdivision; 327.14, 
2.30 	by adding a subdivision; 327.15; 327.16; 327.20, subdivision 1, by adding a 
2.31 	subdivision; 501B.89, by adding a subdivision; 519.05; 604A.33, subdivision 
2.32 	1; 609.232, subdivision 11; 626.556, subdivision 3c; 626.5572, subdivisions 
2.33 	6, 13, 21; Laws 2003, First Special Session chapter 14, article 13C, section 
2.34 	2, subdivision 1, as amended; Laws 2007, chapter 147, article 19, section 3, 
2.35 	subdivision 4, as amended; proposing coding for new law in Minnesota Statutes, 
2.36 	chapters 62Q; 246B; 254B; 256; 256B; proposing coding for new law as 
2.37 	Minnesota Statutes, chapter 402A; repealing Minnesota Statutes 2008, sections 
2.38 	103I.112; 144.9501, subdivision 17b; 148D.180, subdivision 8; 245C.11, 
2.39 	subdivisions 1, 2; 246.51, subdivision 1; 246.53, subdivision 3; 256.962, 
2.40 	subdivision 7; 256B.0655, subdivisions 1, 1a, 1c, 1d, 1e, 1f, 1g, 1h, 1i, 2, 3, 5, 6, 
2.41 	7, 8, 9, 10, 11, 12, 13; 256B.071, subdivisions 1, 2, 3, 4; 256B.092, subdivision 
2.42 	5a; 256B.19, subdivision 1d; 256B.431, subdivision 23; 256I.06, subdivision 
2.43 	9; 256L.17, subdivision 6; 327.14, subdivisions 5, 6; Minnesota Rules, parts 
2.44 	4626.2015, subpart 9; 9555.6125, subpart 4, item B.
2.45 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

2.46 	ARTICLE 1
2.47 	LICENSING

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

3.29 	Sec. 2. Minnesota Statutes 2008, section 245A.10, subdivision 3, is amended to read:
3.30 		Subd. 3.Application fee for initial license or certification. (a) For fees required 
3.31 	under subdivision 1, an applicant for an initial license or certification issued by the 
3.32 	commissioner shall submit a $500 application fee with each new application required 
3.33 	under this subdivision. The application fee shall not be prorated, is nonrefundable, and 
3.34 	is in lieu of the annual license or certification fee that expires on December 31. The 
3.35 	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. The license issued by the commissioner must state the name of each 
4.14 	additional county where services are being provided to persons with developmental 
4.15 	disabilities. A license holder must notify the commissioner before making any changes 
4.16 	that would alter the license information listed under section 245A.04, subdivision 7, 
4.17 	paragraph (a), including any additional counties where persons with developmental 
4.18 	disabilities are being served.
4.19 	(2) For a license to provide supported employment, crisis respite, or 
4.20 	semi-independent living services to persons with developmental disabilities or related 
4.21 	conditions under chapter 245B, an applicant shall submit a single application to provide 
4.22 	services statewide.
4.23 	(3) For a license to provide independent living assistance for youth under section 
4.24 	245A.22, an applicant shall submit a single application to provide services statewide. 

4.25 	Sec. 3. Minnesota Statutes 2008, section 245A.11, subdivision 2a, is amended to read:
4.26 		Subd. 2a.Adult foster care license capacity. The commissioner shall issue adult 
4.27 	foster care licenses with a maximum licensed capacity of four beds, including nonstaff 
4.28 	roomers and boarders, except that the commissioner may issue a license with a capacity of 
4.29 	five beds, including roomers and boarders, according to paragraphs (a) to (e).
4.30 	(a) An adult foster care license holder may have a maximum license capacity of five 
4.31 	if all persons in care are age 55 or over and do not have a serious and persistent mental 
4.32 	illness or a developmental disability.
4.33 	(b) The commissioner may grant variances to paragraph (a) to allow a foster care 
4.34 	provider with a licensed capacity of five persons to admit an individual under the age of 55 
5.1 	if the variance complies with section 245A.04, subdivision 9, and approval of the variance 
5.2 	is recommended by the county in which the licensed foster care provider is located.  
5.3 	(c) The commissioner may grant variances to paragraph (a) to allow the use of a fifth 
5.4 	bed for emergency crisis services for a person with serious and persistent mental illness 
5.5 	or a developmental disability, regardless of age, if the variance complies with section 
5.6 	245A.04, subdivision 9, and approval of the variance is recommended by the county in 
5.7 	which the licensed foster care provider is located.  
5.8 	(d) Notwithstanding paragraph (a),If the 2009 legislature adopts a rate reduction 
5.9 	that impacts providers of adult foster care services, the commissioner may issue an adult 
5.10 	foster care license with a capacity of five adults if the fifth bed does not increase the 
5.11 	overall statewide capacity of licensed adult foster care beds in homes that are not the 
5.12 	primary residence of the license holder, over the licensed capacity in such homes on July 
5.13 	1, 2009, as identified in a plan submitted to the commissioner by the county, when the 
5.14 	capacity is recommended by the county licensing agency of the county in which the 
5.15 	facility is located and if the recommendation verifies that:
5.16 	(1) the facility meets the physical environment requirements in the adult foster 
5.17 	care licensing rule;
5.18 	(2) the five-bed living arrangement is specified for each resident in the resident's:
5.19 	(i) individualized plan of care;
5.20 	(ii) individual service plan under section 256B.092, subdivision 1b, if required; or  
5.21 	(iii) individual resident placement agreement under Minnesota Rules, part 
5.22 	9555.5105, subpart 19, if required;
5.23 	(3) the license holder obtains written and signed informed consent from each 
5.24 	resident or resident's legal representative documenting the resident's informed choice to 
5.25 	living in the home and that the resident's refusal to consent would not have resulted in 
5.26 	service termination; and
5.27 	(4) the facility was licensed for adult foster care before March 1, 2003 2009.
5.28 	(e) The commissioner shall not issue a new adult foster care license under paragraph 
5.29 	(d) after June 30, 2005 2011. The commissioner shall allow a facility with an adult foster 
5.30 	care license issued under paragraph (d) before June 30, 2005 2011, to continue with a 
5.31 	capacity of five adults if the license holder continues to comply with the requirements in 
5.32 	paragraph (d).

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

5.34 	Sec. 4. Minnesota Statutes 2008, section 245A.11, is amended by adding a subdivision 
5.35 	to read:
6.1 		Subd. 7a.Alternate overnight supervision technology; adult foster care license.
 6.2 	(a) The commissioner may grant an applicant or license holder an adult foster care license 
6.3 	for a residence that does not have a caregiver in the residence during normal sleeping 
6.4 	hours as required under Minnesota Rules, part 9555.5105, subpart 37, item B, but uses 
6.5 	monitoring technology to alert the license holder when an incident occurs that may 
6.6 	jeopardize the health, safety, or rights of a foster care recipient. The applicant or license 
6.7 	holder must comply with all other requirements under Minnesota Rules, parts 9555.5105 
6.8 	to 9555.6265, and the requirements under this subdivision. The license printed by the 
6.9 	commissioner must state in bold and large font:
6.10 	(1) that the facility is under electronic monitoring; and
6.11 	(2) the telephone number of the county's common entry point for making reports of 
6.12 	suspected maltreatment of vulnerable adults under section 626.557, subdivision 9.
6.13 	(b) Applications for a license under this section must be submitted directly to 
6.14 	the Department of Human Services licensing division. The licensing division must 
6.15 	immediately notify the host county and lead county contract agency and the host county 
6.16 	licensing agency. The licensing division must collaborate with the county licensing 
6.17 	agency in the review of the application and the licensing of the program.
6.18 	(c) Before a license is issued by the commissioner, and for the duration of the 
6.19 	license, the applicant or license holder must establish, maintain, and document the 
6.20 	implementation of written policies and procedures addressing the requirements in 
6.21 	paragraphs (d) through (f).
6.22 	(d) The applicant or license holder must have policies and procedures that:
6.23 	(1) establish characteristics of target populations that will be admitted into the home, 
6.24 	and characteristics of populations that will not be accepted into the home;
6.25 	(2) explain the discharge process when a foster care recipient requires overnight 
6.26 	supervision or other services that cannot be provided by the license holder due to the 
6.27 	limited hours that the license holder is on-site;
6.28 	(3) describe the types of events to which the program will respond with a physical 
6.29 	presence when those events occur in the home during time when staff are not on-site, and 
6.30 	how the license holder's response plan meets the requirements in paragraph (e), clause 
6.31 	(1) or (2);
6.32 	(4) establish a process for documenting a review of the implementation and 
6.33 	effectiveness of the response protocol for the response required under paragraph (e), 
6.34 	clause (1) or (2). The documentation must include:
6.35 	(i) a description of the triggering incident;
6.36 	(ii) the date and time of the triggering incident;
7.1 	(iii) the time of the response or responses under paragraph (e), clause (1) or (2);
7.2 	(iv) whether the response met the resident's needs;
7.3 	(v) whether the existing policies and response protocols were followed; and
7.4 	(vi) whether the existing policies and protocols are adequate or need modification.
7.5 	When no physical presence response is completed for a three-month period, the 
7.6 	license holder's written policies and procedures must require a physical presence response 
7.7 	drill be to conducted for which the effectiveness of the response protocol under paragraph 
7.8 	(e), clause (1) or (2), will be reviewed and documented as required under this clause; and
7.9 	(5) establish that emergency and nonemergency phone numbers are posted in a 
7.10 	prominent location in a common area of the home where they can be easily observed by a 
7.11 	person responding to an incident who is not otherwise affiliated with the home.
7.12 	(e) The license holder must document and include in the license application which 
7.13 	response alternative under clause (1) or (2) is in place for responding to situations that 
7.14 	present a serious risk to the health, safety, or rights of people receiving foster care services 
7.15 	in the home:
7.16 	(1) response alternative (1) requires only the technology to provide an electronic 
7.17 	notification or alert to the license holder that an event is underway that requires a response. 
7.18 	Under this alternative, no more than ten minutes will pass before the license holder will be 
7.19 	physically present on-site to respond to the situation; or
7.20 	(2) response alternative (2) requires the electronic notification and alert system 
7.21 	under alternative (1), but more than ten minutes may pass before the license holder is 
7.22 	present on-site to respond to the situation. Under alternative (2), all of the following 
7.23 	conditions are met:
7.24 	(i) the license holder has a written description of the interactive technological 
7.25 	applications that will assist the licenser holder in communicating with and assessing the 
7.26 	needs related to care, health, and safety of the foster care recipients. This interactive 
7.27 	technology must permit the license holder to remotely assess the well being of the foster 
7.28 	care recipient without requiring the initiation of the foster care recipient. Requiring the 
7.29 	foster care recipient to initiate a telephone call does not meet this requirement;
7.30 	(ii) the license holder documents how the remote license holder is qualified and 
7.31 	capable of meeting the needs of the foster care recipients and assessing foster care 
7.32 	recipients' needs under item (i) during the absence of the license holder on-site;
7.33 	(iii) the license holder maintains written procedures to dispatch emergency response 
7.34 	personnel to the site in the event of an identified emergency; and
7.35 	(iv) each foster care recipient's individualized plan of care, individual service plan 
7.36 	under section 256B.092, subdivision 1b, if required, or individual resident placement 
8.1 	agreement under Minnesota Rules, part 9555.5105, subpart 19, if required, identifies the 
8.2 	maximum response time, which may be greater than ten minutes, for the license holder 
8.3 	to be on-site for that foster care recipient.
8.4 	(f) All placement agreements, individual service agreements, and plans applicable 
8.5 	to the foster care recipient must clearly state that the adult foster care license category is 
8.6 	a program without the presence of a caregiver in the residence during normal sleeping 
8.7 	hours; the protocols in place for responding to situations that present a serious risk to 
8.8 	health, safety, or rights of foster care recipients under paragraph (e), clause (1) or (2); and a 
8.9 	signed informed consent from each foster care recipient or the person's legal representative 
8.10 	documenting the person's or legal representative's agreement with placement in the 
8.11 	program. If electronic monitoring technology is used in the home, the informed consent 
8.12 	form must also explain the following:
8.13 	(1) how any electronic monitoring is incorporated into the alternative supervision 
8.14 	system;
8.15 	(2) the backup system for any electronic monitoring in times of electrical outages or 
8.16 	other equipment malfunctions;
8.17 	(3) how the license holder is trained on the use of the technology;
8.18 	(4) the event types and license holder response times established under paragraph (e);
8.19 	(5) how the license holder protects the foster care recipient's privacy related to 
8.20 	electronic monitoring and related to any electronically recorded data generated by the 
8.21 	monitoring system. A foster care recipient may not be removed from a program under 
8.22 	this subdivision for failure to consent to electronic monitoring. The consent form must 
8.23 	explain where and how the electronically recorded data is stored, with whom it will be 
8.24 	shared, and how long it is retained; and
8.25 	(6) the risks and benefits of the alternative overnight supervision system. 
8.26 	The written explanations under clauses (1) to (6) may be accomplished through 
8.27 	cross-references to other policies and procedures as long as they are explained to the 
8.28 	person giving consent, and the person giving consent is offered a copy.
8.29 	(g) Nothing in this section requires the applicant or license holder to develop or 
8.30 	maintain separate or duplicative polices, procedures, documentation, consent forms, or 
8.31 	individual plans that may be required for other licensing standards, if the requirements of 
8.32 	this section are incorporated into those documents.
8.33 	(h) The commissioner may grant variances to the requirements of this section 
8.34 	according to section 245A.04, subdivision 9.
9.1 	(i) For the purposes of paragraphs (d) through (h), license holder has the meaning 
9.2 	under section 245A.2, subdivision 9, and additionally includes all staff, volunteers, and 
9.3 	contractors affiliated with the license holder.
9.4 	(j) For the purposes of paragraph (e), the terms "assess" and "assessing" mean to 
9.5 	remotely determine what action the license holder needs to take to protect the well-being 
9.6 	of the foster care recipient.

9.7 	Sec. 5. Minnesota Statutes 2008, section 245A.11, is amended by adding a subdivision 
9.8 	to read:
9.9 		Subd. 8b.Adult foster care data privacy and security. (a) An adult foster 
9.10 	care license holder who creates, collects, records, maintains, stores, or discloses any 
9.11 	individually identifiable recipient data, whether in an electronic or any other format, 
9.12 	must comply with the privacy and security provisions of applicable privacy laws and 
9.13 	regulations, including:
9.14 	(1) the federal Health Insurance Portability and Accountability Act of 1996 
9.15 	(HIPAA), Public Law 104-1; and the HIPAA Privacy Rule, Code of Federal Regulations, 
9.16 	title 45, part 160, and subparts A and E of part 164; and
9.17 	(2) the Minnesota Government Data Practices Act as codified in chapter 13.
9.18 	(b) For purposes of licensure, the license holder shall be monitored for compliance 
9.19 	with the following data privacy and security provisions:
9.20 	(1) the license holder must control access to data on foster care recipients according 
9.21 	to the definitions of public and private data on individuals under section 13.02; 
9.22 	classification of the data on individuals as private under section 13.46, subdivision 2; 
9.23 	and control over the collection, storage, use, access, protection, and contracting related 
9.24 	to data according to section 13.05, in which the license holder is assigned the duties 
9.25 	of a government entity;
9.26 	(2) the license holder must provide each foster care recipient with a notice that 
9.27 	meets the requirements under section 13.04, in which the license holder is assigned the 
9.28 	duties of the government entity, and that meets the requirements of Code of Federal 
9.29 	Regulations, title 45, part 164.52. The notice shall describe the purpose for collection of 
9.30 	the data, and to whom and why it may be disclosed pursuant to law. The notice must 
9.31 	inform the recipient that the license holder uses electronic monitoring and, if applicable, 
9.32 	that recording technology is used;
9.33 	(3) the license holder must not install monitoring cameras in bathrooms;
9.34 	(4) electronic monitoring cameras must not be concealed from the foster care 
9.35 	recipients; and
10.1 	(5) electronic video and audio recordings of foster care recipients shall not be stored 
10.2 	by the license holder for more than five days.
10.3 	(c) The commissioner shall develop, and make available to license holders and 
10.4 	county licensing workers, a checklist of the data privacy provisions to be monitored 
10.5 	for purposes of licensure.

10.6 	Sec. 6. Minnesota Statutes 2008, section 245A.16, subdivision 1, is amended to read:
10.7 		Subdivision 1.Delegation of authority to agencies. (a) County agencies and 
10.8 	private agencies that have been designated or licensed by the commissioner to perform 
10.9 	licensing functions and activities under section 245A.04 and background studies for 
10.10 	adult foster care, family adult day services, and family child care, under chapter 245C; to 
10.11 	recommend denial of applicants under section 245A.05; to issue correction orders, to issue 
10.12 	variances, and recommend a conditional license under section 245A.06, or to recommend 
10.13 	suspending or revoking a license or issuing a fine under section 245A.07, shall comply 
10.14 	with rules and directives of the commissioner governing those functions and with this 
10.15 	section. The following variances are excluded from the delegation of variance authority 
10.16 	and may be issued only by the commissioner:
10.17 	(1) dual licensure of family child care and child foster care, dual licensure of child 
10.18 	and adult foster care, and adult foster care and family child care;
10.19 	(2) adult foster care maximum capacity;
10.20 	(3) adult foster care minimum age requirement;
10.21 	(4) child foster care maximum age requirement;
10.22 	(5) variances regarding disqualified individuals except that county agencies may 
10.23 	issue variances under section 245C.30 regarding disqualified individuals when the county 
10.24 	is responsible for conducting a consolidated reconsideration according to sections 245C.25
10.25 	and 245C.27, subdivision 2, clauses (a) and (b), of a county maltreatment determination 
10.26 	and a disqualification based on serious or recurring maltreatment; and
10.27 	(6) the required presence of a caregiver in the adult foster care residence during 
10.28 	normal sleeping hours.
10.29 	(b) County agencies must report information about disqualification reconsiderations 
10.30 	under sections 245C.25 and 245C.27, subdivision 2, paragraphs (a) and (b), and variances 
10.31 	granted under paragraph (a), clause (5), to the commissioner at least monthly in a format 
10.32 	prescribed by the commissioner.
10.33 	(c) For family day care programs, the commissioner may authorize licensing reviews 
10.34 	every two years after a licensee has had at least one annual review.
11.1 	(d) For family adult day services programs, the commissioner may authorize 
11.2 	licensing reviews every two years after a licensee has had at least one annual review.
11.3 	(e) A license issued under this section may be issued for up to two years.

11.4 	Sec. 7. Minnesota Statutes 2008, section 245A.16, subdivision 3, is amended to read:
11.5 		Subd. 3.Recommendations to commissioner. The county or private agency 
11.6 	shall not make recommendations to the commissioner regarding licensure without first 
11.7 	conducting an inspection, and for adult foster care, family adult day services, and family 
11.8 	child care, a background study of the applicant under chapter 245C. The county or private 
11.9 	agency must forward its recommendation to the commissioner regarding the appropriate 
11.10 	licensing action within 20 working days of receipt of a completed application.

11.11 	Sec. 8. Minnesota Statutes 2008, section 245C.04, subdivision 1, is amended to read:
11.12 		Subdivision 1.Licensed programs. (a) The commissioner shall conduct a 
11.13 	background study of an individual required to be studied under section 245C.03, 
11.14 	subdivision 1, at least upon application for initial license for all license types. 
11.15 	(b) The commissioner shall conduct a background study of an individual required to 
11.16 	be studied under section 245C.03, subdivision 1, at reapplication for a license for adult 
11.17 	foster care, family adult day services, and family child care. 
11.18 	(c) The commissioner is not required to conduct a study of an individual at the time 
11.19 	of reapplication for a license if the individual's background study was completed by the 
11.20 	commissioner of human services for an adult foster care license holder that is also:
11.21 	(1) registered under chapter 144D; or
11.22 	(2) licensed to provide home and community-based services to people with 
11.23 	disabilities at the foster care location and the license holder does not reside in the foster 
11.24 	care residence; and
11.25 	(3) the following conditions are met:
11.26 	(i) a study of the individual was conducted either at the time of initial licensure or 
11.27 	when the individual became affiliated with the license holder;
11.28 	(ii) the individual has been continuously affiliated with the license holder since 
11.29 	the last study was conducted; and
11.30 	(iii) the last study of the individual was conducted on or after October 1, 1995.
11.31 	(d) From July 1, 2007, to June 30, 2009, the commissioner of human services shall 
11.32 	conduct a study of an individual required to be studied under section 245C.03, at the 
11.33 	time of reapplication for a child foster care license. The county or private agency shall 
11.34 	collect and forward to the commissioner the information required under section 245C.05, 
12.1 	subdivisions 1, paragraphs (a) and (b), and 5, paragraphs (a) and (b). The background 
12.2 	study conducted by the commissioner of human services under this paragraph must 
12.3 	include a review of the information required under section 245C.08, subdivisions 1, 
12.4 	paragraph (a), clauses (1) to (5), 3, and 4.
12.5 	(e) The commissioner of human services shall conduct a background study of an 
12.6 	individual specified under section 245C.03, subdivision 1, paragraph (a), clauses (2) 
12.7 	to (6), who is newly affiliated with a child foster care license holder. The county or 
12.8 	private agency shall collect and forward to the commissioner the information required 
12.9 	under section 245C.05, subdivisions 1 and 5. The background study conducted by the 
12.10 	commissioner of human services under this paragraph must include a review of the 
12.11 	information required under section 245C.08, subdivisions 1, 3, and 4.
12.12 	(f) From January 1, 2010, to December 31, 2012, unless otherwise specified in 
12.13 	paragraph (c), the commissioner shall conduct a study of an individual required to be 
12.14 	studied under section 245C.03 at the time of reapplication for an adult foster care or family 
12.15 	adult day services license: (1) the county shall collect and forward to the commissioner 
12.16 	the information required under section 245C.05, subdivision 1, paragraphs (a) and (b), 
12.17 	and subdivision 5, paragraphs (a) and (b), for background studies conducted by the 
12.18 	commissioner for adult foster care and family adult day services when the license holder 
12.19 	resides in the adult foster care or family adult day services residence; (2) the license 
12.20 	holder shall collect and forward to the commissioner the information required under 
12.21 	section 245C.05, subdivisions 1, paragraphs (a) and (b); and 5, paragraphs (a) and (b), 
12.22 	for background studies conducted by the commissioner for adult foster care when the 
12.23 	license holder does not reside in the adult foster care residence; and (3) the background 
12.24 	study conducted by the commissioner under this paragraph must include a review of the 
12.25 	information required under section 245C.08, subdivision 1, paragraph (a), clauses (1) 
12.26 	to (5), and subdivisions 3 and 4.
12.27 	(g) The commissioner shall conduct a background study of an individual specified 
12.28 	under section 245C.03, subdivision 1, paragraph (a), clauses (2) to (6), who is newly 
12.29 	affiliated with an adult foster care or family adult day services license holder: (1) the 
12.30 	county shall collect and forward to the commissioner the information required under 
12.31 	section 245C.05, subdivision 1, paragraphs (a) and (b), and subdivision 5, paragraphs (a) 
12.32 	and (b), for background studies conducted by the commissioner for adult foster care 
12.33 	and family adult day services when the license holder resides in the adult foster care or 
12.34 	family adult day services residence; (2) the license holder shall collect and forward to the 
12.35 	commissioner the information required under section 245C.05, subdivisions 1, paragraphs 
12.36 	(a) and (b); and 5, paragraphs (a) and (b), for background studies conducted by the 
13.1 	commissioner for adult foster care when the license holder does not reside in the adult 
13.2 	foster care residence; and (3) the background study conducted by the commissioner under 
13.3 	this paragraph must include a review of the information required under section 245C.08, 
13.4 	subdivision 1, paragraph (a), and subdivisions 3 and 4.
13.5 	 (h) Applicants for licensure, license holders, and other entities as provided in this 
13.6 	chapter must submit completed background study forms to the commissioner before 
13.7 	individuals specified in section 245C.03, subdivision 1, begin positions allowing direct 
13.8 	contact in any licensed program. 
13.9 	(g) (i)  For purposes of this section, a physician licensed under chapter 147 is 
13.10 	considered to be continuously affiliated upon the license holder's receipt from the 
13.11 	commissioner of health or human services of the physician's background study results.

13.12 	Sec. 9. Minnesota Statutes 2008, section 245C.05, is amended by adding a subdivision 
13.13 	to read:
13.14 		Subd. 2b.County agency to collect and forward information to the 
13.15 	commissioner. For background studies related to adult foster care and family adult 
13.16 	day services when the license holder resides in the adult foster care or family adult 
13.17 	day services residence, the county agency must collect the information required under 
13.18 	subdivision 1 and forward it to the commissioner.

13.19 	Sec. 10. Minnesota Statutes 2008, section 245C.05, subdivision 4, is amended to read:
13.20 		Subd. 4.Electronic transmission. For background studies conducted by the 
13.21 	Department of Human Services, the commissioner shall implement a system for the 
13.22 	electronic transmission of:
13.23 	(1) background study information to the commissioner; 
13.24 	(2) background study results to the license holder; and
13.25 	(3) background study results to county and private agencies for background studies 
13.26 	conducted by the commissioner for child foster care; and
13.27 	(4) background study results to county agencies for background studies conducted 
13.28 	by the commissioner for adult foster care and family adult day services.

13.29 	Sec. 11. Minnesota Statutes 2008, section 245C.08, subdivision 2, is amended to read:
13.30 		Subd. 2.Background studies conducted by a county agency. (a) For a background 
13.31 	study conducted by a county agency for adult foster care, family adult day services, and
13.32 	family child care services, the commissioner shall review:
14.1 	(1) information from the county agency's record of substantiated maltreatment 
14.2 	of adults and the maltreatment of minors;
14.3 	(2) information from juvenile courts as required in subdivision 4 for individuals 
14.4 	listed in section 245C.03, subdivision 1, clauses (2), (5), and (6); and
14.5 	(3) information from the Bureau of Criminal Apprehension.
14.6 	(b) If the individual has resided in the county for less than five years, the study shall 
14.7 	include the records specified under paragraph (a) for the previous county or counties of 
14.8 	residence for the past five years.
14.9 	(c) Notwithstanding expungement by a court, the county agency may consider 
14.10 	information obtained under paragraph (a), clause (3), unless the commissioner received 
14.11 	notice of the petition for expungement and the court order for expungement is directed 
14.12 	specifically to the commissioner.

14.13 	Sec. 12. Minnesota Statutes 2008, section 245C.10, is amended by adding a 
14.14 	subdivision to read:
14.15 		Subd. 5.Adult foster care services. The commissioner shall recover the cost of 
14.16 	background studies required under section 245C.03, subdivision 1, for the purposes of 
14.17 	adult foster care and family adult day services licensing, through a fee of no more than 
14.18 	$20 per study charged to the license holder. The fees collected under this subdivision are 
14.19 	appropriated to the commissioner for the purpose of conducting background studies.

14.20 	Sec. 13. Minnesota Statutes 2008, section 245C.10, is amended by adding a 
14.21 	subdivision to read:
14.22 		Subd. 8.Private agencies. The commissioner shall recover the cost of conducting 
14.23 	background studies under section 245C.33 for studies initiated by private agencies for the 
14.24 	purpose of adoption through a fee of no more than $70 per study charged to the private 
14.25 	agency. The fees collected under this subdivision are appropriated to the commissioner for 
14.26 	the purpose of conducting background studies.

14.27 	Sec. 14. Minnesota Statutes 2008, section 245C.17, is amended by adding a 
14.28 	subdivision to read:
14.29 		Subd. 6.Notice to county agency. For studies on individuals related to a license 
14.30 	to provide adult foster care and family adult day services, the commissioner shall also 
14.31 	provide a notice of the background study results to the county agency that initiated the 
14.32 	background study.

15.1 	Sec. 15. Minnesota Statutes 2008, section 245C.20, is amended to read:
15.2 	245C.20 LICENSE HOLDER RECORD KEEPING.
15.3 	A licensed program shall document the date the program initiates a background 
15.4 	study under this chapter in the program's personnel files. When a background study is 
15.5 	completed under this chapter, a licensed program shall maintain a notice that the study 
15.6 	was undertaken and completed in the program's personnel files. Except when background 
15.7 	studies are initiated through the commissioner's online system, if a licensed program 
15.8 	has not received a response from the commissioner under section 245C.17 within 45 
15.9 	days of initiation of the background study request, the licensed program must contact the 
15.10 	commissioner human services licensing division to inquire about the status of the study.   If 
15.11 	a license holder initiates a background study under the commissioner's online system, but 
15.12 	the background study subject's name does not appear in the list of active or recent studies 
15.13 	initiated by that license holder, the license holder must either contact the human services 
15.14 	licensing division or resubmit the background study information online for that individual.

15.15 	Sec. 16. Minnesota Statutes 2008, section 245C.21, subdivision 1a, is amended to read:
15.16 		Subd. 1a.Submission of reconsideration request to county or private agency. (a) 
15.17 	For disqualifications related to studies conducted by county agencies for family child care, 
15.18 	and for disqualifications related to studies conducted by the commissioner for child foster 
15.19 	care, adult foster care, and family adult day services, the individual shall submit the request 
15.20 	for reconsideration to the county or private agency that initiated the background study.
15.21 	(b) For disqualifications related to studies conducted by the commissioner for child 
15.22 	foster care, the individual shall submit the request for reconsideration to the private agency 
15.23 	that initiated the background study.
15.24 	(c) A reconsideration request shall be submitted within 30 days of the individual's 
15.25 	receipt of the disqualification notice or the time frames specified in subdivision 2, 
15.26 	whichever time frame is shorter.
15.27 	(c) (d)  The county or private agency shall forward the individual's request for 
15.28 	reconsideration and provide the commissioner with a recommendation whether to set aside 
15.29 	the individual's disqualification.

15.30 	Sec. 17. Minnesota Statutes 2008, section 245C.23, subdivision 2, is amended to read:
15.31 		Subd. 2.Commissioner's notice of disqualification that is not set aside. (a) The 
15.32 	commissioner shall notify the license holder of the disqualification and order the license 
15.33 	holder to immediately remove the individual from any position allowing direct contact 
15.34 	with persons receiving services from the license holder if:
16.1 	(1) the individual studied does not submit a timely request for reconsideration 
16.2 	under section 245C.21;
16.3 	(2) the individual submits a timely request for reconsideration, but the commissioner 
16.4 	does not set aside the disqualification for that license holder under section 245C.22;
16.5 	(3) an individual who has a right to request a hearing under sections 245C.27 and 
16.6 	256.045, or 245C.28 and chapter 14 for a disqualification that has not been set aside, does 
16.7 	not request a hearing within the specified time; or
16.8 	(4) an individual submitted a timely request for a hearing under sections 245C.27
16.9 	and 256.045, or 245C.28 and chapter 14, but the commissioner does not set aside the 
16.10 	disqualification under section 245A.08, subdivision 5, or 256.045.
16.11 	(b) If the commissioner does not set aside the disqualification under section 245C.22, 
16.12 	and the license holder was previously ordered under section 245C.17 to immediately 
16.13 	remove the disqualified individual from direct contact with persons receiving services or 
16.14 	to ensure that the individual is under continuous, direct supervision when providing direct 
16.15 	contact services, the order remains in effect pending the outcome of a hearing under 
16.16 	sections 245C.27 and 256.045, or 245C.28 and chapter 14.
16.17 	(c) For background studies related to child foster care, the commissioner shall 
16.18 	also notify the county or private agency that initiated the study of the results of the 
16.19 	reconsideration.
16.20 	(d) For background studies related to adult foster care and family adult day services, 
16.21 	the commissioner shall also notify the county that initiated the study of the results of 
16.22 	the reconsideration.

16.23 	Sec. 18. Minnesota Statutes 2008, section 256B.092, is amended by adding a 
16.24 	subdivision to read:
16.25 		Subd. 5b.Revised per diem based on legislated rate reduction. Notwithstanding 
16.26 	section 252.28, subdivision 3, paragraph (d), if the 2009 legislature adopts a rate reduction 
16.27 	that impacts payment to providers of adult foster care services, the commissioner may 
16.28 	issue adult foster care licenses that permit a capacity of five adults. The application for a 
16.29 	five-bed license must meet the requirements of section 245A.11, subdivision 2a. Prior to 
16.30 	admission of the fifth recipient of adult foster care services, the county must negotiate a 
16.31 	revised per diem rate for room and board and waiver services that reflects the legislated 
16.32 	rate reduction and results in an overall average per diem reduction for all foster care 
16.33 	recipients in that home. The revised per diem must allow the provider to maintain, as 
16.34 	much as possible, the level of services or enhanced services provided in the residence, 
16.35 	while mitigating the losses of the legislated rate reduction.

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

17.2 	Sec. 19. Minnesota Statutes 2008, section 256B.49, subdivision 17, is amended to read:
17.3 		Subd. 17.Cost of services and supports. (a) The commissioner shall ensure 
17.4 	that the average per capita expenditures estimated in any fiscal year for home and 
17.5 	community-based waiver recipients does not exceed the average per capita expenditures 
17.6 	that would have been made to provide institutional services for recipients in the absence 
17.7 	of the waiver.
17.8 	(b) The commissioner shall implement on January 1, 2002, one or more aggregate, 
17.9 	need-based methods for allocating to local agencies the home and community-based 
17.10 	waivered service resources available to support recipients with disabilities in need of 
17.11 	the level of care provided in a nursing facility or a hospital. The commissioner shall 
17.12 	allocate resources to single counties and county partnerships in a manner that reflects 
17.13 	consideration of:
17.14 	(1) an incentive-based payment process for achieving outcomes;
17.15 	(2) the need for a state-level risk pool;
17.16 	(3) the need for retention of management responsibility at the state agency level; and
17.17 	(4) a phase-in strategy as appropriate.
17.18 	(c) Until the allocation methods described in paragraph (b) are implemented, the 
17.19 	annual allowable reimbursement level of home and community-based waiver services 
17.20 	shall be the greater of:
17.21 	(1) the statewide average payment amount which the recipient is assigned under the 
17.22 	waiver reimbursement system in place on June 30, 2001, modified by the percentage of 
17.23 	any provider rate increase appropriated for home and community-based services; or
17.24 	(2) an amount approved by the commissioner based on the recipient's extraordinary 
17.25 	needs that cannot be met within the current allowable reimbursement level. The 
17.26 	increased reimbursement level must be necessary to allow the recipient to be discharged 
17.27 	from an institution or to prevent imminent placement in an institution. The additional 
17.28 	reimbursement may be used to secure environmental modifications; assistive technology 
17.29 	and equipment; and increased costs for supervision, training, and support services 
17.30 	necessary to address the recipient's extraordinary needs. The commissioner may approve 
17.31 	an increased reimbursement level for up to one year of the recipient's relocation from an 
17.32 	institution or up to six months of a determination that a current waiver recipient is at 
17.33 	imminent risk of being placed in an institution.
17.34 	(d) Beginning July 1, 2001, medically necessary private duty nursing services will be 
17.35 	authorized under this section as complex and regular care according to sections 256B.0651
18.1 	and 256B.0653 to 256B.0656. The rate established by the commissioner for registered 
18.2 	nurse or licensed practical nurse services under any home and community-based waiver as 
18.3 	of January 1, 2001, shall not be reduced.
18.4 	(e) Notwithstanding section 252.28, subdivision 3, paragraph (d), if the 2009 
18.5 	legislature adopts a rate reduction that impacts payment to providers of adult foster care 
18.6 	services, the commissioner may issue adult foster care licenses that permit a capacity of 
18.7 	five adults. The application for a five-bed license must meet the requirements of section 
18.8 	245A.11, subdivision 2a. Prior to admission of the fifth recipient of adult foster care 
18.9 	services, the county must negotiate a revised per diem rate for room and board and waiver 
18.10 	services that reflects the legislated rate reduction and results in an overall average per 
18.11 	diem reduction for all foster care recipients in that home. The revised per diem must allow 
18.12 	the provider to maintain, as much as possible, the level of services or enhanced services 
18.13 	provided in the residence, while mitigating the losses of the legislated rate reduction.

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

18.15 	Sec. 20. WAIVER.
 18.16 	By December 1, 2009, the commissioner shall request all federal approvals and 
18.17 	waiver amendments to the disability home and community-based waivers to allow properly 
18.18 	licensed adult foster care homes to provide residential services for up to five individuals.

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

18.20 	Sec. 21.  REPEALER.
 18.21 	(a) Minnesota Statutes 2008, section 245C.11, subdivisions 1 and 2, are repealed.
18.22 	(b) Minnesota Statutes 2008, section 256B.092, subdivision 5a, is repealed effective 
18.23 	July 1, 2009.
18.24 	(c) Minnesota Rules, part 9555.6125, subpart 4, item B, is repealed.

18.25 	ARTICLE 2
18.26 	MFIP/CHILD CARE/ADULT SUPPORTS/FRAUD PREVENTION

18.27 	Section 1. Minnesota Statutes 2008, section 119B.09, subdivision 7, is amended to read:
18.28 		Subd. 7.Date of eligibility for assistance. (a) The date of eligibility for child 
18.29 	care assistance under this chapter is the later of the date the application was signed; the 
18.30 	beginning date of employment, education, or training; the date the infant is born for 
18.31 	applicants to the at-home infant care program; or the date a determination has been made 
19.1 	that the applicant is a participant in employment and training services under Minnesota 
19.2 	Rules, part 3400.0080, or chapter 256J.
19.3 	(b) Payment ceases for a family under the at-home infant child care program when a 
19.4 	family has used a total of 12 months of assistance as specified under section 119B.035. 
19.5 	Payment of child care assistance for employed persons on MFIP is effective the date of 
19.6 	employment or the date of MFIP eligibility, whichever is later. Payment of child care 
19.7 	assistance for MFIP or DWP participants in employment and training services is effective 
19.8 	the date of commencement of the services or the date of MFIP or DWP eligibility, 
19.9 	whichever is later. Payment of child care assistance for transition year child care must be 
19.10 	made retroactive to the date of eligibility for transition year child care. 
19.11 	(c) Notwithstanding paragraph (b), payment of child care assistance for participants 
19.12 	eligible under section 119B.05 may only be made retroactive for a maximum of six 
19.13 	months from the date of application for child care assistance.

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

19.15 	Sec. 2. Minnesota Statutes 2008, section 119B.13, subdivision 6, is amended to read:
19.16 		Subd. 6.Provider payments. (a) Counties or the state shall make vendor payments 
19.17 	to the child care provider or pay the parent directly for eligible child care expenses.
19.18 	(b) If payments for child care assistance are made to providers, the provider shall 
19.19 	bill the county for services provided within ten days of the end of the service period. If 
19.20 	bills are submitted within ten days of the end of the service period, a county or the state 
19.21 	shall issue payment to the provider of child care under the child care fund within 30 days 
19.22 	of receiving a bill from the provider. Counties or the state may establish policies that 
19.23 	make payments on a more frequent basis.
19.24 	(c) All billsIf a provider has received an authorization of care and been issued a 
19.25 	billing form for an eligible family, the bill must be submitted within 60 days of the last 
19.26 	date of service on the bill. A county may pay a bill submitted more than 60 days after 
19.27 	the last date of service if the provider shows good cause why the bill was not submitted 
19.28 	within 60 days. Good cause must be defined in the county's child care fund plan under 
19.29 	section 119B.08, subdivision 3, and the definition of good cause must include county 
19.30 	error. A county may not pay any bill submitted more than a year after the last date of 
19.31 	service on the bill. 
19.32 	(d) If a provider provided care for a time period without receiving an authorization 
19.33 	of care and a billing form for an eligible family, payment of child care assistance may only 
19.34 	be made retroactively for a maximum of six months from the date the provider is issued 
19.35 	an authorization of care and billing form.
20.1 	(e) A county may stop payment issued to a provider or may refuse to pay a bill 
20.2 	submitted by a provider if:
20.3 	(1) the provider admits to intentionally giving the county materially false information 
20.4 	on the provider's billing forms; or
20.5 	(2) a county finds by a preponderance of the evidence that the provider intentionally 
20.6 	gave the county materially false information on the provider's billing forms.
20.7 	(e)(f) A county's payment policies must be included in the county's child care plan 
20.8 	under section 119B.08, subdivision 3. If payments are made by the state, in addition to 
20.9 	being in compliance with this subdivision, the payments must be made in compliance 
20.10 	with section 16A.124. 

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

20.12 	Sec. 3. Minnesota Statutes 2008, section 119B.21, subdivision 5, is amended to read:
20.13 		Subd. 5.Child care services grants. (a) A child care resource and referral program 
20.14 	designated under section 119B.19, subdivision 1a, may award child care services grants 
20.15 	for: 
20.16 	(1) creating new licensed child care facilities and expanding existing facilities, 
20.17 	including, but not limited to, supplies, equipment, facility renovation, and remodeling;
20.18 	(2) improving licensed child care facility programs;
20.19 	(3) staff training and development services including, but not limited to, in-service 
20.20 	training, curriculum development, accreditation, certification, consulting, resource 
20.21 	centers, program and resource materials, supporting effective teacher-child interactions, 
20.22 	child-focused teaching, and content-driven classroom instruction;
20.23 	(4) interim financing;
20.24 	(5) capacity building through the purchase of appropriate technology to create, 
20.25 	enhance, and maintain business management systems;
20.26 	(6) emergency assistance for child care programs;
20.27 	(7) new programs or projects for the creation, expansion, or improvement of 
20.28 	programs that serve ethnic immigrant and refugee communities; and
20.29 	(8) targeted recruitment initiatives to expand and build the capacity of the child 
20.30 	care system and to improve the quality of care provided by legal nonlicensed child care 
20.31 	providers.
20.32 	(b) A child care resource and referral program designated under section 119B.19, 
20.33 	subdivision 1a, may award child care services grants to: 
20.34 	(1) licensed providers;
20.35 	(2) providers in the process of being licensed;
21.1 	(3) corporations or public agencies that develop or provide child care services;
21.2 	(4) school-age care programs;
21.3 	(5) legal nonlicensed or family, friend, and neighbor care providers; or
21.4 	(6) any combination of clauses (1) to (5).
21.5 	(c) A recipient of a child care services grant for facility improvements, interim 
21.6 	financing, or staff training and development must provide a 25 percent local match.
21.7 	(d) Beginning July 1, 2009, grants under this subdivision shall be increasingly 
21.8 	awarded for activities that improve provider quality, including activities under paragraph 
21.9 	(a), clauses (1) to (3) and (7).

21.10 	Sec. 4. Minnesota Statutes 2008, section 119B.21, subdivision 10, is amended to read:
21.11 		Subd. 10.Family child care technical assistance grants. (a) A child care resource 
21.12 	and referral organization designated under section 119B.19, subdivision 1a, may award 
21.13 	technical assistance grants of up to $1,000. These grants may be used for: 
21.14 	(1) facility improvements, including, but not limited to, improvements to meet 
21.15 	licensing requirements;
21.16 	(2) improvements to expand a child care facility or program;
21.17 	(3) toys, materials, and equipment to improve the learning environment;
21.18 	(4) technology and software to create, enhance, and maintain business management 
21.19 	systems;
21.20 	(5) start-up costs;
21.21 	(6) staff training and development; and
21.22 	(7) other uses approved by the commissioner.
21.23 	(b) A child care resource and referral program may award family child care technical 
21.24 	assistance grants to:
21.25 	(1) licensed family child care providers; 
21.26 	(2) child care providers in the process of becoming licensed; or
21.27 	(3) legal nonlicensed or family, friend, and neighbor care providers.
21.28 	(c) A local match is not required for a family child care technical assistance grant.
21.29 	(d) Beginning July 1, 2009, grants under this subdivision shall be increasingly 
21.30 	awarded for activities that improve provider quality, including activities under paragraph 
21.31 	(a), clauses (1), (3), and (6).

21.32 	Sec. 5. Minnesota Statutes 2008, section 119B.231, subdivision 2, is amended to read:
21.33 		Subd. 2.Provider eligibility. (a) To be considered for an SRSA, a provider shall 
21.34 	apply to the commissioner or have been chosen as an SRSA provider prior to June 30, 
22.1 	2009, and have complied with all requirements of the SRSA agreement. Priority for funds 
22.2 	is given to providers who had agreements prior to June 30, 2009. If sufficient funds are 
22.3 	available, the commissioner shall make applications available to additional providers. To 
22.4 	be eligible to apply for an SRSA, a provider shall:
22.5 	(1) be eligible for child care assistance payments under chapter 119B;
22.6 	(2) have at least 25 percent of the children enrolled with the provider subsidized 
22.7 	through the child care assistance program;
22.8 	(3) provide full-time, full-year child care services; and
22.9 	(4) serve at least one child who is subsidized through the child care assistance 
22.10 	program and who is expected to enter kindergarten within the following 30 months have 
22.11 	obtained a level 3 or 4 star rating under the voluntary Parent Aware quality rating system.
22.12 	(b) The commissioner may waive the 25 percent requirement in paragraph (a), 
22.13 	clause (2), if necessary to achieve geographic distribution of SRSA providers and diversity 
22.14 	of types of care provided by SRSA providers.
22.15 	(c) An eligible provider who would like to enter into an SRSA with the commissioner 
22.16 	shall submit an SRSA application. To determine whether to enter into an SRSA with a 
22.17 	provider, the commissioner shall evaluate the following factors:
22.18 	(1) the qualifications of the provider and the provider's staff provider's Parent 
22.19 	Aware rating score;
22.20 	(2) the provider's staff-child ratios;
22.21 	(3) the provider's curriculum;
22.22 	(4) the provider's current or planned parent education activities;
22.23 	(5)(2) the provider's current or planned social service and employment linkages;
22.24 	(6) the provider's child development assessment plan;
22.25 	(7)(3) the geographic distribution needed for SRSA providers;
22.26 	(8)(4) the inclusion of a variety of child care delivery models; and
22.27 	(9)(5) other related factors determined by the commissioner.

22.28 	Sec. 6. Minnesota Statutes 2008, section 119B.231, subdivision 3, is amended to read:
22.29 		Subd. 3.Family and child eligibility. (a) A family eligible to choose an SRSA 
22.30 	provider for their children shall:
22.31 	(1) be eligible to receive child care assistance under any provision in chapter 119B 
22.32 	except section 119B.035;
22.33 	(2) be in an authorized activity for an average of at least 35 hours per week when 
22.34 	initial eligibility is determined; and
22.35 	(3) include a child who has not yet entered kindergarten.
23.1 	(b) A family who is determined to be eligible to choose an SRSA provider remains 
23.2 	eligible to be paid at a higher rate through the SRSA provider when the following 
23.3 	conditions exist:
23.4 	(1) the child attends child care with the SRSA provider a minimum of 25 hours per 
23.5 	week, on average;
23.6 	(2) the family has a child who has not yet entered kindergarten; and
23.7 	(3) the family maintains eligibility under chapter 119B except section 119B.035.
23.8 	(c) For the 12 months After initial eligibility has been determined, a decrease in the 
23.9 	family's authorized activities to an average of less than 35 hours per week does not result 
23.10 	in ineligibility for the SRSA rate. A family must continue to maintain eligibility under this 
23.11 	chapter and be in an authorized activity.
23.12 	(d) A family that moves between counties but continues to use the same SRSA 
23.13 	provider shall continue to receive SRSA funding for the increased payments.

23.14 	Sec. 7. Minnesota Statutes 2008, section 119B.231, subdivision 4, is amended to read:
23.15 		Subd. 4.Requirements of providers. An SRSA must include assessment, 
23.16 	evaluation, and reporting requirements that promote the goals of improved school 
23.17 	readiness and movement toward appropriate child development milestones. A provider 
23.18 	who enters into an SRSA shall comply with all SRSA requirements, including the 
23.19 	assessment, evaluation, and reporting requirements in the SRSA. Providers who have been 
23.20 	selected previously for SRSAs must begin the process to obtain a rating using Parent 
23.21 	Aware according to timelines established by the commissioner. If the initial Parent Aware 
23.22 	rating is less than three stars, the provider must submit a plan to improve the rating. If 
23.23 	a 3 or 4 star rating is not obtained within established timelines, the commissioner may 
23.24 	consider continuation of the agreement, depending upon the progress made and other 
23.25 	factors. Providers who apply and are selected for a new SRSA agreement on or after July 
23.26 	1, 2009, must have a level 3 or 4 star rating under the voluntary Parent Aware quality 
23.27 	rating system at the time the SRSA agreement is signed.

23.28 	Sec. 8. Minnesota Statutes 2008, section 145A.17, is amended by adding a subdivision 
23.29 	to read:
23.30 		Subd. 4a.Home visitors as MFIP employment and training service providers.
 23.31 	The county social service agency and the local public health department may mutually 
23.32 	agree to utilize home visitors under this section as MFIP employment and training service 
23.33 	providers under section 256J.49, subdivision 4, for MFIP participants who are: (1) ill or 
23.34 	incapacitated under section 256J.425, subdivision 2; or (2) minor caregivers under section 
24.1 	256J.54. The county social service agency and the local public health department may 
24.2 	also mutually agree to utilize home visitors to provide outreach to MFIP families who are 
24.3 	being sanctioned or who have been terminated from MFIP due to the 60-month time limit.

24.4 	Sec. 9. Minnesota Statutes 2008, section 256.045, subdivision 3, is amended to read:
24.5 		Subd. 3.State agency hearings. (a) State agency hearings are available for the 
24.6 	following: 
24.7 	(1) any person applying for, receiving or having received public assistance, medical 
24.8 	care, or a program of social services granted by the state agency or a county agency or 
24.9 	the federal Food Stamp Act whose application for assistance is denied, not acted upon 
24.10 	with reasonable promptness, or whose assistance is suspended, reduced, terminated, or 
24.11 	claimed to have been incorrectly paid;
24.12 	(2) any patient or relative aggrieved by an order of the commissioner under section 
24.13 	252.27; 
24.14 	(3) a party aggrieved by a ruling of a prepaid health plan;
24.15 	(4) except as provided under chapter 245C, any individual or facility determined by 
24.16 	a lead agency to have maltreated a vulnerable adult under section 626.557 after they have 
24.17 	exercised their right to administrative reconsideration under section 626.557;
24.18 	(5) any person whose claim for foster care payment according to a placement of the 
24.19 	child resulting from a child protection assessment under section 626.556 is denied or not 
24.20 	acted upon with reasonable promptness, regardless of funding source;
24.21 	(6) any person to whom a right of appeal according to this section is given by other 
24.22 	provision of law;
24.23 	(7) an applicant aggrieved by an adverse decision to an application for a hardship 
24.24 	waiver under section 256B.15;
24.25 	(8) an applicant aggrieved by an adverse decision to an application or redetermination 
24.26 	for a Medicare Part D prescription drug subsidy under section 256B.04, subdivision 4a; 
24.27 	(9) except as provided under chapter 245A, an individual or facility determined 
24.28 	to have maltreated a minor under section 626.556, after the individual or facility has 
24.29 	exercised the right to administrative reconsideration under section 626.556; or
24.30 	(10) except as provided under chapter 245C, an individual disqualified under sections 
24.31 	245C.14 and 245C.15, on the basis of serious or recurring maltreatment; a preponderance 
24.32 	of the evidence that the individual has committed an act or acts that meet the definition 
24.33 	of any of the crimes listed in section 245C.15, subdivisions 1 to 4; or for failing to make 
24.34 	reports required under section 626.556, subdivision 3, or 626.557, subdivision 3. Hearings 
24.35 	regarding a maltreatment determination under clause (4) or (9) and a disqualification under 
25.1 	this clause in which the basis for a disqualification is serious or recurring maltreatment, 
25.2 	which has not been set aside under sections 245C.22 and 245C.23, shall be consolidated 
25.3 	into a single fair hearing. In such cases, the scope of review by the human services referee 
25.4 	shall include both the maltreatment determination and the disqualification. The failure to 
25.5 	exercise the right to an administrative reconsideration shall not be a bar to a hearing under 
25.6 	this section if federal law provides an individual the right to a hearing to dispute a finding 
25.7 	of maltreatment. Individuals and organizations specified in this section may contest the 
25.8 	specified action, decision, or final disposition before the state agency by submitting a 
25.9 	written request for a hearing to the state agency within 30 days after receiving written 
25.10 	notice of the action, decision, or final disposition, or within 90 days of such written notice 
25.11 	if the applicant, recipient, patient, or relative shows good cause why the request was not 
25.12 	submitted within the 30-day time limit.; or
25.13 	(11) any person with an outstanding debt resulting from receipt of public assistance, 
25.14 	medical care, or the federal Food Stamp Act who is contesting a setoff claim by the 
25.15 	Department of Human Services or a county agency. The scope of the appeal is the validity 
25.16 	of the claimant agency's intention to request a setoff of a refund under chapter 270A 
25.17 	against the debt.
25.18 	(b) The hearing for an individual or facility under paragraph (a), clause (4), (9), or 
25.19 	(10), is the only administrative appeal to the final agency determination specifically, 
25.20 	including a challenge to the accuracy and completeness of data under section 13.04. 
25.21 	Hearings requested under paragraph (a), clause (4), apply only to incidents of maltreatment 
25.22 	that occur on or after October 1, 1995. Hearings requested by nursing assistants in nursing 
25.23 	homes alleged to have maltreated a resident prior to October 1, 1995, shall be held as a 
25.24 	contested case proceeding under the provisions of chapter 14. Hearings requested under 
25.25 	paragraph (a), clause (9), apply only to incidents of maltreatment that occur on or after 
25.26 	July 1, 1997. A hearing for an individual or facility under paragraph (a), clause (9), is 
25.27 	only available when there is no juvenile court or adult criminal action pending. If such 
25.28 	action is filed in either court while an administrative review is pending, the administrative 
25.29 	review must be suspended until the judicial actions are completed. If the juvenile court 
25.30 	action or criminal charge is dismissed or the criminal action overturned, the matter may be 
25.31 	considered in an administrative hearing.
25.32 	(c) For purposes of this section, bargaining unit grievance procedures are not an 
25.33 	administrative appeal.
25.34 	(d) The scope of hearings involving claims to foster care payments under paragraph 
25.35 	(a), clause (5), shall be limited to the issue of whether the county is legally responsible 
25.36 	for a child's placement under court order or voluntary placement agreement and, if so, 
26.1 	the correct amount of foster care payment to be made on the child's behalf and shall not 
26.2 	include review of the propriety of the county's child protection determination or child 
26.3 	placement decision.
26.4 	(e) A vendor of medical care as defined in section 256B.02, subdivision 7, or a 
26.5 	vendor under contract with a county agency to provide social services is not a party and 
26.6 	may not request a hearing under this section, except if assisting a recipient as provided in 
26.7 	subdivision 4.
26.8 	(f) An applicant or recipient is not entitled to receive social services beyond the 
26.9 	services prescribed under chapter 256M or other social services the person is eligible 
26.10 	for under state law.
26.11 	(g) The commissioner may summarily affirm the county or state agency's proposed 
26.12 	action without a hearing when the sole issue is an automatic change due to a change in 
26.13 	state or federal law.

26.14 	Sec. 10. Minnesota Statutes 2008, section 256.983, subdivision 1, is amended to read:
26.15 		Subdivision 1.Programs established. Within the limits of available appropriations, 
26.16 	the commissioner of human services shall require the maintenance of budget neutral 
26.17 	fraud prevention investigation programs in the counties participating in the fraud 
26.18 	prevention investigation project established under this section. If funds are sufficient, 
26.19 	the commissioner may also extend fraud prevention investigation programs to other 
26.20 	counties provided the expansion is budget neutral to the state. Under any expansion, the 
26.21 	commissioner has the final authority in decisions regarding the creation and realignment 
26.22 	of individual county or regional operations.

26.23 	Sec. 11. Minnesota Statutes 2008, section 256I.03, subdivision 7, is amended to read:
26.24 		Subd. 7.Countable income. "Countable income" means all income received by an 
26.25 	applicant or recipient less any applicable exclusions or disregards. For a recipient of any 
26.26 	cash benefit from the SSI program, countable income means the SSI benefit limit in effect 
26.27 	at the time the person is in a GRH setting less $20, less the medical assistance personal 
26.28 	needs allowance. If the SSI limit has been reduced for a person due to events occurring 
26.29 	prior to the persons entering the GRH setting, countable income means actual income less 
26.30 	any applicable exclusions and disregards.

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

26.32 	Sec. 12. Minnesota Statutes 2008, section 256I.05, subdivision 7c, is amended to read:
27.1 		Subd. 7c.Demonstration project. The commissioner is authorized to pursue the 
27.2 	expansion of a demonstration project under federal food stamp regulation for the purpose 
27.3 	of gaining additional federal reimbursement of food and nutritional costs currently paid by 
27.4 	the state group residential housing program. The commissioner shall seek approval no 
27.5 	later than January 1, 2004 October 1, 2009. Any reimbursement received is nondedicated 
27.6 	revenue to the general fund.

27.7 	Sec. 13. Minnesota Statutes 2008, section 256J.24, subdivision 5, is amended to read:
27.8 		Subd. 5.MFIP transitional standard. The MFIP transitional standard is based 
27.9 	on the number of persons in the assistance unit eligible for both food and cash assistance 
27.10 	unless the restrictions in subdivision 6 on the birth of a child apply. The following table 
27.11 	represents the transitional standards effective October 1, 2007 April 1, 2009.

27.12	Number of Eligible People
	Transitional Standard
	Cash Portion
	Food Portion

27.13	1
	$391 $428:
	$250
	$141 $178
		
27.14	2
	$698 $764:
	$437
	$261$327
		
27.15	3
	$910$1,005:
	$532
	$378$473
		
27.16	4
	$1,091 $1,217:
	$621
	$470 $596
		
27.17	5
	$1,245 $1,393:
	$697
	$548 $696
		
27.18	6
	$1,425$1,602:
	$773
	$652 $829
		
27.19	7
	$1,553 $1,748:
	$850
	$703$898
		
27.20	8
	$1,713 $1,934:
	$916
	$797$1,018
		
27.21	9
	$1,871 $2,119:
	$980
	$891$1,139
		
27.22	10
	$2,024 $2,298:
	$1,035
	$989 $1,263
		
27.23	over 10
	add $151 $178:
	$53
	$98 $125
		
27.24	per additional member.
				
27.25 	The commissioner shall annually publish in the State Register the transitional 
27.26 	standard for an assistance unit sizes 1 to 10 including a breakdown of the cash and food 
27.27 	portions.

27.28 	EFFECTIVE DATE. This section is effective retroactively from April 1, 2009.

27.29 	Sec. 14. Minnesota Statutes 2008, section 256J.425, subdivision 2, is amended to read:
27.30 		Subd. 2.Ill or incapacitated. (a) An assistance unit subject to the time limit in 
27.31 	section 256J.42, subdivision 1, is eligible to receive months of assistance under a hardship 
27.32 	extension if the participant who reached the time limit belongs to any of the following 
27.33 	groups:
27.34 	(1) participants who are suffering from an illness, injury, or incapacity which 
27.35 	has been certified by a qualified professional when the illness, injury, or incapacity is 
28.1 	expected to continue for more than 30 days and prevents the person from obtaining or 
28.2 	retaining employment severely limits the person's ability to obtain or maintain suitable 
28.3 	employment. These participants must follow the treatment recommendations of the 
28.4 	qualified professional certifying the illness, injury, or incapacity;
28.5 	(2) participants whose presence in the home is required as a caregiver because of 
28.6 	the illness, injury, or incapacity of another member in the assistance unit, a relative in the 
28.7 	household, or a foster child in the household when the illness or incapacity and the need 
28.8 	for a person to provide assistance in the home has been certified by a qualified professional 
28.9 	and is expected to continue for more than 30 days; or
28.10 	(3) caregivers with a child or an adult in the household who meets the disability or 
28.11 	medical criteria for home care services under section 256B.0651, subdivision 1, paragraph 
28.12 	(c), or a home and community-based waiver services program under chapter 256B, or 
28.13 	meets the criteria for severe emotional disturbance under section 245.4871, subdivision 
28.14 	6, or for serious and persistent mental illness under section 245.462, subdivision 20, 
28.15 	paragraph (c). Caregivers in this category are presumed to be prevented from obtaining 
28.16 	or retaining employment.
28.17 	(b) An assistance unit receiving assistance under a hardship extension under this 
28.18 	subdivision may continue to receive assistance as long as the participant meets the criteria 
28.19 	in paragraph (a), clause (1), (2), or (3).

28.20 	Sec. 15. Minnesota Statutes 2008, section 256J.425, subdivision 3, is amended to read:
28.21 		Subd. 3.Hard-to-employ participants. (a) An assistance unit subject to the time 
28.22 	limit in section 256J.42, subdivision 1, is eligible to receive months of assistance under 
28.23 	a hardship extension if the participant who reached the time limit belongs to any of the 
28.24 	following groups: 
28.25 	(1) a person who is diagnosed by a licensed physician, psychological practitioner, 
28.26 	or other qualified professional, as developmentally disabled or mentally ill, and that 
28.27 	condition prevents the person from obtaining or retaining unsubsidized employment the 
28.28 	condition severely limits the person's ability to obtain or maintain suitable employment;
28.29 	(2) a person who:
28.30 	(i) has been assessed by a vocational specialist or the county agency to be 
28.31 	unemployable for purposes of this subdivision; or
28.32 	(ii) has an IQ below 80 who has been assessed by a vocational specialist or a county 
28.33 	agency to be employable, but not at a level that makes the participant eligible for an 
28.34 	extension under subdivision 4 the condition severely limits the person's ability to obtain or 
28.35 	maintain suitable employment. The determination of IQ level must be made by a qualified 
29.1 	professional. In the case of a non-English-speaking person: (A) the determination must 
29.2 	be made by a qualified professional with experience conducting culturally appropriate 
29.3 	assessments, whenever possible; (B) the county may accept reports that identify an 
29.4 	IQ range as opposed to a specific score; (C) these reports must include a statement of 
29.5 	confidence in the results;
29.6 	(3) a person who is determined by a qualified professional to be learning disabled, 
29.7 	and the disability condition severely limits the person's ability to obtain, perform, or 
29.8 	maintain suitable employment. For purposes of the initial approval of a learning disability 
29.9 	extension, the determination must have been made or confirmed within the previous 12 
29.10 	months. In the case of a non-English-speaking person: (i) the determination must be made 
29.11 	by a qualified professional with experience conducting culturally appropriate assessments, 
29.12 	whenever possible; and (ii) these reports must include a statement of confidence in the 
29.13 	results. If a rehabilitation plan for a participant extended as learning disabled is developed 
29.14 	or approved by the county agency, the plan must be incorporated into the employment 
29.15 	plan. However, a rehabilitation plan does not replace the requirement to develop and 
29.16 	comply with an employment plan under section 256J.521; or 
29.17 	(4) a person who has been granted a family violence waiver, and who is complying 
29.18 	with an employment plan under section 256J.521, subdivision 3. 
29.19 	(b) For purposes of this section, "severely limits the person's ability to obtain or 
29.20 	maintain suitable employment" means that a qualified professional has determined that the 
29.21 	person's condition prevents the person from working 20 or more hours per week.

29.22 	Sec. 16. Minnesota Statutes 2008, section 256J.49, subdivision 1, is amended to read:
29.23 		Subdivision 1.Scope. The terms used in sections 256J.50 256J.425 to 256J.72 have 
29.24 	the meanings given them in this section.  

29.25 	Sec. 17. Minnesota Statutes 2008, section 256J.49, subdivision 4, is amended to read:
29.26 		Subd. 4.Employment and training service provider. "Employment and training 
29.27 	service provider" means:
29.28 	(1) a public, private, or nonprofit agency with which a county has contracted to 
29.29 	provide employment and training services and which is included in the county's service 
29.30 	agreement submitted under section 256J.626, subdivision 4; or
29.31 	(2) a county agency, if the county has opted to provide employment and training 
29.32 	services and the county has indicated that fact in the service agreement submitted under 
29.33 	section 256J.626, subdivision 4; or
30.1 	(3) a local public health department under section 145A.17, subdivision 3a, that a 
30.2 	county has designated to provide employment and training services and is included in the 
30.3 	county's service agreement submitted under section 256J.626, subdivision 4.
30.4 	Notwithstanding section 116L.871, an employment and training services provider 
30.5 	meeting this definition may deliver employment and training services under this chapter.

30.6 	Sec. 18. Minnesota Statutes 2008, section 256J.521, subdivision 2, is amended to read:
30.7 		Subd. 2.Employment plan; contents. (a) Based on the assessment under 
30.8 	subdivision 1, the job counselor and the participant must develop an employment plan 
30.9 	that includes participation in activities and hours that meet the requirements of section 
30.10 	256J.55, subdivision 1. The purpose of the employment plan is to identify for each 
30.11 	participant the most direct path to unsubsidized employment and any subsequent steps that 
30.12 	support long-term economic stability. The employment plan should be developed using 
30.13 	the highest level of activity appropriate for the participant. Activities must be chosen from 
30.14 	clauses (1) to (6), which are listed in order of preference. Notwithstanding this order of 
30.15 	preference for activities, priority must be given for activities related to a family violence 
30.16 	waiver when developing the employment plan. The employment plan must also list the 
30.17 	specific steps the participant will take to obtain employment, including steps necessary 
30.18 	for the participant to progress from one level of activity to another, and a timetable for 
30.19 	completion of each step. Levels of activity include:
30.20 	(1) unsubsidized employment;
30.21 	(2) job search;
30.22 	(3) subsidized employment or unpaid work experience;
30.23 	(4) unsubsidized employment and job readiness education or job skills training;
30.24 	(5) unsubsidized employment or unpaid work experience and activities related to 
30.25 	a family violence waiver or preemployment needs; and
30.26 	(6) activities related to a family violence waiver or preemployment needs.
30.27 	(b) Participants who are determined to possess sufficient skills such that the 
30.28 	participant is likely to succeed in obtaining unsubsidized employment must job search at 
30.29 	least 30 hours per week for up to six weeks and accept any offer of suitable employment. 
30.30 	The remaining hours necessary to meet the requirements of section 256J.55, subdivision 
30.31 	1, may be met through participation in other work activities under section 256J.49, 
30.32 	subdivision 13. The participant's employment plan must specify, at a minimum: (1) 
30.33 	whether the job search is supervised or unsupervised; (2) support services that will 
30.34 	be provided; and (3) how frequently the participant must report to the job counselor. 
30.35 	Participants who are unable to find suitable employment after six weeks must meet 
31.1 	with the job counselor to determine whether other activities in paragraph (a) should be 
31.2 	incorporated into the employment plan. Job search activities which are continued after six 
31.3 	weeks must be structured and supervised. 
31.4 	(c) Beginning July 1, 2004, activities and hourly requirements in the employment 
31.5 	plan may be adjusted as necessary to accommodate the personal and family circumstances 
31.6 	of participants identified under section 256J.561, subdivision 2, paragraph (d). Participants 
31.7 	who no longer meet the provisions of section 256J.561, subdivision 2, paragraph (d), 
31.8 	must meet with the job counselor within ten days of the determination to revise the 
31.9 	employment plan. 
31.10 	(d) Participants who are determined to have barriers to obtaining or retaining 
31.11 	employment that will not be overcome during six weeks of job search under paragraph (b) 
31.12 	must work with the job counselor to develop an employment plan that addresses those 
31.13 	barriers by incorporating appropriate activities from paragraph (a), clauses (1) to (6). 
31.14 	The employment plan must include enough hours to meet the participation requirements 
31.15 	in section 256J.55, subdivision 1, unless a compelling reason to require fewer hours 
31.16 	is noted in the participant's file. 
31.17 	(e)(d) The job counselor and the participant must sign the employment plan to 
31.18 	indicate agreement on the contents.
31.19 	(f)(e) Except as provided under paragraph (g) (f), failure to develop or comply with 
31.20 	activities in the plan, or voluntarily quitting suitable employment without good cause, will 
31.21 	result in the imposition of a sanction under section 256J.46. 
31.22 	(g)(f) When a participant fails to meet the agreed upon hours of participation in paid 
31.23 	employment because the participant is not eligible for holiday pay and the participant's 
31.24 	place of employment is closed for a holiday, the job counselor shall not impose a sanction 
31.25 	or increase the hours of participation in any other activity, including paid employment, to 
31.26 	offset the hours that were missed due to the holiday.
31.27 	(h)(g) Employment plans must be reviewed at least every three months to determine 
31.28 	whether activities and hourly requirements should be revised. The job counselor is 
31.29 	encouraged to allow participants who are participating in at least 20 hours of work 
31.30 	activities to also participate in education and training activities in order to meet the federal 
31.31 	hourly participation rates.

31.32 	Sec. 19. Minnesota Statutes 2008, section 256J.545, is amended to read:
31.33 	256J.545 FAMILY VIOLENCE WAIVER CRITERIA.
32.1 	(a) In order to qualify for a family violence waiver, an individual must provide 
32.2 	documentation of past or current family violence which may prevent the individual from 
32.3 	participating in certain employment activities. 
32.4 	(b) The following items may be considered acceptable documentation or verification 
32.5 	of family violence:
32.6 	(1) police, government agency, or court records;
32.7 	(2) a statement from a battered women's shelter staff with knowledge of the 
32.8 	circumstances or credible evidence that supports the sworn statement;
32.9 	(3) a statement from a sexual assault or domestic violence advocate with knowledge 
32.10 	of the circumstances or credible evidence that supports the sworn statement; or
32.11 	(4) a statement from professionals from whom the applicant or recipient has sought 
32.12 	assistance for the abuse.
32.13 	(c) A claim of family violence may also be documented by a sworn statement from 
32.14 	the applicant or participant and a sworn statement from any other person with knowledge 
32.15 	of the circumstances or credible evidence that supports the client's statement.

32.16 	Sec. 20. Minnesota Statutes 2008, section 256J.561, subdivision 2, is amended to read:
32.17 		Subd. 2.Participation requirements. (a) All MFIP caregivers, except caregivers 
32.18 	who meet the criteria in subdivision 3, must participate in employment services develop an 
32.19 	individualized employment plan that identifies the activities the participant is required to 
32.20 	participate in and the required hours of participation. Except as specified in paragraphs (b) 
32.21 	to (d), the employment plan must meet the requirements of section 256J.521, subdivision 
32.22 	2, contain allowable work activities, as defined in section 256J.49, subdivision 13, and, 
32.23 	include at a minimum, the number of participation hours required under section 256J.55, 
32.24 	subdivision 1.
32.25 	(b) Minor caregivers and caregivers who are less than age 20 who have not 
32.26 	completed high school or obtained a GED are required to comply with section 256J.54.
32.27 	(c) A participant who has a family violence waiver shall develop and comply with 
32.28 	an employment plan under section 256J.521, subdivision 3.
32.29 	(d) As specified in section 256J.521, subdivision 2, paragraph (c), a participant who 
32.30 	meets any one of the following criteria may work with the job counselor to develop an 
32.31 	employment plan that contains less than the number of participation hours under section 
32.32 	256J.55, subdivision 1. Employment plans for participants covered under this paragraph 
32.33 	must be tailored to recognize the special circumstances of caregivers and families 
32.34 	including limitations due to illness or disability and caregiving needs:
32.35 	(1) a participant who is age 60 or older;
33.1 	(2) a participant who has been diagnosed by a qualified professional as suffering 
33.2 	from an illness or incapacity that is expected to last for 30 days or more, including a 
33.3 	pregnant participant who is determined to be unable to obtain or retain employment due 
33.4 	to the pregnancy; or
33.5 	(3) a participant who is determined by a qualified professional as being needed in 
33.6 	the home to care for an ill or incapacitated family member, including caregivers with a 
33.7 	child or an adult in the household who meets the disability or medical criteria for home 
33.8 	care services under section 256B.0651, subdivision 1, paragraph (c), or a home and 
33.9 	community-based waiver services program under chapter 256B, or meets the criteria for 
33.10 	severe emotional disturbance under section 245.4871, subdivision 6, or for serious and 
33.11 	persistent mental illness under section 245.462, subdivision 20, paragraph (c).
33.12 	(e) For participants covered under paragraphs (c) and (d), the county shall review 
33.13 	the participant's employment services status every three months to determine whether 
33.14 	conditions have changed. When it is determined that the participant's status is no longer 
33.15 	covered under paragraph (c) or (d), the county shall notify the participant that a new or 
33.16 	revised employment plan is needed. The participant and job counselor shall meet within 
33.17 	ten days of the determination to revise the employment plan.
33.18 	(b) Participants who meet the eligibility requirements in section 256J.575, 
33.19 	subdivision 3, must develop a family stabilization services plan that meets the 
33.20 	requirements in section 256J.575, subdivision 5.
33.21 	(c) Minor caregivers and caregivers who are less than age 20 who have not 
33.22 	completed high school or obtained a GED must develop an education plan that meets the 
33.23 	requirements in section 256J.54.
33.24 	(d) Participants with a family violence waiver must develop an employment plan 
33.25 	that meets the requirements in section 256J.521, which cover the provisions in section 
33.26 	256J.575, subdivision 5.
33.27 	(e) All other participants must develop an employment plan that meets the 
33.28 	requirements of section 256J.521, subdivision 2, and contains allowable work activities, 
33.29 	as defined in section 256J.49, subdivision 13. The employment plan must include, at a 
33.30 	minimum, the number of participation hours required under section 256J.55, subdivision 1.

33.31 	Sec. 21. Minnesota Statutes 2008, section 256J.561, subdivision 3, is amended to read:
33.32 		Subd. 3.Child under 12 weeks months of age. (a) A participant who has a 
33.33 	natural born child who is less than 12 weeks months of age who meets the criteria in this 
33.34 	subdivision is not required to participate in employment services until the child reaches 
33.35 	12 weeks months of age. To be eligible for this provision, the assistance unit must not 
34.1 	have already used this provision or the previously allowed child under age one exemption. 
34.2 	However, an assistance unit that has an approved child under age one exemption at the 
34.3 	time this provision becomes effective may continue to use that exemption until the child 
34.4 	reaches one year of age.
34.5 	(b) The provision in paragraph (a) ends the first full month after the child reaches 
34.6 	12 weeks months of age. This provision is available only once in a caregiver's lifetime. 
34.7 	In a two-parent household, only one parent shall be allowed to use this provision. The 
34.8 	participant and job counselor must meet within ten days after the child reaches 12 weeks
34.9 	months of age to revise the participant's employment plan.

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

34.11 	Sec. 22. Minnesota Statutes 2008, section 256J.57, subdivision 1, is amended to read:
34.12 		Subdivision 1.Good cause for failure to comply. The county agency shall not 
34.13 	impose the sanction under section 256J.46 if it determines that the participant has good 
34.14 	cause for failing to comply with the requirements of sections 256J.515 to 256J.57. Good 
34.15 	cause exists when: 
34.16 	(1) appropriate child care is not available;
34.17 	(2) the job does not meet the definition of suitable employment;
34.18 	(3) the participant is ill or injured;
34.19 	(4) a member of the assistance unit, a relative in the household, or a foster child in 
34.20 	the household is ill and needs care by the participant that prevents the participant from 
34.21 	complying with the employment plan;
34.22 	(5) the participant is unable to secure necessary transportation;
34.23 	(6) the participant is in an emergency situation that prevents compliance with the 
34.24 	employment plan;
34.25 	(7) the schedule of compliance with the employment plan conflicts with judicial 
34.26 	proceedings;
34.27 	(8) a mandatory MFIP meeting is scheduled during a time that conflicts with a 
34.28 	judicial proceeding or a meeting related to a juvenile court matter, or a participant's work 
34.29 	schedule;
34.30 	(9) the participant is already participating in acceptable work activities;
34.31 	(10) the employment plan requires an educational program for a caregiver under age 
34.32 	20, but the educational program is not available;
34.33 	(11) activities identified in the employment plan are not available;
34.34 	(12) the participant is willing to accept suitable employment, but suitable 
34.35 	employment is not available; or
35.1 	(13) the participant documents other verifiable impediments to compliance with the 
35.2 	employment plan beyond the participant's control; or
35.3 	(14) the documentation needed to determine if a participant is eligible for family 
35.4 	stabilization services is not available, but there is information that the participant may 
35.5 	qualify and the participant is cooperating with the county or employment service provider's 
35.6 	efforts to obtain the documentation necessary to determine eligibility.
35.7 	The job counselor shall work with the participant to reschedule mandatory meetings 
35.8 	for individuals who fall under clauses (1), (3), (4), (5), (6), (7), and (8).

35.9 	Sec. 23. Minnesota Statutes 2008, section 256J.575, subdivision 3, is amended to read:
35.10 		Subd. 3.Eligibility. (a) The following MFIP or diversionary work program (DWP)
35.11 	participants are eligible for the services under this section:
35.12 	(1) a participant who meets the requirements for or has been granted a hardship 
35.13 	extension under section 256J.425, subdivision 2 or 3, except that it is not necessary for 
35.14 	the participant to have reached or be approaching 60 months of eligibility for this section 
35.15 	to apply;
35.16 	(2) a participant who is applying for Supplemental Security Income or Social 
35.17 	Security disability insurance; and
35.18 	(3) a participant who is a noncitizen who has been in the United States for 12 or 
35.19 	fewer months; and
35.20 	(4) a participant who is age 60 or older.
35.21 	(b) Families must meet all other eligibility requirements for MFIP established in 
35.22 	this chapter. Families are eligible for financial assistance to the same extent as if they 
35.23 	were participating in MFIP.
35.24 	(c) A participant under paragraph (a), clause (3), must be provided with English as a 
35.25 	second language opportunities and skills training for up to 12 months. After 12 months, 
35.26 	the case manager and participant must determine whether the participant should continue 
35.27 	with English as a second language classes or skills training, or both, and continue to 
35.28 	receive family stabilization services.
35.29 	(d) If a county agency or employment services provider has information that 
35.30 	an MFIP participant may meet the eligibility criteria set forth in this subdivision, the 
35.31 	county agency or employment services provider must assist the participant in obtaining 
35.32 	the documentation necessary to determine eligibility. Until necessary documentation is 
35.33 	obtained, the participant must be treated as an eligible participant under subdivisions 5 to 7.

36.1 	EFFECTIVE DATE. This section is effective July 1, 2009, except the amendment 
36.2 	to paragraph (a) striking "or diversionary work program (DWP)" is effective March 1, 
36.3 	2010.

36.4 	Sec. 24. Minnesota Statutes 2008, section 256J.575, subdivision 4, is amended to read:
36.5 		Subd. 4.Universal participation. All caregivers must participate in family 
36.6 	stabilization services as defined in subdivision 2, except for caregivers exempt under 
36.7 	section 256J.561, subdivision 3.

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

36.9 	Sec. 25. Minnesota Statutes 2008, section 256J.575, subdivision 6, is amended to read:
36.10 		Subd. 6.Cooperation with services requirements. (a) To be eligible, A participant 
36.11 	who is eligible for family stabilization services under this section shall comply with 
36.12 	paragraphs (b) to (d).
36.13 	(b) Participants shall engage in family stabilization plan services for the appropriate 
36.14 	number of hours per week that the activities are scheduled and available, unless good 
36.15 	cause exists for not doing so, as defined in section 256J.57, subdivision 1. The appropriate 
36.16 	number of hours must be based on the participant's plan.
36.17 	(c) The case manager shall review the participant's progress toward the goals in the 
36.18 	family stabilization plan every six months to determine whether conditions have changed, 
36.19 	including whether revisions to the plan are needed.
36.20 	(d) A participant's requirement to comply with any or all family stabilization plan 
36.21 	requirements under this subdivision is excused when the case management services, 
36.22 	training and educational services, or family support services identified in the participant's 
36.23 	family stabilization plan are unavailable for reasons beyond the control of the participant, 
36.24 	including when money appropriated is not sufficient to provide the services.

36.25 	Sec. 26. Minnesota Statutes 2008, section 256J.575, subdivision 7, is amended to read:
36.26 		Subd. 7.Sanctions. (a) The county agency or employment services provider must 
36.27 	follow the requirements of this subdivision at the time the county agency or employment 
36.28 	services provider has information that an MFIP recipient may meet the eligibility criteria 
36.29 	in subdivision 3. 
36.30 	(b) The financial assistance grant of a participating family is reduced according to 
36.31 	section 256J.46, if a participating adult fails without good cause to comply or continue 
36.32 	to comply with the family stabilization plan requirements in this subdivision, unless 
36.33 	compliance has been excused under subdivision 6, paragraph (d).
37.1 	(b) (c) Given the purpose of the family stabilization services  in this section and the 
37.2 	nature of the underlying family circumstances that act as barriers to both employment and 
37.3 	full compliance with program requirements, there must be a review by the county agency 
37.4 	prior to imposing a sanction to determine whether the plan was appropriated to the needs 
37.5 	of the participant and family, and. There must be a current assessment by a behavioral 
37.6 	health or medical professional confirming that the participant in all ways had the ability to 
37.7 	comply with the plan, as confirmed by a behavioral health or medical professional.
37.8 	(c) (d) Prior to the imposition of a sanction, the county agency or employment 
37.9 	services provider shall review the participant's case to determine if the family stabilization 
37.10 	plan is still appropriate and meet with the participant face-to-face. The participant may 
37.11 	bring an advocate The county agency or employment services provider must inform the 
37.12 	participant of the right to bring an advocate to the face-to-face meeting. 
37.13 	During the face-to-face meeting, the county agency shall:
37.14 	(1) determine whether the continued noncompliance can be explained and mitigated 
37.15 	by providing a needed family stabilization service, as defined in subdivision 2, paragraph 
37.16 	(d);
37.17 	(2) determine whether the participant qualifies for a good cause exception under 
37.18 	section 256J.57, or if the sanction is for noncooperation with child support requirements, 
37.19 	determine if the participant qualifies for a good cause exemption under section 256.741, 
37.20 	subdivision 10;
37.21 	(3) determine whether activities in the family stabilization plan are appropriate 
37.22 	based on the family's circumstances;
37.23 	(4) explain the consequences of continuing noncompliance;
37.24 	(5) identify other resources that may be available to the participant to meet the 
37.25 	needs of the family; and
37.26 	(6) inform the participant of the right to appeal under section 256J.40.
37.27 	If the lack of an identified activity or service can explain the noncompliance, the 
37.28 	county shall work with the participant to provide the identified activity.
37.29 	(d) If the participant fails to come to the face-to-face meeting, the case manager or a 
37.30 	designee shall attempt at least one home visit. If a face-to-face meeting is not conducted, 
37.31 	the county agency shall send the participant a written notice that includes the information 
37.32 	under paragraph (c).
37.33 	(e) After the requirements of paragraphs (c) and (d) are met and prior to imposition 
37.34 	of a sanction, the county agency shall provide a notice of intent to sanction under section 
37.35 	256J.57, subdivision 2, and, when applicable, a notice of adverse action under section 
37.36 	256J.31.
38.1 	(f) Section 256J.57 applies to this section except to the extent that it is modified 
38.2 	by this subdivision.

38.3 	Sec. 27. Minnesota Statutes 2008, section 256J.621, is amended to read:
38.4 	256J.621 WORK PARTICIPATION CASH BENEFITS.
38.5 	(a) Effective October 1, 2009, upon exiting the diversionary work program (DWP) 
38.6 	or upon terminating the Minnesota family investment program with earnings, a participant 
38.7 	who is employed may be eligible for work participation cash benefits of $75 $50 per 
38.8 	month to assist in meeting the family's basic needs as the participant continues to move 
38.9 	toward self-sufficiency.
38.10 	(b) To be eligible for work participation cash benefits, the participant shall not 
38.11 	receive MFIP or diversionary work program assistance during the month and the 
38.12 	participant or participants must meet the following work requirements:
38.13 	(1) if the participant is a single caregiver and has a child under six years of age, the 
38.14 	participant must be employed at least 87 hours per month;
38.15 	(2) if the participant is a single caregiver and does not have a child under six years of 
38.16 	age, the participant must be employed at least 130 hours per month; or
38.17 	(3) if the household is a two-parent family, at least one of the parents must be 
38.18 	employed an average of at least 130 hours per month.
38.19 	Whenever a participant exits the diversionary work program or is terminated from 
38.20 	MFIP and meets the other criteria in this section, work participation cash benefits are 
38.21 	available for up to 24 consecutive months.
38.22 	(c) Expenditures on the program are maintenance of effort state funds under 
38.23 	a separate state program for participants under paragraph (b), clauses (1) and (2). 
38.24 	Expenditures for participants under paragraph (b), clause (3), are nonmaintenance of effort 
38.25 	funds. Months in which a participant receives work participation cash benefits under this 
38.26 	section do not count toward the participant's MFIP 60-month time limit.

38.27 	Sec. 28. Minnesota Statutes 2008, section 256J.626, subdivision 7, is amended to read:
38.28 		Subd. 7.Performance base funds. (a) For the purpose of this section, the following 
38.29 	terms have the meanings given.
38.30 	(1) "Caseload Reduction Credit" (CRC) means the measure of how much Minnesota 
38.31 	TANF and separate state program caseload has fallen relative to federal fiscal year 2005 
38.32 	based on caseload data from October 1 to September 30.
38.33 	(2) "TANF participation rate target" means a 50 percent participation rate reduced by 
38.34 	the CRC for the previous year.
39.1 	(b) For calendar year 2009 2010 and yearly thereafter, each county and tribe will be 
39.2 	allocated 95 percent of their initial calendar year allocation. Counties and tribes will be 
39.3 	allocated additional funds based on performance as follows:
39.4 	(1) a county or tribe that achieves a 50 percent the TANF participation rate target
39.5 	or a five percentage point improvement over the previous year's TANF participation rate 
39.6 	under section 256J.751, subdivision 2, clause (7), as averaged across 12 consecutive 
39.7 	months for the most recent year for which the measurements are available, will receive an 
39.8 	additional allocation equal to 2.5 percent of its initial allocation; and
39.9 	(2) a county or tribe that performs within or above its range of expected performance 
39.10 	on the annualized three-year self-support index under section 256J.751, subdivision 2, 
39.11 	clause (6), will receive an additional allocation equal to 2.5 percent of its initial allocation; 
39.12 	and
39.13 	(3) a county or tribe that does not achieve a 50 percent the TANF participation rate
39.14 	target or a five percentage point improvement over the previous year's TANF participation 
39.15 	rate under section 256J.751, subdivision 2, clause (7), as averaged across 12 consecutive 
39.16 	months for the most recent year for which the measurements are available, will not 
39.17 	receive an additional 2.5 percent of its initial allocation until after negotiating a multiyear 
39.18 	improvement plan with the commissioner; or 
39.19 	(4) a county or tribe that does not perform within or above its range of expected 
39.20 	performance on the annualized three-year self-support index under section 256J.751, 
39.21 	subdivision 2, clause (6), will not receive an additional allocation equal to 2.5 percent 
39.22 	of its initial allocation until after negotiating a multiyear improvement plan with the 
39.23 	commissioner.
39.24 	(b) (c) For calendar year 2009 and yearly thereafter, performance-based funds for 
39.25 	a federally approved tribal TANF program in which the state and tribe have in place 
39.26 	a contract under section 256.01, addressing consolidated funding, will be allocated as 
39.27 	follows:
39.28 	(1) a tribe that achieves the participation rate approved in its federal TANF plan 
39.29 	using the average of 12 consecutive months for the most recent year for which the 
39.30 	measurements are available, will receive an additional allocation equal to 2.5 percent of 
39.31 	its initial allocation; and
39.32 	(2) a tribe that performs within or above its range of expected performance on the 
39.33 	annualized three-year self-support index under section 256J.751, subdivision 2, clause (6), 
39.34 	will receive an additional allocation equal to 2.5 percent of its initial allocation; or 
39.35 	(3) a tribe that does not achieve the participation rate approved in its federal TANF 
39.36 	plan using the average of 12 consecutive months for the most recent year for which the 
40.1 	measurements are available, will not receive an additional allocation equal to 2.5 percent 
40.2 	of its initial allocation until after negotiating a multiyear improvement plan with the 
40.3 	commissioner; or
40.4 	(4) a tribe that does not perform within or above its range of expected performance 
40.5 	on the annualized three-year self-support index under section 256J.751, subdivision 
40.6 	2, clause (6), will not receive an additional allocation equal to 2.5 percent until after 
40.7 	negotiating a multiyear improvement plan with the commissioner.
40.8 	(c) (d) Funds remaining unallocated after the performance-based allocations 
40.9 	in paragraph (a) (b) are available to the commissioner for innovation projects under 
40.10 	subdivision 5.
40.11 	(d) (1) If available funds are insufficient to meet county and tribal allocations under 
40.12 	paragraph (a) (b), the commissioner may make available for allocation funds that are 
40.13 	unobligated and available from the innovation projects through the end of the current 
40.14 	biennium.
40.15 	(2) If after the application of clause (1) funds remain insufficient to meet county 
40.16 	and tribal allocations under paragraph (a) (b), the commissioner must proportionally 
40.17 	reduce the allocation of each county and tribe with respect to their maximum allocation 
40.18 	available under paragraph (a) (b).

40.19 	Sec. 29. Minnesota Statutes 2008, section 256J.95, subdivision 3, is amended to read:
40.20 		Subd. 3.Eligibility for diversionary work program. (a) Except for the categories 
40.21 	of family units listed below, all family units who apply for cash benefits and who 
40.22 	meet MFIP eligibility as required in sections 256J.11 to 256J.15 are eligible and must 
40.23 	participate in the diversionary work program. Family units that are not eligible for the 
40.24 	diversionary work program include:
40.25 	(1) child only cases;
40.26 	(2) a single-parent family unit that includes a child under 12 weeks months of age. 
40.27 	A parent is eligible for this exception once in a parent's lifetime and is not eligible if 
40.28 	the parent has already used the previously allowed child under age one exemption from 
40.29 	MFIP employment services;
40.30 	(3) a minor parent without a high school diploma or its equivalent;
40.31 	(4) an 18- or 19-year-old caregiver without a high school diploma or its equivalent 
40.32 	who chooses to have an employment plan with an education option;
40.33 	(5) a caregiver age 60 or over;
40.34 	(6) family units with a caregiver who received DWP benefits in the 12 months prior 
40.35 	to the month the family applied for DWP, except as provided in paragraph (c);
41.1 	(7) family units with a caregiver who received MFIP within the 12 months prior to 
41.2 	the month the family unit applied for DWP;
41.3 	(8) a family unit with a caregiver who received 60 or more months of TANF 
41.4 	assistance; 
41.5 	(9) a family unit with a caregiver who is disqualified from DWP or MFIP due to 
41.6 	fraud; and
41.7 	(10) refugees and asylees as defined in Code of Federal Regulations, title 45, part 
41.8 	400, subpart d, section 400.43, who arrived in the United States in the 12 months prior to 
41.9 	the date of application for family cash assistance.
41.10 	(b) A two-parent family must participate in DWP unless both caregivers meet the 
41.11 	criteria for an exception under paragraph (a), clauses (1) through (5), or the family unit 
41.12 	includes a parent who meets the criteria in paragraph (a), clause (6), (7), (8), (9), or (10).
41.13 	(c) Once DWP eligibility is determined, the four months run consecutively. If a 
41.14 	participant leaves the program for any reason and reapplies during the four-month period, 
41.15 	the county must redetermine eligibility for DWP.

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

41.17 	Sec. 30. Minnesota Statutes 2008, section 256J.95, subdivision 11, is amended to read:
41.18 		Subd. 11.Universal participation required. (a) All DWP caregivers, except 
41.19 	caregivers who meet the criteria in paragraph (d), are required to participate in DWP 
41.20 	employment services. Except as specified in paragraphs (b) and (c), employment plans 
41.21 	under DWP must, at a minimum, meet the requirements in section 256J.55, subdivision 1.
41.22 	(b) A caregiver who is a member of a two-parent family that is required to participate 
41.23 	in DWP who would otherwise be ineligible for DWP under subdivision 3 may be allowed 
41.24 	to develop an employment plan under section 256J.521, subdivision 2, paragraph (c), that 
41.25 	may contain alternate activities and reduced hours.
41.26 	(c) A participant who is a victim of family violence shall be allowed to develop an 
41.27 	employment plan under section 256J.521, subdivision 3. A claim of family violence must 
41.28 	be documented by the applicant or participant by providing a sworn statement which is 
41.29 	supported by collateral documentation in section 256J.545, paragraph (b).
41.30 	(d) One parent in a two-parent family unit that has a natural born child under 12 
41.31 	weeks months of age is not required to have an employment plan until the child reaches 12 
41.32 	weeks months of age unless the family unit has already used the exclusion under section 
41.33 	256J.561, subdivision 3, or the previously allowed child under age one exemption under 
41.34 	section 256J.56, paragraph (a), clause (5).
42.1 	(e) The provision in paragraph (d) ends the first full month after the child reaches 12 
42.2 	weeks months of age. This provision is allowable only once in a caregiver's lifetime. In a 
42.3 	two-parent household, only one parent shall be allowed to use this category.
42.4 	(f) The participant and job counselor must meet within ten working days after the 
42.5 	child reaches 12 weeks months of age to revise the participant's employment plan. The 
42.6 	employment plan for a family unit that has a child under 12 weeks months of age that has 
42.7 	already used the exclusion in section 256J.561 or the previously allowed child under 
42.8 	age one exemption under section 256J.56, paragraph (a), clause (5), must be tailored to 
42.9 	recognize the caregiving needs of the parent.

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

42.11 	Sec. 31. Minnesota Statutes 2008, section 256J.95, subdivision 12, is amended to read:
42.12 		Subd. 12.Conversion or referral to MFIP. (a) If at any time during the DWP 
42.13 	application process or during the four-month DWP eligibility period, it is determined that 
42.14 	a participant is unlikely to benefit from the diversionary work program, the county shall 
42.15 	convert or refer the participant to MFIP as specified in paragraph (d). Participants who are 
42.16 	determined to be unlikely to benefit from the diversionary work program must develop 
42.17 	and sign an employment plan. Participants who meet any one of the criteria in paragraph 
42.18 	(b) shall be considered to be unlikely to benefit from DWP, provided the necessary 
42.19 	documentation is available to support the determination.
42.20 	(b) A participant who: meets the eligibility requirements under section 256J.575, 
42.21 	subdivision 3, must be considered to be unlikely to benefit from DWP, provided the 
42.22 	necessary documentation is available to support the determination.
42.23 	(1) has been determined by a qualified professional as being unable to obtain or retain 
42.24 	employment due to an illness, injury, or incapacity that is expected to last at least 60 days;
42.25 	(2) is required in the home as a caregiver because of the illness, injury, or incapacity, 
42.26 	of a family member, or a relative in the household, or a foster child, and the illness, injury, 
42.27 	or incapacity and the need for a person to provide assistance in the home has been certified 
42.28 	by a qualified professional and is expected to continue more than 60 days;
42.29 	(3) is determined by a qualified professional as being needed in the home to care for 
42.30 	a child or adult meeting the special medical criteria in section 256J.561, subdivision 2, 
42.31 	paragraph (d), clause (3); 
42.32 	(4) is pregnant and is determined by a qualified professional as being unable to 
42.33 	obtain or retain employment due to the pregnancy; or
42.34 	(5) has applied for SSI or SSDI.
43.1 	(c) In a two-parent family unit, both parents must be if one parent is determined 
43.2 	to be unlikely to benefit from the diversionary work program before, the family unit 
43.3 	can must be converted or referred to MFIP.
43.4 	(d) A participant who is determined to be unlikely to benefit from the diversionary 
43.5 	work program shall be converted to MFIP and, if the determination was made within 30 
43.6 	days of the initial application for benefits, no additional application form is required. 
43.7 	A participant who is determined to be unlikely to benefit from the diversionary work 
43.8 	program shall be referred to MFIP and, if the determination is made more than 30 
43.9 	days after the initial application, the participant must submit a program change request 
43.10 	form. The county agency shall process the program change request form by the first of 
43.11 	the following month to ensure that no gap in benefits is due to delayed action by the 
43.12 	county agency. In processing the program change request form, the county must follow 
43.13 	section 256J.32, subdivision 1, except that the county agency shall not require additional 
43.14 	verification of the information in the case file from the DWP application unless the 
43.15 	information in the case file is inaccurate, questionable, or no longer current. 
43.16 	(e) The county shall not request a combined application form for a participant who 
43.17 	has exhausted the four months of the diversionary work program, has continued need for 
43.18 	cash and food assistance, and has completed, signed, and submitted a program change 
43.19 	request form within 30 days of the fourth month of the diversionary work program. The 
43.20 	county must process the program change request according to section 256J.32, subdivision 
43.21 	1, except that the county agency shall not require additional verification of information 
43.22 	in the case file unless the information is inaccurate, questionable, or no longer current. 
43.23 	When a participant does not request MFIP within 30 days of the diversionary work 
43.24 	program benefits being exhausted, a new combined application form must be completed 
43.25 	for any subsequent request for MFIP. 

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

43.27 	Sec. 32. Minnesota Statutes 2008, section 256J.95, subdivision 13, is amended to read:
43.28 		Subd. 13.Immediate referral to employment services. Within one working day of 
43.29 	determination that the applicant is eligible for the diversionary work program, but before 
43.30 	benefits are issued to or on behalf of the family unit, the county shall refer all caregivers to 
43.31 	employment services. The referral to the DWP employment services must be in writing 
43.32 	and must contain the following information:
43.33 	(1) notification that, as part of the application process, applicants are required to 
43.34 	develop an employment plan or the DWP application will be denied;
43.35 	(2) the employment services provider name and phone number;
44.1 	(3) the date, time, and location of the scheduled employment services interview;
44.2 	(4) the immediate availability of supportive services, including, but not limited to, 
44.3 	child care, transportation, and other work-related aid; and
44.4 	(5) (4) the rights, responsibilities, and obligations of participants in the program, 
44.5 	including, but not limited to, the grounds for good cause, the consequences of refusing or 
44.6 	failing to participate fully with program requirements, and the appeal process.

44.7 	Sec. 33. Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision 
44.8 	to read:
44.9 		Subd. 3b.Extension; adoption finalized after age 16. A child who has attained the 
44.10 	age of 16 prior to finalization of their adoption is eligible for extension of the adoption 
44.11 	assistance agreement to the date the child attains age 21 if the child is:
44.12 	(1) completing a secondary education program or a program leading to an equivalent 
44.13 	credential;
44.14 	(2) enrolled in an institution which provides postsecondary or vocational education;
44.15 	(3) participating in a program or activity designed to promote or remove barriers to 
44.16 	employment;
44.17 	(4) employed for at least 80 hours per month; or
44.18 	(5) incapable of doing any of the activities described in clauses (1) to (4) due to a 
44.19 	medical condition which incapability is supported by regularly updated information in 
44.20 	the case plan of the child.

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

44.22 	Sec. 34. Minnesota Statutes 2008, section 270A.09, is amended by adding a 
44.23 	subdivision to read:
44.24 		Subd. 1b.Department of Human Services claims. Notwithstanding subdivision 1, 
44.25 	any debtor contesting a setoff claim by the Department of Human Services or a county 
44.26 	agency whose claim relates to a debt resulting from receipt of public assistance, medical 
44.27 	care, or the federal Food Stamp Act shall have a hearing conducted in the same manner as 
44.28 	an appeal under sections 256.045 and 256.0451.

44.29 	Sec. 35. AMERICAN INDIAN CHILD WELFARE PROJECTS.
 44.30 	Notwithstanding Minnesota Statutes, section 16A.28, the commissioner of human 
44.31 	services shall extend payment of state fiscal year 2009 funds in state fiscal year 2010 
44.32 	to tribes participating in the American Indian child welfare projects under Minnesota 
44.33 	Statutes, section 256.01, subdivision 14b. Future extensions of payment for a tribe 
45.1 	participating in the Indian child welfare projects under Minnesota Statutes, section 256.01, 
45.2 	subdivision 14b, must be granted according to the commissioner's authority under 
45.3 	Minnesota Statutes, section 16A.28.

45.4 	Sec. 36.  REPEALER.
 45.5 	Minnesota Statutes 2008, section 256I.06, subdivision 9, is repealed.

45.6 	ARTICLE 3
45.7 	STATE-OPERATED SERVICES/MINNESOTA SEX OFFENDER PROGRAM

45.8 	Section 1. Minnesota Statutes 2008, section 246.50, subdivision 5, is amended to read:
45.9 		Subd. 5.Cost of care. "Cost of care" means the commissioner's charge for services 
45.10 	provided to any person admitted to a state facility.
45.11 	For purposes of this subdivision, "charge for services" means the cost of services, 
45.12 	treatment, maintenance, bonds issued for capital improvements, depreciation of buildings 
45.13 	and equipment, and indirect costs related to the operation of state facilities. The 
45.14 	commissioner may determine the charge for services on an anticipated average per diem 
45.15 	basis as an all inclusive charge per facility, per disability group, or per treatment program. 
45.16 	The commissioner may determine a charge per service, using a method that includes direct 
45.17 	and indirect costs usual and customary fee charged for services provided to clients. The 
45.18 	usual and customary fee shall be established in a manner required to appropriately bill 
45.19 	services to all payers and shall include the costs related to the operations of any program 
45.20 	offered by the state.

45.21 	Sec. 2. Minnesota Statutes 2008, section 246.50, is amended by adding a subdivision 
45.22 	to read:
45.23 		Subd. 10.State-operated community-based program.  "State-operated 
45.24 	community-based program" means any program operated in the community including 
45.25 	community behavioral health hospitals, crisis centers, residential facilities, outpatient 
45.26 	services, and other community-based services developed and operated by the state and 
45.27 	under the commissioner's control.

45.28 	Sec. 3. Minnesota Statutes 2008, section 246.50, is amended by adding a subdivision 
45.29 	to read:
45.30 		Subd. 11.Health plan company. "Health plan company" has the meaning given it 
45.31 	in section 62Q.01, subdivision 4, and also includes a demonstration provider as defined in 
45.32 	section 256B.69, subdivision 2, paragraph (b), a county or group of counties participating 
46.1 	in county-based purchasing according to section 256B.692, and a children's mental health 
46.2 	collaborative under contract to provide medical assistance for individuals enrolled in 
46.3 	the prepaid medical assistance and MinnesotaCare programs under sections 245.493 to 
46.4 	245.495.

46.5 	Sec. 4. Minnesota Statutes 2008, section 246.51, is amended by adding a subdivision 
46.6 	to read:
46.7 		Subd. 1a.Clients in state-operated community-based programs; determination.
 46.8 	The commissioner shall determine available health plan coverage from a health plan 
46.9 	company for services provided to clients admitted to a state-operated community-based 
46.10 	program. If the health plan coverage requires a co-pay or deductible, or if there is no 
46.11 	available health plan coverage, the commissioner shall determine or redetermine, what 
46.12 	part of the noncovered cost of care, if any, the client is able to pay. If the client is unable to 
46.13 	pay the uncovered cost of care, the commissioner shall determine the client's relatives' 
46.14 	ability to pay. The client and relatives shall provide to the commissioner documents and 
46.15 	proof necessary to determine the client and relatives' ability to pay. Failure to provide the 
46.16 	commissioner with sufficient information to determine ability to pay may make the client 
46.17 	or relatives liable for the full cost of care until the time when sufficient information is 
46.18 	provided. If it is determined that the responsible party does not have the ability to pay, 
46.19 	the commissioner shall waive payment of the portion that exceeds ability to pay under 
46.20 	the determination.

46.21 	Sec. 5. Minnesota Statutes 2008, section 246.51, is amended by adding a subdivision 
46.22 	to read:
46.23 		Subd. 1b.Clients served by regional treatment centers or nursing homes; 
46.24 	determination. The commissioner shall determine or redetermine, if necessary, what part 
46.25 	of the cost of care, if any, a client served in regional treatment centers or nursing homes 
46.26 	operated by state-operated services, is able to pay. If the client is unable to pay the full cost 
46.27 	of care, the commissioner shall determine if the client's relatives have the ability to pay. 
46.28 	The client and relatives shall provide to the commissioner documents and proof necessary 
46.29 	to determine the client and relatives' ability to pay. Failure to provide the commissioner 
46.30 	with sufficient information to determine ability to pay may make the client or relatives 
46.31 	liable for the full cost of care until the time when sufficient information is provided. No 
46.32 	parent shall be liable for the cost of care given a client at a regional treatment center after 
46.33 	the client has reached the age of 18 years.

47.1 	Sec. 6. Minnesota Statutes 2008, section 246.511, is amended to read:
47.2 	246.511 RELATIVE RESPONSIBILITY.
47.3 	Except for chemical dependency services paid for with funds provided under chapter 
47.4 	254B, a client's relatives shall not, pursuant to the commissioner's authority under section 
47.5 	246.51, be ordered to pay more than ten percent of the cost ofthe following: (1) for 
47.6 	services provided in a community-based service, the noncovered cost of care as determined 
47.7 	under the ability to pay determination; and (2) for services provided at a regional treatment 
47.8 	center operated by state-operated services, 20 percent of the cost of care, unless they 
47.9 	reside outside the state. Parents of children in state facilities shall have their responsibility 
47.10 	to pay determined according to section 252.27, subdivision 2, or in rules adopted under 
47.11 	chapter 254B if the cost of care is paid under chapter 254B. The commissioner may 
47.12 	accept voluntary payments in excess of ten 20 percent. The commissioner may require 
47.13 	full payment of the full per capita cost of care in state facilities for clients whose parent, 
47.14 	parents, spouse, guardian, or conservator do not reside in Minnesota.  

47.15 	Sec. 7. Minnesota Statutes 2008, section 246.52, is amended to read:
47.16 	246.52 PAYMENT FOR CARE; ORDER; ACTION.
47.17 	The commissioner shall issue an order to the client or the guardian of the estate, if 
47.18 	there be one, and relatives determined able to pay requiring them to pay monthly to the 
47.19 	state of Minnesota the amounts so determined the total of which shall not exceed the full 
47.20 	cost of care. Such order shall specifically state the commissioner's determination and shall 
47.21 	be conclusive unless appealed from as herein provided. When a client or relative fails to 
47.22 	pay the amount due hereunder the attorney general, upon request of the commissioner, 
47.23 	may institute, or direct the appropriate county attorney to institute, civil action to recover 
47.24 	such amount.

47.25 	Sec. 8. Minnesota Statutes 2008, section 246.54, subdivision 2, is amended to read:
47.26 		Subd. 2.Exceptions. (a) Subdivision 1 does not apply to services provided at the 
47.27 	Minnesota Security Hospital, the Minnesota sex offender program, or the Minnesota 
47.28 	extended treatment options program. For services at these facilities, a county's payment 
47.29 	shall be made from the county's own sources of revenue and payments shall be paid as 
47.30 	follows: payments to the state from the county shall equal ten percent of the cost of care, 
47.31 	as determined by the commissioner, for each day, or the portion thereof, that the client 
47.32 	spends at the facility. If payments received by the state under sections 246.50 to 246.53
47.33 	exceed 90 percent of the cost of care, the county shall be responsible for paying the state 
48.1 	only the remaining amount. The county shall not be entitled to reimbursement from the 
48.2 	client, the client's estate, or from the client's relatives, except as provided in section 246.53. 
48.3 	(b) Regardless of the facility to which the client is committed, subdivision 1 does 
48.4 	not apply to the following individuals:
48.5 	(1) clients who are committed as mentally ill and dangerous under section 253B.02, 
48.6 	subdivision 17;
48.7 	(2) clients who are committed as sexual psychopathic personalities under section 
48.8 	253B.02, subdivision 18b; and
48.9 	(3) clients who are committed as sexually dangerous persons under section 253B.02, 
48.10 	subdivision 18c.
48.11 	For each of the individuals in clauses (1) to (3), the payment by the county to the state 
48.12 	shall equal ten percent of the cost of care for each day as determined by the commissioner.

48.13 	Sec. 9. Minnesota Statutes 2008, section 246B.01, is amended by adding a subdivision 
48.14 	to read:
48.15 		Subd. 1a.Client. "Client" means a person who is admitted to the Minnesota sex 
48.16 	offender program or subject to a court hold order under section 253B.185 for the purpose 
48.17 	of assessment, diagnosis, care, treatment, supervision, or other services provided by the 
48.18 	Minnesota sex offender program.

48.19 	Sec. 10. Minnesota Statutes 2008, section 246B.01, is amended by adding a 
48.20 	subdivision to read:
48.21 		Subd. 1b.Client's county. "Client's county" means the county of the client's 
48.22 	legal settlement for poor relief purposes at the time of commitment. If the client has no 
48.23 	legal settlement for poor relief in this state, it means the county of commitment, except 
48.24 	that when a client with no legal settlement for poor relief is committed while serving a 
48.25 	sentence at a penal institution, it means the county from which the client was sentenced.

48.26 	Sec. 11. Minnesota Statutes 2008, section 246B.01, is amended by adding a subdivision 
48.27 	to read:
48.28 		Subd. 2a.Cost of care. "Cost of care" means the commissioner's charge for housing 
48.29 	and treatment services provided to any person admitted to the Minnesota sex offender 
48.30 	program.
48.31 	For purposes of this subdivision, "charge for housing and treatment services" means 
48.32 	the cost of services, treatment, maintenance, bonds issued for capital improvements, 
48.33 	depreciation of buildings and equipment, and indirect costs related to the operation of 
49.1 	state facilities. The commissioner may determine the charge for services on an anticipated 
49.2 	average per diem basis as an all-inclusive charge per facility.

49.3 	Sec. 12. Minnesota Statutes 2008, section 246B.01, is amended by adding a 
49.4 	subdivision to read:
49.5 		Subd. 2b.Local social services agency. "Local social services agency" means the 
49.6 	local social services agency of the client's county as defined in subdivision 1b and of the 
49.7 	county of commitment, and any other local social services agency possessing information 
49.8 	regarding, or requested by the commissioner to investigate, the financial circumstances 
49.9 	of a client.

49.10 	Sec. 13. [246B.07] PAYMENT FOR CARE AND TREATMENT: 
49.11 	DETERMINATION.
49.12 		Subdivision 1.Procedures. The commissioner shall determine or redetermine, if 
49.13 	necessary, what amount of the cost of care, if any, the client is able to pay. The client shall 
49.14 	provide to the commissioner documents and proof necessary to determine the ability to 
49.15 	pay. Failure to provide the commissioner with sufficient information to determine ability 
49.16 	to pay may make the client liable for the full cost of care until the time when sufficient 
49.17 	information is provided.
49.18 		Subd. 2.Rules. The commissioner shall use the standards in section 246.51, 
49.19 	subdivision 2, to determine the client's liability for the care provided by the Minnesota sex 
49.20 	offender program.
49.21 		Subd. 3.Applicability. The commissioner may recover, under sections 246B.07 to 
49.22 	246B.10, the cost of any care provided by the Minnesota sex offender program.

49.23 	Sec. 14. [246B.08] PAYMENT FOR CARE; ORDER; ACTION.
49.24 	The commissioner shall issue an order to the client or the guardian of the estate, if 
49.25 	there is one, requiring the client or guardian to pay to the state the amounts determined, the 
49.26 	total of which must not exceed the full cost of care. The order must specifically state the 
49.27 	commissioner's determination and must be conclusive, unless appealed. If a client fails to 
49.28 	pay the amount due, the attorney general, upon request of the commissioner, may institute, 
49.29 	or direct the appropriate county attorney to institute a civil action to recover the amount.

49.30 	Sec. 15. [246B.09] CLAIM AGAINST ESTATE OF DECEASED CLIENT.
49.31 		Subdivision 1.Client's estate. Upon the death of a client, or a former client, the 
49.32 	total cost of care provided to the client, less the amount actually paid toward the cost of 
50.1 	care by the client, must be filed by the commissioner as a claim against the estate of the 
50.2 	client with the court having jurisdiction to probate the estate, and all proceeds collected 
50.3 	by the state in the case must be divided between the state and county in proportion to 
50.4 	the cost of care each has borne.
50.5 		Subd. 2.Preferred status. An estate claim in subdivision 1 must be considered an 
50.6 	expense of the last illness for purposes of section 524.3-805.
50.7 	If the commissioner determines that the property or estate of a client is not more 
50.8 	than needed to care for and maintain the spouse and minor or dependent children of a 
50.9 	deceased client, the commissioner has the power to compromise the claim of the state in a 
50.10 	manner deemed just and proper.
50.11 		Subd. 3.Exception from statute of limitations. Any statute of limitations that 
50.12 	limits the commissioner in recovering the cost of care obligation incurred by a client or 
50.13 	former client must not apply to any claim against an estate made under this section to 
50.14 	recover cost of care.

50.15 	Sec. 16. [246B.10] LIABILITY OF COUNTY; REIMBURSEMENT.
50.16 	The client's county shall pay to the state a portion of the cost of care provided in 
50.17 	the Minnesota sex offender program to a client who has legally settled in that county. A 
50.18 	county's payment must be made from the county's own sources of revenue and payments 
50.19 	must equal ten percent of the cost of care, as determined by the commissioner, for each 
50.20 	day or portion of a day, that the client spends at the facility. If payments received by the 
50.21 	state under this chapter exceed 90 percent of the cost of care, the county is responsible 
50.22 	for paying the state the remaining amount. The county is not entitled to reimbursement 
50.23 	from the client, the client's estate, or from the client's relatives, except as provided in 
50.24 	section 246B.07.

50.25 	Sec. 17. Minnesota Statutes 2008, section 252.025, subdivision 7, is amended to read:
50.26 		Subd. 7.Minnesota extended treatment options. The commissioner shall develop 
50.27 	by July 1, 1997, the Minnesota extended treatment options to serve Minnesotans who have 
50.28 	developmental disabilities and exhibit severe behaviors which present a risk to public 
50.29 	safety. This program is statewide and must provide specialized residential services in 
50.30 	Cambridge and an array of community support community-based services statewide with 
50.31 	sufficient levels of care and a sufficient number of specialists to ensure that individuals 
50.32 	referred to the program receive the appropriate care. The individuals working in the 
50.33 	community-based services under this section are state employees supervised by the 
51.1 	commissioner of human services. No layoffs shall occur as a result of restructuring 
51.2 	under this section.

51.3 	Sec. 18. REQUIRING THE DEVELOPMENT OF COMMUNITY-BASED 
51.4 	MENTAL HEALTH SERVICES FOR PATIENTS COMMITTED TO THE 
51.5 	ANOKA-METRO REGIONAL TREATMENT CENTER.
 51.6 	In consultation with community partners, the commissioner of human services 
51.7 	shall develop an array of community-based services to transform the current services 
51.8 	now provided to patients at the Anoka-Metro Regional Treatment Center. The 
51.9 	community-based services may be provided in facilities with 16 or fewer beds, and must 
51.10 	provide the appropriate level of care for the patients being admitted to the facilities. The 
51.11 	planning for this transition must be completed by October 1, 2009, with an initial report 
51.12 	to the committee chairs of health and human services by November 30, 2009, and a 
51.13 	semiannual report on progress until the transition is completed. The commissioner of 
51.14 	human services shall solicit interest from stakeholders and potential community partners. 
51.15 	The individuals working in the community-based services facilities under this section are 
51.16 	state employees supervised by the commissioner of human services. No layoffs shall 
51.17 	occur as a result of restructuring under this section.

51.18 	Sec. 19.  REPEALER.
 51.19 	Minnesota Statutes 2008, sections 246.51, subdivision 1; and 246.53, subdivision 
51.20 	3, are repealed.

51.21 	ARTICLE 4
51.22 	DEPARTMENT OF HEALTH

51.23 	Section 1. Minnesota Statutes 2008, section 62J.495, is amended to read:
51.24 	62J.495 HEALTH INFORMATION TECHNOLOGY AND 
51.25 	INFRASTRUCTURE.
51.26 		Subdivision 1.Implementation. By January 1, 2015, all hospitals and health care 
51.27 	providers must have in place an interoperable electronic health records system within their 
51.28 	hospital system or clinical practice setting. The commissioner of health, in consultation 
51.29 	with the e-Health Information Technology and Infrastructure Advisory Committee, 
51.30 	shall develop a statewide plan to meet this goal, including uniform standards to be used 
51.31 	for the interoperable system for sharing and synchronizing patient data across systems. 
51.32 	The standards must be compatible with federal efforts. The uniform standards must be 
52.1 	developed by January 1, 2009, with a status report on the development of these standards 
52.2 	submitted to the legislature by January 15, 2008 and updated on an ongoing basis. The 
52.3 	commissioner shall include an update on standards development as part of an annual 
52.4 	report to the legislature.
52.5 		Subd. 1a.Definitions. (a) "Certified electronic health record technology" means an 
52.6 	electronic health record that is certified pursuant to section 3001(c)(5) of the HITECH 
52.7 	Act to meet the standards and implementation specifications adopted under section 3004 
52.8 	as applicable.
52.9 	(b) "Commissioner" means the commissioner of health.
52.10 	(c) "Pharmaceutical electronic data intermediary" means any entity that provides 
52.11 	the infrastructure to connect computer systems or other electronic devices utilized 
52.12 	by prescribing practitioners with those used by pharmacies, health plans, third party 
52.13 	administrators, and pharmacy benefit manager in order to facilitate the secure transmission 
52.14 	of electronic prescriptions, refill authorization requests, communications, and other 
52.15 	prescription-related information between such entities.
52.16 	(d) "HITECH Act" means the Health Information Technology for Economic and 
52.17 	Clinical Health Act in division A, title XIII and division B, title IV of the American 
52.18 	Recovery and Reinvestment Act of 2009, including federal regulations adopted under 
52.19 	that act.
52.20 	(e) "Interoperable electronic health record" means an electronic health record that 
52.21 	securely exchanges health information with another electronic health record system that 
52.22 	meets national requirements for certification under the HITECH Act.
52.23 	(f) "Qualified electronic health record" means an electronic record of health-related 
52.24 	information on an individual that includes patient demographic and clinical health 
52.25 	information and has the capacity to:
52.26 	(1) provide clinical decision support;
52.27 	(2) support physician order entry;
52.28 	(3) capture and query information relevant to health care quality; and
52.29 	(4) exchange electronic health information with, and integrate such information 
52.30 	from, other sources.
52.31 		Subd. 2.E-Health Information Technology and Infrastructure Advisory 
52.32 	Committee. (a) The commissioner shall establish aan e-Health Information Technology 
52.33 	and Infrastructure Advisory Committee governed by section 15.059 to advise the 
52.34 	commissioner on the following matters:
52.35 	(1) assessment of the adoption and effective use of health information technology by 
52.36 	the state, licensed health care providers and facilities, and local public health agencies;
53.1 	(2) recommendations for implementing a statewide interoperable health information 
53.2 	infrastructure, to include estimates of necessary resources, and for determining standards 
53.3 	for administrative clinical data exchange, clinical support programs, patient privacy 
53.4 	requirements, and maintenance of the security and confidentiality of individual patient 
53.5 	data; 
53.6 	(3) recommendations for encouraging use of innovative health care applications 
53.7 	using information technology and systems to improve patient care and reduce the cost 
53.8 	of care, including applications relating to disease management and personal health 
53.9 	management that enable remote monitoring of patients' conditions, especially those with 
53.10 	chronic conditions; and 
53.11 	(4) other related issues as requested by the commissioner.
53.12 	(b) The members of the e-Health Information Technology and Infrastructure
53.13 	Advisory Committee shall include the commissioners, or commissioners' designees, of 
53.14 	health, human services, administration, and commerce and additional members to be 
53.15 	appointed by the commissioner to include persons representing Minnesota's local public 
53.16 	health agencies, licensed hospitals and other licensed facilities and providers, private 
53.17 	purchasers, the medical and nursing professions, health insurers and health plans, the 
53.18 	state quality improvement organization, academic and research institutions, consumer 
53.19 	advisory organizations with an interest and expertise in health information technology, and 
53.20 	other stakeholders as identified by the Health Information Technology and Infrastructure 
53.21 	Advisory Committee commissioner to fulfill the requirements of section 3013, paragraph 
53.22 	(g) of the HITECH Act.
53.23 	(c) The commissioner shall prepare and issue an annual report not later than January 
53.24 	30 of each year outlining progress to date in implementing a statewide health information 
53.25 	infrastructure and recommending future projects action on policy and necessary resources 
53.26 	to continue the promotion of adoption and effective use of health information technology.
53.27 	(d) Notwithstanding section 15.059, this subdivision expires June 30, 2015.
53.28 		Subd. 3.Interoperable electronic health record requirements. (a) To meet the 
53.29 	requirements of subdivision 1, hospitals and health care providers must meet the following 
53.30 	criteria when implementing an interoperable electronic health records system within their 
53.31 	hospital system or clinical practice setting.
53.32 	(a) The electronic health record must be a qualified electronic health record.
53.33 	(b) The electronic health record must be certified by the Certification Commission 
53.34 	for Healthcare Information Technology, or its successor Office of the National Coordinator 
53.35 	pursuant to the HITECH Act. This criterion only applies to hospitals and health care 
53.36 	providers whose practice setting is a practice setting covered by the Certification 
54.1 	Commission for Healthcare Information Technology certifications only if a certified 
54.2 	electronic health record product for the provider's particular practice setting is available. 
54.3 	This criterion shall be considered met if a hospital or health care provider is using an 
54.4 	electronic health records system that has been certified within the last three years, even if a 
54.5 	more current version of the system has been certified within the three-year period.
54.6 	(c) The electronic health record must meet the standards established according to 
54.7 	section 3004 of the HITECH Act as applicable.
54.8 	(d) The electronic health record must have the ability to generate information on 
54.9 	clinical quality measures and other measures reported under sections 4101, 4102, and 
54.10 	4201 of the HITECH Act.
54.11 	(c) (e) A health care provider who is a prescriber or dispenser of controlled 
54.12 	substances legend drugs must have an electronic health record system that meets the 
54.13 	requirements of section 62J.497.
54.14 		Subd. 4.Coordination with national HIT activities. (a) The commissioner, 
54.15 	in consultation with the e-Health Advisory Committee, shall update the statewide 
54.16 	implementation plan required under subdivision 2 and released June 2008, to be consistent 
54.17 	with the updated Federal HIT Strategic Plan released by the Office of the National 
54.18 	Coordinator in accordance with section 3001 of the HITECH Act.  The statewide plan 
54.19 	shall meet the requirements for a plan required under section 3013 of the HITECH Act.
54.20 	(b) The commissioner, in consultation with the e-Health Advisory Committee, shall 
54.21 	work to ensure coordination between state, regional, and national efforts to support and 
54.22 	accelerate efforts to effectively use health information technology to improve the quality 
54.23 	and coordination of health care and continuity of patient care among health care providers, 
54.24 	to reduce medical errors, to improve population health, to reduce health disparities, and 
54.25 	to reduce chronic disease.  The commissioner's coordination efforts shall include but not 
54.26 	be limited to:
54.27 	(1) assisting in the development and support of health information technology 
54.28 	regional extension centers established under section 3012(c) of the HITECH Act to 
54.29 	provide technical assistance and disseminate best practices; and
54.30 	(2) providing supplemental information to the best practices gathered by regional 
54.31 	centers to ensure that the information is relayed in a meaningful way to the Minnesota 
54.32 	health care community.
54.33 	(c) The commissioner, in consultation with the e-Health Advisory Committee, shall 
54.34 	monitor national activity related to health information technology and shall coordinate 
54.35 	statewide input on policy development.  The commissioner shall coordinate statewide 
54.36 	responses to proposed federal health information technology regulations in order to ensure 
55.1 	that the needs of the Minnesota health care community are adequately and efficiently 
55.2 	addressed in the proposed regulations. The commissioner's responses may include, but 
55.3 	are not limited to:
55.4 	(1) reviewing and evaluating any standard, implementation specification, or 
55.5 	certification criteria proposed by the national HIT standards committee;
55.6 	(2) reviewing and evaluating policy proposed by the national HIT policy 
55.7 	committee relating to the implementation of a nationwide health information technology 
55.8 	infrastructure;
55.9 	(3) monitoring and responding to activity related to the development of quality 
55.10 	measures and other measures as required by section 4101 of the HITECH Act. Any 
55.11 	response related to quality measures shall consider and address the quality efforts required 
55.12 	under chapter 62U; and
55.13 	(4) monitoring and responding to national activity related to privacy, security, and 
55.14 	data stewardship of electronic health information and individually identifiable health 
55.15 	information.
55.16 	(d) To the extent that the state is either required or allowed to apply, or designate an 
55.17 	entity to apply for or carry out activities and programs under section 3013 of the HITECH 
55.18 	Act, the commissioner of health, in consultation with the e-Health Advisory Committee 
55.19 	and the commissioner of human services, shall be the lead applicant or sole designating 
55.20 	authority. The commissioner shall make such designations consistent with the goals and 
55.21 	objectives of sections 62J.495 to 62J.497, and sections 62J.50 to 62J.61.
55.22 	(e) The commissioner of human services shall apply for funding necessary to 
55.23 	administer the incentive payments to providers authorized under title IV of the American 
55.24 	Recovery and Reinvestment Act.
55.25 	(f) The commissioner shall include in the report to the legislature information on the 
55.26 	activities of this subdivision and provide recommendations on any relevant policy changes 
55.27 	that should be considered in Minnesota.
55.28 		Subd. 5.Collection of data for assessment and eligibility determination. (a) 
55.29 	The commissioner of health, in consultation with the commissioner of human services, 
55.30 	may require providers, dispensers, group purchasers, and pharmaceutical electronic data 
55.31 	intermediaries to submit data in a form and manner specified by the commissioner to 
55.32 	assess the status of adoption, effective use, and interoperability of electronic health 
55.33 	records for the purpose of:
55.34 	(1) demonstrating Minnesota's progress on goals established by the Office of the 
55.35 	National Coordinator to accelerate the adoption and effective use of health information 
55.36 	technology established under the HITECH Act;
56.1 	(2) assisting the Center for Medicare and Medicaid Services and Department of 
56.2 	Human Services in determining eligibility of health care professionals and hospitals 
56.3 	to receive federal incentives for the adoption and effective use of health information 
56.4 	technology under the HITECH Act or other federal incentive programs;
56.5 	(3) assisting the Office of the National Coordinator in completing required 
56.6 	assessments of the impact of the implementation and effective use of health information 
56.7 	technology in achieving goals identified in the national strategic plan, and completing 
56.8 	studies required by the HITECH Act;
56.9 	(4) providing the data necessary to assist the Office of the National Coordinator in 
56.10 	conducting evaluations of regional extension centers as required by the HITECH Act; and
56.11 	(5) other purposes as necessary to support the implementation of the HITECH Act.
56.12 	(b) The commissioner shall coordinate with the commissioner of human services 
56.13 	and other state agencies in the collection of data required under this section to:
56.14 	(1) avoid duplicative reporting requirements;
56.15 	(2) maximize efficiencies in the development of reports on state activities as 
56.16 	required by HITECH; and
56.17 	(3) determine health professional and hospital eligibility for incentives available 
56.18 	under the HITECH Act.
56.19 	(c) The commissioner must not collect data or publish analyses that identify, or could 
56.20 	potentially identify, individual patients. The commissioner must not collect individual 
56.21 	data in identified or de-identified form.

56.22 	Sec. 2. Minnesota Statutes 2008, section 62J.496, is amended to read:
56.23 	62J.496 ELECTRONIC HEALTH RECORD SYSTEM REVOLVING 
56.24 	ACCOUNT AND LOAN PROGRAM.
56.25 		Subdivision 1.Account establishment. (a) An account is established to:provide 
56.26 	loans to eligible borrowers to assist in financing the installation or support of an 
56.27 	interoperable health record system. The system must provide for the interoperable 
56.28 	exchange of health care information between the applicant and, at a minimum, a hospital 
56.29 	system, pharmacy, and a health care clinic or other physician group.
56.30 	(1) finance the purchase of certified electronic health records or qualified electronic 
56.31 	health records as defined in section 62J.495, subdivision 1a;
56.32 	(2) enhance the utilization of electronic health record technology, which may include 
56.33 	costs associated with upgrading the technology to meet the criteria necessary to be a 
56.34 	certified electronic health record or a qualified electronic health record;
56.35 	(3) train personnel in the use of electronic health record technology; and
57.1 	(4) improve the secure electronic exchange of health information.
57.2 	(b) Amounts deposited in the account, including any grant funds obtained through 
57.3 	federal or other sources, loan repayments, and interest earned on the amounts shall be 
57.4 	used only for awarding loans or loan guarantees, as a source of reserve and security for 
57.5 	leveraged loans, or for the administration of the account.
57.6 	(c) The commissioner may accept contributions to the account from private sector 
57.7 	entities subject to the following provisions:
57.8 	(1) the contributing entity may not specify the recipient or recipients of any loan 
57.9 	issued under this subdivision;
57.10 	(2) the commissioner shall make public the identity of any private contributor to the 
57.11 	loan fund, as well as the amount of the contribution provided; and
57.12 	(3) the commissioner may issue letters of commendation or make other awards that 
57.13 	have no financial value to any such entity.
57.14 	A contributing entity may not specify that the recipient or recipients of any loan use 
57.15 	specific products or services, nor may the contributing entity imply that a contribution is 
57.16 	an endorsement of any specific product or service.
57.17 	(d) The commissioner may use the loan funds to reimburse private sector entities 
57.18 	for any contribution made to the loan fund. Reimbursement to private entities may not 
57.19 	exceed the principle amount contributed to the loan fund.
57.20 	(e) The commissioner may use funds deposited in the account to guarantee, or 
57.21 	purchase insurance for, a local obligation if the guarantee or purchase would improve 
57.22 	credit market access or reduce the interest rate applicable to the obligation involved.
57.23 	(f) The commissioner may use funds deposited in the account as a source of revenue 
57.24 	or security for the payment of principal and interest on revenue or bonds issued by the 
57.25 	state if the proceeds of the sale of the bonds will be deposited into the loan fund.
57.26 		Subd. 2.Eligibility. (a) "Eligible borrower" means one of the following:
57.27 	(1) federally qualified health centers;
57.28 	(1) (2) community clinics, as defined under section 145.9268;
57.29 	(2) (3) nonprofit or local unit of government hospitals eligible for rural hospital 
57.30 	capital improvement grants, as defined  in section 144.148 licensed under sections 144.50 
57.31 	to 144.56;
57.32 	(3) physician clinics located in a community with a population of less than 50,000 
57.33 	according to United States Census Bureau statistics and outside the seven-county 
57.34 	metropolitan area;
57.35 	(4) individual or small group physician practices that are focused primarily on 
57.36 	primary care;
58.1 	(4) (5) nursing facilities licensed under sections 144A.01 to 144A.27; and
58.2 	(6) local public health departments as defined in chapter 145A; and
58.3 	(5) (7) other providers of health or health care services approved by the 
58.4 	commissioner for which interoperable electronic health record capability would improve 
58.5 	quality of care, patient safety, or community health.
58.6 	 (b) The commissioner shall administer the loan fund to prioritize support and 
58.7 	assistance to:
58.8 	(1) critical access hospitals;
58.9 	(2) federally qualified health centers;
58.10 	(3) entities that serve uninsured, underinsured, and medically underserved 
58.11 	individuals, regardless of whether such area is urban or rural; and
58.12 	(4) individual or small group practices that are primarily focused on primary care.
58.13 	(b) To be eligible for a loan under this section, the (c) An eligible applicant must 
58.14 	submit a loan application to the commissioner of health on forms prescribed by the 
58.15 	commissioner. The application must include, at a minimum:
58.16 	(1) the amount of the loan requested and a description of the purpose or project 
58.17 	for which the loan proceeds will be used;
58.18 	(2) a quote from a vendor;
58.19 	(3) a description of the health care entities and other groups participating in the 
58.20 	project;
58.21 	(4) evidence of financial stability and a demonstrated ability to repay the loan; and
58.22 	(5) a description of how the system to be financed interconnects interoperates or 
58.23 	plans in the future to interconnect interoperate with other health care entities and provider 
58.24 	groups located in the same geographical area;
58.25 	(6) a plan on how the certified electronic health record technology will be maintained 
58.26 	and supported over time; and
58.27 	(7) any other requirements for applications included or developed pursuant to 
58.28 	section 3014 of the HITECH Act.
58.29 		Subd. 3.Loans. (a) The commissioner of health may make a no interest loan or 
58.30 	low interest loan to a provider or provider group who is eligible under subdivision 2 
58.31 	on a first-come, first-served basis provided that the applicant is able to comply with this 
58.32 	section consistent with the priorities established in subdivision 2. The total accumulative 
58.33 	loan principal must not exceed $1,500,000 $3,000,000 per loan. The interest rate for each 
58.34 	loan, if imposed, shall not exceed the current market interest rate. The commissioner of 
58.35 	health has discretion over the size, interest rate, and number of loans made. Nothing in 
59.1 	this section shall require the commissioner to make a loan to an eligible borrower under 
59.2 	subdivision 2.
59.3 	(b) The commissioner of health may prescribe forms and establish an application 
59.4 	process and, notwithstanding section 16A.1283, may impose a reasonable nonrefundable 
59.5 	application fee to cover the cost of administering the loan program. Any application 
59.6 	fees imposed and collected under the electronic health records system revolving account 
59.7 	and loan program in this section are appropriated to the commissioner of health for the 
59.8 	duration of the loan program. The commissioner may apply for and use all federal funds 
59.9 	available through the HITECH Act to administer the loan program.
59.10 	(c) For loans approved prior to July 1, 2009, the borrower must begin repaying the 
59.11 	principal no later than two years from the date of the loan. Loans must be amortized no 
59.12 	later than six years from the date of the loan.
59.13 	(d) For loans granted on January 1, 2010, or thereafter, the borrower must begin 
59.14 	repaying the principle no later than one year from the date of the loan.  Loans must be 
59.15 	amortized no later than six years after the date of the loan.
59.16 	(d) Repayments (e) All repayments and interest paid on each loan must be credited 
59.17 	to the account.
59.18 	(f) The loan agreement shall include the assurances that borrower meets requirements 
59.19 	included or developed pursuant to section 3014 of the HITECH Act. The requirements 
59.20 	shall include, but are not limited to:
59.21 	(1) submitting reports on quality measures in compliance with regulations adopted 
59.22 	by the federal government;
59.23 	(2) demonstrating that any certified electronic health record technology purchased, 
59.24 	improved, or otherwise financially supported by this loan program is used to exchange 
59.25 	health information in a manner that, in accordance with law and standards applicable to 
59.26 	the exchange of information, improves the quality of health care;
59.27 	(3) including a plan on how the borrower intends to maintain and support the 
59.28 	certified electronic health record technology over time and the resources expected to be 
59.29 	used to maintain and support the technology purchased with the loan; and
59.30 	(4) complying with other requirements the secretary may require to use loans funds 
59.31 	under the HITECH Act.
59.32 		Subd. 4.Data classification. Data collected by the commissioner of health on the 
59.33 	application to determine eligibility under subdivision 2 and to monitor borrowers' default 
59.34 	risk or collect payments owed under subdivision 3 are (1) private data on individuals as 
59.35 	defined in section 13.02, subdivision 12; and (2) nonpublic data as defined in section 
60.1 	13.02, subdivision 9. The names of borrowers and the amounts of the loans granted 
60.2 	are public data.

60.3 	Sec. 3. Minnesota Statutes 2008, section 62J.497, subdivision 1, is amended to read:
60.4 		Subdivision 1.Definitions. For the purposes of this section, the following terms 
60.5 	have the meanings given.
60.6 	(a) "Backward compatible" means that the newer version of a data transmission 
60.7 	standard would retain, at a minimum, the full functionality of the versions previously 
60.8 	adopted, and would permit the successful completion of the applicable transactions with 
60.9 	entities that continue to use the older versions.
60.10 	(a) (b) "Dispense" or "dispensing" has the meaning given in section 151.01, 
60.11 	subdivision 30. Dispensing does not include the direct administering of a controlled 
60.12 	substance to a patient by a licensed health care professional.
60.13 	(b) (c) "Dispenser" means a person authorized by law to dispense a controlled 
60.14 	substance, pursuant to a valid prescription.
60.15 	(c) (d) "Electronic media" has the meaning given under Code of Federal Regulations, 
60.16 	title 45, part 160.103.
60.17 	(d) (e) "E-prescribing" means the transmission using electronic media of prescription 
60.18 	or prescription-related information between a prescriber, dispenser, pharmacy benefit 
60.19 	manager, or group purchaser, either directly or through an intermediary, including 
60.20 	an e-prescribing network. E-prescribing includes, but is not limited to, two-way 
60.21 	transmissions between the point of care and the dispenser and two-way transmissions 
60.22 	related to eligibility, formulary, and medication history information.
60.23 	(e) (f) "Electronic prescription drug program" means a program that provides for 
60.24 	e-prescribing.
60.25 	(f) (g) "Group purchaser" has the meaning given in section 62J.03, subdivision 6.
60.26 	(g) (h) "HL7 messages" means a standard approved by the standards development 
60.27 	organization known as Health Level Seven.
60.28 	(h) (i) "National Provider Identifier" or "NPI" means the identifier described under 
60.29 	Code of Federal Regulations, title 45, part 162.406.
60.30 	(i) (j) "NCPDP" means the National Council for Prescription Drug Programs, Inc.
60.31 	(j) (k) "NCPDP Formulary and Benefits Standard" means the National Council for 
60.32 	Prescription Drug Programs Formulary and Benefits Standard, Implementation Guide, 
60.33 	Version 1, Release 0, October 2005.
60.34 	(k) (l) "NCPDP SCRIPT Standard" means the National Council for Prescription 
60.35 	Drug Programs Prescriber/Pharmacist Interface SCRIPT Standard, Implementation 
61.1 	Guide Version 8, Release 1 (Version 8.1), October 2005, or the most recent standard 
61.2 	adopted by the Centers for Medicare and Medicaid Services for e-prescribing under 
61.3 	Medicare Part D as required by section 1860D-4(e)(4)(D) of the Social Security Act, and 
61.4 	regulations adopted under it. The standards shall be implemented according to the Centers 
61.5 	for Medicare and Medicaid Services schedule for compliance. Subsequently released 
61.6 	versions of the NCPDP SCRIPT Standard may be used, provided that the new version 
61.7 	of the standard is backward compatible to the current version adopted by the Centers for 
61.8 	Medicare and Medicaid Services.
61.9 	(l) (m) "Pharmacy" has the meaning given in section 151.01, subdivision 2.
61.10 	(m) (n) "Prescriber" means a licensed health care professional who is authorized to 
61.11 	prescribe a controlled substance under section 152.12, subdivision 1. practitioner, other 
61.12 	than a veterinarian, as defined in section 151.01, subdivision 23.
61.13 	(n) (o) "Prescription-related information" means information regarding eligibility for 
61.14 	drug benefits, medication history, or related health or drug information.
61.15 	(o) (p) "Provider" or "health care provider" has the meaning given in section 62J.03, 
61.16 	subdivision 8.

61.17 	Sec. 4. Minnesota Statutes 2008, section 62J.497, subdivision 2, is amended to read:
61.18 		Subd. 2.Requirements for electronic prescribing. (a) Effective January 1, 2011, 
61.19 	all providers, group purchasers, prescribers, and dispensers must establish and, maintain, 
61.20 	and use an electronic prescription drug program that complies. This program must comply
61.21 	with the applicable standards in this section for transmitting, directly or through an 
61.22 	intermediary, prescriptions and prescription-related information using electronic media.
61.23 	(b) Nothing in this section requires providers, group purchasers, prescribers, or 
61.24 	dispensers to conduct the transactions described in this section. If transactions described in 
61.25 	this section are conducted, they must be done electronically using the standards described 
61.26 	in this section. Nothing in this section requires providers, group purchasers, prescribers, 
61.27 	or dispensers to electronically conduct transactions that are expressly prohibited by other 
61.28 	sections or federal law.
61.29 	(c) Providers, group purchasers, prescribers, and dispensers must use either HL7 
61.30 	messages or the NCPDP SCRIPT Standard to transmit prescriptions or prescription-related 
61.31 	information internally when the sender and the recipient are part of the same legal entity. If 
61.32 	an entity sends prescriptions outside the entity, it must use the NCPDP SCRIPT Standard 
61.33 	or other applicable standards required by this section. Any pharmacy within an entity 
61.34 	must be able to receive electronic prescription transmittals from outside the entity using 
61.35 	the adopted NCPDP SCRIPT Standard. This exemption does not supersede any Health 
62.1 	Insurance Portability and Accountability Act (HIPAA) requirement that may require the 
62.2 	use of a HIPAA transaction standard within an organization.
62.3 	(d) Entities transmitting prescriptions or prescription-related information where the 
62.4 	prescriber is required by law to issue a prescription for a patient to a nonprescribing 
62.5 	provider that in turn forwards the prescription to a dispenser are exempt from the 
62.6 	requirement to use the NCPDP SCRIPT Standard when transmitting prescriptions or 
62.7 	prescription-related information.

62.8 	Sec. 5. Minnesota Statutes 2008, section 62J.497, is amended by adding a subdivision 
62.9 	to read:
62.10 		Subd. 4.Development and use of uniform formulary exception form. (a) The 
62.11 	commissioner of health, in consultation with the Minnesota Administrative Uniformity 
62.12 	Committee, shall develop by July 1, 2009, or six weeks after enactment of this subdivision, 
62.13 	whichever is later, a uniform formulary exception form that allows health care providers 
62.14 	to request exceptions from group purchaser formularies using a uniform form. Upon 
62.15 	development of the form, all health care providers must submit requests for formulary 
62.16 	exceptions using the uniform form, and all group purchasers must accept this form from 
62.17 	health care providers.
62.18 	(b) No later than January 1, 2011, the uniform formulary exception form must be 
62.19 	accessible and submitted by health care providers, and accepted and processed by group 
62.20 	purchasers, through secure electronic transmissions. Facsimile shall not be considered 
62.21 	secure electronic transmissions.

62.22 	Sec. 6. Minnesota Statutes 2008, section 62J.497, is amended by adding a subdivision 
62.23 	to read:
62.24 		Subd. 5.Electronic drug prior authorization standardization and transmission.
 62.25 	(a) The commissioner of health, in consultation with the Minnesota e-Health Advisory 
62.26 	Committee and the Minnesota Administrative Uniformity Committee, shall, by February 
62.27 	15, 2010, identify an outline on how best to standardize drug prior authorization request 
62.28 	transactions between providers and group purchasers with the goal of maximizing 
62.29 	administrative simplification and efficiency in preparation for electronic transmissions.
62.30 	(b) No later than January 1, 2011, drug prior authorization requests must be 
62.31 	accessible and submitted by health care providers, and accepted and processed by group 
62.32 	purchasers, electronically through secure electronic transmissions. Facsimile shall not be 
62.33 	considered electronic transmission.

63.1 	Sec. 7. [62Q.676] MEDICATION THERAPY MANAGEMENT.
63.2 	A pharmacy benefit manager that provides prescription drug services must make 
63.3 	available medication therapy management services for enrollees taking four or more 
63.4 	prescriptions to treat or prevent two or more chronic medical conditions. For purposes 
63.5 	of this section, "medication therapy management" means the provision of the following 
63.6 	pharmaceutical care services by, or under the supervision of, a licensed pharmacist to 
63.7 	optimize the therapeutic outcomes of the patient's medications:
63.8 	(1) performing a comprehensive medication review to identify, resolve, and prevent 
63.9 	medication-related problems, including adverse drug events;
63.10 	(2) communicating essential information to the patient's other primary care 
63.11 	providers; and
63.12 	(3) providing verbal education and training designed to enhance patient 
63.13 	understanding and appropriate use of the patient's medications.
63.14 	Nothing in this section shall be construed to expand or modify the scope of practice 
63.15 	of the pharmacist as defined in section 151.01, subdivision 27.

63.16 	Sec. 8. Minnesota Statutes 2008, section 144.122, is amended to read:
63.17 	144.122 LICENSE, PERMIT, AND SURVEY FEES.
63.18 	(a) The state commissioner of health, by rule, may prescribe procedures and fees 
63.19 	for filing with the commissioner as prescribed by statute and for the issuance of original 
63.20 	and renewal permits, licenses, registrations, and certifications issued under authority of 
63.21 	the commissioner. The expiration dates of the various licenses, permits, registrations, 
63.22 	and certifications as prescribed by the rules shall be plainly marked thereon. Fees may 
63.23 	include application and examination fees and a penalty fee for renewal applications 
63.24 	submitted after the expiration date of the previously issued permit, license, registration, 
63.25 	and certification. The commissioner may also prescribe, by rule, reduced fees for permits, 
63.26 	licenses, registrations, and certifications when the application therefor is submitted 
63.27 	during the last three months of the permit, license, registration, or certification period. 
63.28 	Fees proposed to be prescribed in the rules shall be first approved by the Department of 
63.29 	Finance. All fees proposed to be prescribed in rules shall be reasonable. The fees shall be 
63.30 	in an amount so that the total fees collected by the commissioner will, where practical, 
63.31 	approximate the cost to the commissioner in administering the program. All fees collected 
63.32 	shall be deposited in the state treasury and credited to the state government special revenue 
63.33 	fund unless otherwise specifically appropriated by law for specific purposes.
63.34 	(b) The commissioner may charge a fee for voluntary certification of medical 
63.35 	laboratories and environmental laboratories, and for environmental and medical laboratory 
64.1 	services provided by the department, without complying with paragraph (a) or chapter 14. 
64.2 	Fees charged for environment and medical laboratory services provided by the department 
64.3 	must be approximately equal to the costs of providing the services.
64.4 	(c) The commissioner may develop a schedule of fees for diagnostic evaluations 
64.5 	conducted at clinics held by the services for children with disabilities program. All 
64.6 	receipts generated by the program are annually appropriated to the commissioner for use 
64.7 	in the maternal and child health program.
64.8 	(d) The commissioner shall set license fees for hospitals and nursing homes that are 
64.9 	not boarding care homes at the following levels:

64.10
64.11
64.12
64.13	Joint Commission on Accreditation of 
Healthcare Organizations (JCAHO) and 
American Osteopathic Association (AOA) 
hospitals
	$7,555$7,655 plus $13$16 per bed
	
64.14	Non-JCAHO and non-AOA hospitals
	$5,180$5,280 plus $247$250 per bed
	
64.15	Nursing home
	$183 plus $91 per bed
	
64.16 	The commissioner shall set license fees for outpatient surgical centers, boarding care 
64.17 	homes, and supervised living facilities at the following levels:

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

64.24	Prospective payment surveys for hospitals
	$
	900
	
64.25	Swing bed surveys for nursing homes
	$
	1,200
	
64.26	Psychiatric hospitals
	$
	1,400
	
64.27	Rural health facilities
	$
	1,100
	
64.28	Portable x-ray providers
	$
	500
	
64.29	Home health agencies
	$
	1,800
	
64.30	Outpatient therapy agencies
	$
	800
	
64.31	End stage renal dialysis providers
	$
	2,100
	
64.32	Independent therapists
	$
	800
	
64.33	Comprehensive rehabilitation outpatient facilities
	$
	1,200
	
64.34	Hospice providers
	$
	1,700
	
64.35	Ambulatory surgical providers
	$
	1,800
	
64.36	Hospitals
	$
	4,200
	
64.37
64.38
64.39	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.
	
65.1 	These fees shall be submitted at the time of the application for federal certification 
65.2 	and shall not be refunded. All fees collected after the date that the imposition of fees is not 
65.3 	prohibited by federal law shall be deposited in the state treasury and credited to the state 
65.4 	government special revenue fund.

65.5 	Sec. 9. Minnesota Statutes 2008, section 144.226, subdivision 4, is amended to read:
65.6 		Subd. 4.Vital records surcharge. (a) In addition to any fee prescribed under 
65.7 	subdivision 1, there is a nonrefundable surcharge of $2 for each certified and noncertified 
65.8 	birth, stillbirth, or death record, and for a certification that the record cannot be found. 
65.9 	The local or state registrar shall forward this amount to the commissioner of finance to 
65.10 	be deposited into the state government special revenue fund. This surcharge shall not be 
65.11 	charged under those circumstances in which no fee for a birth, stillbirth, or death record is 
65.12 	permitted under subdivision 1, paragraph (a).
65.13 	(b) Effective August 1, 2005, to June 30, 2009, the surcharge in paragraph (a) shall 
65.14 	be is $4.

65.15 	Sec. 10. Minnesota Statutes 2008, section 148.6445, is amended by adding a 
65.16 	subdivision to read:
65.17 		Subd. 2a.Duplicate license fee. The fee for a duplicate license is $25.

65.18 	ARTICLE 5
65.19 	HEALTH CARE

65.20 	Section 1. Minnesota Statutes 2008, section 60A.092, subdivision 2, is amended to 
65.21 	read:
65.22 		Subd. 2.Licensed assuming insurer. Reinsurance is ceded to an assuming insurer 
65.23 	if the assuming insurer is licensed to transact insurance or reinsurance in this state. For 
65.24 	purposes of reinsuring any health risk, an insurer is defined under section 62A.63.

65.25 	Sec. 2. Minnesota Statutes 2008, section 62D.03, subdivision 4, is amended to read:
65.26 		Subd. 4.Application requirements. Each application for a certificate of authority 
65.27 	shall be verified by an officer or authorized representative of the applicant, and shall be 
65.28 	in a form prescribed by the commissioner of health. Each application shall include the 
65.29 	following:
65.30 	(a) a copy of the basic organizational document, if any, of the applicant and of 
65.31 	each major participating entity; such as the articles of incorporation, or other applicable 
65.32 	documents, and all amendments thereto;
66.1 	(b) a copy of the bylaws, rules and regulations, or similar document, if any, and all 
66.2 	amendments thereto which regulate the conduct of the affairs of the applicant and of 
66.3 	each major participating entity;
66.4 	(c) a list of the names, addresses, and official positions of the following:
66.5 	(1) all members of the board of directors, or governing body of the local government 
66.6 	unit, and the principal officers and shareholders of the applicant organization; and
66.7 	(2) all members of the board of directors, or governing body of the local government 
66.8 	unit, and the principal officers of the major participating entity and each shareholder 
66.9 	beneficially owning more than ten percent of any voting stock of the major participating 
66.10 	entity;
66.11 	The commissioner may by rule identify persons included in the term "principal 
66.12 	officers";
66.13 	(d) a full disclosure of the extent and nature of any contract or financial arrangements 
66.14 	between the following:
66.15 	(1) the health maintenance organization and the persons listed in clause (c)(1);
66.16 	(2) the health maintenance organization and the persons listed in clause (c)(2);
66.17 	(3) each major participating entity and the persons listed in clause (c)(1) concerning 
66.18 	any financial relationship with the health maintenance organization; and
66.19 	(4) each major participating entity and the persons listed in clause (c)(2) concerning 
66.20 	any financial relationship with the health maintenance organization;
66.21 	(e) the name and address of each participating entity and the agreed upon duration of 
66.22 	each contract or agreement;
66.23 	(f) a copy of the form of each contract binding the participating entities and the 
66.24 	health maintenance organization. Contractual provisions shall be consistent with the 
66.25 	purposes of sections 62D.01 to 62D.30, in regard to the services to be performed under the 
66.26 	contract, the manner in which payment for services is determined, the nature and extent 
66.27 	of responsibilities to be retained by the health maintenance organization, the nature and 
66.28 	extent of risk sharing permissible, and contractual termination provisions; 
66.29 	(g) a copy of each contract binding major participating entities and the health 
66.30 	maintenance organization. Contract information filed with the commissioner shall be 
66.31 	confidential and subject to the provisions of section 13.37, subdivision 1, clause (b), upon 
66.32 	the request of the health maintenance organization. 
66.33 	Upon initial filing of each contract, the health maintenance organization shall file 
66.34 	a separate document detailing the projected annual expenses to the major participating 
66.35 	entity in performing the contract and the projected annual revenues received by the entity 
66.36 	from the health maintenance organization for such performance. The commissioner 
67.1 	shall disapprove any contract with a major participating entity if the contract will result 
67.2 	in an unreasonable expense under section 62D.19. The commissioner shall approve or 
67.3 	disapprove a contract within 30 days of filing. 
67.4 	Within 120 days of the anniversary of the implementation of each contract, the 
67.5 	health maintenance organization shall file a document detailing the actual expenses 
67.6 	incurred and reported by the major participating entity in performing the contract in the 
67.7 	preceding year and the actual revenues received from the health maintenance organization 
67.8 	by the entity in payment for the performance;
67.9 	(h) a statement generally describing the health maintenance organization, its health 
67.10 	maintenance contracts and separate health service contracts, facilities, and personnel, 
67.11 	including a statement describing the manner in which the applicant proposes to provide 
67.12 	enrollees with comprehensive health maintenance services and separate health services;
67.13 	(i) a copy of the form of each evidence of coverage to be issued to the enrollees;
67.14 	(j) a copy of the form of each individual or group health maintenance contract 
67.15 	and each separate health service contract which is to be issued to enrollees or their 
67.16 	representatives;
67.17 	(k) financial statements showing the applicant's assets, liabilities, and sources of 
67.18 	financial support. If the applicant's financial affairs are audited by independent certified 
67.19 	public accountants, a copy of the applicant's most recent certified financial statement 
67.20 	may be deemed to satisfy this requirement;
67.21 	(l) a description of the proposed method of marketing the plan, a schedule of 
67.22 	proposed charges, and a financial plan which includes a three-year projection of the 
67.23 	expenses and income and other sources of future capital;
67.24 	(m) a statement reasonably describing the geographic area or areas to be served and 
67.25 	the type or types of enrollees to be served;
67.26 	(n) a description of the complaint procedures to be utilized as required under section 
67.27 	62D.11; 
67.28 	(o) a description of the procedures and programs to be implemented to meet the 
67.29 	requirements of section 62D.04, subdivision 1, clauses (b) and (c) and to monitor the 
67.30 	quality of health care provided to enrollees; 
67.31 	(p) a description of the mechanism by which enrollees will be afforded an 
67.32 	opportunity to participate in matters of policy and operation under section 62D.06; 
67.33 	(q) a copy of any agreement between the health maintenance organization and 
67.34 	an insurer or, including any  nonprofit health service corporation or another health 
67.35 	maintenance organization, regarding reinsurance, stop-loss coverage, insolvency 
68.1 	coverage, or any other type of coverage for potential costs of health services, as authorized 
68.2 	in sections 62D.04, subdivision 1, clause (f), 62D.05, subdivision 3, and 62D.13; 
68.3 	(r) a copy of the conflict of interest policy which applies to all members of the board 
68.4 	of directors and the principal officers of the health maintenance organization, as described 
68.5 	in section 62D.04, subdivision 1, paragraph (g). All currently licensed health maintenance 
68.6 	organizations shall also file a conflict of interest policy with the commissioner within 60 
68.7 	days after August 1, 1990, or at a later date if approved by the commissioner; 
68.8 	(s) a copy of the statement that describes the health maintenance organization's prior 
68.9 	authorization administrative procedures; and
68.10 	(t) other information as the commissioner of health may reasonably require to be 
68.11 	provided.

68.12 	Sec. 3. Minnesota Statutes 2008, section 62D.05, subdivision 3, is amended to read:
68.13 		Subd. 3.Contracts; health services. A health maintenance organization may 
68.14 	contract with providers of health care services to render the services the health maintenance 
68.15 	organization has promised to provide under the terms of its health maintenance contracts, 
68.16 	may, subject to section 62D.12, subdivision 11, enter into separate prepaid dental contracts, 
68.17 	or other separate health service contracts, may, subject to the limitations of section 
68.18 	62D.04, subdivision 1, clause (f), contract with insurance companies and, including 
68.19 	 nonprofit health service plan corporations or other health maintenance organizations, 
68.20 	for insurance, indemnity or reimbursement of its cost of providing health care services 
68.21 	for enrollees or against the risks incurred by the health maintenance organization, may 
68.22 	contract with insurance companies and nonprofit health service plan corporations for 
68.23 	insolvency insurance coverage, and may contract with insurance companies and nonprofit 
68.24 	health service plan corporations to insure or cover the enrollees' costs and expenses in the 
68.25 	health maintenance organization, including the customary prepayment amount and any 
68.26 	co-payment obligations, and may contract to provide reinsurance or insolvency insurance 
68.27 	coverage to health insurers or nonprofit health service plan corporations.  

68.28 	Sec. 4. Minnesota Statutes 2008, section 62J.692, subdivision 7, is amended to read:
68.29 		Subd. 7.Transfers from the commissioner of human services. (a) The amount 
68.30 	transferred according to section 256B.69, subdivision 5c, paragraph (a), clause (1), shall 
68.31 	be distributed by the commissioner annually to clinical medical education programs that 
68.32 	meet the qualifications of subdivision 3 based on the formula in subdivision 4, paragraph 
68.33 	(a) Of the amount transferred according to section 256B.69, subdivision 5c, paragraph (a), 
68.34 	clauses (1) to (4), $21,714,000 shall be distributed as follows:
69.1 	(1) $2,157,000 shall be distributed by the commissioner to the University of 
69.2 	Minnesota Board of Regents for the purposes described in sections 137.38 to 137.40;
69.3 	(2) $1,035,360 shall be distributed by the commissioner to the Hennepin County 
69.4 	Medical Center for clinical medical education;
69.5 	(3) $17,400,000 shall be distributed by the commissioner to the University of 
69.6 	Minnesota Board of Regents for purposes of medial education;
69.7 	(4) $1,121,640 shall be distributed by the commissioner to clinical medical education 
69.8 	dental innovation grants in accordance with subdivision 7a; and
69.9 	(5) the remainder of the amount transferred according to section 256B.69, 
69.10 	subdivision 5c, clauses (1) to (4), shall be distributed by the commissioner annually to 
69.11 	clinical medical education programs that meet the qualifications of subdivision 3 based on 
69.12 	the formula in subdivision 4, paragraph (a).
69.13 	(b) Fifty percent of the amount transferred according to section 256B.69, subdivision 
69.14 	5c, paragraph (a), clause (2), shall be distributed by the commissioner to the University of 
69.15 	Minnesota Board of Regents for the purposes described in sections 137.38 to 137.40. Of 
69.16 	the remaining amount transferred according to section 256B.69, subdivision 5c, paragraph 
69.17 	(a), clause (2), 24 percent of the amount shall be distributed by the commissioner to 
69.18 	the Hennepin County Medical Center for clinical medical education. The remaining 26 
69.19 	percent of the amount transferred shall be distributed by the commissioner in accordance 
69.20 	with subdivision 7a. If the federal approval is not obtained for the matching funds under 
69.21 	section 256B.69, subdivision 5c, paragraph (a), clause (2), 100 percent of the amount 
69.22 	transferred under this paragraph shall be distributed by the commissioner to the University 
69.23 	of Minnesota Board of Regents for the purposes described in sections 137.38 to 137.40.
69.24 	(c) The amount transferred according to section 256B.69, subdivision 5c, paragraph 
69.25 	(a), clauses (3) and (4), shall be distributed by the commissioner upon receipt to the 
69.26 	University of Minnesota Board of Regents for the purposes of clinical graduate medical 
69.27 	education.

69.28 	Sec. 5. Minnesota Statutes 2008, section 256.01, subdivision 2b, is amended to read:
69.29 		Subd. 2b. Performance payments. (a) The commissioner shall develop and 
69.30 	implement a pay-for-performance system to provide performance payments to eligible 
69.31 	medical groups and clinics that demonstrate optimum care in serving individuals 
69.32 	with chronic diseases who are enrolled in health care programs administered by the 
69.33 	commissioner under chapters 256B, 256D, and 256L. The commissioner may receive any 
69.34 	federal matching money that is made available through the medical assistance program 
69.35 	for managed care oversight contracted through vendors, including consumer surveys, 
70.1 	studies, and external quality reviews as required by the federal Balanced Budget Act of 
70.2 	1997, Code of Federal Regulations, title 42, part 438-managed care, subpart E-external 
70.3 	quality review. Any federal money received for managed care oversight is appropriated 
70.4 	to the commissioner for this purpose. The commissioner may expend the federal money 
70.5 	received in either year of the biennium. 
70.6 	(b) Effective July 1, 2008, or upon federal approval, whichever is later, the 
70.7 	commissioner shall develop and implement a patient incentive health program to provide 
70.8 	incentives and rewards to patients who are enrolled in health care programs administered 
70.9 	by the commissioner under chapters 256B, 256D, and 256L, and who have agreed to and 
70.10 	have met personal health goals established with the patients' primary care providers to 
70.11 	manage a chronic disease or condition, including but not limited to diabetes, high blood 
70.12 	pressure, and coronary artery disease. 

70.13 	Sec. 6. Minnesota Statutes 2008, section 256.01, is amended by adding a subdivision 
70.14 	to read:
70.15 		Subd. 18a.Public Assistance Reporting Information System. (a) Effective 
70.16 	October 1, 2009, the commissioner shall comply with the federal requirements in Public 
70.17 	Law 110-379 in implementing the Public Assistance Reporting Information System 
70.18 	(PARIS) to determine eligibility for all individuals applying for:
70.19 	(1) health care benefits under chapters 256B, 256D, and 256L; and
70.20 	(2) public benefits under chapters 119B, 256D, 256I, and the supplemental nutrition 
70.21 	assistance program.
70.22 	(b) The commissioner shall determine eligibility under paragraph (a) by performing 
70.23 	data matches, including matching with medical assistance, cash, child care, and 
70.24 	supplemental assistance programs operated by other states.

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

70.26 	Sec. 7. Minnesota Statutes 2008, section 256.01, is amended by adding a subdivision 
70.27 	to read:
70.28 		Subd. 18b.Protections for American Indians. Effective February 18, 2009, the 
70.29 	commissioner shall comply with the federal requirements in the American Recovery and 
70.30 	Reinvestment Act of 2009, Public Law 111-5, section 5006, regarding American Indians.

70.31 	Sec. 8. Minnesota Statutes 2008, section 256.962, subdivision 2, is amended to read:
71.1 		Subd. 2.Outreach grants. (a) The commissioner shall award grants to public and 
71.2 	private organizations, regional collaboratives, and regional health care outreach centers 
71.3 	for outreach activities, including, but not limited to: 
71.4 	(1) providing information, applications, and assistance in obtaining coverage 
71.5 	through Minnesota public health care programs;
71.6 	(2) collaborating with public and private entities such as hospitals, providers, health 
71.7 	plans, legal aid offices, pharmacies, insurance agencies, and faith-based organizations to 
71.8 	develop outreach activities and partnerships to ensure the distribution of information 
71.9 	and applications and provide assistance in obtaining coverage through Minnesota health 
71.10 	care programs; and
71.11 	(3) providing or collaborating with public and private entities to provide multilingual 
71.12 	and culturally specific information and assistance to applicants in areas of high 
71.13 	uninsurance in the state or populations with high rates of uninsurance; and
71.14 	(4) targeting geographic areas with high rates of (i) eligible but unenrolled children, 
71.15 	including children who reside in rural areas, or (ii) racial and ethnic minorities and health 
71.16 	disparity populations.
71.17 	(b) The commissioner shall ensure that all outreach materials are available in 
71.18 	languages other than English.
71.19 	(c) The commissioner shall establish an outreach trainer program to provide 
71.20 	training to designated individuals from the community and public and private entities on 
71.21 	application assistance in order for these individuals to provide training to others in the 
71.22 	community on an as-needed basis.

71.23 	Sec. 9. Minnesota Statutes 2008, section 256.962, subdivision 6, is amended to read:
71.24 		Subd. 6.School districts and charter schools. (a) At the beginning of each school 
71.25 	year, a school district  or charter school shall provide information to each student on the 
71.26 	availability of health care coverage through the Minnesota health care programs and how 
71.27 	to obtain an application for the Minnesota health care programs.
71.28 	(b) For each child who is determined to be eligible for the free and reduced-price 
71.29 	school lunch program, the district shall provide the child's family with information on how 
71.30 	to obtain an application for the Minnesota health care programs and application assistance.
71.31 	(c) A school district or charter school shall also ensure that applications and 
71.32 	information on application assistance are available at early childhood education sites and 
71.33 	public schools located within the district's jurisdiction.
71.34 	(d) (c) Each district shall designate an enrollment specialist to provide application 
71.35 	assistance and follow-up services with families who have indicated an interest in receiving 
72.1 	information or an application for the Minnesota health care program. A district is eligible 
72.2 	for the application assistance bonus described in subdivision 5.
72.3 	(e) Each (d) If a school district or charter school maintains a district Web site, the
72.4 	school district or charter school shall provide on their its Web site a link to information on 
72.5 	how to obtain an application and application assistance.

72.6 	Sec. 10. [256.964] DENTAL CARE PILOT PROJECTS.
72.7 	The commissioner shall authorize pilot projects to reduce the total cost to the state 
72.8 	for dental services provided to enrollees of the state public health care programs by 
72.9 	reducing hospital emergency room costs for preventable or nonemergency dental services. 
72.10 	As part of the project, a community dental clinic or dental provider, in collaboration with a 
72.11 	hospital emergency room, shall provide urgent care dental services as an alternative to the 
72.12 	hospital emergency room for nonemergency dental care. The project participants shall 
72.13 	establish a process to divert a patient presenting at the emergency room for nonemergency 
72.14 	dental care to the dental community clinic or to an appropriate dental provider. The 
72.15 	commissioner may establish special payment rates for urgent care services provided and 
72.16 	may change or waive existing payment policies in order to adequately reimburse providers 
72.17 	for providing cost-effective alternative services in an outpatient or urgent care setting. 
72.18 	The commissioner may establish a project in conjunction with the initiative authorized 
72.19 	under section 256.963.

72.20 	Sec. 11. Minnesota Statutes 2008, section 256.969, subdivision 2b, is amended to read:
72.21 		Subd. 2b.Operating payment rates. In determining operating payment rates for 
72.22 	admissions occurring on or after the rate year beginning January 1, 1991, and every two 
72.23 	years after, or more frequently as determined by the commissioner, the commissioner 
72.24 	shall obtain operating data from an updated base year and establish operating payment 
72.25 	rates per admission for each hospital based on the cost-finding methods and allowable 
72.26 	costs of the Medicare program in effect during the base year. Rates under the general 
72.27 	assistance medical care, medical assistance, and MinnesotaCare programs shall not be 
72.28 	rebased to more current data on January 1, 1997, January 1, 2005, and for the first 24 
72.29 	months of the rebased period beginning January 1, 2009, and for the first three months of 
72.30 	the rebased period beginning January 1, 2011. From April 1, 2011, to March 31, 2012, 
72.31 	rates shall be rebased at 39.2 percent of the full value of the rebasing percentage change. 
72.32 	Effective April 1, 2012, rates shall be rebased at full value. The base year operating 
72.33 	payment rate per admission is standardized by the case mix index and adjusted by the 
72.34 	hospital cost index, relative values, and disproportionate population adjustment. The 
73.1 	cost and charge data used to establish operating rates shall only reflect inpatient services 
73.2 	covered by medical assistance and shall not include property cost information and costs 
73.3 	recognized in outlier payments.

73.4 	Sec. 12. Minnesota Statutes 2008, section 256.969, subdivision 3a, is amended to read:
73.5 		Subd. 3a.Payments. (a) Acute care hospital billings under the medical 
73.6 	assistance program must not be submitted until the recipient is discharged. However, 
73.7 	the commissioner shall establish monthly interim payments for inpatient hospitals that 
73.8 	have individual patient lengths of stay over 30 days regardless of diagnostic category. 
73.9 	Except as provided in section 256.9693, medical assistance reimbursement for treatment 
73.10 	of mental illness shall be reimbursed based on diagnostic classifications. Individual 
73.11 	hospital payments established under this section and sections 256.9685, 256.9686, and 
73.12 	256.9695, in addition to third party and recipient liability, for discharges occurring during 
73.13 	the rate year shall not exceed, in aggregate, the charges for the medical assistance covered 
73.14 	inpatient services paid for the same period of time to the hospital. This payment limitation 
73.15 	shall be calculated separately for medical assistance and general assistance medical 
73.16 	care services. The limitation on general assistance medical care shall be effective for 
73.17 	admissions occurring on or after July 1, 1991. Services that have rates established under 
73.18 	subdivision 11 or 12, must be limited separately from other services. After consulting with 
73.19 	the affected hospitals, the commissioner may consider related hospitals one entity and 
73.20 	may merge the payment rates while maintaining separate provider numbers. The operating 
73.21 	and property base rates per admission or per day shall be derived from the best Medicare 
73.22 	and claims data available when rates are established. The commissioner shall determine 
73.23 	the best Medicare and claims data, taking into consideration variables of recency of the 
73.24 	data, audit disposition, settlement status, and the ability to set rates in a timely manner. 
73.25 	The commissioner shall notify hospitals of payment rates by December 1 of the year 
73.26 	preceding the rate year. The rate setting data must reflect the admissions data used to 
73.27 	establish relative values. Base year changes from 1981 to the base year established for the 
73.28 	rate year beginning January 1, 1991, and for subsequent rate years, shall not be limited 
73.29 	to the limits ending June 30, 1987, on the maximum rate of increase under subdivision 
73.30 	1. The commissioner may adjust base year cost, relative value, and case mix index data 
73.31 	to exclude the costs of services that have been discontinued by the October 1 of the year 
73.32 	preceding the rate year or that are paid separately from inpatient services. Inpatient stays 
73.33 	that encompass portions of two or more rate years shall have payments established based 
73.34 	on payment rates in effect at the time of admission unless the date of admission preceded 
73.35 	the rate year in effect by six months or more. In this case, operating payment rates for 
74.1 	services rendered during the rate year in effect and established based on the date of 
74.2 	admission shall be adjusted to the rate year in effect by the hospital cost index.
74.3 	(b) For fee-for-service admissions occurring on or after July 1, 2002, the total 
74.4 	payment, before third-party liability and spenddown, made to hospitals for inpatient 
74.5 	services is reduced by .5 percent from the current statutory rates.
74.6 	(c) In addition to the reduction in paragraph (b), the total payment for fee-for-service 
74.7 	admissions occurring on or after July 1, 2003, made to hospitals for inpatient services 
74.8 	before third-party liability and spenddown, is reduced five percent from the current 
74.9 	statutory rates. Mental health services within diagnosis related groups 424 to 432, and 
74.10 	facilities defined under subdivision 16 are excluded from this paragraph.
74.11 	(d) In addition to the reduction in paragraphs (b) and (c), the total payment for 
74.12 	fee-for-service admissions occurring on or after July 1, 2005, made to hospitals for 
74.13 	inpatient services before third-party liability and spenddown, is reduced 6.0 percent 
74.14 	from the current statutory rates. Mental health services within diagnosis related groups 
74.15 	424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph. 
74.16 	Notwithstanding section 256.9686, subdivision 7, for purposes of this paragraph, medical 
74.17 	assistance does not include general assistance medical care. Payments made to managed 
74.18 	care plans shall be reduced for services provided on or after January 1, 2006, to reflect 
74.19 	this reduction.
74.20 	(e) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for 
74.21 	fee-for-service admissions occurring on or after July 1, 2008, through June 30, 2009, made 
74.22 	to hospitals for inpatient services before third-party liability and spenddown, is reduced 
74.23 	3.46 percent from the current statutory rates. Mental health services with diagnosis related 
74.24 	groups 424 to 432 and facilities defined under subdivision 16 are excluded from this 
74.25 	paragraph. Payments made to managed care plans shall be reduced for services provided 
74.26 	on or after January 1, 2009, through June 30, 2009, to reflect this reduction.
74.27 	(f) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for 
74.28 	fee-for-service admissions occurring on or after July 1, 2009, through June 30, 2010, made 
74.29 	to hospitals for inpatient services before third-party liability and spenddown, is reduced 
74.30 	1.9 percent from the current statutory rates. Mental health services with diagnosis related 
74.31 	groups 424 to 432 and facilities defined under subdivision 16 are excluded from this 
74.32 	paragraph. Payments made to managed care plans shall be reduced for services provided 
74.33 	on or after July 1, 2009, through June 30, 2010, to reflect this reduction.
74.34 	(g) In addition to the reductions in paragraphs (b), (c), and (d), the total payment 
74.35 	for fee-for-service admissions occurring on or after July 1, 2010, made to hospitals for 
74.36 	inpatient services before third-party liability and spenddown, is reduced 1.79 percent 
75.1 	from the current statutory rates. Mental health services with diagnosis related groups 
75.2 	424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph. 
75.3 	Payments made to managed care plans shall be reduced for services provided on or after 
75.4 	July 1, 2010, to reflect this reduction.
75.5 	(h) In addition to the reductions in paragraphs (b), (c), (d), (f), and (g), the total 
75.6 	payment for fee-for-service admissions occurring on or after July 1, 2009, made to 
75.7 	hospitals for inpatient services before third-party liability and spenddown, is reduced 
75.8 	one percent from the current statutory rates. Facilities defined under subdivision 16 are 
75.9 	excluded from this paragraph. Payments made to managed care plans shall be reduced for 
75.10 	services provided on or after October 1, 2009, to reflect this reduction.

75.11 	Sec. 13. Minnesota Statutes 2008, section 256.969, is amended by adding a subdivision 
75.12 	to read:
75.13 		Subd. 3b.Nonpayment for hospital-acquired conditions and for certain 
75.14 	treatments. (a) The commissioner must not make medical assistance payments to a 
75.15 	hospital for any costs of care that result from a condition listed in paragraph (c), if the 
75.16 	condition was hospital acquired. 
75.17 	(b) For purposes of this subdivision, a condition is hospital acquired if it is not 
75.18 	identified by the hospital as present on admission. For purposes of this subdivision, 
75.19 	medical assistance includes general assistance medical care and MinnesotaCare.
75.20 	(c) The prohibition in paragraph (a) applies to payment for each hospital-acquired 
75.21 	condition listed in this paragraph that is represented by an ICD-9-CM diagnosis code and 
75.22 	is designated as a complicating condition or a major complicating condition:
75.23 	(1) foreign object retained after surgery (ICD-9-CM codes 998.4 or 998.7);
75.24 	(2) air embolism (ICD-9-CM code 999.1);
75.25 	(3) blood incompatibility (ICD-9-CM code 999.6);
75.26 	(4) pressure ulcers stage III or IV (ICD-9-CM codes 707.23 or 707.24);
75.27 	(5) falls and trauma, including fracture, dislocation, intracranial injury, crushing 
75.28 	injury, burn, and electric shock (ICD-9-CM codes with these ranges on the complicating 
75.29 	condition and major complicating condition list: 800-829; 830-839; 850-854; 925-929; 
75.30 	940-949; and 991-994);
75.31 	(6) catheter-associated urinary tract infection (ICD-9-CM code 996.64);
75.32 	(7) vascular catheter-associated infection (ICD-9-CM code 999.31);
75.33 	(8) manifestations of poor glycemic control (ICD-9-CM codes 249.10; 249.11; 
75.34 	249.20; 249.21; 250.10; 250.11; 250.12; 250.13; 250.20; 250.21; 250.22; 250.23; and 
75.35 	251.0);
76.1 	(9) surgical site infection (ICD-9-CM codes 996.67 or 998.59) following certain 
76.2 	orthopedic procedures (procedure codes 81.01; 81.02; 81.03; 81.04; 81.05; 81.06; 81.07; 
76.3 	81.08; 81.23; 81.24; 81.31; 81.32; 81.33; 81.34; 81.35; 81.36; 81.37; 81.38; 81.83; and 
76.4 	81.85);
76.5 	(10) surgical site infection (ICD-9-CM code 998.59) following bariatric surgery 
76.6 	(procedure codes 44.38; 44.39; or 44.95) for a principal diagnosis of morbid obesity 
76.7 	(ICD-9-CM code 278.01);
76.8 	(11) surgical site infection, mediastinitis (ICD-9-CM code 519.2) following coronary 
76.9 	artery bypass graft (procedure codes 36.10 to 36.19); and
76.10 	(12) deep vein thrombosis (ICD-9-CM codes 453.40 to 453.42) or pulmonary 
76.11 	embolism (ICD-9-CM codes 415.11 or 415.91) following total knee replacement 
76.12 	(procedure code 81.54) or hip replacement (procedure codes 00.85 to 00.87 or 81.51 
76.13 	to 81.52).
76.14 	(d) The prohibition in paragraph (a) applies to any additional payments that result 
76.15 	from a hospital-acquired condition listed in paragraph (c), including, but not limited to, 
76.16 	additional treatment or procedures, readmission to the facility after discharge, increased 
76.17 	length of stay, change to a higher diagnostic category, or transfer to another hospital. In 
76.18 	the event of a transfer to another hospital, the hospital where the condition listed under 
76.19 	paragraph (c) was acquired is responsible for any costs incurred at the hospital to which 
76.20 	the patient is transferred.
76.21 	(e) A hospital shall not bill a recipient of services for any payment disallowed under 
76.22 	this subdivision.

76.23 	Sec. 14. Minnesota Statutes 2008, section 256.969, is amended by adding a subdivision 
76.24 	to read:
76.25 		Subd. 28.Temporary rate increase for qualifying hospitals. For the period 
76.26 	from April 1, 2009, to September 30, 2010, for each hospital with a medical assistance 
76.27 	utilization rate equal to or greater than 25 percent during the base year, the commissioner 
76.28 	shall provide an equal percentage rate increase for each medical assistance admission. The 
76.29 	commissioner shall estimate the percentage rate increase using as the state share of the 
76.30 	increase the amount available under section 256B.199, paragraph (d). The commissioner 
76.31 	shall settle up payments to qualifying hospitals based on actual payments under that 
76.32 	section and actual hospital admissions.

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

77.1 	Sec. 15. Minnesota Statutes 2008, section 256.969, is amended by adding a subdivision 
77.2 	to read:
77.3 		Subd. 29.Reimbursement for the fee increase for the early hearing detection 
77.4 	and intervention program. For services provided on or after July 1, 2010, in addition to 
77.5 	any other payment under this section, the commissioner shall reimburse hospitals for the 
77.6 	increase in the fee for the early hearing detection and intervention program described in 
77.7 	section 144.125, subdivision 1, paid by the hospital for public program recipients.

77.8 	Sec. 16. [256B.032] ELIGIBLE VENDORS OF MEDICAL CARE.
77.9 	(a) Effective January 1, 2011, the commissioner shall establish performance 
77.10 	thresholds for health care providers included in the provider peer grouping system 
77.11 	developed by the commissioner of health under section 62U.04. The thresholds shall be 
77.12 	set at the 10th percentile of the combined cost and quality measure used for provider peer 
77.13 	grouping, and separate thresholds shall be set for hospital and physician services.
77.14 	(b) Beginning January 1, 2012, any health care provider with a combined cost and 
77.15 	quality score below the threshold set in paragraph (a) shall be prohibited from enrolling 
77.16 	as a vendor of medical care in the medical assistance, general assistance medical care, 
77.17 	or MinnesotaCare programs, and shall not be eligible for direct payments under those 
77.18 	programs or for payments made by managed care plans under their contracts with the 
77.19 	commissioner under section 256B.69 or 256L.12. A health care provider that is prohibited 
77.20 	from enrolling as a vendor or receiving payments under this paragraph may reenroll 
77.21 	effective January 1 of any subsequent year if the provider's most recent combined cost and 
77.22 	quality score exceeds the threshold established in paragraph (a).
77.23 	(c) Notwithstanding paragraph (b), a provider may continue to participate as a vendor 
77.24 	or as part of a managed care plan provider network if the commissioner determines that a 
77.25 	contract with the provider is necessary to ensure adequate access to health care services.
77.26 	(d) By January 15, 2013, the commissioner shall report to the legislature on the 
77.27 	impact of this section. The commissioner's report shall include information on:
77.28 	(1) the providers falling below the thresholds as of January 1, 2012;
77.29 	(2) the volume of services and cost of care provided to enrollees in the medical 
77.30 	assistance, general assistance medical care, or MinnesotaCare programs in the 12 months 
77.31 	prior to January 1, 2012, by providers falling below the thresholds;
77.32 	(3) providers who fell below the thresholds but continued to be eligible vendors 
77.33 	under paragraph (c);
77.34 	(4) the estimated cost savings achieved by not contracting with providers who do 
77.35 	not meet the performance thresholds; and
78.1 	(5) recommendations for increasing the threshold levels of performance over time.

78.2 	Sec. 17. Minnesota Statutes 2008, section 256B.056, subdivision 3c, is amended to 
78.3 	read:
78.4 		Subd. 3c.Asset limitations for families and children. A household of two or more 
78.5 	persons must not own more than $20,000 in total net assets, and a household of one 
78.6 	person must not own more than $10,000 in total net assets. In addition to these maximum 
78.7 	amounts, an eligible individual or family may accrue interest on these amounts, but they 
78.8 	must be reduced to the maximum at the time of an eligibility redetermination. The value of 
78.9 	assets that are not considered in determining eligibility for medical assistance for families 
78.10 	and children is the value of those assets excluded under the AFDC state plan as of July 16, 
78.11 	1996, as required by the Personal Responsibility and Work Opportunity Reconciliation 
78.12 	Act of 1996 (PRWORA), Public Law 104-193, with the following exceptions:
78.13 	(1) household goods and personal effects are not considered;
78.14 	(2) capital and operating assets of a trade or business up to $200,000 are not 
78.15 	considered, except that a bank account that contains personal income or assets, or is used to 
78.16 	pay personal expenses, is not considered a capital or operating asset of a trade or business;
78.17 	(3) one motor vehicle is excluded for each person of legal driving age who is 
78.18 	employed or seeking employment;
78.19 	(4) one burial plot and all other burial expenses equal to the supplemental security 
78.20 	income program asset limit are not considered for each individual;
78.21 	(5) court-ordered settlements up to $10,000 are not considered;
78.22 	(6) individual retirement accounts and funds are not considered; and
78.23 	(7) assets owned by children are not considered.
78.24 	The assets specified in clause (2) must be disclosed to the local agency at the time of 
78.25 	application and at the time of an eligibility redetermination, and must be verified upon 
78.26 	request of the local agency.

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

78.29 	Sec. 18. Minnesota Statutes 2008, section 256B.056, subdivision 3d, is amended to 
78.30 	read:
78.31 		Subd. 3d.Reduction of excess assets. Assets in excess of the limits in subdivisions 
78.32 	3 to 3c may be reduced to allowable limits as follows:
79.1 	(a) Assets may be reduced in any of the three calendar months before the month 
79.2 	of application in which the applicant seeks coverage by:
79.3 	(1) designating burial funds up to $1,500 for each applicant, spouse, and MA-eligible 
79.4 	dependent child; and
79.5 	(2) paying health service bills for health services that are incurred in the retroactive 
79.6 	period for which the applicant seeks eligibility, starting with the oldest bill. After assets 
79.7 	are reduced to allowable limits, eligibility begins with the next dollar of MA-covered 
79.8 	health services incurred in the retroactive period. Applicants reducing assets under this 
79.9 	subdivision who also have excess income shall first spend excess assets to pay health 
79.10 	service bills and may meet the income spenddown on remaining bills.
79.11 	(b) Assets may be reduced beginning the month of application by:
79.12 	(1) paying bills for health services that are incurred during the period specified in 
79.13 	Minnesota Rules, part 9505.0090, subpart 2, that would otherwise be paid by medical 
79.14 	assistance; and. After assets are reduced to allowable limits, eligibility begins with the 
79.15 	next dollar of medical assistance covered health services incurred in the period. Applicants 
79.16 	reducing assets under this subdivision who also have excess income shall first spend excess 
79.17 	assets to pay health service bills and may meet the income spenddown on remaining bills.
79.18 	(2) using any means other than a transfer of assets for less than fair market value as 
79.19 	defined in section 256B.0595, subdivision 1, paragraph (b).

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

79.21 	Sec. 19. Minnesota Statutes 2008, section 256B.057, is amended by adding a 
79.22 	subdivision to read:
79.23 		Subd. 11.Treatment for colorectal cancer. (a) Medical assistance shall be paid for 
79.24 	an individual who:
79.25 	(1) has been screened for colorectal cancer by the colorectal cancer prevention 
79.26 	demonstration project;
79.27 	(2) according to the individual's treating health professional, needs treatment for 
79.28 	colorectal cancer;
79.29 	(3) meets income eligibility guidelines for the colorectal cancer prevention 
79.30 	demonstration project;
79.31 	(4) is under the age of 65; and
79.32 	(5) is not otherwise eligible for medical assistance or covered under creditable 
79.33 	coverage as defined under United States Code, title 42, section 300gg(a).
79.34 	(b) Medical assistance provided under this subdivision shall be limited to services 
79.35 	provided during the period that the individual receives treatment for colorectal cancer.
80.1 	(c) An individual meeting the criteria in paragraph (a) is eligible for medical 
80.2 	assistance without meeting the eligibility criteria relating to income and assets in section 
80.3 	256B.056, subdivisions 1a to 5b.
80.4 	(d) This subdivision expires December 31, 2010.

80.5 	Sec. 20. Minnesota Statutes 2008, section 256B.0575, is amended to read:
80.6 	256B.0575 AVAILABILITY OF INCOME FOR INSTITUTIONALIZED 
80.7 	PERSONS.
80.8 		Subdivision 1.Income deductions. When an institutionalized person is determined 
80.9 	eligible for medical assistance, the income that exceeds the deductions in paragraphs (a) 
80.10 	and (b) must be applied to the cost of institutional care.
80.11 	(a) The following amounts must be deducted from the institutionalized person's 
80.12 	income in the following order:
80.13 	(1) the personal needs allowance under section 256B.35 or, for a veteran who 
80.14 	does not have a spouse or child, or a surviving spouse of a veteran having no child, the 
80.15 	amount of an improved pension received from the veteran's administration not exceeding 
80.16 	$90 per month;
80.17 	(2) the personal allowance for disabled individuals under section 256B.36;
80.18 	(3) if the institutionalized person has a legally appointed guardian or conservator, 
80.19 	five percent of the recipient's gross monthly income up to $100 as reimbursement for 
80.20 	guardianship or conservatorship services;
80.21 	(4) a monthly income allowance determined under section 256B.058, subdivision 
80.22 	2, but only to the extent income of the institutionalized spouse is made available to the 
80.23 	community spouse;
80.24 	(5) a monthly allowance for children under age 18 which, together with the net 
80.25 	income of the children, would provide income equal to the medical assistance standard 
80.26 	for families and children according to section 256B.056, subdivision 4, for a family size 
80.27 	that includes only the minor children. This deduction applies only if the children do not 
80.28 	live with the community spouse and only to the extent that the deduction is not included 
80.29 	in the personal needs allowance under section 256B.35, subdivision 1, as child support 
80.30 	garnished under a court order;
80.31 	(6) a monthly family allowance for other family members, equal to one-third of the 
80.32 	difference between 122 percent of the federal poverty guidelines and the monthly income 
80.33 	for that family member;
81.1 	(7) reparations payments made by the Federal Republic of Germany and reparations 
81.2 	payments made by the Netherlands for victims of Nazi persecution between 1940 and 
81.3 	1945;
81.4 	(8) all other exclusions from income for institutionalized persons as mandated by 
81.5 	federal law; and
81.6 	(9) amounts for reasonable expenses, as specified in subdivision 2, incurred for 
81.7 	necessary medical or remedial care for the institutionalized person that are recognized 
81.8 	under state law, not medical assistance covered expenses, and that are not subject to 
81.9 	payment by a third party.
81.10 	Reasonable expenses are limited to expenses that have not been previously used as a 
81.11 	deduction from income and are incurred during the enrollee's current period of eligibility, 
81.12 	including retroactive months associated with the current period of eligibility, for medical 
81.13 	assistance payment of long-term care services.
81.14 	For purposes of clause (6), "other family member" means a person who resides 
81.15 	with the community spouse and who is a minor or dependent child, dependent parent, or 
81.16 	dependent sibling of either spouse. "Dependent" means a person who could be claimed as 
81.17 	a dependent for federal income tax purposes under the Internal Revenue Code.
81.18 	(b) Income shall be allocated to an institutionalized person for a period of up to three 
81.19 	calendar months, in an amount equal to the medical assistance standard for a family 
81.20 	size of one if:
81.21 	(1) a physician certifies that the person is expected to reside in the long-term care 
81.22 	facility for three calendar months or less;
81.23 	(2) if the person has expenses of maintaining a residence in the community; and
81.24 	(3) if one of the following circumstances apply:
81.25 	(i) the person was not living together with a spouse or a family member as defined in 
81.26 	paragraph (a) when the person entered a long-term care facility; or
81.27 	(ii) the person and the person's spouse become institutionalized on the same date, in 
81.28 	which case the allocation shall be applied to the income of one of the spouses.
81.29 	For purposes of this paragraph, a person is determined to be residing in a licensed nursing 
81.30 	home, regional treatment center, or medical institution if the person is expected to remain 
81.31 	for a period of one full calendar month or more.
81.32 		Subd. 2.Reasonable expenses. For the purposes of subdivision 1, paragraph (a), 
81.33 	clause (9), reasonable expenses are limited to expenses that have not been previously used 
81.34 	as a deduction from income and were not:
81.35 	(1) for long-term care expenses incurred during a period of ineligibility as defined in 
81.36 	section 256B.0595, subdivision 2;
82.1 	(2) incurred more than three months before the month of application associated with 
82.2 	the current period of eligibility;
82.3 	(3) for expenses incurred by a recipient that are duplicative of services that are 
82.4 	covered under chapter 256B; or
82.5 	(4) nursing facility expenses incurred without a timely assessment as required under 
82.6 	section 256B.0911.

82.7 	Sec. 21. Minnesota Statutes 2008, section 256B.0595, subdivision 1, is amended to 
82.8 	read:
82.9 		Subdivision 1. Prohibited transfers. (a) For transfers of assets made on or before 
82.10 	August 10, 1993, if an institutionalized person or the institutionalized person's spouse has 
82.11 	given away, sold, or disposed of, for less than fair market value, any asset or interest 
82.12 	therein, except assets other than the homestead that are excluded under the supplemental 
82.13 	security program, within 30 months before or any time after the date of institutionalization 
82.14 	if the person has been determined eligible for medical assistance, or within 30 months 
82.15 	before or any time after the date of the first approved application for medical assistance 
82.16 	if the person has not yet been determined eligible for medical assistance, the person is 
82.17 	ineligible for long-term care services for the period of time determined under subdivision 
82.18 	2. 
82.19 	(b) Effective for transfers made after August 10, 1993, an institutionalized person, an 
82.20 	institutionalized person's spouse, or any person, court, or administrative body with legal 
82.21 	authority to act in place of, on behalf of, at the direction of, or upon the request of the 
82.22 	institutionalized person or institutionalized person's spouse, may not give away, sell, or 
82.23 	dispose of, for less than fair market value, any asset or interest therein, except assets other 
82.24 	than the homestead that are excluded under the Supplemental Security Income program, 
82.25 	for the purpose of establishing or maintaining medical assistance eligibility. This applies 
82.26 	to all transfers, including those made by a community spouse after the month in which 
82.27 	the institutionalized spouse is determined eligible for medical assistance. For purposes of 
82.28 	determining eligibility for long-term care services, any transfer of such assets within 36 
82.29 	months before or any time after an institutionalized person requests medical assistance 
82.30 	payment of long-term care services, or 36 months before or any time after a medical 
82.31 	assistance recipient becomes an institutionalized person, for less than fair market value 
82.32 	may be considered. Any such transfer is presumed to have been made for the purpose 
82.33 	of establishing or maintaining medical assistance eligibility and the institutionalized 
82.34 	person is ineligible for long-term care services for the period of time determined under 
82.35 	subdivision 2, unless the institutionalized person furnishes convincing evidence to 
83.1 	establish that the transaction was exclusively for another purpose, or unless the transfer is 
83.2 	permitted under subdivision 3 or 4.  In the case of payments from a trust or portions of a 
83.3 	trust that are considered transfers of assets under federal law, or in the case of any other 
83.4 	disposal of assets made on or after February 8, 2006, any transfers made within 60 months 
83.5 	before or any time after an institutionalized person requests medical assistance payment of 
83.6 	long-term care services and within 60 months before or any time after a medical assistance 
83.7 	recipient becomes an institutionalized person, may be considered. 
83.8 	(c) This section applies to transfers, for less than fair market value, of income 
83.9 	or assets, including assets that are considered income in the month received, such as 
83.10 	inheritances, court settlements, and retroactive benefit payments or income to which the 
83.11 	institutionalized person or the institutionalized person's spouse is entitled but does not 
83.12 	receive due to action by the institutionalized person, the institutionalized person's spouse, 
83.13 	or any person, court, or administrative body with legal authority to act in place of, on 
83.14 	behalf of, at the direction of, or upon the request of the institutionalized person or the 
83.15 	institutionalized person's spouse. 
83.16 	(d) This section applies to payments for care or personal services provided by a 
83.17 	relative, unless the compensation was stipulated in a notarized, written agreement which 
83.18 	was in existence when the service was performed, the care or services directly benefited 
83.19 	the person, and the payments made represented reasonable compensation for the care 
83.20 	or services provided. A notarized written agreement is not required if payment for the 
83.21 	services was made within 60 days after the service was provided. 
83.22 	(e) This section applies to the portion of any asset or interest that an institutionalized 
83.23 	person, an institutionalized person's spouse, or any person, court, or administrative body 
83.24 	with legal authority to act in place of, on behalf of, at the direction of, or upon the request 
83.25 	of the institutionalized person or the institutionalized person's spouse, transfers to any 
83.26 	annuity that exceeds the value of the benefit likely to be returned to the institutionalized 
83.27 	person or institutionalized person's spouse while alive, based on estimated life expectancy 
83.28 	as determined according to the current actuarial tables published by the Office of the 
83.29 	Chief Actuary of the Social Security Administration. The commissioner may adopt rules 
83.30 	reducing life expectancies based on the need for long-term care. This section applies to an 
83.31 	annuity purchased on or after March 1, 2002, that: 
83.32 	(1) is not purchased from an insurance company or financial institution that is 
83.33 	subject to licensing or regulation by the Minnesota Department of Commerce or a similar 
83.34 	regulatory agency of another state; 
83.35 	(2) does not pay out principal and interest in equal monthly installments; or 
83.36 	(3) does not begin payment at the earliest possible date after annuitization. 
84.1 	(f) Effective for transactions, including the purchase of an annuity, occurring on or 
84.2 	after February 8, 2006, by or on behalf of an institutionalized person who has applied for 
84.3 	or is receiving long-term care services or the institutionalized person's spouse shall be 
84.4 	treated as the disposal of an asset for less than fair market value unless the department is 
84.5 	named a preferred remainder beneficiary  as described in section 256B.056, subdivision 
84.6 	11. Any subsequent change to the designation of the department as a preferred remainder 
84.7 	beneficiary shall result in the annuity being treated as a disposal of assets for less than 
84.8 	fair market value. The amount of such transfer shall be the maximum amount the 
84.9 	institutionalized person or the institutionalized person's spouse could receive from the 
84.10 	annuity or similar financial instrument. Any change in the amount of the income or 
84.11 	principal being withdrawn from the annuity or other similar financial instrument at the 
84.12 	time of the most recent disclosure shall be deemed to be a transfer of assets for less than 
84.13 	fair market value unless the institutionalized person or the institutionalized person's spouse 
84.14 	demonstrates that the transaction was for fair market value. In the event a distribution 
84.15 	of income or principal has been improperly distributed or disbursed from an annuity or 
84.16 	other retirement planning instrument of an institutionalized person or the institutionalized 
84.17 	person's spouse, a cause of action exists against the individual receiving the improper 
84.18 	distribution for the cost of medical assistance services provided or the amount of the 
84.19 	improper distribution, whichever is less. 
84.20 	(g) Effective for transactions, including the purchase of an annuity, occurring on 
84.21 	or after February 8, 2006, by or on behalf of an institutionalized person applying for or 
84.22 	receiving long-term care services shall be treated as a disposal of assets for less than fair 
84.23 	market value unless it is: 
84.24 	(i) an annuity described in subsection (b) or (q) of section 408 of the Internal 
84.25 	Revenue Code of 1986; or 
84.26 	(ii) purchased with proceeds from: 
84.27 	(A) an account or trust described in subsection (a), (c), or (p) of section 408 of the 
84.28 	Internal Revenue Code; 
84.29 	(B) a simplified employee pension within the meaning of section 408(k) of the 
84.30 	Internal Revenue Code; or 
84.31 	(C) a Roth IRA described in section 408A of the Internal Revenue Code; or 
84.32 	(iii) an annuity that is irrevocable and nonassignable; is actuarially sound as 
84.33 	determined in accordance with actuarial publications of the Office of the Chief Actuary of 
84.34 	the Social Security Administration; and provides for payments in equal amounts during 
84.35 	the term of the annuity, with no deferral and no balloon payments made.
85.1 	 (h) For purposes of this section, long-term care services include services in a nursing 
85.2 	facility, services that are eligible for payment according to section 256B.0625, subdivision 
85.3 	2, because they are provided in a swing bed, intermediate care facility for persons with 
85.4 	developmental disabilities, and home and community-based services provided pursuant 
85.5 	to sections 256B.0915, 256B.092, and 256B.49. For purposes of this subdivision and 
85.6 	subdivisions 2, 3, and 4, "institutionalized person" includes a person who is an inpatient 
85.7 	in a nursing facility or in a swing bed, or intermediate care facility for persons with 
85.8 	developmental disabilities or who is receiving home and community-based services under 
85.9 	sections 256B.0915, 256B.092, and 256B.49. 
85.10 	(i) This section applies to funds used to purchase a promissory note, loan, or 
85.11 	mortgage unless the note, loan, or mortgage: 
85.12 	(1) has a repayment term that is actuarially sound; 
85.13 	(2) provides for payments to be made in equal amounts during the term of the loan, 
85.14 	with no deferral and no balloon payments made; and 
85.15 	(3) prohibits the cancellation of the balance upon the death of the lender. 
85.16 	In the case of a promissory note, loan, or mortgage that does not meet an exception 
85.17 	in clauses (1) to (3), the value of such note, loan, or mortgage shall be the outstanding 
85.18 	balance due as of the date of the institutionalized person's request for medical assistance 
85.19 	payment of long-term care services. 
85.20 	(j) This section applies to the purchase of a life estate interest in another person's 
85.21 	home unless the purchaser resides in the home for a period of at least one year after the 
85.22 	date of purchase. 
85.23 	(k) This section applies to transfers into a pooled trust that qualifies under United 
85.24 	States Code, title 42, section 1396p(d)(4)(C), by:
85.25 	(1) a person age 65 or older or the person's spouse; or
85.26 	(2) any person, court, or administrative body with legal authority to act in place 
85.27 	of, on behalf of, at the direction of, or upon the request of a person age 65 or older or 
85.28 	the person's spouse.

85.29 	Sec. 22. Minnesota Statutes 2008, section 256B.0595, subdivision 2, is amended to 
85.30 	read:
85.31 		Subd. 2. Period of ineligibility for long-term care services. (a) For any 
85.32 	uncompensated transfer occurring on or before August 10, 1993, the number of months 
85.33 	of ineligibility for long-term care services shall be the lesser of 30 months, or the 
85.34 	uncompensated transfer amount divided by the average medical assistance rate for nursing 
85.35 	facility services in the state in effect on the date of application. The amount used to 
86.1 	calculate the average medical assistance payment rate shall be adjusted each July 1 to 
86.2 	reflect payment rates for the previous calendar year. The period of ineligibility begins 
86.3 	with the month in which the assets were transferred. If the transfer was not reported to 
86.4 	the local agency at the time of application, and the applicant received long-term care 
86.5 	services during what would have been the period of ineligibility if the transfer had been 
86.6 	reported, a cause of action exists against the transferee for the cost of long-term care 
86.7 	services provided during the period of ineligibility, or for the uncompensated amount of 
86.8 	the transfer, whichever is less. The uncompensated transfer amount is the fair market 
86.9 	value of the asset at the time it was given away, sold, or disposed of, less the amount of 
86.10 	compensation received. 
86.11 	(b) For uncompensated transfers made after August 10, 1993, the number of months 
86.12 	of ineligibility for long-term care services shall be the total uncompensated value of the 
86.13 	resources transferred divided by the average medical assistance rate for nursing facility 
86.14 	services in the state in effect on the date of application. The amount used to calculate 
86.15 	the average medical assistance payment rate shall be adjusted each July 1 to reflect 
86.16 	payment rates for the previous calendar year. The period of ineligibility begins with the 
86.17 	first day of the month after the month in which the assets were transferred except that 
86.18 	if one or more uncompensated transfers are made during a period of ineligibility, the 
86.19 	total assets transferred during the ineligibility period shall be combined and a penalty 
86.20 	period calculated to begin on the first day of the month after the month in which the first 
86.21 	uncompensated transfer was made. If the transfer was reported to the local agency after 
86.22 	the date that advance notice of a period of ineligibility that affects the next month could 
86.23 	be provided to the recipient and the recipient received medical assistance services or the 
86.24 	transfer was not reported to the local agency, and the applicant or recipient received 
86.25 	medical assistance services during what would have been the period of ineligibility if 
86.26 	the transfer had been reported, a cause of action exists against the transferee for that 
86.27 	portion of long-term care services provided during the period of ineligibility, or for the 
86.28 	uncompensated amount of the transfer, whichever is less. The uncompensated transfer 
86.29 	amount is the fair market value of the asset at the time it was given away, sold, or disposed 
86.30 	of, less the amount of compensation received. Effective for transfers made on or after 
86.31 	March 1, 1996, involving persons who apply for medical assistance on or after April 13, 
86.32 	1996, no cause of action exists for a transfer unless: 
86.33 	(1) the transferee knew or should have known that the transfer was being made by a 
86.34 	person who was a resident of a long-term care facility or was receiving that level of care in 
86.35 	the community at the time of the transfer; 
87.1 	(2) the transferee knew or should have known that the transfer was being made to 
87.2 	assist the person to qualify for or retain medical assistance eligibility; or 
87.3 	(3) the transferee actively solicited the transfer with intent to assist the person to 
87.4 	qualify for or retain eligibility for medical assistance. 
87.5 	(c) For uncompensated transfers made on or after February 8, 2006, the period 
87.6 	of ineligibility: 
87.7 	(1) for uncompensated transfers by or on behalf of individuals receiving medical 
87.8 	assistance payment of long-term care services, begins the first day of the month following 
87.9 	advance notice of the penalty period of ineligibility, but no later than the first day of the 
87.10 	month that follows three full calendar months from the date of the report or discovery 
87.11 	of the transfer; or 
87.12 	(2) for uncompensated transfers by individuals requesting medical assistance 
87.13 	payment of long-term care services, begins the date on which the individual is eligible 
87.14 	for medical assistance under the Medicaid state plan and would otherwise be receiving 
87.15 	long-term care services based on an approved application for such care but for the
87.16 	application of the penalty period of ineligibility resulting from the uncompensated 
87.17 	transfer; and 
87.18 	(3) cannot begin during any other period of ineligibility. 
87.19 	(d) If a calculation of a penalty period of ineligibility results in a partial month, 
87.20 	payments for long-term care services shall be reduced in an amount equal to the fraction. 
87.21 	(e) In the case of multiple fractional transfers of assets in more than one month for 
87.22 	less than fair market value on or after February 8, 2006, the period of ineligibility is 
87.23 	calculated by treating the total, cumulative, uncompensated value of all assets transferred 
87.24 	during all months on or after February 8, 2006, as one transfer. 
87.25 	(f) A period of ineligibility established under paragraph (c) may be eliminated if 
87.26 	all of the assets transferred for less than fair market value used to calculate the period of 
87.27 	ineligibility, or cash equal to the value of the assets at the time of the transfer, are returned 
87.28 	within 12 months after the date the period of ineligibility began. A period of ineligibility 
87.29 	must not be adjusted if less than the full amount of the transferred assets or the full cash 
87.30 	value of the transferred assets are returned.

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

87.33 	Sec. 23. Minnesota Statutes 2008, section 256B.06, subdivision 4, is amended to read:
87.34 		Subd. 4. Citizenship requirements. (a) Eligibility for medical assistance is limited 
87.35 	to citizens of the United States, qualified noncitizens as defined in this subdivision, and 
88.1 	other persons residing lawfully in the United States. Citizens or nationals of the United 
88.2 	States must cooperate in obtaining satisfactory documentary evidence of citizenship or 
88.3 	nationality according to the requirements of the federal Deficit Reduction Act of 2005, 
88.4 	Public Law 109-171. 
88.5 	(b) "Qualified noncitizen" means a person who meets one of the following 
88.6 	immigration criteria: 
88.7 	(1) admitted for lawful permanent residence according to United States Code, title 8; 
88.8 	(2) admitted to the United States as a refugee according to United States Code, 
88.9 	title 8, section 1157; 
88.10 	(3) granted asylum according to United States Code, title 8, section 1158; 
88.11 	(4) granted withholding of deportation according to United States Code, title 8, 
88.12 	section 1253(h); 
88.13 	(5) paroled for a period of at least one year according to United States Code, title 8, 
88.14 	section 1182(d)(5); 
88.15 	(6) granted conditional entrant status according to United States Code, title 8, 
88.16 	section 1153(a)(7); 
88.17 	(7) determined to be a battered noncitizen by the United States Attorney General 
88.18 	according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, 
88.19 	title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200; 
88.20 	(8) is a child of a noncitizen determined to be a battered noncitizen by the United 
88.21 	States Attorney General according to the Illegal Immigration Reform and Immigrant 
88.22 	Responsibility Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill, 
88.23 	Public Law 104-200; or 
88.24 	(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public 
88.25 	Law 96-422, the Refugee Education Assistance Act of 1980. 
88.26 	(c) All qualified noncitizens who were residing in the United States before August 
88.27 	22, 1996, who otherwise meet the eligibility requirements of this chapter, are eligible for 
88.28 	medical assistance with federal financial participation. 
88.29 	(d) All qualified noncitizens who entered the United States on or after August 22, 
88.30 	1996, and who otherwise meet the eligibility requirements of this chapter, are eligible for 
88.31 	medical assistance with federal financial participation through November 30, 1996. 
88.32 	Beginning December 1, 1996, qualified noncitizens who entered the United States 
88.33 	on or after August 22, 1996, and who otherwise meet the eligibility requirements of this 
88.34 	chapter are eligible for medical assistance with federal participation for five years if they 
88.35 	meet one of the following criteria: 
89.1 	(i) refugees admitted to the United States according to United States Code, title 8, 
89.2 	section 1157; 
89.3 	(ii) persons granted asylum according to United States Code, title 8, section 1158; 
89.4 	(iii) persons granted withholding of deportation according to United States Code, 
89.5 	title 8, section 1253(h); 
89.6 	(iv) veterans of the United States armed forces with an honorable discharge for 
89.7 	a reason other than noncitizen status, their spouses and unmarried minor dependent 
89.8 	children; or 
89.9 	(v) persons on active duty in the United States armed forces, other than for training, 
89.10 	their spouses and unmarried minor dependent children. 
89.11 	Beginning December 1, 1996, qualified noncitizens who do not meet one of the 
89.12 	criteria in items (i) to (v) are eligible for medical assistance without federal financial 
89.13 	participation as described in paragraph (j). 
89.14 	Notwithstanding paragraph (j), beginning July 1, 2010, children and pregnant 
89.15 	women who are qualified noncitizens, as described in paragraph (b), are eligible for 
89.16 	medical assistance with federal financial participation as provided by the federal Children's 
89.17 	Health Insurance Program Reauthorization Act of 2009, Public Law 111-3.
89.18 	(e) Noncitizens who are not qualified noncitizens as defined in paragraph (b), who 
89.19 	are lawfully present in the United States, as defined in Code of Federal Regulations, title 
89.20 	8, section 103.12, and who otherwise meet the eligibility requirements of this chapter, are 
89.21 	eligible for medical assistance under clauses (1) to (3). These individuals must cooperate 
89.22 	with the United States Citizenship and Immigration Services to pursue any applicable 
89.23 	immigration status, including citizenship, that would qualify them for medical assistance 
89.24 	with federal financial participation. 
89.25 	(1) Persons who were medical assistance recipients on August 22, 1996, are eligible 
89.26 	for medical assistance with federal financial participation through December 31, 1996. 
89.27 	(2) Beginning January 1, 1997, persons described in clause (1) are eligible for 
89.28 	medical assistance without federal financial participation as described in paragraph (j). 
89.29 	(3) Beginning December 1, 1996, persons residing in the United States prior to 
89.30 	August 22, 1996, who were not receiving medical assistance and persons who arrived on 
89.31 	or after August 22, 1996, are eligible for medical assistance without federal financial 
89.32 	participation as described in paragraph (j). 
89.33 	(f) Nonimmigrants who otherwise meet the eligibility requirements of this chapter 
89.34 	are eligible for the benefits as provided in paragraphs (g) to (i). For purposes of this 
89.35 	subdivision, a "nonimmigrant" is a person in one of the classes listed in United States 
89.36 	Code, title 8, section 1101(a)(15). 
90.1 	(g) Payment shall also be made for care and services that are furnished to noncitizens, 
90.2 	regardless of immigration status, who otherwise meet the eligibility requirements of 
90.3 	this chapter, if such care and services are necessary for the treatment of an emergency 
90.4 	medical condition, except for organ transplants and related care and services and routine 
90.5 	prenatal care. 
90.6 	(h) For purposes of this subdivision, the term "emergency medical condition" means 
90.7 	a medical condition that meets the requirements of United States Code, title 42, section 
90.8 	1396b(v). 
90.9 	(i) Beginning July 1, 2009, pregnant noncitizens who are undocumented, 
90.10 	nonimmigrants, or eligible for medical assistance as described in paragraph (j),lawfully 
90.11 	present as designated in paragraph (e) and who are not covered by a group health plan 
90.12 	or health insurance coverage according to Code of Federal Regulations, title 42, section 
90.13 	457.310, and who otherwise meet the eligibility requirements of this chapter, are eligible 
90.14 	for medical assistance through the period of pregnancy, including labor and delivery,
90.15 	and 60 days postpartum, to the extent federal funds are available under title XXI of the 
90.16 	Social Security Act, and the state children's health insurance program, followed by 60 
90.17 	days postpartum without federal financial participation. 
90.18 	(j) Qualified noncitizens as described in paragraph (d), and all other noncitizens 
90.19 	lawfully residing in the United States as described in paragraph (e), who are ineligible 
90.20 	for medical assistance with federal financial participation and who otherwise meet the 
90.21 	eligibility requirements of chapter 256B and of this paragraph, are eligible for medical 
90.22 	assistance without federal financial participation. Qualified noncitizens as described 
90.23 	in paragraph (d) are only eligible for medical assistance without federal financial 
90.24 	participation for five years from their date of entry into the United States. 
90.25 	(k) Beginning October 1, 2003, persons who are receiving care and rehabilitation 
90.26 	services from a nonprofit center established to serve victims of torture and are otherwise 
90.27 	ineligible for medical assistance under this chapter are eligible for medical assistance 
90.28 	without federal financial participation. These individuals are eligible only for the period 
90.29 	during which they are receiving services from the center. Individuals eligible under this 
90.30 	paragraph shall not be required to participate in prepaid medical assistance. 

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

90.32 	Sec. 24. Minnesota Statutes 2008, section 256B.06, subdivision 5, is amended to read:
90.33 		Subd. 5.Deeming of sponsor income and resources. When determining eligibility 
90.34 	for any federal or state funded medical assistance under this section, the income 
90.35 	and resources of all noncitizens shall be deemed to include their sponsors' income 
91.1 	and resources as required under the Personal Responsibility and Work Opportunity 
91.2 	Reconciliation Act of 1996, title IV, Public Law 104-193, sections 421 and 422, and 
91.3 	subsequently set out in federal rules. This section is effective May 1, 1997. Beginning 
91.4 	July 1, 2010, sponsor deeming does not apply to pregnant women and children who are 
91.5 	qualified noncitizens, as described in section 256B.06, subdivision 4, paragraph (b).

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

91.7 	Sec. 25. Minnesota Statutes 2008, section 256B.0625, subdivision 3, is amended to 
91.8 	read:
91.9 		Subd. 3.Physicians' services. (a) Medical assistance covers physicians' services.
91.10 	(b)  Rates paid for anesthesiology services provided by physicians shall be according 
91.11 	to the formula utilized in the Medicare program and shall use a conversion factor "at 
91.12 	percentile of calendar year set by legislature.," except that rates paid to physicians for the 
91.13 	medical direction of a certified registered nurse anesthetist shall be the same as the rate 
91.14 	paid to the certified registered nurse anesthetist under medical direction.

91.15 	Sec. 26. Minnesota Statutes 2008, section 256B.0625, subdivision 3c, is amended to 
91.16 	read:
91.17 		Subd. 3c. Health Services Policy Committee. (a) The commissioner, after 
91.18 	receiving recommendations from professional physician associations, professional 
91.19 	associations representing licensed nonphysician health care professionals, and consumer 
91.20 	groups, shall establish a 13-member Health Services Policy Committee, which consists of 
91.21 	12 voting members and one nonvoting member. The Health Services Policy Committee 
91.22 	shall advise the commissioner regarding health services pertaining to the administration 
91.23 	of health care benefits covered under the medical assistance, general assistance medical 
91.24 	care, and MinnesotaCare programs. The Health Services Policy Committee shall meet at 
91.25 	least quarterly. The Health Services Policy Committee shall annually elect a physician 
91.26 	chair from among its members, who shall work directly with the commissioner's medical 
91.27 	director, to establish the agenda for each meeting. The Health Services Policy Committee 
91.28 	shall also recommend criteria for verifying centers of excellence for specific aspects of 
91.29 	medical care where a specific set of combined services, a volume of patients necessary to 
91.30 	maintain a high level of competency, or a specific level of technical capacity is associated 
91.31 	with improved health outcomes. 
91.32 	(b) The commissioner shall establish a dental subcommittee to operate under the 
91.33 	Health Services Policy Committee. The dental subcommittee consists of general dentists, 
91.34 	dental specialists, safety net providers, dental hygienists, health plan company and 
92.1 	county and public health representatives, health researchers, consumers, and a designee 
92.2 	of the commissioner of health. The dental subcommittee shall advise the commissioner 
92.3 	regarding:
92.4 	(1) the critical access dental program under section 256B.76, subdivision 4, including 
92.5 	but not limited to criteria for designating and terminating critical access dental providers;
92.6 	(2) any changes to the critical access dental provider program necessary to comply 
92.7 	with program expenditure limits;
92.8 	(3) dental coverage policy based on evidence, quality, continuity of care, and best 
92.9 	practices;
92.10 	(4) the development of dental delivery models; and
92.11 	(5) dental services to be added or eliminated from subdivision 9, paragraph (b).
92.12 	(c) The Health Services Policy Committee shall study approaches to making 
92.13 	provider reimbursement under the medical assistance, MinnesotaCare, and general 
92.14 	assistance medical care programs contingent on patient participation in a patient-centered 
92.15 	decision-making process, and shall evaluate the impact of these approaches on health 
92.16 	care quality, patient satisfaction, and health care costs. The committee shall present 
92.17 	findings and recommendations to the commissioner and the legislative committees with 
92.18 	jurisdiction over health care by January 15, 2010.
92.19 	(d) The Health Services Policy Committee shall monitor and track the practice 
92.20 	patterns of physicians providing services to medical assistance, MinnesotaCare, and 
92.21 	general assistance medical care enrollees under fee-for-service, managed care, and 
92.22 	county-based purchasing. The committee shall focus on services or specialties for which 
92.23 	there is a high variation in utilization across physicians, or which are associated with 
92.24 	high medical costs. The commissioner, based upon the findings of the committee, shall 
92.25 	regularly notify physicians whose practice patterns indicate higher than average utilization 
92.26 	or costs. Managed care and county-based purchasing plans shall provide the committee 
92.27 	with utilization and cost data necessary to implement this paragraph.
92.28 	(e) The Health Services Policy Committee shall review caesarean section rates 
92.29 	for the fee-for-service medical assistance population. The committee may develop best 
92.30 	practices policies related to the minimization of caesarean sections, including but not 
92.31 	limited to standards and guidelines for health care providers and health care facilities.

92.32 	Sec. 27. Minnesota Statutes 2008, section 256B.0625, subdivision 9, is amended to 
92.33 	read:
93.1 		Subd. 9.Dental services. (a) Medical assistance covers dental services. Dental 
93.2 	services include, with prior authorization, fixed bridges that are cost-effective for persons 
93.3 	who cannot use removable dentures because of their medical condition.
93.4 	(b) Medical assistance dental coverage for nonpregnant adults is limited to the 
93.5 	following services:
93.6 	(1) comprehensive exams, limited to once every five years;
93.7 	(2) periodic exams, limited to one per year;
93.8 	(3) limited exams;
93.9 	(4) bitewing x-rays, limited to one per year;
93.10 	(5) periapical x-rays;
93.11 	(6) panoramic x-rays, limited to one every five years, and only if provided in 
93.12 	conjunction with a posterior extraction or scheduled outpatient facility procedure, or as 
93.13 	medically necessary for the diagnosis and follow-up of oral and maxillofacial pathology 
93.14 	and trauma. Panoramic x-rays may be taken once every two years for patients who cannot 
93.15 	cooperate for intraoral film due to a developmental disability or medical condition that 
93.16 	does not allow for intraoral film placement;
93.17 	(7) prophylaxis, limited to one per year;
93.18 	(8) application of fluoride varnish, limited to one per year;
93.19 	(9) posterior fillings, all at the amalgam rate;
93.20 	(10) anterior fillings;
93.21 	(11) endodontics, limited to root canals on the anterior and premolars only;
93.22 	(12) removable prostheses, each dental arch limited to one every six years;
93.23 	(13) oral surgery, limited to extractions, biopsies, and incision and drainage of 
93.24 	abscesses;
93.25 	(14) palliative treatment and sedative fillings for relief of pain; and
93.26 	(15) full-mouth debridement, limited to one every five years.
93.27 	(c) In addition to the services specified in paragraph (b), medical assistance 
93.28 	covers the following services for adults, if provided in an outpatient hospital setting or 
93.29 	freestanding ambulatory surgical center as part of outpatient dental surgery:
93.30 	(1) periodontics, limited to periodontal scaling and root planing once every two 
93.31 	years;
93.32 	(2) general anesthesia; and
93.33 	(3) full-mouth survey once every five years.
93.34 	(d) Medical assistance covers dental services for children that are medically 
93.35 	necessary. The following guidelines apply:
93.36 	(1) posterior fillings are paid at the amalgam rate;
94.1 	(2) application of sealants once every five years per permanent molar; and
94.2 	(3) application of fluoride varnish once every six months.

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

94.4 	Sec. 28. Minnesota Statutes 2008, section 256B.0625, subdivision 11, is amended to 
94.5 	read:
94.6 		Subd. 11.Nurse anesthetist services. Medical assistance covers nurse anesthetist 
94.7 	services. Rates paid for anesthesiology services provided by a certified registered nurse 
94.8 	anesthetistsanesthetist under the direction of a physician shall be according to the formula 
94.9 	utilized in the Medicare program and shall use the conversion factor that is used by 
94.10 	the Medicare program. Rates paid for anesthesiology services provided by a certified 
94.11 	registered nurse anesthetist who is not directed by a physician shall be the same rate as 
94.12 	paid under subdivision 3, paragraph (b).

94.13 	Sec. 29. Minnesota Statutes 2008, section 256B.0625, subdivision 13, is amended to 
94.14 	read:
94.15 		Subd. 13.Drugs. (a) Medical assistance covers drugs, except for fertility drugs 
94.16 	when specifically used to enhance fertility, if prescribed by a licensed practitioner and 
94.17 	dispensed by a licensed pharmacist, by a physician enrolled in the medical assistance 
94.18 	program as a dispensing physician, or by a physician, physician assistant,  or a nurse 
94.19 	practitioner employed by or under contract with a community health board as defined in 
94.20 	section 145A.02, subdivision 5, for the purposes of communicable disease control.
94.21 	(b) The dispensed quantity of a prescription drug must not exceed a 34-day supply, 
94.22 	unless authorized by the commissioner.
94.23 	(c) Medical assistance covers the following over-the-counter drugs when prescribed 
94.24 	by a licensed practitioner or by a licensed pharmacist who meets standards established by 
94.25 	the commissioner, in consultation with the board of pharmacy: antacids, acetaminophen, 
94.26 	family planning products, aspirin, insulin, products for the treatment of lice, vitamins for 
94.27 	adults with documented vitamin deficiencies, vitamins for children under the age of seven 
94.28 	and pregnant or nursing women, and any other over-the-counter drug identified by the 
94.29 	commissioner, in consultation with the formulary committee, as necessary, appropriate, 
94.30 	and cost-effective for the treatment of certain specified chronic diseases, conditions, 
94.31 	or disorders, and this determination shall not be subject to the requirements of chapter 
94.32 	14. A pharmacist may prescribe over-the-counter medications as provided under this 
94.33 	paragraph for purposes of receiving reimbursement under Medicaid. When prescribing 
94.34 	over-the-counter drugs under this paragraph, licensed pharmacists must consult with the 
95.1 	recipient to determine necessity, provide drug counseling, review drug therapy for potential 
95.2 	adverse interactions, and make referrals as needed to other health care professionals.
95.3 	(d) Effective January 1, 2006, medical assistance shall not cover drugs that 
95.4 	are coverable under Medicare Part D as defined in the Medicare Prescription Drug, 
95.5 	Improvement, and Modernization Act of 2003, Public Law 108-173, section 1860D-2(e), 
95.6 	for individuals eligible for drug coverage as defined in the Medicare Prescription 
95.7 	Drug, Improvement, and Modernization Act of 2003, Public Law 108-173, section 
95.8 	1860D-1(a)(3)(A). For these individuals, medical assistance may cover drugs from the 
95.9 	drug classes listed in United States Code, title 42, section 1396r-8(d)(2), subject to this 
95.10 	subdivision and subdivisions 13a to 13g, except that drugs listed in United States Code, 
95.11 	title 42, section 1396r-8(d)(2)(E), shall not be covered.

95.12 	Sec. 30. Minnesota Statutes 2008, section 256B.0625, subdivision 13e, is amended to 
95.13 	read:
95.14 		Subd. 13e.Payment rates. (a) The basis for determining the amount of payment 
95.15 	shall be the lower of the actual acquisition costs of the drugs plus a fixed dispensing fee; 
95.16 	the maximum allowable cost set by the federal government or by the commissioner plus 
95.17 	the fixed dispensing fee; or the usual and customary price charged to the public. The 
95.18 	amount of payment basis must be reduced to reflect all discount amounts applied to the 
95.19 	charge by any provider/insurer agreement or contract for submitted charges to medical 
95.20 	assistance programs. The net submitted charge may not be greater than the patient liability 
95.21 	for the service. The pharmacy dispensing fee shall be $3.65, except that the dispensing fee 
95.22 	for intravenous solutions which must be compounded by the pharmacist shall be $8 per 
95.23 	bag, $14 per bag for cancer chemotherapy products, and $30 per bag for total parenteral 
95.24 	nutritional products dispensed in one liter quantities, or $44 per bag for total parenteral 
95.25 	nutritional products dispensed in quantities greater than one liter. Actual acquisition 
95.26 	cost includes quantity and other special discounts except time and cash discounts. 
95.27 	Effective July 1, 2008 2009, the actual acquisition cost of a drug shall be estimated by the 
95.28 	commissioner, at average wholesale price minus 1415 percent. The actual acquisition 
95.29 	cost of antihemophilic factor drugs shall be estimated at the average wholesale price 
95.30 	minus 30 percent. The maximum allowable cost of a multisource drug may be set by the 
95.31 	commissioner and it shall be comparable to, but no higher than, the maximum amount 
95.32 	paid by other third-party payors in this state who have maximum allowable cost programs. 
95.33 	Establishment of the amount of payment for drugs shall not be subject to the requirements 
95.34 	of the Administrative Procedure Act.
96.1 	(b) An additional dispensing fee of $.30 may be added to the dispensing fee paid 
96.2 	to pharmacists for legend drug prescriptions dispensed to residents of long-term care 
96.3 	facilities when a unit dose blister card system, approved by the department, is used. Under 
96.4 	this type of dispensing system, the pharmacist must dispense a 30-day supply of drug. 
96.5 	The National Drug Code (NDC) from the drug container used to fill the blister card must 
96.6 	be identified on the claim to the department. The unit dose blister card containing the 
96.7 	drug must meet the packaging standards set forth in Minnesota Rules, part 6800.2700, 
96.8 	that govern the return of unused drugs to the pharmacy for reuse. The pharmacy provider 
96.9 	will be required to credit the department for the actual acquisition cost of all unused 
96.10 	drugs that are eligible for reuse. Over-the-counter medications must be dispensed in the 
96.11 	manufacturer's unopened package. The commissioner may permit the drug clozapine to be 
96.12 	dispensed in a quantity that is less than a 30-day supply.
96.13 	(c) Whenever a generically equivalent product is available, payment shall be on the 
96.14 	basis of the actual acquisition cost of the generic drug, or on the maximum allowable cost 
96.15 	established by the commissioner.
96.16 	(d) The basis for determining the amount of payment for drugs administered in an 
96.17 	outpatient setting shall be the lower of the usual and customary cost submitted by the 
96.18 	provider or the amount established for Medicare by the United States Department of 
96.19 	Health and Human Services pursuant to title XVIII, section 1847a of the federal Social 
96.20 	Security Act.
96.21 	(e) The commissioner may negotiate lower reimbursement rates for specialty 
96.22 	pharmacy products than the rates specified in paragraph (a). The commissioner may 
96.23 	require individuals enrolled in the health care programs administered by the department 
96.24 	to obtain specialty pharmacy products from providers with whom the commissioner has 
96.25 	negotiated lower reimbursement rates. Specialty pharmacy products are defined as those 
96.26 	used by a small number of recipients or recipients with complex and chronic diseases 
96.27 	that require expensive and challenging drug regimens. Examples of these conditions 
96.28 	include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis 
96.29 	C, growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms 
96.30 	of cancer. Specialty pharmaceutical products include injectable and infusion therapies, 
96.31 	biotechnology drugs, high-cost therapies, and therapies that require complex care. The 
96.32 	commissioner shall consult with the formulary committee to develop a list of specialty 
96.33 	pharmacy products subject to this paragraph. In consulting with the formulary committee 
96.34 	in developing this list, the commissioner shall take into consideration the population 
96.35 	served by specialty pharmacy products, the current delivery system and standard of care in 
97.1 	the state, and access to care issues. The commissioner shall have the discretion to adjust 
97.2 	the reimbursement rate to prevent access to care issues.

97.3 	Sec. 31. Minnesota Statutes 2008, section 256B.0625, subdivision 13h, is amended to 
97.4 	read:
97.5 		Subd. 13h. Medication therapy management services. (a) Medical assistance 
97.6 	and general assistance medical care cover medication therapy management services for 
97.7 	a recipient taking four or more prescriptions to treat or prevent two or more chronic 
97.8 	medical conditions, or a recipient with a drug therapy problem that is identified or prior 
97.9 	authorized by the commissioner that has resulted or is likely to result in significant 
97.10 	nondrug program costs. The commissioner may cover medical therapy management 
97.11 	services under MinnesotaCare if the commissioner determines this is cost-effective. For 
97.12 	purposes of this subdivision, "medication therapy management" means the provision 
97.13 	of the following pharmaceutical care services by a licensed pharmacist to optimize the 
97.14 	therapeutic outcomes of the patient's medications: 
97.15 	(1) performing or obtaining necessary assessments of the patient's health status; 
97.16 	(2) formulating a medication treatment plan; 
97.17 	(3) monitoring and evaluating the patient's response to therapy, including safety 
97.18 	and effectiveness; 
97.19 	(4) performing a comprehensive medication review to identify, resolve, and prevent 
97.20 	medication-related problems, including adverse drug events; 
97.21 	(5) documenting the care delivered and communicating essential information to 
97.22 	the patient's other primary care providers; 
97.23 	(6) providing verbal education and training designed to enhance patient 
97.24 	understanding and appropriate use of the patient's medications; 
97.25 	(7) providing information, support services, and resources designed to enhance 
97.26 	patient adherence with the patient's therapeutic regimens; and 
97.27 	(8) coordinating and integrating medication therapy management services within the 
97.28 	broader health care management services being provided to the patient. 
97.29 	Nothing in this subdivision shall be construed to expand or modify the scope of practice of 
97.30 	the pharmacist as defined in section 151.01, subdivision 27. 
97.31 	(b) To be eligible for reimbursement for services under this subdivision, a pharmacist 
97.32 	must meet the following requirements: 
97.33 	(1) have a valid license issued under chapter 151; 
97.34 	(2) have graduated from an accredited college of pharmacy on or after May 1996, or 
97.35 	completed a structured and comprehensive education program approved by the Board of 
98.1 	Pharmacy and the American Council of Pharmaceutical Education for the provision and 
98.2 	documentation of pharmaceutical care management services that has both clinical and 
98.3 	didactic elements; 
98.4 	(3) be practicing in an ambulatory care setting as part of a multidisciplinary team or 
98.5 	have developed a structured patient care process that is offered in a private or semiprivate 
98.6 	patient care area that is separate from the commercial business that also occurs in the 
98.7 	setting, or in home settings, excluding long-term care and group homes, if the service is 
98.8 	ordered by the provider-directed care coordination team; and 
98.9 	(4) make use of an electronic patient record system that meets state standards. 
98.10 	(c) For purposes of reimbursement for medication therapy management services, 
98.11 	the commissioner may enroll individual pharmacists as medical assistance and general 
98.12 	assistance medical care providers. The commissioner may also establish contact 
98.13 	requirements between the pharmacist and recipient, including limiting the number of 
98.14 	reimbursable consultations per recipient. 
98.15 	(d) The commissioner, after receiving recommendations from professional medical 
98.16 	associations, professional pharmacy associations, and consumer groups, shall convene 
98.17 	an 11-member Medication Therapy Management Advisory Committee to advise 
98.18 	the commissioner on the implementation and administration of medication therapy 
98.19 	management services. The committee shall be comprised of: two licensed physicians; 
98.20 	two licensed pharmacists; two consumer representatives; two health plan company 
98.21 	representatives; and three members with expertise in the area of medication therapy 
98.22 	management, who may be licensed physicians or licensed pharmacists. The committee is 
98.23 	governed by section 15.059, except that committee members do not receive compensation 
98.24 	or reimbursement for expenses. The advisory committee expires on June 30, 2007. 
98.25 	(e) The commissioner shall evaluate the effect of medication therapy management 
98.26 	on quality of care, patient outcomes, and program costs, and shall include a description 
98.27 	of any savings generated in the medical assistance and general assistance medical care 
98.28 	programs that can be attributable to this coverage. The evaluation shall be submitted to 
98.29 	the legislature by December 15, 2007. The commissioner may contract with a vendor 
98.30 	or an academic institution that has expertise in evaluating health care outcomes for the 
98.31 	purpose of completing the evaluation. 
98.32 	(d) The commissioner shall establish a pilot project for an intensive medication 
98.33 	therapy management program for patients identified by the commissioner with multiple 
98.34 	chronic conditions and a high number of medications who are at high risk of preventable 
98.35 	hospitalizations, emergency room use, medication complications, and suboptimal 
98.36 	treatment outcomes due to medication-related problems. For purposes of the pilot 
99.1 	project, medication therapy management services may be provided in a patient's home 
99.2 	or community setting, in addition to other authorized settings. The commissioner may 
99.3 	waive existing payment policies and establish special payment rates for the pilot project. 
99.4 	The pilot project must be designed to produce a net savings to the state compared to the 
99.5 	estimated costs that would otherwise be incurred for similar patients without the program.

99.6 	Sec. 32. Minnesota Statutes 2008, section 256B.0625, subdivision 17, is amended to 
99.7 	read:
99.8 		Subd. 17.Transportation costs. (a) Medical assistance covers medical 
99.9 	transportation costs incurred solely for obtaining emergency medical care or transportation 
99.10 	costs incurred by eligible persons in obtaining emergency or nonemergency medical 
99.11 	care when paid directly to an ambulance company, common carrier, or other recognized 
99.12 	providers of transportation services. Medical transportation must be provided by:
99.13 	(1) an ambulance, as defined in section 144E.001, subdivision 2;
99.14 	(2) special transportation; or
99.15 	(3) common carrier including, but not limited to, bus, taxicab, other commercial 
99.16 	carrier, or private automobile.
99.17 	(b) Medical assistance covers special transportation, as defined in Minnesota Rules, 
99.18 	part 9505.0315, subpart 1, item F, if the recipient has a physical or mental impairment that 
99.19 	would prohibit the recipient from safely accessing and using a bus, taxi, other commercial 
99.20 	transportation, or private automobile.
99.21 	The commissioner may use an order by the recipient's attending physician to certify that 
99.22 	the recipient requires special transportation services. Special transportation includes
99.23 	providers shall perform driver-assisted service to services for eligible individuals. 
99.24 	Driver-assisted service includes passenger pickup at and return to the individual's 
99.25 	residence or place of business, assistance with admittance of the individual to the medical 
99.26 	facility, and assistance in passenger securement or in securing of wheelchairs or stretchers 
99.27 	in the vehicle. Special transportation providers must obtain written documentation 
99.28 	from the health care service provider who is serving the recipient being transported, 
99.29 	identifying the time that the recipient arrived. Special transportation providers may not 
99.30 	bill for separate base rates for the continuation of a trip beyond the original destination. 
99.31 	Special transportation providers must take recipients to the nearest appropriate health 
99.32 	care provider, using the most direct route available. The maximum minimum medical 
99.33 	assistance reimbursement rates for special transportation services are:
99.34 	(1) (i) $17 for the base rate and $1.35 per mile for special transportation services to 
99.35 	eligible persons who need a wheelchair-accessible van;
100.1 	(2) (ii)  $11.50 for the base rate and $1.30 per mile for special transportation services 
100.2 	to eligible persons who do not need a wheelchair-accessible van; and
100.3 	(3) (iii)  $60 for the base rate and $2.40 per mile, and an attendant rate of $9 per trip, 
100.4 	for special transportation services to eligible persons who need a stretcher-accessible 
100.5 	vehicle;
100.6 	(2) the base rates for special transportation services in areas defined under RUCA 
100.7 	to be super rural shall be equal to the reimbursement rate established in clause (1) plus 
100.8 	11.3 percent; and
100.9 	(3) for special transportation services in areas defined under RUCA to be rural 
100.10 	or super rural areas:
100.11 	(i) for a trip equal to 17 miles or less, mileage reimbursement shall be equal to 125 
100.12 	percent of the respective mileage rate in clause (1); and
100.13 	(ii) for a trip between 18 and 50 miles, mileage reimbursement shall be equal to 
100.14 	112.5 percent of the respective mileage rate in clause (1).
100.15 	(c) For purposes of reimbursement rates for special transportation services under 
100.16 	paragraph (b), the zip code of the recipient's place of residence shall determine whether 
100.17 	the urban, rural, or super rural reimbursement rate applies.
100.18 	(d) For purposes of this subdivision, "rural urban commuting area" or "RUCA" 
100.19 	means a census-tract based classification system under which a geographical area is 
100.20 	determined to be urban, rural, or super rural.

100.21 	Sec. 33. Minnesota Statutes 2008, section 256B.0625, subdivision 17a, is amended to 
100.22 	read:
100.23 		Subd. 17a.Payment for ambulance services. Medical assistance covers 
100.24 	ambulance services. Providers shall bill ambulance services according to Medicare 
100.25 	criteria. Nonemergency ambulance services shall not be paid as emergencies. Effective 
100.26 	for services rendered on or after July 1, 2001, medical assistance payments for ambulance 
100.27 	services shall be paid at the Medicare reimbursement rate or at the medical assistance 
100.28 	payment rate in effect on July 1, 2000, whichever is greater.

100.29 	Sec. 34. Minnesota Statutes 2008, section 256B.0625, is amended by adding a 
100.30 	subdivision to read:
100.31 		Subd. 18b.Broker dispatching prohibition. The commissioner shall not use a 
100.32 	broker or coordinator for any purpose related to transportation services under subdivision 
100.33 	18.

101.1 	Sec. 35. Minnesota Statutes 2008, section 256B.0625, is amended by adding a 
101.2 	subdivision to read:
101.3 		Subd. 25a.Prior authorization of diagnostic imaging services. (a) Effective 
101.4 	January 1, 2010, the commissioner shall require prior authorization or decision support 
101.5 	for the ordering providers at the time the service is ordered for the following outpatient 
101.6 	diagnostic imaging services: computerized tomography (CT), magnetic resonance 
101.7 	imaging (MRI), magnetic resonance angiography (MRA), positive emission tomography 
101.8 	(PET), cardiac imaging and ultrasound diagnostic imaging.
101.9 	(b) Prior authorization under this subdivision is not required for diagnostic imaging 
101.10 	services performed as part of a hospital emergency room visit, inpatient hospitalization, or 
101.11 	if concurrent with or on the same day as an urgent care facility visit.
101.12 	(c) This subdivision does not apply to services provided to recipients who are 
101.13 	enrolled in Medicare, the prepaid medical assistance program, the prepaid general 
101.14 	assistance medical care program, or the MinnesotaCare program.
101.15 	(d) The commissioner may contract with a private entity to provide the prior 
101.16 	authorization or decision support required under this subdivision. The contracting entity 
101.17 	must incorporate clinical guidelines that are based on evidence-based medical literature, if 
101.18 	available. By January 1, 2012, the contracting entity shall report to the commissioner the 
101.19 	results of prior authorization or decision support.

101.20 	Sec. 36. Minnesota Statutes 2008, section 256B.0625, subdivision 26, is amended to 
101.21 	read:
101.22 		Subd. 26.Special education services. (a) Medical assistance covers medical 
101.23 	services identified in a recipient's individualized education plan and covered under the 
101.24 	medical assistance state plan. Covered services include occupational therapy, physical 
101.25 	therapy, speech-language therapy, clinical psychological services, nursing services, 
101.26 	school psychological services, school social work services, personal care assistants 
101.27 	serving as management aides, assistive technology devices, transportation services, 
101.28 	health assessments, and other services covered under the medical assistance state plan. 
101.29 	Mental health services eligible for medical assistance reimbursement must be provided or 
101.30 	coordinated through a children's mental health collaborative where a collaborative exists if 
101.31 	the child is included in the collaborative operational target population. The provision or 
101.32 	coordination of services does not require that the individual education plan be developed 
101.33 	by the collaborative.
101.34 	The services may be provided by a Minnesota school district that is enrolled as a 
101.35 	medical assistance provider or its subcontractor, and only if the services meet all the 
102.1 	requirements otherwise applicable if the service had been provided by a provider other 
102.2 	than a school district, in the following areas: medical necessity, physician's orders, 
102.3 	documentation, personnel qualifications, and prior authorization requirements. The 
102.4 	nonfederal share of costs for services provided under this subdivision is the responsibility 
102.5 	of the local school district as provided in section 125A.74. Services listed in a child's 
102.6 	individual education plan are eligible for medical assistance reimbursement only if those 
102.7 	services meet criteria for federal financial participation under the Medicaid program. 
102.8 	(b) Approval of health-related services for inclusion in the individual education plan 
102.9 	does not require prior authorization for purposes of reimbursement under this chapter. 
102.10 	The commissioner may require physician review and approval of the plan not more than 
102.11 	once annually or upon any modification of the individual education plan that reflects a 
102.12 	change in health-related services.
102.13 	(c) Services of a speech-language pathologist provided under this section are covered 
102.14 	notwithstanding Minnesota Rules, part 9505.0390, subpart 1, item L, if the person:
102.15 	(1) holds a masters degree in speech-language pathology;
102.16 	(2) is licensed by the Minnesota Board of Teaching as an educational 
102.17 	speech-language pathologist; and
102.18 	(3) either has a certificate of clinical competence from the American Speech and 
102.19 	Hearing Association, has completed the equivalent educational requirements and work 
102.20 	experience necessary for the certificate or has completed the academic program and is 
102.21 	acquiring supervised work experience to qualify for the certificate.
102.22 	(d) Medical assistance coverage for medically necessary services provided under 
102.23 	other subdivisions in this section may not be denied solely on the basis that the same or 
102.24 	similar services are covered under this subdivision.
102.25 	(e) The commissioner shall develop and implement package rates, bundled rates, or 
102.26 	per diem rates for special education services under which separately covered services are 
102.27 	grouped together and billed as a unit in order to reduce administrative complexity.
102.28 	(f) The commissioner shall develop a cost-based payment structure for payment 
102.29 	of these services. The commissioner shall reimburse claims submitted based on an 
102.30 	interim rate, and shall settle at a final rate once the department has determined it. The 
102.31 	commissioner shall notify the school district of the final rate. The school district has 60 
102.32 	days to appeal the final rate. To appeal the final rate, the school district shall file a written 
102.33 	appeal request to the commissioner within 60 days of the date the final rate determination 
102.34 	was mailed. The appeal request shall specify (1) the disputed items and (2) the name and 
102.35 	address of the person to contact regarding the appeal.
103.1 	(g) Effective July 1, 2000, medical assistance services provided under an individual 
103.2 	education plan or an individual family service plan by local school districts shall not count 
103.3 	against medical assistance authorization thresholds for that child.
103.4 	(h) Nursing services as defined in section 148.171, subdivision 15, and provided 
103.5 	as an individual education plan health-related service, are eligible for medical assistance 
103.6 	payment if they are otherwise a covered service under the medical assistance program. 
103.7 	Medical assistance covers the administration of prescription medications by a licensed 
103.8 	nurse who is employed by or under contract with a school district when the administration 
103.9 	of medications is identified in the child's individualized education plan. The simple 
103.10 	administration of medications alone is not covered under medical assistance when 
103.11 	administered by a provider other than a school district or when it is not identified in the 
103.12 	child's individualized education plan. 

103.13 	Sec. 37. Minnesota Statutes 2008, section 256B.08, is amended by adding a 
103.14 	subdivision to read:
103.15 		Subd. 4.Data from Social Security. The commissioner shall accept data from the 
103.16 	Social Security Administration in accordance with United States Code, title 42, section 
103.17 	1396U-5(a).

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

103.19 	Sec. 38. Minnesota Statutes 2008, section 256B.15, subdivision 1, is amended to read:
103.20 		Subdivision 1.Policy and applicability. (a) It is the policy of this state that 
103.21 	individuals or couples, either or both of whom participate in the medical assistance 
103.22 	program, use their own assets to pay their share of the total cost of their care during or 
103.23 	after their enrollment in the program according to applicable federal law and the laws of 
103.24 	this state. The following provisions apply:
103.25 	(1) subdivisions 1c to 1k shall not apply to claims arising under this section which 
103.26 	are presented under section 525.313;
103.27 	(2) the provisions of subdivisions 1c to 1k expanding the interests included in an 
103.28 	estate for purposes of recovery under this section give effect to the provisions of United 
103.29 	States Code, title 42, section 1396p, governing recoveries, but do not give rise to any 
103.30 	express or implied liens in favor of any other parties not named in these provisions;
103.31 	(3) the continuation of a recipient's life estate or joint tenancy interest in real 
103.32 	property after the recipient's death for the purpose of recovering medical assistance under 
103.33 	this section modifies common law principles holding that these interests terminate on 
103.34 	the death of the holder;
104.1 	(4) all laws, rules, and regulations governing or involved with a recovery of medical 
104.2 	assistance shall be liberally construed to accomplish their intended purposes;
104.3 	(5) a deceased recipient's life estate and joint tenancy interests continued under this 
104.4 	section shall be owned by the remaindermen or surviving joint tenants as their interests 
104.5 	may appear on the date of the recipient's death. They shall not be merged into the 
104.6 	remainder interest or the interests of the surviving joint tenants by reason of ownership. 
104.7 	They shall be subject to the provisions of this section. Any conveyance, transfer, sale, 
104.8 	assignment, or encumbrance by a remainderman, a surviving joint tenant, or their heirs, 
104.9 	successors, and assigns shall be deemed to include all of their interest in the deceased 
104.10 	recipient's life estate or joint tenancy interest continued under this section; and
104.11 	(6) the provisions of subdivisions 1c to 1k continuing a recipient's joint tenancy 
104.12 	interests in real property after the recipient's death do not apply to a homestead owned 
104.13 	of record, on the date the recipient dies, by the recipient and the recipient's spouse as 
104.14 	joint tenants with a right of survivorship. Homestead means the real property occupied 
104.15 	by the surviving joint tenant spouse as their sole residence on the date the recipient dies 
104.16 	and classified and taxed to the recipient and surviving joint tenant spouse as homestead 
104.17 	property for property tax purposes in the calendar year in which the recipient dies. For 
104.18 	purposes of this exemption, real property the recipient and their surviving joint tenant 
104.19 	spouse purchase solely with the proceeds from the sale of their prior homestead, own 
104.20 	of record as joint tenants, and qualify as homestead property under section 273.124 in 
104.21 	the calendar year in which the recipient dies and prior to the recipient's death shall be 
104.22 	deemed to be real property classified and taxed to the recipient and their surviving joint 
104.23 	tenant spouse as homestead property in the calendar year in which the recipient dies. 
104.24 	The surviving spouse, or any person with personal knowledge of the facts, may provide 
104.25 	an affidavit describing the homestead property affected by this clause and stating facts 
104.26 	showing compliance with this clause. The affidavit shall be prima facie evidence of the 
104.27 	facts it states.
104.28 	(b) For purposes of this section, "medical assistance" includes the medical assistance 
104.29 	program under this chapter and the general assistance medical care program under chapter 
104.30 	256D and alternative care for nonmedical assistance recipients under section 256B.0913.
104.31 	(c) For purposes of this section, beginning January 1, 2010, "medical assistance" 
104.32 	does not include Medicare cost-sharing benefits in accordance with United States Code, 
104.33 	title 42, section 1396p.
104.34 	(d) All provisions in this subdivision, and subdivisions 1d, 1f, 1g, 1h, 1i, and 1j, 
104.35 	related to the continuation of a recipient's life estate or joint tenancy interests in real 
104.36 	property after the recipient's death for the purpose of recovering medical assistance, are 
105.1 	effective only for life estates and joint tenancy interests established on or after August 1, 
105.2 	2003. For purposes of this paragraph, medical assistance does not include alternative care.

105.3 	Sec. 39. Minnesota Statutes 2008, section 256B.15, subdivision 1a, is amended to read:
105.4 		Subd. 1a.Estates subject to claims. (a) If a person receives any medical assistance 
105.5 	hereunder, on the person's death, if single, or on the death of the survivor of a married 
105.6 	couple, either or both of whom received medical assistance, or as otherwise provided 
105.7 	for in this section, the total amount paid for medical assistance rendered for the person 
105.8 	and spouse shall be filed as a claim against the estate of the person or the estate of the 
105.9 	surviving spouse in the court having jurisdiction to probate the estate or to issue a decree 
105.10 	of descent according to sections 525.31 to 525.313. 
105.11 	(b) For the purposes of this section, the person's estate must consist of:
105.12 	(1) the person's probate estate;
105.13 	(2) all of the person's interests or proceeds of those interests in real property the 
105.14 	person owned as a life tenant or as a joint tenant with a right of survivorship at the time of 
105.15 	the person's death;
105.16 	(3) all of the person's interests or proceeds of those interests in securities the person 
105.17 	owned in beneficiary form as provided under sections 524.6-301 to 524.6-311 at the time 
105.18 	of the person's death, to the extent the interests or proceeds of those interests become part 
105.19 	of the probate estate under section 524.6-307;
105.20 	(4) all of the person's interests in joint accounts, multiple-party accounts, and 
105.21 	pay-on-death accounts, brokerage accounts, investment accounts, or the proceeds of 
105.22 	those accounts, as provided under sections 524.6-201 to 524.6-214 at the time of the 
105.23 	person's death to the extent the interests become part of the probate estate under section 
105.24 	524.6-207; and
105.25 	(5) assets conveyed to a survivor, heir, or assign of the person through survivorship, 
105.26 	living trust, or other arrangements.
105.27 	(c) For the purpose of this section and recovery in a surviving spouse's estate for 
105.28 	medical assistance paid for a predeceased spouse, the estate must consist of all of the legal 
105.29 	title and interests the deceased individual's predeceased spouse had in jointly owned or 
105.30 	marital property at the time of the spouse's death, as defined in subdivision 2b, and the 
105.31 	proceeds of those interests, that passed to the deceased individual or another individual, a 
105.32 	survivor, an heir, or an assign of the predeceased spouse through a joint tenancy, tenancy 
105.33 	in common, survivorship, life estate, living trust, or other arrangement. A deceased 
105.34 	recipient who, at death, owned the property jointly with the surviving spouse shall have 
105.35 	an interest in the entire property.
106.1 	(d) For the purpose of recovery in a single person's estate or the estate of a survivor 
106.2 	of a married couple, "other arrangement" includes any other means by which title to all or 
106.3 	any part of the jointly owned or marital property or interest passed from the predeceased 
106.4 	spouse to another including, but not limited to, transfers between spouses which are 
106.5 	permitted, prohibited, or penalized for purposes of medical assistance.
106.6 	(e) A claim shall be filed if medical assistance was rendered for either or both 
106.7 	persons under one of the following circumstances:
106.8 	(a) (1) the person was over 55 years of age, and received services under this chapter;
106.9 	(b) (2) the person resided in a medical institution for six months or longer, received 
106.10 	services under this chapter, and, at the time of institutionalization or application for 
106.11 	medical assistance, whichever is later, the person could not have reasonably been expected 
106.12 	to be discharged and returned home, as certified in writing by the person's treating 
106.13 	physician. For purposes of this section only, a "medical institution" means a skilled 
106.14 	nursing facility, intermediate care facility, intermediate care facility for persons with 
106.15 	developmental disabilities, nursing facility, or inpatient hospital; or
106.16 	(c) (3) the person received general assistance medical care services under chapter 
106.17 	256D.
106.18 	(f) The claim shall be considered an expense of the last illness of the decedent for the 
106.19 	purpose of section 524.3-805. Notwithstanding any law or rule to the contrary, a state or 
106.20 	county agency with a claim under this section must be a creditor under section 524.6-307.
106.21 	Any statute of limitations that purports to limit any county agency or the state agency, 
106.22 	or both, to recover for medical assistance granted hereunder shall not apply to any claim 
106.23 	made hereunder for reimbursement for any medical assistance granted hereunder. Notice 
106.24 	of the claim shall be given to all heirs and devisees of the decedent whose identity can be 
106.25 	ascertained with reasonable diligence. The notice must include procedures and instructions 
106.26 	for making an application for a hardship waiver under subdivision 5; time frames for 
106.27 	submitting an application and determination; and information regarding appeal rights and 
106.28 	procedures. Counties are entitled to one-half of the nonfederal share of medical assistance 
106.29 	collections from estates that are directly attributable to county effort. Counties are entitled 
106.30 	to ten percent of the collections for alternative care directly attributable to county effort. 

106.31 	Sec. 40. Minnesota Statutes 2008, section 256B.15, subdivision 1h, is amended to read:
106.32 		Subd. 1h. Estates of specific persons receiving medical assistance. (a) For 
106.33 	purposes of this section, paragraphs (b) to (k) (j) apply if a person received medical 
106.34 	assistance for which a claim may be filed under this section and died single, or the 
107.1 	surviving spouse of the couple and was not survived by any of the persons described 
107.2 	in subdivisions 3 and 4. 
107.3 	(b) For purposes of this section, the person's estate consists of: (1) the person's 
107.4 	probate estate; (2) all of the person's interests or proceeds of those interests in real property 
107.5 	the person owned as a life tenant or as a joint tenant with a right of survivorship at the 
107.6 	time of the person's death; (3) all of the person's interests or proceeds of those interests in 
107.7 	securities the person owned in beneficiary form as provided under sections 524.6-301 to 
107.8 	524.6-311 at the time of the person's death, to the extent they become part of the probate 
107.9 	estate under section 524.6-307; (4) all of the person's interests in joint accounts, multiple 
107.10 	party accounts, and pay on death accounts, or the proceeds of those accounts, as provided 
107.11 	under sections 524.6-201 to 524.6-214 at the time of the person's death to the extent 
107.12 	they become part of the probate estate under section 524.6-207; and (5) the person's 
107.13 	legal title or interest at the time of the person's death in real property transferred under 
107.14 	a transfer on death deed under section 507.071, or in the proceeds from the subsequent 
107.15 	sale of the person's interest in the real property. Notwithstanding any law or rule to the 
107.16 	contrary, a state or county agency with a claim under this section shall be a creditor under 
107.17 	section 524.6-307. 
107.18 	(c) (b) Notwithstanding any law or rule to the contrary, the person's life estate or joint 
107.19 	tenancy interest in real property not subject to a medical assistance lien under sections 
107.20 	514.980 to 514.985 on the date of the person's death shall not end upon the person's death 
107.21 	and shall continue as provided in this subdivision. The life estate in the person's estate 
107.22 	shall be that portion of the interest in the real property subject to the life estate that is equal 
107.23 	to the life estate percentage factor for the life estate as listed in the Life Estate Mortality 
107.24 	Table of the health care program's manual for a person who was the age of the medical 
107.25 	assistance recipient on the date of the person's death. The joint tenancy interest in real 
107.26 	property in the estate shall be equal to the fractional interest the person would have owned 
107.27 	in the jointly held interest in the property had they and the other owners held title to the 
107.28 	property as tenants in common on the date the person died. 
107.29 	(d) (c) The court upon its own motion, or upon motion by the personal representative 
107.30 	or any interested party, may enter an order directing the remaindermen or surviving joint 
107.31 	tenants and their spouses, if any, to sign all documents, take all actions, and otherwise 
107.32 	fully cooperate with the personal representative and the court to liquidate the decedent's 
107.33 	life estate or joint tenancy interests in the estate and deliver the cash or the proceeds of 
107.34 	those interests to the personal representative and provide for any legal and equitable 
107.35 	sanctions as the court deems appropriate to enforce and carry out the order, including an 
107.36 	award of reasonable attorney fees. 
108.1 	(e) (d) The personal representative may make, execute, and deliver any conveyances 
108.2 	or other documents necessary to convey the decedent's life estate or joint tenancy interest 
108.3 	in the estate that are necessary to liquidate and reduce to cash the decedent's interest or 
108.4 	for any other purposes. 
108.5 	(f) (e) Subject to administration, all costs, including reasonable attorney fees, 
108.6 	directly and immediately related to liquidating the decedent's life estate or joint tenancy 
108.7 	interest in the decedent's estate, shall be paid from the gross proceeds of the liquidation 
108.8 	allocable to the decedent's interest and the net proceeds shall be turned over to the personal 
108.9 	representative and applied to payment of the claim presented under this section. 
108.10 	(g) (f) The personal representative shall bring a motion in the district court in which 
108.11 	the estate is being probated to compel the remaindermen or surviving joint tenants to 
108.12 	account for and deliver to the personal representative all or any part of the proceeds of any 
108.13 	sale, mortgage, transfer, conveyance, or any disposition of real property allocable to the 
108.14 	decedent's life estate or joint tenancy interest in the decedent's estate, and do everything 
108.15 	necessary to liquidate and reduce to cash the decedent's interest and turn the proceeds of 
108.16 	the sale or other disposition over to the personal representative. The court may grant any 
108.17 	legal or equitable relief including, but not limited to, ordering a partition of real estate 
108.18 	under chapter 558 necessary to make the value of the decedent's life estate or joint tenancy 
108.19 	interest available to the estate for payment of a claim under this section. 
108.20 	(h) (g) Subject to administration, the personal representative shall use all of the cash 
108.21 	or proceeds of interests to pay an allowable claim under this section. The remaindermen 
108.22 	or surviving joint tenants and their spouses, if any, may enter into a written agreement 
108.23 	with the personal representative or the claimant to settle and satisfy obligations imposed at 
108.24 	any time before or after a claim is filed. 
108.25 	(i) (h) The personal representative may, at their discretion, provide any or all of the 
108.26 	other owners, remaindermen, or surviving joint tenants with an affidavit terminating the 
108.27 	decedent's estate's interest in real property the decedent owned as a life tenant or as a joint 
108.28 	tenant with others, if the personal representative determines in good faith that neither the 
108.29 	decedent nor any of the decedent's predeceased spouses received any medical assistance 
108.30 	for which a claim could be filed under this section, or if the personal representative has 
108.31 	filed an affidavit with the court that the estate has other assets sufficient to pay a claim, as 
108.32 	presented, or if there is a written agreement under paragraph (h) (g), or if the claim, as 
108.33 	allowed, has been paid in full or to the full extent of the assets the estate has available 
108.34 	to pay it. The affidavit may be recorded in the office of the county recorder or filed in 
108.35 	the Office of the Registrar of Titles for the county in which the real property is located. 
108.36 	Except as provided in section 514.981, subdivision 6, when recorded or filed, the affidavit 
109.1 	shall terminate the decedent's interest in real estate the decedent owned as a life tenant or a 
109.2 	joint tenant with others. The affidavit shall:
109.3 	(1) be signed by the personal representative;
109.4 	(2) identify the decedent and the interest being terminated;
109.5 	(3) give recording information sufficient to identify the instrument that created the 
109.6 	interest in real property being terminated;
109.7 	(4) legally describe the affected real property;
109.8 	(5) state that the personal representative has determined that neither the decedent 
109.9 	nor any of the decedent's predeceased spouses received any medical assistance for which 
109.10 	a claim could be filed under this section;
109.11 	(6) state that the decedent's estate has other assets sufficient to pay the claim, as 
109.12 	presented, or that there is a written agreement between the personal representative and 
109.13 	the claimant and the other owners or remaindermen or other joint tenants to satisfy the 
109.14 	obligations imposed under this subdivision; and
109.15 	(7) state that the affidavit is being given to terminate the estate's interest under this 
109.16 	subdivision, and any other contents as may be appropriate.
109.17 	The recorder or registrar of titles shall accept the affidavit for recording or filing. The 
109.18 	affidavit shall be effective as provided in this section and shall constitute notice even if it 
109.19 	does not include recording information sufficient to identify the instrument creating the 
109.20 	interest it terminates. The affidavit shall be conclusive evidence of the stated facts. 
109.21 	(j) (i) The holder of a lien arising under subdivision 1c shall release the lien at 
109.22 	the holder's expense against an interest terminated under paragraph (h) (g) to the extent 
109.23 	of the termination. 
109.24 	(k) (j) If a lien arising under subdivision 1c is not released under paragraph (j) (i), 
109.25 	prior to closing the estate, the personal representative shall deed the interest subject to the 
109.26 	lien to the remaindermen or surviving joint tenants as their interests may appear. Upon 
109.27 	recording or filing, the deed shall work a merger of the recipient's life estate or joint 
109.28 	tenancy interest, subject to the lien, into the remainder interest or interest the decedent and 
109.29 	others owned jointly. The lien shall attach to and run with the property to the extent of 
109.30 	the decedent's interest at the time of the decedent's death. 

109.31 	Sec. 41. Minnesota Statutes 2008, section 256B.15, subdivision 2, is amended to read:
109.32 		Subd. 2.Limitations on claims. The claim shall include only the total amount 
109.33 	of medical assistance rendered after age 55 or during a period of institutionalization 
109.34 	described in subdivision 1a, clause (b) paragraph (e), and the total amount of general 
109.35 	assistance medical care rendered, and shall not include interest. Claims that have been 
110.1 	allowed but not paid shall bear interest according to section 524.3-806, paragraph (d). A 
110.2 	claim against the estate of a surviving spouse who did not receive medical assistance, for 
110.3 	medical assistance rendered for the predeceased spouse, shall be payable from the full 
110.4 	value of all of the predeceased spouse's assets and interests which are part of the surviving 
110.5 	spouse's estate under subdivisions 1a and 2b. Recovery of medical assistance expenses in 
110.6 	the nonrecipient surviving spouse's estate is limited to the value of the assets of the estate 
110.7 	that were marital property or jointly owned property at any time during the marriage. The 
110.8 	claim is not payable from the value of assets or proceeds of assets in the estate attributable 
110.9 	to a predeceased spouse whom the individual married after the death of the predeceased 
110.10 	recipient spouse for whom the claim is filed or from assets and the proceeds of assets in the 
110.11 	estate which the nonrecipient decedent spouse acquired with assets which were not marital 
110.12 	property or jointly owned property after the death of the predeceased recipient spouse.
110.13 	Claims for alternative care shall be net of all premiums paid under section 256B.0913, 
110.14 	subdivision 12, on or after July 1, 2003, and shall be limited to services provided on or 
110.15 	after July 1, 2003. Claims against marital property shall be limited to claims against 
110.16 	recipients who died on or after July 1, 2009.

110.17 	Sec. 42. Minnesota Statutes 2008, section 256B.15, is amended by adding a 
110.18 	subdivision to read:
110.19 		Subd. 2b.Controlling provisions. (a) For purposes of this subdivision and 
110.20 	subdivisions 1a and 2, paragraphs (b) to (d) apply.
110.21 	(b) At the time of death of a recipient spouse and solely for purpose of recovery of 
110.22 	medical assistance benefits received, a predeceased recipient spouse shall have a legal 
110.23 	title or interest in the undivided whole of all of the property which the recipient and the 
110.24 	recipient's surviving spouse owned jointly or which was marital property at any time 
110.25 	during their marriage regardless of the form of ownership and regardless of whether 
110.26 	it was owned or titled in the names of one or both the recipient and the recipient's 
110.27 	spouse. Title and interest in the property of a predeceased recipient spouse shall not end 
110.28 	or extinguish upon the person's death and shall continue for the purpose of allowing 
110.29 	recovery of medical assistance in the estate of the surviving spouse. Upon the death of 
110.30 	the predeceased recipient spouse, title and interest in the predeceased spouse's property 
110.31 	shall vest in the surviving spouse by operation of law and without the necessity for any 
110.32 	probate or decree of descent proceedings and shall continue to exist after the death of the 
110.33 	predeceased spouse and the surviving spouse to permit recovery of medical assistance. 
110.34 	The recipient spouse and the surviving spouse of a deceased recipient spouse shall not 
111.1 	encumber, disclaim, transfer, alienate, hypothecate, or otherwise divest themselves of 
111.2 	these interests before or upon death.
111.3 	(c) For purposes of this section, "marital property" includes any and all real or 
111.4 	personal property of any kind or interests in such property the predeceased recipient 
111.5 	spouse and their spouse, or either of them, owned at the time of their marriage to each 
111.6 	other or acquired during their marriage regardless of whether it was owned or titled in 
111.7 	the names of one or both of them. If either or both spouses of a married couple received 
111.8 	medical assistance, all property owned during the marriage or which either or both spouses 
111.9 	acquired during their marriage shall be presumed to be marital property for purposes of 
111.10 	recovering medical assistance unless there is clear and convincing evidence to the contrary.
111.11 	(d) The agency responsible for the claim for medical assistance for a recipient spouse 
111.12 	may, at its discretion, release specific real and personal property from the provisions of 
111.13 	this section. The release shall extinguish the interest created under paragraph (b) in the 
111.14 	land it describes upon filing or recording. The release need not be attested, certified, or 
111.15 	acknowledged as a condition of filing or recording and shall be filed or recorded in the 
111.16 	office of the county recorder or registrar of titles, as appropriate, in the county where the 
111.17 	real property is located. The party to whom the release is given shall be responsible for 
111.18 	paying all fees and costs necessary to record and file the release. If the property described 
111.19 	in the release is registered property, the registrar of titles shall accept it for recording and 
111.20 	shall record it on the certificate of title for each parcel of property described in the release. 
111.21 	If the property described in the release is abstract property, the recorder shall accept it 
111.22 	for filing and file it in the county's grantor-grantee indexes and any tract index the county 
111.23 	maintains for each parcel of property described in the release.

111.24 	Sec. 43. Minnesota Statutes 2008, section 256B.15, is amended by adding a 
111.25 	subdivision to read:
111.26 		Subd. 9.Commissioner's intervention. The commissioner shall be permitted to 
111.27 	intervene as a party in any proceeding involving recovery of medical assistance upon 
111.28 	filing a notice of intervention and serving such notice on the other parties.

111.29 	Sec. 44. [256B.196] INTERGOVERNMENTAL TRANSFERS; HOSPITAL 
111.30 	PAYMENTS.
111.31 		Subdivision 1.Federal approval required. This section is contingent on federal 
111.32 	approval of the intergovernmental transfers and payments authorized under this section. 
111.33 	This section is also contingent on current payment by the government entities of the 
111.34 	intergovernmental transfers under this section.
112.1 		Subd. 2.Commissioner's duties. (a) For the purposes of this subdivision and 
112.2 	subdivision 3, the commissioner shall determine the fee-for-service outpatient hospital 
112.3 	services upper payment limit for nonstate government hospitals. The commissioner shall 
112.4 	then determine the amount of a supplemental payment to Hennepin County Medical 
112.5 	Center and Regions Hospital for these services that would increase medical assistance 
112.6 	spending in this category to the aggregate upper payment limit for all nonstate government 
112.7 	hospitals in Minnesota. In making this determination, the commissioner shall allot the 
112.8 	available increases between Hennepin County Medical Center and Regions Hospital 
112.9 	based on the ratio of medical assistance fee-for-service outpatient hospital payments to 
112.10 	the two facilities. The commissioner shall adjust this allotment as necessary based on 
112.11 	federal approvals, the amount of intergovernmental transfers received from Hennepin and 
112.12 	Ramsey Counties, and other factors, in order to maximize the additional total payments. 
112.13 	The commissioner shall inform Hennepin County and Ramsey County of the periodic 
112.14 	intergovernmental transfers necessary to match federal Medicaid payments available 
112.15 	under this subdivision in order to make supplementary medical assistance payments to 
112.16 	Hennepin County Medical Center and Regions Hospital equal to an amount that when 
112.17 	combined with existing medical assistance payments to nonstate governmental hospitals 
112.18 	would increase total payments to hospitals in this category for outpatient services to 
112.19 	the aggregate upper payment limit for all hospitals in this category in Minnesota. Upon 
112.20 	receipt of these periodic transfers, the commissioner shall make supplementary payments 
112.21 	to Hennepin County Medical Center and Regions Hospital.
112.22 	(b) For the purposes of this subdivision and subdivision 3, the commissioner shall 
112.23 	determine an upper payment limit for physicians affiliated with Hennepin County Medical 
112.24 	Center and with Regions Hospital. The upper payment limit shall be based on the average 
112.25 	commercial rate or be determined using another method acceptable to the Centers for 
112.26 	Medicare and Medicaid Services. The commissioner shall inform Hennepin County and 
112.27 	Ramsey County of the periodic intergovernmental transfers necessary to match the federal 
112.28 	Medicaid payments available under this subdivision in order to make supplementary 
112.29 	payments to physicians affiliated with Hennepin County Medical Center and Regions 
112.30 	Hospital equal to the difference between the established medical assistance payment for 
112.31 	physician services and the upper payment limit. Upon receipt of these periodic transfers, 
112.32 	the commissioner shall make supplementary payments to physicians of Hennepin Faculty 
112.33 	Associates and HealthPartners.
112.34 	(c) Beginning January 1, 2010, Hennepin County and Ramsey County shall make 
112.35 	monthly intergovernmental transfers to the commissioner in the following amounts: 
112.36 	$133,333 by Hennepin County and $100,000 by Ramsey County. The commissioner shall 
113.1 	increase the medical assistance capitation payments to Metropolitan Health Plan and 
113.2 	HealthPartners by an amount equal to the annual value of the monthly transfers plus 
113.3 	federal financial participation.
113.4 	(d) The commissioner shall inform Hennepin County and Ramsey County on an 
113.5 	ongoing basis of the need for any changes needed in the intergovernmental transfers 
113.6 	in order to continue the payments under paragraphs (a) to (c), at their maximum level, 
113.7 	including increases in upper payment limits, changes in the federal Medicaid match, and 
113.8 	other factors.
113.9 	(e) The payments in paragraphs (a) to (c) shall be implemented independently of 
113.10 	each other, subject to federal approval and to the receipt of transfers under subdivision 3.
113.11 		Subd. 3.Intergovernmental transfers. Based on the determination by the 
113.12 	commissioner under subdivision 2, Hennepin County and Ramsey County shall make 
113.13 	periodic intergovernmental transfers to the commissioner for the purposes of subdivision 
113.14 	2, paragraphs (a) to (c). All of the intergovernmental transfers made by Hennepin County 
113.15 	shall be used to match federal payments to Hennepin County Medical Center under 
113.16 	subdivision 2, paragraph (a); to physicians affiliated with Hennepin Faculty Associates 
113.17 	under subdivision 2, paragraph (b); and to Metropolitan Health Plan under subdivision 
113.18 	2, paragraph (c). All of the intergovernmental transfers made by Ramsey County shall 
113.19 	be used to match federal payments to Regions Hospital under subdivision 2, paragraph 
113.20 	(a); to physicians affiliated with HealthPartners under subdivision 2, paragraph (b); and to 
113.21 	HealthPartners under subdivision 2, paragraph (c).
113.22 		Subd. 4.Adjustments permitted. (a) The commissioner may adjust the 
113.23 	intergovernmental transfers under subdivision 3 and the payments under subdivision 
113.24 	2, based on the commissioner's determination of Medicare upper payment limits, 
113.25 	hospital-specific charge limits, hospital-specific limitations on disproportionate share 
113.26 	payments, medical inflation, actuarial certification, and cost-effectiveness for purposes 
113.27 	of federal waivers. Any adjustments must be made on a proportional basis. The 
113.28 	commissioner may make adjustments under this subdivision only after consultation 
113.29 	with the affected counties and hospitals. All payments under subdivision 2 and all 
113.30 	intergovernmental transfers under subdivision 3 are limited to amounts available after all 
113.31 	other base rates, adjustments, and supplemental payments in chapter 256B are calculated.
113.32 	(b) The ratio of medical assistance payments specified in subdivision 2 to the 
113.33 	voluntary intergovernmental transfers specified in subdivision 3 shall not be reduced 
113.34 	except as provided under paragraph (a).
113.35 		Subd. 5.Recession period. Each type of intergovernmental transfer in subdivision 
113.36 	2, paragraphs (a) to (d), for payment periods from October 1, 2008, through December 
114.1 	31, 2010, is voluntary on the part of Hennepin and Ramsey Counties, meaning that the 
114.2 	transfer must be agreed to, in writing, by the counties prior to any payments being issued. 
114.3 	One agreement on each type of transfer shall cover the entire recession period.

114.4 	Sec. 45. Minnesota Statutes 2008, section 256B.199, is amended to read:
114.5 	256B.199 PAYMENTS REPORTED BY GOVERNMENTAL ENTITIES.
114.6 	(a) Effective July 1, 2007, the commissioner shall apply for federal matching funds 
114.7 	for the expenditures in paragraphs (b) and (c).
114.8 	(b) The commissioner shall apply for federal matching funds for certified public 
114.9 	expenditures as follows:
114.10 	(1) Hennepin County, Hennepin County Medical Center, Ramsey County, Regions 
114.11 	Hospital, the University of Minnesota, and Fairview-University Medical Center shall 
114.12 	report quarterly to the commissioner beginning June 1, 2007, payments made during the 
114.13 	second previous quarter that may qualify for reimbursement under federal law;
114.14 	 (2) based on these reports, the commissioner shall apply for federal matching 
114.15 	funds. These funds are appropriated to the commissioner for the payments under section 
114.16 	256.969, subdivision 27; and
114.17 	 (3) by May 1 of each year, beginning May 1, 2007, the commissioner shall inform 
114.18 	the nonstate entities listed in paragraph (a) of the amount of federal disproportionate share 
114.19 	hospital payment money expected to be available in the current federal fiscal year.
114.20 	(c) The commissioner shall apply for federal matching funds for general assistance 
114.21 	medical care expenditures as follows:
114.22 	(1) for hospital services occurring on or after July 1, 2007, general assistance medical 
114.23 	care expenditures for fee-for-service inpatient and outpatient hospital payments made by 
114.24 	the department shall be used to apply for federal matching funds, except as limited below:
114.25 	(i) only those general assistance medical care expenditures made to an individual 
114.26 	hospital that would not cause the hospital to exceed its individual hospital limits under 
114.27 	section 1923 of the Social Security Act may be considered; and
114.28 	(ii) general assistance medical care expenditures may be considered only to the extent 
114.29 	of Minnesota's aggregate allotment under section 1923 of the Social Security Act; and
114.30 	(2) all hospitals must provide any necessary expenditure, cost, and revenue 
114.31 	information required by the commissioner as necessary for purposes of obtaining federal 
114.32 	Medicaid matching funds for general assistance medical care expenditures.
114.33 	(d) For the period from April 1, 2009, to September 30, 2010, the commissioner shall 
114.34 	apply for additional federal matching funds available as disproportionate share hospital 
114.35 	payments under the American Recovery and Reinvestment Act of 2009. These funds shall 
115.1 	be made available as the state share of payments under section 256.969, subdivision 28. 
115.2 	The entities required to report certified public expenditures under paragraph (b), clause 
115.3 	(1), shall report additional certified public expenditures as necessary under this paragraph.

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

115.5 	Sec. 46. Minnesota Statutes 2008, section 256B.69, subdivision 5a, is amended to read:
115.6 		Subd. 5a.Managed care contracts. (a) Managed care contracts under this section 
115.7 	and sections 256L.12 and 256D.03, shall be entered into or renewed on a calendar year 
115.8 	basis beginning January 1, 1996. Managed care contracts which were in effect on June 
115.9 	30, 1995, and set to renew on July 1, 1995, shall be renewed for the period July 1, 1995 
115.10 	through December 31, 1995 at the same terms that were in effect on June 30, 1995. The 
115.11 	commissioner may issue separate contracts with requirements specific to services to 
115.12 	medical assistance recipients age 65 and older.
115.13 	(b) A prepaid health plan providing covered health services for eligible persons 
115.14 	pursuant to chapters 256B, 256D, and 256L, is responsible for complying with the terms 
115.15 	of its contract with the commissioner. Requirements applicable to managed care programs 
115.16 	under chapters 256B, 256D, and 256L, established after the effective date of a contract 
115.17 	with the commissioner take effect when the contract is next issued or renewed.
115.18 	(c) Effective for services rendered on or after January 1, 2003, the commissioner shall 
115.19 	withhold five percent of managed care plan payments under this section and county-based 
115.20 	purchasing plan's payment rate under section 256B.692 for the prepaid medical assistance 
115.21 	and general assistance medical care programs pending completion of performance targets. 
115.22 	Each performance target must be quantifiable, objective, measurable, and reasonably 
115.23 	attainable, except in the case of a performance target based on a federal or state law or rule. 
115.24 	Criteria for assessment of each performance target must be outlined in writing prior to the 
115.25 	contract effective date. The managed care plan must demonstrate, to the commissioner's 
115.26 	satisfaction, that the data submitted regarding attainment of the performance target is 
115.27 	accurate. The commissioner shall periodically change the administrative measures used 
115.28 	as performance targets in order to improve plan performance across a broader range of 
115.29 	administrative services. The performance targets must include measurement of plan 
115.30 	efforts to contain spending on health care services and administrative activities. The 
115.31 	commissioner may adopt plan-specific performance targets that take into account factors 
115.32 	affecting only one plan, including characteristics of the plan's enrollee population. The 
115.33 	withheld funds must be returned no sooner than July of the following year if performance 
115.34 	targets in the contract are achieved. The commissioner may exclude special demonstration 
115.35 	projects under subdivision 23. A managed care plan or a county-based purchasing plan 
116.1 	under section 256B.692 may include as admitted assets under section 62D.044 any amount 
116.2 	withheld under this paragraph that is reasonably expected to be returned.
116.3 	(d)(1) Effective for services rendered on or after January 1, 2009, through December 
116.4 	31, 2009, the commissioner shall withhold three percent of managed care plan payments 
116.5 	under this section and county-based purchasing plan payments under section 256B.692 for 
116.6 	the prepaid medical assistance and general assistance medical care programs. The withheld 
116.7 	funds must be returned no sooner than July 1 and no later than July 31 of the following 
116.8 	year. The commissioner may exclude special demonstration projects under subdivision 23.
116.9 	(2) A managed care plan or a county-based purchasing plan under section 256B.692 
116.10 	may include as admitted assets under section 62D.044 any amount withheld under 
116.11 	this paragraph. The return of the withhold under this paragraph is not subject to the 
116.12 	requirements of paragraph (c).
116.13 	(e) Effective for services rendered on or after January 1, 2010, through December 
116.14 	31, 2010, the commissioner shall withhold 3.5 percent of managed care plan payments 
116.15 	under this section and county-based purchasing plan payments under section 256B.692 
116.16 	for the prepaid medical assistance program. The withheld funds must be returned no 
116.17 	sooner than July 1 and no later than July 31 of the following year. The commissioner may 
116.18 	exclude special demonstration projects under subdivision 23. 
116.19 	(f) Effective for services rendered on or after January 1, 2011, through December 31, 
116.20 	2011, the commissioner shall withhold four percent of managed care plan payments under 
116.21 	this section and county-based purchasing plan payments under section 256B.692 for the 
116.22 	prepaid medical assistance program. The withheld funds must be returned no sooner than 
116.23 	July 1 and no later than July 31 of the following year. The commissioner may exclude 
116.24 	special demonstration projects under subdivision 23. 
116.25 	(g) Effective for services rendered on or after January 1, 2012, through December 
116.26 	31, 2012, the commissioner shall withhold 4.5 percent of managed care plan payments 
116.27 	under this section and county-based purchasing plan payments under section 256B.692 
116.28 	for the prepaid medical assistance program. The withheld funds must be returned no 
116.29 	sooner than July 1 and no later than July 31 of the following year. The commissioner may 
116.30 	exclude special demonstration projects under subdivision 23.
116.31 	(h) Effective for services rendered on or after January 1, 2013, through December 
116.32 	31, 2013, the commissioner shall withhold 4.5 percent of managed care plan payments 
116.33 	under this section and county-based purchasing plan payments under section 256B.692 
116.34 	for the prepaid medical assistance program. The withheld funds must be returned no 
116.35 	sooner than July 1 and no later than July 31 of the following year. The commissioner may 
116.36 	exclude special demonstration projects under subdivision 23.
117.1 	(i) Effective for services rendered on or after January 1, 2014, the commissioner 
117.2 	shall withhold three percent of managed care plan payments under this section and 
117.3 	county-based purchasing plan payments under section 256B.692 for the prepaid medical 
117.4 	assistance and prepaid general assistance medical care programs. The withheld funds must 
117.5 	be returned no sooner than July 1 and no later than July 31 of the following year. The 
117.6 	commissioner may exclude special demonstration projects under subdivision 23.
117.7 	(j) A managed care plan or a county-based purchasing plan under section 256B.692 
117.8 	may include as admitted assets under section 62D.044 any amount withheld under this 
117.9 	section that is reasonably expected to be returned.

117.10 	Sec. 47. Minnesota Statutes 2008, section 256B.69, subdivision 5c, is amended to read:
117.11 		Subd. 5c.Medical education and research fund. (a) Except as provided in 
117.12 	paragraph (c), the commissioner of human services shall transfer each year to the medical 
117.13 	education and research fund established under section 62J.692, the following: 
117.14 	(1) an amount equal to the reduction in the prepaid medical assistance and prepaid 
117.15 	general assistance medical care payments as specified in this clause. Until January 1, 
117.16 	2002, the county medical assistance and general assistance medical care capitation base 
117.17 	rate prior to plan specific adjustments and after the regional rate adjustments under section 
117.18 	256B.69, subdivision 5b, is reduced 6.3 percent for Hennepin County, two percent for 
117.19 	the remaining metropolitan counties, and no reduction for nonmetropolitan Minnesota 
117.20 	counties; and after January 1, 2002, the county medical assistance and general assistance 
117.21 	medical care capitation base rate prior to plan specific adjustments is reduced 6.3 percent 
117.22 	for Hennepin County, two percent for the remaining metropolitan counties, and 1.6 percent 
117.23 	for nonmetropolitan Minnesota counties. Nursing facility and elderly waiver payments 
117.24 	and demonstration project payments operating under subdivision 23 are excluded from 
117.25 	this reduction. The amount calculated under this clause shall not be adjusted for periods 
117.26 	already paid due to subsequent changes to the capitation payments; 
117.27 	(2) beginning July 1, 2003, $2,157,000$4,314,000 from the capitation rates paid 
117.28 	under this section plus any federal matching funds on this amount;
117.29 	(3) beginning July 1, 2002, an additional $12,700,000 from the capitation rates 
117.30 	paid under this section; and
117.31 	(4) beginning July 1, 2003, an additional $4,700,000 from the capitation rates paid 
117.32 	under this section.
117.33 	(b) This subdivision shall be effective upon approval of a federal waiver which 
117.34 	allows federal financial participation in the medical education and research fund. Effective 
117.35 	July 1, 2009, and thereafter, the transfers required by paragraph (a), clauses (1) to (4), 
118.1 	shall not exceed the total amount transferred for fiscal year 2009. Any excess shall first 
118.2 	reduce the amounts otherwise required to be transferred under paragraph (a), clauses 
118.3 	(2) to (4). Any excess following this reduction shall proportionally reduce the transfers 
118.4 	under paragraph (a), clause (1).
118.5 	(c) Effective July 1, 2003, the amount reduced from the prepaid general assistance 
118.6 	medical care payments under paragraph (a), clause (1), shall be transferred to the general 
118.7 	fund.
118.8 	(d) Beginning July 1, 2009, of the amounts in paragraph (a), the commissioner shall 
118.9 	transfer $21,714,000 each fiscal year to the medical education and research fund. The 
118.10 	balance of the transfers under paragraph (a) shall be transferred to the medical education 
118.11 	and research fund no earlier than July 1 of the following fiscal year.

118.12 	Sec. 48. Minnesota Statutes 2008, section 256B.69, subdivision 5f, is amended to read:
118.13 		Subd. 5f.Capitation rates. (a) Beginning July 1, 2002, the capitation rates paid 
118.14 	under this section are increased by $12,700,000 per year. Beginning July 1, 2003, the 
118.15 	capitation rates paid under this section are increased by $4,700,000 per year.
118.16 	(b) Beginning July 1, 2009, the capitation rates paid under this section are increased 
118.17 	each year by the lesser of $21,714,000 or an amount equal to the difference between the 
118.18 	estimated value of the reductions described in subdivision 5c, paragraph (a), clause (1), 
118.19 	and the amount of the limit described in subdivision 5c, paragraph (b).

118.20 	Sec. 49. Minnesota Statutes 2008, section 256B.69, subdivision 23, is amended to read:
118.21 		Subd. 23.Alternative services; elderly and disabled persons. (a) The 
118.22 	commissioner may implement demonstration projects to create alternative integrated 
118.23 	delivery systems for acute and long-term care services to elderly persons and persons 
118.24 	with disabilities as defined in section 256B.77, subdivision 7a, that provide increased 
118.25 	coordination, improve access to quality services, and mitigate future cost increases. 
118.26 	The commissioner may seek federal authority to combine Medicare and Medicaid 
118.27 	capitation payments for the purpose of such demonstrations and may contract with 
118.28 	Medicare-approved special needs plans to provide Medicaid services. Medicare funds and 
118.29 	services shall be administered according to the terms and conditions of the federal contract 
118.30 	and demonstration provisions. For the purpose of administering medical assistance funds, 
118.31 	demonstrations under this subdivision are subject to subdivisions 1 to 22. The provisions 
118.32 	of Minnesota Rules, parts 9500.1450 to 9500.1464, apply to these demonstrations, 
118.33 	with the exceptions of parts 9500.1452, subpart 2, item B; and 9500.1457, subpart 1, 
118.34 	items B and C, which do not apply to persons enrolling in demonstrations under this 
119.1 	section. An initial open enrollment period may be provided. Persons who disenroll from 
119.2 	demonstrations under this subdivision remain subject to Minnesota Rules, parts 9500.1450 
119.3 	to 9500.1464. When a person is enrolled in a health plan under these demonstrations and 
119.4 	the health plan's participation is subsequently terminated for any reason, the person shall 
119.5 	be provided an opportunity to select a new health plan and shall have the right to change 
119.6 	health plans within the first 60 days of enrollment in the second health plan. Persons 
119.7 	required to participate in health plans under this section who fail to make a choice of 
119.8 	health plan shall not be randomly assigned to health plans under these demonstrations. 
119.9 	Notwithstanding section 256L.12, subdivision 5, and Minnesota Rules, part 9505.5220, 
119.10 	subpart 1, item A, if adopted, for the purpose of demonstrations under this subdivision, 
119.11 	the commissioner may contract with managed care organizations, including counties, to 
119.12 	serve only elderly persons eligible for medical assistance, elderly and disabled persons, or 
119.13 	disabled persons only. For persons with a primary diagnosis of developmental disability, 
119.14 	serious and persistent mental illness, or serious emotional disturbance, the commissioner 
119.15 	must ensure that the county authority has approved the demonstration and contracting 
119.16 	design. Enrollment in these projects for persons with disabilities shall be voluntary. The 
119.17 	commissioner shall not implement any demonstration project under this subdivision for 
119.18 	persons with a primary diagnosis of developmental disabilities, serious and persistent 
119.19 	mental illness, or serious emotional disturbance, without approval of the county board of 
119.20 	the county in which the demonstration is being implemented.
119.21 	(b) Notwithstanding chapter 245B, sections 252.40 to 252.46, 256B.092, 256B.501
119.22 	to 256B.5015, and Minnesota Rules, parts 9525.0004 to 9525.0036, 9525.1200 to 
119.23 	9525.1330, 9525.1580, and 9525.1800 to 9525.1930, the commissioner may implement 
119.24 	under this section projects for persons with developmental disabilities. The commissioner 
119.25 	may capitate payments for ICF/MR services, waivered services for developmental 
119.26 	disabilities, including case management services, day training and habilitation and 
119.27 	alternative active treatment services, and other services as approved by the state and by the 
119.28 	federal government. Case management and active treatment must be individualized and 
119.29 	developed in accordance with a person-centered plan. Costs under these projects may not 
119.30 	exceed costs that would have been incurred under fee-for-service. Beginning July 1, 2003, 
119.31 	and until four years after the pilot project implementation date, subcontractor participation 
119.32 	in the long-term care developmental disability pilot is limited to a nonprofit long-term 
119.33 	care system providing ICF/MR services, home and community-based waiver services, 
119.34 	and in-home services to no more than 120 consumers with developmental disabilities in 
119.35 	Carver, Hennepin, and Scott Counties. The commissioner shall report to the legislature 
120.1 	prior to expansion of the developmental disability pilot project. This paragraph expires 
120.2 	four years after the implementation date of the pilot project.
120.3 	(c) Before implementation of a demonstration project for disabled persons, the 
120.4 	commissioner must provide information to appropriate committees of the house of 
120.5 	representatives and senate and must involve representatives of affected disability groups 
120.6 	in the design of the demonstration projects.
120.7 	(d) A nursing facility reimbursed under the alternative reimbursement methodology 
120.8 	in section 256B.434 may, in collaboration with a hospital, clinic, or other health care entity 
120.9 	provide services under paragraph (a). The commissioner shall amend the state plan and 
120.10 	seek any federal waivers necessary to implement this paragraph.
120.11 	(e) The commissioner, in consultation with the commissioners of commerce and 
120.12 	health, may approve and implement programs for all-inclusive care for the elderly (PACE) 
120.13 	according to federal laws and regulations governing that program and state laws or rules 
120.14 	applicable to participating providers. The process for approval of these programs shall 
120.15 	begin only after the commissioner receives grant money in an amount sufficient to cover 
120.16 	the state share of the administrative and actuarial costs to implement the programs during 
120.17 	state fiscal years 2006 and 2007. Grant amounts for this purpose shall be deposited in an 
120.18 	account in the special revenue fund and are appropriated to the commissioner to be used 
120.19 	solely for the purpose of PACE administrative and actuarial costs. A PACE provider is 
120.20 	not required to be licensed or certified as a health plan company as defined in section 
120.21 	62Q.01, subdivision 4. Persons age 55 and older who have been screened by the county 
120.22 	and found to be eligible for services under the elderly waiver or community alternatives 
120.23 	for disabled individuals or who are already eligible for Medicaid but meet level of 
120.24 	care criteria for receipt of waiver services may choose to enroll in the PACE program. 
120.25 	Medicare and Medicaid services will be provided according to this subdivision and 
120.26 	federal Medicare and Medicaid requirements governing PACE providers and programs. 
120.27 	PACE enrollees will receive Medicaid home and community-based services through the 
120.28 	PACE provider as an alternative to services for which they would otherwise be eligible 
120.29 	through home and community-based waiver programs and Medicaid State Plan Services. 
120.30 	The commissioner shall establish Medicaid rates for PACE providers that do not exceed 
120.31 	costs that would have been incurred under fee-for-service or other relevant managed care 
120.32 	programs operated by the state.
120.33 	(f) The commissioner shall seek federal approval to expand the Minnesota disability 
120.34 	health options (MnDHO) program established under this subdivision in stages, first to 
120.35 	regional population centers outside the seven-county metro area and then to all areas of 
120.36 	the state. Until July 1, 2009, expansion for MnDHO projects that include home and 
121.1 	community-based services is limited to the two projects and service areas in effect on 
121.2 	March 1, 2006.  Enrollment in integrated MnDHO programs that include home and 
121.3 	community-based services shall remain voluntary. Costs for home and community-based 
121.4 	services included under MnDHO must not exceed costs that would have been incurred 
121.5 	under the fee-for-service program. Notwithstanding whether expansion occurs under 
121.6 	this paragraph, in determining MnDHO payment rates and risk adjustment methods for 
121.7 	contract years starting in 2012, the commissioner must consider the methods used to 
121.8 	determine county allocations for home and community-based program participants. If 
121.9 	necessary to reduce MnDHO rates to comply with the provision regarding MnDHO costs 
121.10 	for home and community-based services, the commissioner shall achieve the reduction by 
121.11 	maintaining the base rate for contract years 2010 and 2011 for services provided under the 
121.12 	community alternatives for disabled individuals waiver at the same level as for contract 
121.13 	year 2009. The commissioner may apply other reductions to MnDHO rates to implement 
121.14 	decreases in provider payment rates required by state law. In developing program 
121.15 	specifications for expansion of integrated programs, the commissioner shall involve and 
121.16 	consult the state-level stakeholder group established in subdivision 28, paragraph (d), 
121.17 	including consultation on whether and how to include home and community-based waiver 
121.18 	programs. Plans for further expansion of MnDHO projects shall be presented to the chairs 
121.19 	of the house of representatives and senate committees with jurisdiction over health and 
121.20 	human services policy and finance by February 1, 2007.
121.21 	(g) Notwithstanding section 256B.0261, health plans providing services under this 
121.22 	section are responsible for home care targeted case management and relocation targeted 
121.23 	case management. Services must be provided according to the terms of the waivers and 
121.24 	contracts approved by the federal government.

121.25 	Sec. 50. [256B.756] REIMBURSEMENT RATES FOR BIRTHS.
121.26 		Subdivision 1.Facility rate. (a) Notwithstanding section 256.969, effective for 
121.27 	services provided on or after October 1, 2009, the facility payment rate for the following 
121.28 	diagnosis-related groups, as they fall within the diagnostic categories: (1) 371 cesarean 
121.29 	section without complicating diagnosis; (2) 372 vaginal delivery with complicating 
121.30 	diagnosis; and (3) 373 vaginal delivery without complicating diagnosis, shall be calculated 
121.31 	as provided in paragraph (b).
121.32 	(b) The commissioner shall calculate a single rate for all of the diagnostic related 
121.33 	groups specified in paragraph (a) consistent with an increase in the proportion of births 
121.34 	by vaginal delivery and a reduction in the percentage of births by cesarean section. The 
121.35 	calculated single rate must be based on an expected increase in the number of vaginal 
122.1 	births and expected reduction in the number of cesarean section such that the reduction 
122.2 	in cesarean sections is less than or equal to one standard deviation below the average in 
122.3 	the frequency of cesarean births for Minnesota health care program clients at hospitals 
122.4 	performing greater than 50 deliveries per year.
122.5 	(c) The rates described in this subdivision do not include newborn care.
122.6 		Subd. 2.Provider rate. Notwithstanding section 256B.76, effective for services 
122.7 	provided on or after October 1, 2009, the payment rate for professional services related 
122.8 	to labor, delivery, and antepartum and postpartum care when provided for any of the 
122.9 	diagnostic categories identified in subdivision 1, paragraph (a), shall be calculated using 
122.10 	the methodology specified in subdivision 1, paragraph (b).
122.11 		Subd. 3.Health plans. Payments to managed care and county-based purchasing 
122.12 	plans under sections 256B.69, 256B.692, or 256L.12 shall be reduced for services 
122.13 	provided on or after October 1, 2009, to reflect the adjustments in subdivisions 1 and 2.
122.14 		Subd. 4.Prior authorization. Prior authorization shall not be required before 
122.15 	reimbursement is paid for a cesarean section delivery.

122.16 	Sec. 51. Minnesota Statutes 2008, section 256B.76, subdivision 1, is amended to read:
122.17 		Subdivision 1.Physician reimbursement.  (a) Effective for services rendered on 
122.18 	or after October 1, 1992, the commissioner shall make payments for physician services 
122.19 	as follows:
122.20 	(1) payment for level one Centers for Medicare and Medicaid Services' common 
122.21 	procedural coding system codes titled "office and other outpatient services," "preventive 
122.22 	medicine new and established patient," "delivery, antepartum, and postpartum care," 
122.23 	"critical care," cesarean delivery and pharmacologic management provided to psychiatric 
122.24 	patients, and level three codes for enhanced services for prenatal high risk, shall be paid 
122.25 	at the lower of (i) submitted charges, or (ii) 25 percent above the rate in effect on June 
122.26 	30, 1992. If the rate on any procedure code within these categories is different than the 
122.27 	rate that would have been paid under the methodology in section 256B.74, subdivision 2, 
122.28 	then the larger rate shall be paid; 
122.29 	(2) payments for all other services shall be paid at the lower of (i) submitted charges, 
122.30 	or (ii) 15.4 percent above the rate in effect on June 30, 1992; and
122.31 	(3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th 
122.32 	percentile of 1989, less the percent in aggregate necessary to equal the above increases 
122.33 	except that payment rates for home health agency services shall be the rates in effect 
122.34 	on September 30, 1992.
123.1 	(b) Effective for services rendered on or after January 1, 2000, payment rates for 
123.2 	physician and professional services shall be increased by three percent over the rates 
123.3 	in effect on December 31, 1999, except for home health agency and family planning 
123.4 	agency services. The increases in this paragraph shall be implemented January 1, 2000, 
123.5 	for managed care.
123.6 	(c) Effective for services rendered on or after July 1, 2009, payment rates for 
123.7 	physician and professional services shall be reduced by five percent over the rates in effect 
123.8 	on June 30, 2009. This reduction does not apply to office or other outpatient services 
123.9 	(procedure codes 99201 to 99215), preventive medicine services (procedure codes 99381 
123.10 	to 99412) and family planning services billed by the following primary care specialties: 
123.11 	general practice, internal medicine, pediatrics, geriatrics, family practice, or by an 
123.12 	advanced practice registered nurse or physician assistant practicing in pediatrics, geriatrics, 
123.13 	or family practice. This reduction does not apply to federally qualified health centers, 
123.14 	rural health centers, and Indian health services. Effective October 1, 2009, payments 
123.15 	made to managed care plans and county-based purchasing plans under sections 256B.69, 
123.16 	256B.692, and 256L.12 shall reflect the payment reduction described in this paragraph.

123.17 	Sec. 52. [256B.766] REIMBURSEMENT FOR BASIC CARE SERVICES.
123.18 	(a) Effective for services provided on or after July 1, 2009, total payments for basic 
123.19 	care services, shall be reduced by three percent, prior to third-party liability and spenddown 
123.20 	calculation. Payments made to managed care plans and county-based purchasing plans 
123.21 	shall be reduced for services provided on or after October 1, 2009, to reflect this reduction.
123.22 	(b) This section does not apply to physician and professional services, inpatient 
123.23 	hospital services, family planning services, mental health services, dental services, 
123.24 	prescription drugs, and medical transportation.

123.25 	Sec. 53. Minnesota Statutes 2008, section 256D.03, subdivision 4, is amended to read:
123.26 		Subd. 4.General assistance medical care; services. (a)(i) For a person who is 
123.27 	eligible under subdivision 3, paragraph (a), clause (2), item (i), general assistance medical 
123.28 	care covers, except as provided in paragraph (c):
123.29 	(1) inpatient hospital services;
123.30 	(2) outpatient hospital services;
123.31 	(3) services provided by Medicare certified rehabilitation agencies;
123.32 	(4) prescription drugs and other products recommended through the process 
123.33 	established in section 256B.0625, subdivision 13;
124.1 	(5) equipment necessary to administer insulin and diagnostic supplies and equipment 
124.2 	for diabetics to monitor blood sugar level;
124.3 	(6) eyeglasses and eye examinations provided by a physician or optometrist;
124.4 	(7) hearing aids;
124.5 	(8) prosthetic devices;
124.6 	(9) laboratory and X-ray services;
124.7 	(10) physician's services;
124.8 	(11) medical transportation except special transportation;
124.9 	(12) chiropractic services as covered under the medical assistance program;
124.10 	(13) podiatric services;
124.11 	(14) dental services as covered under the medical assistance program;
124.12 	(15) mental health services covered under chapter 256B;
124.13 	(16) prescribed medications for persons who have been diagnosed as mentally ill as 
124.14 	necessary to prevent more restrictive institutionalization;
124.15 	(17) medical supplies and equipment, and Medicare premiums, coinsurance and 
124.16 	deductible payments;
124.17 	(18) medical equipment not specifically listed in this paragraph when the use of 
124.18 	the equipment will prevent the need for costlier services that are reimbursable under 
124.19 	this subdivision;
124.20 	(19) services performed by a certified pediatric nurse practitioner, a certified family 
124.21 	nurse practitioner, a certified adult nurse practitioner, a certified obstetric/gynecological 
124.22 	nurse practitioner, a certified neonatal nurse practitioner, or a certified geriatric nurse 
124.23 	practitioner in independent practice, if (1) the service is otherwise covered under this 
124.24 	chapter as a physician service, (2) the service provided on an inpatient basis is not included 
124.25 	as part of the cost for inpatient services included in the operating payment rate, and (3) the 
124.26 	service is within the scope of practice of the nurse practitioner's license as a registered 
124.27 	nurse, as defined in section 148.171;
124.28 	(20) services of a certified public health nurse or a registered nurse practicing in 
124.29 	a public health nursing clinic that is a department of, or that operates under the direct 
124.30 	authority of, a unit of government, if the service is within the scope of practice of the 
124.31 	public health nurse's license as a registered nurse, as defined in section 148.171;
124.32 	(21) telemedicine consultations, to the extent they are covered under section 
124.33 	256B.0625, subdivision 3b; 
124.34 	(22) care coordination and patient education services provided by a community 
124.35 	health worker according to section 256B.0625, subdivision 49; and
125.1 	(23) regardless of the number of employees that an enrolled health care provider 
125.2 	may have, sign language interpreter services when provided by an enrolled health care 
125.3 	provider during the course of providing a direct, person-to-person covered health care 
125.4 	service to an enrolled recipient who has a hearing loss and uses interpreting services.
125.5 	(ii) Effective October 1, 2003, for a person who is eligible under subdivision 3, 
125.6 	paragraph (a), clause (2), item (ii), general assistance medical care coverage is limited 
125.7 	to inpatient hospital services, including physician services provided during the inpatient 
125.8 	hospital stay. A $1,000 deductible is required for each inpatient hospitalization.
125.9 	(b) Effective August 1, 2005, sex reassignment surgery is not covered under this 
125.10 	subdivision.
125.11 	(c) In order to contain costs, the commissioner of human services shall select 
125.12 	vendors of medical care who can provide the most economical care consistent with high 
125.13 	medical standards and shall where possible contract with organizations on a prepaid 
125.14 	capitation basis to provide these services. The commissioner shall consider proposals by 
125.15 	counties and vendors for prepaid health plans, competitive bidding programs, block grants, 
125.16 	or other vendor payment mechanisms designed to provide services in an economical 
125.17 	manner or to control utilization, with safeguards to ensure that necessary services are 
125.18 	provided. Before implementing prepaid programs in counties with a county operated or 
125.19 	affiliated public teaching hospital or a hospital or clinic operated by the University of 
125.20 	Minnesota, the commissioner shall consider the risks the prepaid program creates for the 
125.21 	hospital and allow the county or hospital the opportunity to participate in the program in a 
125.22 	manner that reflects the risk of adverse selection and the nature of the patients served by 
125.23 	the hospital, provided the terms of participation in the program are competitive with the 
125.24 	terms of other participants considering the nature of the population served. Payment for 
125.25 	services provided pursuant to this subdivision shall be as provided to medical assistance 
125.26 	vendors of these services under sections 256B.02, subdivision 8, and 256B.0625. For 
125.27 	payments made during fiscal year 1990 and later years, the commissioner shall consult 
125.28 	with an independent actuary in establishing prepayment rates, but shall retain final control 
125.29 	over the rate methodology.
125.30 	(d) Effective January 1, 2008, drug coverage under general assistance medical 
125.31 	care is limited to prescription drugs that:
125.32 	(i) are covered under the medical assistance program as described in section 
125.33 	256B.0625, subdivisions 13 and 13d; and
125.34 	(ii) are provided by manufacturers that have fully executed general assistance 
125.35 	medical care rebate agreements with the commissioner and comply with the agreements. 
125.36 	Prescription drug coverage under general assistance medical care must conform to 
126.1 	coverage under the medical assistance program according to section 256B.0625, 
126.2 	subdivisions 13 to 13g.
126.3 	 (e) Recipients eligible under subdivision 3, paragraph (a), shall pay the following 
126.4 	co-payments for services provided on or after October 1, 2003, and before January 1, 2009:
126.5 	(1) $25 for eyeglasses;
126.6 	(2) $25 for nonemergency visits to a hospital-based emergency room;
126.7 	(3) $3 per brand-name drug prescription and $1 per generic drug prescription, 
126.8 	subject to a $12 per month maximum for prescription drug co-payments. No co-payments 
126.9 	shall apply to antipsychotic drugs when used for the treatment of mental illness; and
126.10 	(4) 50 percent coinsurance on restorative dental services.
126.11 	(f) Recipients eligible under subdivision 3, paragraph (a), shall include the following 
126.12 	co-payments for services provided on or after January 1, 2009: 
126.13 	(1) $25 for nonemergency visits to a hospital-based emergency room; and
126.14 	(2) $3 per brand-name drug prescription and $1 per generic drug prescription, 
126.15 	subject to a $7 per month maximum for prescription drug co-payments. No co-payments 
126.16 	shall apply to antipsychotic drugs when used for the treatment of mental illness.
126.17 	(g) MS 2007 Supp [Expired]
126.18 	(h) Effective January 1, 2009, co-payments shall be limited to one per day per 
126.19 	provider for nonemergency visits to a hospital-based emergency room. Recipients of 
126.20 	general assistance medical care are responsible for all co-payments in this subdivision. 
126.21 	The general assistance medical care reimbursement to the provider shall be reduced by the 
126.22 	amount of the co-payment, except that reimbursement for prescription drugs shall not be 
126.23 	reduced once a recipient has reached the $7 per month maximum for prescription drug 
126.24 	co-payments. The provider collects the co-payment from the recipient. Providers may not 
126.25 	deny services to recipients who are unable to pay the co-payment.
126.26 	(i) General assistance medical care reimbursement to fee-for-service providers 
126.27 	and payments to managed care plans shall not be increased as a result of the removal of 
126.28 	the co-payments effective January 1, 2009.
126.29 	(j) Any county may, from its own resources, provide medical payments for which 
126.30 	state payments are not made.
126.31 	(k) Chemical dependency services that are reimbursed under chapter 254B must not 
126.32 	be reimbursed under general assistance medical care.
126.33 	(l) The maximum payment for new vendors enrolled in the general assistance 
126.34 	medical care program after the base year shall be determined from the average usual and 
126.35 	customary charge of the same vendor type enrolled in the base year.
127.1 	(m) The conditions of payment for services under this subdivision are the same 
127.2 	as the conditions specified in rules adopted under chapter 256B governing the medical 
127.3 	assistance program, unless otherwise provided by statute or rule.
127.4 	 (n) Inpatient and outpatient payments shall be reduced by five percent, effective July 
127.5 	1, 2003. This reduction is in addition to the five percent reduction effective July 1, 2003, 
127.6 	and incorporated by reference in paragraph (l).
127.7 	(o) Payments for all other health services except inpatient, outpatient, and pharmacy 
127.8 	services shall be reduced by five percent, effective July 1, 2003.
127.9 	(p) Payments to managed care plans shall be reduced by five percent for services 
127.10 	provided on or after October 1, 2003.
127.11 	(q) A hospital receiving a reduced payment as a result of this section may apply the 
127.12 	unpaid balance toward satisfaction of the hospital's bad debts.
127.13 	(r) Fee-for-service payments for nonpreventive visits shall be reduced by $3 for 
127.14 	services provided on or after January 1, 2006. For purposes of this subdivision, a visit 
127.15 	means an episode of service which is required because of a recipient's symptoms, 
127.16 	diagnosis, or established illness, and which is delivered in an ambulatory setting by 
127.17 	a physician or physician ancillary, chiropractor, podiatrist, advance practice nurse, 
127.18 	audiologist, optician, or optometrist.
127.19 	(s) Payments to managed care plans shall not be increased as a result of the removal 
127.20 	of the $3 nonpreventive visit co-payment effective January 1, 2006.
127.21 	(t) Payments for mental health services added as covered benefits after December 
127.22 	31, 2007, are not subject to the reductions in paragraphs (l), (n), (o), and (p).
127.23 	(u) Effective for services provided on or after July 1, 2009, total payment rates for 
127.24 	basic care services shall be reduced by three percent, in accordance with section 256B.766. 
127.25 	Payments made to managed care plans shall be reduced for services provided on or after 
127.26 	October 1, 2009, to reflect this reduction.
127.27 	(v) Effective for services provided on or after July 1, 2009, payment rates for 
127.28 	physician and professional services shall be reduced as described under section 256B.76, 
127.29 	subdivision 1, paragraph (c). Payments made to managed care plans shall be reduced for 
127.30 	services provided on or after October 1, 2009, to reflect this reduction.

127.31 	Sec. 54. Minnesota Statutes 2008, section 256L.03, is amended by adding a subdivision 
127.32 	to read:
127.33 		Subd. 3b.Chiropractic services. MinnesotaCare covers the following chiropractic 
127.34 	services: medically necessary exams, manual manipulation of the spine, and x-rays.

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

128.1 	Sec. 55. Minnesota Statutes 2008, section 256L.04, subdivision 1, is amended to read:
128.2 		Subdivision 1.Families with children. (a) Families with children with family 
128.3 	income equal to or less than 275 percent of the federal poverty guidelines for the 
128.4 	applicable family size shall be eligible for MinnesotaCare according to this section. All 
128.5 	other provisions of sections 256L.01 to 256L.18, including the insurance-related barriers 
128.6 	to enrollment under section 256L.07, shall apply unless otherwise specified. 
128.7 	(b) Parents who enroll in the MinnesotaCare program must also enroll their children, 
128.8 	if the children are eligible. Children may be enrolled separately without enrollment by 
128.9 	parents. However, if one parent in the household enrolls, both parents must enroll, unless 
128.10 	other insurance is available. If one child from a family is enrolled, all children must 
128.11 	be enrolled, unless other insurance is available. If one spouse in a household enrolls, 
128.12 	the other spouse in the household must also enroll, unless other insurance is available. 
128.13 	Families cannot choose to enroll only certain uninsured members.
128.14 	(c) Beginning October 1, 2003, the dependent sibling definition no longer applies 
128.15 	to the MinnesotaCare program. These persons are no longer counted in the parental 
128.16 	household and may apply as a separate household.
128.17 	(d) Beginning July 1, 2003, or upon federal approval, whichever is later, parents are 
128.18 	not eligible for MinnesotaCare if their gross income exceeds $57,500.
128.19 	(e) Children formerly enrolled in medical assistance and automatically deemed 
128.20 	eligible for MinnesotaCare according to section 256B.057, subdivision 2c, are exempt 
128.21 	from the requirements of this section until renewal.
128.22 	(f) Children deemed eligible for MinnesotaCare under section 256L.07, subdivision 
128.23 	8, are exempt from the eligibility requirements of this subdivision.

128.24 	Sec. 56. Minnesota Statutes 2008, section 256L.04, is amended by adding a subdivision 
128.25 	to read:
128.26 		Subd. 1b.Children with family income greater than 275 percent of federal 
128.27 	poverty guidelines. Children with family income greater than 275 percent of federal 
128.28 	poverty guidelines for the applicable family size shall be eligible for MinnesotaCare. All 
128.29 	other provisions of sections 256L.01 to 256L.18, including the insurance-related barriers 
128.30 	to enrollment under section 256L.07, shall apply unless otherwise specified.

128.31 	EFFECTIVE DATE. This section is effective July 1, 2009, or upon federal 
128.32 	approval, whichever is later.

128.33 	Sec. 57. Minnesota Statutes 2008, section 256L.04, subdivision 7a, is amended to read:
129.1 		Subd. 7a.Ineligibility. ApplicantsAdults whose income is greater than the limits 
129.2 	established under this section may not enroll in the MinnesotaCare program.

129.3 	EFFECTIVE DATE. This section is effective July 1, 2009, or upon federal 
129.4 	approval, whichever is later.

129.5 	Sec. 58. Minnesota Statutes 2008, section 256L.04, subdivision 10a, is amended to 
129.6 	read:
129.7 		Subd. 10a.Sponsor's income and resources deemed available; documentation.
 129.8 	When determining eligibility for any federal or state benefits under sections 256L.01 to 
129.9 	256L.18, the income and resources of all noncitizens whose sponsor signed an affidavit of 
129.10 	support as defined under United States Code, title 8, section 1183a, shall be deemed to 
129.11 	include their sponsors' income and resources as defined in the Personal Responsibility 
129.12 	and Work Opportunity Reconciliation Act of 1996, title IV, Public Law 104-193, sections 
129.13 	421 and 422, and subsequently set out in federal rules. To be eligible for the program, 
129.14 	noncitizens must provide documentation of their immigration status. Beginning July 
129.15 	1, 2010, or upon federal approval, whichever is later, sponsor deeming does not apply 
129.16 	to pregnant women and children who are qualified noncitizens, as described in section 
129.17 	256B.06, subdivision 4, paragraph (b).

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

129.21 	Sec. 59. Minnesota Statutes 2008, section 256L.05, subdivision 1, is amended to read:
129.22 		Subdivision 1.Application assistance and information availability. (a) 
129.23 	Applications and application assistance must be made available at provider offices, local 
129.24 	human services agencies, school districts, public and private elementary schools in which 
129.25 	25 percent or more of the students receive free or reduced price lunches, community health 
129.26 	offices, Women, Infants and Children (WIC) program sites, Head Start program sites, 
129.27 	public housing councils, crisis nurseries, child care centers, early childhood education 
129.28 	and preschool program sites, legal aid offices, and libraries. These sites may accept 
129.29 	applications and forward the forms to the commissioner or local county human services 
129.30 	agencies that choose to participate as an enrollment site. Otherwise, applicants may apply 
129.31 	directly to the commissioner or to participating local county human services agencies. 
129.32 	(b) Application assistance must be available for applicants choosing to file an 
129.33 	online application.

130.1 	Sec. 60. Minnesota Statutes 2008, section 256L.05, is amended by adding a subdivision 
130.2 	to read:
130.3 		Subd. 1c.Open enrollment and streamlined application and enrollment 
130.4 	process. (a) The commissioner and local agencies working in partnership must develop a 
130.5 	streamlined and efficient application and enrollment process for medical assistance and 
130.6 	MinnesotaCare enrollees that meets the criteria specified in this subdivision.
130.7 	(b) The commissioners of human services and education shall provide 
130.8 	recommendations to the legislature by January 15, 2010, on the creation of an open 
130.9 	enrollment process for medical assistance and MinnesotaCare that is coordinated with 
130.10 	the public education system. The recommendations must:
130.11 	(1) be developed in consultation with medical assistance and MinnesotaCare 
130.12 	enrollees and representatives from organizations that advocate on behalf of children and 
130.13 	families, low-income persons and minority populations, counties, school administrators 
130.14 	and nurses, health plans, and health care providers;
130.15 	 (2) be based on enrollment and renewal procedures best practices, including express 
130.16 	lane eligibility as required under subdivision 1d;
130.17 	(3) simplify the enrollment and renewal processes wherever possible; and
130.18 	(4) establish a process:
130.19 	(i) to disseminate information on medical assistance and MinnesotaCare to all 
130.20 	children in the public education system, including prekindergarten programs; and
130.21 	(ii) for the commissioner of human services to enroll children and other household 
130.22 	members who are eligible.
130.23 	The commissioner of human services in coordination with the commissioner of 
130.24 	education shall implement an open enrollment process by August 1, 2010, to be effective 
130.25 	beginning with the 2010-2011 school year.
130.26 	(c) The commissioner and local agencies shall develop an online application process 
130.27 	for medical assistance and MinnesotaCare.
130.28 	(d) The commissioner shall develop an application that is easily understandable 
130.29 	and does not exceed four pages in length.
130.30 	(e) The commissioner of human services shall present to the legislature, by January 
130.31 	15, 2010, an implementation plan for the open enrollment period and online application 
130.32 	process.

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

130.35 	Sec. 61. Minnesota Statutes 2008, section 256L.05, subdivision 3, is amended to read:
131.1 		Subd. 3.Effective date of coverage. (a) The effective date of coverage is the 
131.2 	first day of the month following the month in which eligibility is approved and the first 
131.3 	premium payment has been received. As provided in section 256B.057, coverage for 
131.4 	newborns is automatic from the date of birth and must be coordinated with other health 
131.5 	coverage. The effective date of coverage for eligible newly adoptive children added to a 
131.6 	family receiving covered health services is the month of placement. The effective date 
131.7 	of coverage for other new members added to the family is the first day of the month 
131.8 	following the month in which the change is reported. All eligibility criteria must be met 
131.9 	by the family at the time the new family member is added. The income of the new family 
131.10 	member is included with the family's gross income and the adjusted premium begins in 
131.11 	the month the new family member is added.
131.12 	(b) The initial premium must be received by the last working day of the month for 
131.13 	coverage to begin the first day of the following month.
131.14 	(c) Benefits are not available until the day following discharge if an enrollee is 
131.15 	hospitalized on the first day of coverage.
131.16 	(d) Notwithstanding any other law to the contrary, benefits under sections 256L.01 to 
131.17 	256L.18 are secondary to a plan of insurance or benefit program under which an eligible 
131.18 	person may have coverage and the commissioner shall use cost avoidance techniques to 
131.19 	ensure coordination of any other health coverage for eligible persons. The commissioner 
131.20 	shall identify eligible persons who may have coverage or benefits under other plans of 
131.21 	insurance or who become eligible for medical assistance.
131.22 	(e) The effective date of coverage for single adults and households with no children 
131.23 	formerly enrolled in general assistance medical care and enrolled in MinnesotaCare 
131.24 	according to section 256D.03, subdivision 3, is the first day of the month following the 
131.25 	last day of general assistance medical care coverage.
131.26 	(f) The effective date of coverage for children eligible under section 256L.07, 
131.27 	subdivision 8, is the first day of the month following the date of termination from foster 
131.28 	care or release from a juvenile residential correctional facility.

131.29 	EFFECTIVE DATE. This section is effective July 1, 2009, or upon federal 
131.30 	approval, whichever is later.

131.31 	Sec. 62. Minnesota Statutes 2008, section 256L.05, subdivision 3a, is amended to read:
131.32 		Subd. 3a.Renewal of eligibility. (a) Beginning July 1, 2007, an enrollee's eligibility 
131.33 	must be renewed every 12 months. The 12-month period begins in the month after the 
131.34 	month the application is approved.
132.1 	(b) Each new period of eligibility must take into account any changes in 
132.2 	circumstances that impact eligibility and premium amount. An enrollee must provide all 
132.3 	the information needed to redetermine eligibility by the first day of the month that ends 
132.4 	the eligibility period. If there is no change in circumstances, the enrollee may renew 
132.5 	eligibility at designated locations that include community clinics and health care providers' 
132.6 	offices. The designated sites shall forward the renewal forms to the commissioner. The 
132.7 	commissioner may establish criteria and timelines for sites to forward applications to the 
132.8 	commissioner or county agencies. The premium for the new period of eligibility must be 
132.9 	received as provided in section 256L.06 in order for eligibility to continue.
132.10 	(c) For single adults and households with no children formerly enrolled in general 
132.11 	assistance medical care and enrolled in MinnesotaCare according to section 256D.03, 
132.12 	subdivision 3, the first period of eligibility begins the month the enrollee submitted the 
132.13 	application or renewal for general assistance medical care.
132.14 	(d) An enrolleeNotwithstanding paragraph (e), an enrollee who fails to submit 
132.15 	renewal forms and related documentation necessary for verification of continued eligibility 
132.16 	in a timely manner shall remain eligible for one additional month beyond the end of the 
132.17 	current eligibility period before being disenrolled. The enrollee remains responsible for 
132.18 	MinnesotaCare premiums for the additional month.
132.19 	(e) Children in families with family income equal to or below 275 percent of federal 
132.20 	poverty guidelines who fail to submit renewal forms and related documentation necessary 
132.21 	for verification of continued eligibility in a timely manner shall remain eligible for the 
132.22 	program. The commissioner shall use the means described in subdivision 2 or any other 
132.23 	means available to verify family income. If the commissioner determines that there has 
132.24 	been a change in income in which premium payment is required to remain enrolled, the 
132.25 	commissioner shall notify the family of the premium payment, and that the children 
132.26 	will be disenrolled if the premium payment is not received effective the first day of the 
132.27 	calendar month following the calendar month for which the premium is due.
132.28 	(f) For children enrolled in MinnesotaCare under section 256L.07, subdivision 8, the 
132.29 	first period of renewal begins the month the enrollee turns 21 years of age.

132.30 	EFFECTIVE DATE. This section is effective July 1, 2009, or upon federal 
132.31 	approval, whichever is later.

132.32 	Sec. 63. Minnesota Statutes 2008, section 256L.07, subdivision 1, is amended to read:
132.33 		Subdivision 1.General requirements. (a) Children enrolled in the original 
132.34 	children's health plan as of September 30, 1992, children who enrolled in the 
132.35 	MinnesotaCare program after September 30, 1992, pursuant to Laws 1992, chapter 549, 
133.1 	article 4, section 17, and children who have family gross incomes that are equal to or 
133.2 	less than 150200 percent of the federal poverty guidelines are eligible without meeting 
133.3 	the requirements of subdivision 2 and the four-month requirement in subdivision 3, as 
133.4 	long as they maintain continuous coverage in the MinnesotaCare program or medical 
133.5 	assistance. Children who apply for MinnesotaCare on or after the implementation date 
133.6 	of the employer-subsidized health coverage program as described in Laws 1998, chapter 
133.7 	407, article 5, section 45, who have family gross incomes that are equal to or less than 150 
133.8 	percent of the federal poverty guidelines, must meet the requirements of subdivision 2 to 
133.9 	be eligible for MinnesotaCare.
133.10 	FamiliesParents enrolled in MinnesotaCare under section 256L.04, subdivision 1, 
133.11 	whose income increases above 275 percent of the federal poverty guidelines, are no longer 
133.12 	eligible for the program and shall be disenrolled by the commissioner. Beginning January 
133.13 	1, 2008, individuals enrolled in MinnesotaCare under section 256L.04, subdivision 
133.14 	7, whose income increases above 200 percent of the federal poverty guidelines or 250 
133.15 	percent of the federal poverty guidelines on or after July 1, 2009, are no longer eligible for 
133.16 	the program and shall be disenrolled by the commissioner. For persons disenrolled under 
133.17 	this subdivision, MinnesotaCare coverage terminates the last day of the calendar month 
133.18 	following the month in which the commissioner determines that the income of a family or 
133.19 	individual exceeds program income limits.
133.20 	(b) Notwithstanding paragraph (a), Children may remain enrolled in MinnesotaCare 
133.21 	if ten percent of their gross individual or gross family income as defined in section 
133.22 	256L.01, subdivision 4, is less than the annual premium for a policy with a $500 
133.23 	deductible available through the Minnesota Comprehensive Health Association. Children 
133.24 	who are no longer eligible for MinnesotaCare under this clause shall be given a 12-month 
133.25 	notice period from the date that ineligibility is determined before disenrollment greater 
133.26 	than 275 percent of federal poverty guidelines. The premium for children remaining 
133.27 	eligible under this clauseparagraph shall be the maximum premium determined under 
133.28 	section 256L.15, subdivision 2, paragraph (b).
133.29 	(c) Notwithstanding paragraphsparagraph (a) and (b), parents are not eligible for 
133.30 	MinnesotaCare if gross household income exceeds $57,500 for the 12-month period 
133.31 	of eligibility.

133.32 	EFFECTIVE DATE. This section is effective July 1, 2009, or upon federal 
133.33 	approval, whichever is later.

133.34 	Sec. 64. Minnesota Statutes 2008, section 256L.07, subdivision 2, is amended to read:
134.1 		Subd. 2.Must not have access to employer-subsidized coverage. (a) To be 
134.2 	eligible, a family or individual must not have access to subsidized health coverage through 
134.3 	an employer and must not have had access to employer-subsidized coverage through 
134.4 	a current employer for 18 months prior to application or reapplication. A family or 
134.5 	individual whose employer-subsidized coverage is lost due to an employer terminating 
134.6 	health care coverage as an employee benefit during the previous 18 months is not eligible.
134.7 	(b) This subdivision does not apply to a family or individual who was enrolled 
134.8 	in MinnesotaCare within six months or less of reapplication and who no longer has 
134.9 	employer-subsidized coverage due to the employer terminating health care coverage as an 
134.10 	employee benefit. This subdivision does not apply to children with family gross incomes 
134.11 	that are equal to or less than 200 percent of federal poverty guidelines.
134.12 	(c) For purposes of this requirement, subsidized health coverage means health 
134.13 	coverage for which the employer pays at least 50 percent of the cost of coverage for 
134.14 	the employee or dependent, or a higher percentage as specified by the commissioner. 
134.15 	Children are eligible for employer-subsidized coverage through either parent, including 
134.16 	the noncustodial parent. The commissioner must treat employer contributions to Internal 
134.17 	Revenue Code Section 125 plans and any other employer benefits intended to pay 
134.18 	health care costs as qualified employer subsidies toward the cost of health coverage for 
134.19 	employees for purposes of this subdivision.

134.20 	EFFECTIVE DATE. This section is effective July 1, 2009, or upon federal 
134.21 	approval, whichever is later.

134.22 	Sec. 65. Minnesota Statutes 2008, section 256L.07, subdivision 3, is amended to read:
134.23 		Subd. 3.Other health coverage. (a) Families and individuals enrolled in the 
134.24 	MinnesotaCare program must have no health coverage while enrolled or for at least four 
134.25 	months prior to application and renewal. Children with family gross incomes equal to or 
134.26 	greater than 200 percent of federal poverty guidelines, and adults, must have had no health 
134.27 	coverage for at least four months prior to application and renewal. Children enrolled in the 
134.28 	original children's health plan and children in families with income equal to or less than 
134.29 	150200 percent of the federal poverty guidelines, who have other health insurance, are 
134.30 	eligible if the coverage:
134.31 	(1) lacks two or more of the following:
134.32 	(i) basic hospital insurance;
134.33 	(ii) medical-surgical insurance;
134.34 	(iii) prescription drug coverage;
134.35 	(iv) dental coverage; or
135.1 	(v) vision coverage;
135.2 	(2) requires a deductible of $100 or more per person per year; or
135.3 	(3) lacks coverage because the child has exceeded the maximum coverage for a 
135.4 	particular diagnosis or the policy excludes a particular diagnosis.
135.5 	The commissioner may change this eligibility criterion for sliding scale premiums 
135.6 	in order to remain within the limits of available appropriations. The requirement of no 
135.7 	health coverage does not apply to newborns.
135.8 	(b) Medical assistance, general assistance medical care, and the Civilian Health and 
135.9 	Medical Program of the Uniformed Service, CHAMPUS, or other coverage provided under 
135.10 	United States Code, title 10, subtitle A, part II, chapter 55, are not considered insurance or 
135.11 	health coverage for purposes of the four-month requirement described in this subdivision.
135.12 	(c) For purposes of this subdivision, an applicant or enrollee who is entitled to 
135.13 	Medicare Part A or enrolled in Medicare Part B coverage under title XVIII of the Social 
135.14 	Security Act, United States Code, title 42, sections 1395c to 1395w-152, is considered to 
135.15 	have health coverage. An applicant or enrollee who is entitled to premium-free Medicare 
135.16 	Part A may not refuse to apply for or enroll in Medicare coverage to establish eligibility 
135.17 	for MinnesotaCare.
135.18 	(d) Applicants who were recipients of medical assistance or general assistance 
135.19 	medical care within one month of application must meet the provisions of this subdivision 
135.20 	and subdivision 2.
135.21 	(e) Cost-effective health insurance that was paid for by medical assistance is not 
135.22 	considered health coverage for purposes of the four-month requirement under this 
135.23 	section, except if the insurance continued after medical assistance no longer considered it 
135.24 	cost-effective or after medical assistance closed.

135.25 	EFFECTIVE DATE. This section is effective July 1, 2009, or upon federal 
135.26 	approval, whichever is later.

135.27 	Sec. 66. Minnesota Statutes 2008, section 256L.07, is amended by adding a subdivision 
135.28 	to read:
135.29 		Subd. 8.Automatic eligibility for certain children. Any child who was residing 
135.30 	in foster care or a juvenile residential correctional facility on the child's 18th birthday is 
135.31 	automatically deemed eligible for MinnesotaCare upon termination or release until the 
135.32 	child reaches the age of 21, and is exempt from the requirements of this section and 
135.33 	section 256L.15. To be enrolled under this section, a child must complete an initial 
135.34 	application for MinnesotaCare. The commissioner shall contact individuals enrolled 
136.1 	under this section annually to ensure the individual continues to reside in the state and is 
136.2 	interested in continuing MinnesotaCare coverage.

136.3 	EFFECTIVE DATE. This section is effective July 1, 2009, or upon federal 
136.4 	approval, whichever is later.

136.5 	Sec. 67. Minnesota Statutes 2008, section 256L.11, subdivision 1, is amended to read:
136.6 		Subdivision 1.Medical assistance rate to be used. (a) Payment to providers under 
136.7 	sections 256L.01 to 256L.11 shall be at the same rates and conditions established for 
136.8 	medical assistance, except as provided in subdivisions 2 to 6. 
136.9 	(b) Effective for services provided on or after July 1, 2009, total payments for basic 
136.10 	care services shall be reduced by three percent, in accordance with section 256B.766. 
136.11 	Payments made to managed care plans shall be reduced for services provided on or after 
136.12 	October 1, 2009, to reflect this reduction.

136.13 	Sec. 68. Minnesota Statutes 2008, section 256L.15, subdivision 2, is amended to read:
136.14 		Subd. 2.Sliding fee scale; monthly gross individual or family income. (a) The 
136.15 	commissioner shall establish a sliding fee scale to determine the percentage of monthly 
136.16 	gross individual or family income that households at different income levels must pay to 
136.17 	obtain coverage through the MinnesotaCare program. The sliding fee scale must be based 
136.18 	on the enrollee's monthly gross individual or family income. The sliding fee scale must 
136.19 	contain separate tables based on enrollment of one, two, or three or more persons. Until 
136.20 	June 30, 2009, the sliding fee scale begins with a premium of 1.5 percent of monthly gross 
136.21 	individual or family income for individuals or families with incomes below the limits for 
136.22 	the medical assistance program for families and children in effect on January 1, 1999, and 
136.23 	proceeds through the following evenly spaced steps: 1.8, 2.3, 3.1, 3.8, 4.8, 5.9, 7.4, and 
136.24 	8.8 percent. These percentages are matched to evenly spaced income steps ranging from 
136.25 	the medical assistance income limit for families and children in effect on January 1, 1999, 
136.26 	to 275 percent of the federal poverty guidelines for the applicable family size, up to a 
136.27 	family size of five. The sliding fee scale for a family of five must be used for families of 
136.28 	more than five. The sliding fee scale and percentages are not subject to the provisions of 
136.29 	chapter 14. If a family or individual reports increased income after enrollment, premiums 
136.30 	shall be adjusted at the time the change in income is reported.
136.31 	(b) Children in families whose gross income is above 275 percent of the federal 
136.32 	poverty guidelines shall pay the maximum premium. The maximum premium is defined 
136.33 	as a base charge for one, two, or three or more enrollees so that if all MinnesotaCare 
136.34 	cases paid the maximum premium, the total revenue would equal the total cost of 
137.1 	MinnesotaCare medical coverage and administration. In this calculation, administrative 
137.2 	costs shall be assumed to equal ten percent of the total. The costs of medical coverage 
137.3 	for pregnant women and children under age two and the enrollees in these groups shall 
137.4 	be excluded from the total. The maximum premium for two enrollees shall be twice the 
137.5 	maximum premium for one, and the maximum premium for three or more enrollees shall 
137.6 	be three times the maximum premium for one.
137.7 	(c) Beginning July 1, 2009, MinnesotaCare enrollees shall pay premiums according 
137.8 	to the premium scale specified in paragraph (d) with the exception that children in families 
137.9 	with income at or below 150200 percent of the federal poverty guidelines shall pay 
137.10 	a monthly premium of $4 no premiums. For purposes of paragraph (d), "minimum" 
137.11 	means a monthly premium of $4.
137.12 	(d) The following premium scale is established for individuals and families with 
137.13 	gross family incomes of 300 percent of the federal poverty guidelines or less:

137.14
137.15	Federal Poverty Guideline Range
	Percent of Average Gross Monthly 
Income
	
137.16	0-45%
	minimum
	
137.17	46-54%
	1.1%
	
137.18	55-81%
	1.6%
	
137.19	82-109%
	2.2%
	
137.20	110-136%
	2.9%
	
137.21	137-164%
	3.6%
	
137.22	165-191%
	4.6%
	
137.23	192-219%
	5.6%
	
137.24	220-248%
	6.5%
	
137.25	249-274%
	7.2%
	
137.26	275-300%
	8.0%

137.27 	EFFECTIVE DATE. This section is effective July 1, 2009, or upon federal 
137.28 	approval, whichever is later.

137.29 	Sec. 69. Minnesota Statutes 2008, section 256L.15, subdivision 3, is amended to read:
137.30 		Subd. 3.Exceptions to sliding scale. Children in families with income at or below 
137.31 	150200 percent of the federal poverty guidelines shall pay ano monthly premium of 
137.32 	$4 premiums.

137.33 	EFFECTIVE DATE. This section is effective July 1, 2009, or upon federal 
137.34 	approval, whichever is later.

137.35 	Sec. 70. Minnesota Statutes 2008, section 256L.17, subdivision 3, is amended to read:
138.1 		Subd. 3.Documentation. (a) The commissioner of human services shall require 
138.2 	individuals and families, at the time of application or renewal, to indicate on a checkoff
138.3 	form developed by the commissioner whether they satisfy the MinnesotaCare asset 
138.4 	requirement. 
138.5 	(b) The commissioner may require individuals and families to provide any 
138.6 	information the commissioner determines necessary to verify compliance with the asset 
138.7 	requirement, if the commissioner determines that there is reason to believe that an 
138.8 	individual or family has assets that exceed the program limit.

138.9 	Sec. 71. Minnesota Statutes 2008, section 256L.17, subdivision 5, is amended to read:
138.10 		Subd. 5.Exemption. This section does not apply to pregnant women or children. 
138.11 	For purposes of this subdivision, a woman is considered pregnant for 60 days postpartum.

138.12 	Sec. 72. Minnesota Statutes 2008, section 501B.89, is amended by adding a 
138.13 	subdivision to read:
138.14 		Subd. 4.Annual filing requirement for supplemental needs trusts. (a) A trustee 
138.15 	of a trust under subdivision 3 and United States Code, title 42, section 1396p(d)(4)(A) or 
138.16 	(C), shall submit to the commissioner of human services, at the time of a beneficiary's 
138.17 	request for medical assistance, the following information about the trust:
138.18 	(1) a copy of the trust instrument; and
138.19 	(2) an inventory of the beneficiary's trust account assets and the value of those assets.
138.20 	(b) A trustee of a trust under subdivision 3 and United States Code, title 42, section 
138.21 	1396p(d)(4)(A) or (C), shall submit an accounting of the beneficiary's trust account to the 
138.22 	commissioner of human services at least annually until the trust, or the beneficiary's 
138.23 	interest in the trust, terminates. Accountings are due on the anniversary of the execution 
138.24 	date of the trust unless another annual date is established by the terms of the trust. The 
138.25 	accounting must include the following information for the accounting period:
138.26 	(1) an inventory of trust assets and the value of those assets at the beginning of the 
138.27 	accounting period;
138.28 	(2) additions to the trust during the accounting period and the source of those 
138.29 	additions;
138.30 	(3) itemized distributions from the trust during the accounting period, including the 
138.31 	purpose of the distributions and to whom the distributions were made;
138.32 	(4) an inventory of trust assets and the value of those assets at the end of the 
138.33 	accounting period; and
138.34 	(5) changes to the trust instrument during the accounting period.
139.1 	(c) For the purpose of paragraph (b), an accounting period is 12 months unless an 
139.2 	accounting period of a different length is permitted by the commissioner.

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

139.5 	Sec. 73. Minnesota Statutes 2008, section 519.05, is amended to read:
139.6 	519.05 LIABILITY OF HUSBAND AND WIFE.
139.7 	(a) A spouse is not liable to a creditor for any debts of the other spouse. Where 
139.8 	husband and wife are living together, they shall be jointly and severally liable for 
139.9 	necessary medical services that have been furnished to either spouse, including any claims 
139.10 	arising under section 246.53, 256B.15, 256D.16, or 261.04, and necessary household 
139.11 	articles and supplies furnished to and used by the family. Notwithstanding this paragraph, 
139.12 	in a proceeding under chapter 518 the court may apportion such debt between the spouses.
139.13 	(b) Either spouse may close a credit card account or other unsecured consumer line 
139.14 	of credit on which both spouses are contractually liable, by giving written notice to the 
139.15 	creditor.

139.16 	Sec. 74. Laws 2003, First Special Session chapter 14, article 13C, section 2, subdivision 
139.17 	1, as amended by Laws 2004, chapter 272, article 2, section 2, is amended to read:

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

139.19	Summary by Fund
	
139.20	General
	3,301,811,000
	3,561,055,000
	
139.21
139.22	State Government 
Special Revenue
	534,000
	534,000
	
139.23	Health Care Access
	273,723,000
	302,272,000
	
139.24	Federal TANF
	270,425,000
	270,363,000
	
139.25	Lottery Cash Flow
	1,556,000
	1,556,000
	
139.26 	Federal Contingency Appropriation. (a) 
139.27 	Federal Medicaid funds made available 
139.28 	under title IV of the federal Jobs and Growth 
139.29 	Tax Relief Reconciliation Act of 2003 
139.30 	are appropriated to the commissioner of 
139.31 	human services for use in the state's medical 
139.32 	assistance and MinnesotaCare programs. 
139.33 	The commissioners of human services and 
139.34 	finance shall report to the legislative advisory 
140.1 	committee on the additional federal Medicaid 
140.2 	matching funds that will be available to the 
140.3 	state.
140.4 	(b) Because of the availability of these funds, 
140.5 	the following policies shall become effective:
140.6 	(1) medical assistance and MinnesotaCare 
140.7 	eligibility and local financial participation 
140.8 	changes provided for in this act may be 
140.9 	implemented prior to September 2, 2003, or 
140.10 	may be delayed as necessary to maximize 
140.11 	the use of federal funds received under 
140.12 	title IV of the Jobs and Growth Tax Relief 
140.13 	Reconciliation Act of 2003;
140.14 	(2) the aggregate cap on the services 
140.15 	identified in Minnesota Statutes, section 
140.16 	256L.035, paragraph (a), clause (3), shall 
140.17 	be increased from $2,000 to $5,000. This 
140.18 	increase shall expire at the end of fiscal year 
140.19 	2007. Funds may be transferred from the 
140.20 	general fund to the health care access fund as 
140.21 	necessary to implement this provision; and
140.22 	(3) the following payment shifts shall not be 
140.23 	implemented:
140.24 	(i) MFIP payment shift found in subdivision 
140.25 	11;
140.26 	(ii) the county payment shift found in 
140.27 	subdivision 1; and
140.28 	(iii) the delay in medical assistance 
140.29 	and general assistance medical care 
140.30 	fee-for-service payments found in 
140.31 	subdivision 6.
140.32 	(c) Notwithstanding section 14, paragraphs 
140.33 	(a) and (b) shall expire June 30, 2007.
141.1 	Receipts for Systems Projects.
141.2 	Appropriations and federal receipts for 
141.3 	information system projects for MAXIS, 
141.4 	PRISM, MMIS, and SSIS must be deposited 
141.5 	in the state system account authorized in 
141.6 	Minnesota Statutes, section 256.014. Money 
141.7 	appropriated for computer projects approved 
141.8 	by the Minnesota office of technology, 
141.9 	funded by the legislature, and approved 
141.10 	by the commissioner of finance may be 
141.11 	transferred from one project to another 
141.12 	and from development to operations as the 
141.13 	commissioner of human services considers 
141.14 	necessary. Any unexpended balance in 
141.15 	the appropriation for these projects does 
141.16 	not cancel but is available for ongoing 
141.17 	development and operations.
141.18 	Gifts. Notwithstanding Minnesota Statutes, 
141.19 	chapter 7, the commissioner may accept 
141.20 	on behalf of the state additional funding 
141.21 	from sources other than state funds for the 
141.22 	purpose of financing the cost of assistance 
141.23 	program grants or nongrant administration. 
141.24 	All additional funding is appropriated to the 
141.25 	commissioner for use as designated by the 
141.26 	grantor of funding.
141.27 	Systems Continuity. In the event of 
141.28 	disruption of technical systems or computer 
141.29 	operations, the commissioner may use 
141.30 	available grant appropriations to ensure 
141.31 	continuity of payments for maintaining the 
141.32 	health, safety, and well-being of clients 
141.33 	served by programs administered by the 
141.34 	department of human services. Grant funds 
141.35 	must be used in a manner consistent with the 
141.36 	original intent of the appropriation.
142.1 	Nonfederal Share Transfers. The 
142.2 	nonfederal share of activities for which 
142.3 	federal administrative reimbursement is 
142.4 	appropriated to the commissioner may be 
142.5 	transferred to the special revenue fund.
142.6 	TANF Funds Appropriated to Other 
142.7 	Entities. Any expenditures from the TANF 
142.8 	block grant shall be expended in accordance 
142.9 	with the requirements and limitations of part 
142.10 	A of title IV of the Social Security Act, as 
142.11 	amended, and any other applicable federal 
142.12 	requirement or limitation. Prior to any 
142.13 	expenditure of these funds, the commissioner 
142.14 	shall assure that funds are expended in 
142.15 	compliance with the requirements and 
142.16 	limitations of federal law and that any 
142.17 	reporting requirements of federal law are 
142.18 	met. It shall be the responsibility of any entity 
142.19 	to which these funds are appropriated to 
142.20 	implement a memorandum of understanding 
142.21 	with the commissioner that provides the 
142.22 	necessary assurance of compliance prior to 
142.23 	any expenditure of funds. The commissioner 
142.24 	shall receipt TANF funds appropriated 
142.25 	to other state agencies and coordinate all 
142.26 	related interagency accounting transactions 
142.27 	necessary to implement these appropriations. 
142.28 	Unexpended TANF funds appropriated to 
142.29 	any state, local, or nonprofit entity cancel 
142.30 	at the end of the state fiscal year unless 
142.31 	appropriating language permits otherwise.
142.32 	TANF Funds Transferred to Other Federal 
142.33 	Grants. The commissioner must authorize 
142.34 	transfers from TANF to other federal block 
142.35 	grants so that funds are available to meet the 
142.36 	annual expenditure needs as appropriated. 
143.1 	Transfers may be authorized prior to the 
143.2 	expenditure year with the agreement of the 
143.3 	receiving entity. Transferred funds must be 
143.4 	expended in the year for which the funds 
143.5 	were appropriated unless appropriation 
143.6 	language permits otherwise. In accelerating 
143.7 	transfer authorizations, the commissioner 
143.8 	must aim to preserve the future potential 
143.9 	transfer capacity from TANF to other block 
143.10 	grants.
143.11 	TANF Maintenance of Effort. (a) In 
143.12 	order to meet the basic maintenance of 
143.13 	effort (MOE) requirements of the TANF 
143.14 	block grant specified under Code of Federal 
143.15 	Regulations, title 45, section 263.1, the 
143.16 	commissioner may only report nonfederal 
143.17 	money expended for allowable activities 
143.18 	listed in the following clauses as TANF/MOE 
143.19 	expenditures:
143.20 	(1) MFIP cash, diversionary work program, 
143.21 	and food assistance benefits under Minnesota 
143.22 	Statutes, chapter 256J;
143.23 	(2) the child care assistance programs 
143.24 	under Minnesota Statutes, sections 119B.03
143.25 	and 119B.05, and county child care 
143.26 	administrative costs under Minnesota 
143.27 	Statutes, section 119B.15;
143.28 	(3) state and county MFIP administrative 
143.29 	costs under Minnesota Statutes, chapters 
143.30 	256J and 256K;
143.31 	(4) state, county, and tribal MFIP 
143.32 	employment services under Minnesota 
143.33 	Statutes, chapters 256J and 256K;
143.34 	(5) expenditures made on behalf of 
143.35 	noncitizen MFIP recipients who qualify 
144.1 	for the medical assistance without federal 
144.2 	financial participation program under 
144.3 	Minnesota Statutes, section 256B.06, 
144.4 	subdivision 4, paragraphs (d), (e), and (j); 
144.5 	and
144.6 	(6) qualifying working family credit 
144.7 	expenditures under Minnesota Statutes, 
144.8 	section 290.0671.
144.9 	(b) The commissioner shall ensure that 
144.10 	sufficient qualified nonfederal expenditures 
144.11 	are made each year to meet the state's 
144.12 	TANF/MOE requirements. For the activities 
144.13 	listed in paragraph (a), clauses (2) to 
144.14 	(6), the commissioner may only report 
144.15 	expenditures that are excluded from the 
144.16 	definition of assistance under Code of 
144.17 	Federal Regulations, title 45, section 260.31.
144.18 	(c) By August 31 of each year, the 
144.19 	commissioner shall make a preliminary 
144.20 	calculation to determine the likelihood 
144.21 	that the state will meet its annual federal 
144.22 	work participation requirement under Code 
144.23 	of Federal Regulations, title 45, sections 
144.24 	261.21 and 261.23, after adjustment for any 
144.25 	caseload reduction credit under Code of 
144.26 	Federal Regulations, title 45, section 261.41. 
144.27 	If the commissioner determines that the 
144.28 	state will meet its federal work participation 
144.29 	rate for the federal fiscal year ending that 
144.30 	September, the commissioner may reduce the 
144.31 	expenditure under paragraph (a), clause (1), 
144.32 	to the extent allowed under Code of Federal 
144.33 	Regulations, title 45, section 263.1(a)(2).
144.34 	(d) For fiscal years beginning with state 
144.35 	fiscal year 2003, the commissioner shall 
145.1 	assure that the maintenance of effort used 
145.2 	by the commissioner of finance for the 
145.3 	February and November forecasts required 
145.4 	under Minnesota Statutes, section 16A.103, 
145.5 	contains expenditures under paragraph (a), 
145.6 	clause (1), equal to at least 25 percent of 
145.7 	the total required under Code of Federal 
145.8 	Regulations, title 45, section 263.1.
145.9 	(e) If nonfederal expenditures for the 
145.10 	programs and purposes listed in paragraph 
145.11 	(a) are insufficient to meet the state's 
145.12 	TANF/MOE requirements, the commissioner 
145.13 	shall recommend additional allowable 
145.14 	sources of nonfederal expenditures to the 
145.15 	legislature, if the legislature is or will be in 
145.16 	session to take action to specify additional 
145.17 	sources of nonfederal expenditures for 
145.18 	TANF/MOE before a federal penalty is 
145.19 	imposed. The commissioner shall otherwise 
145.20 	provide notice to the legislative commission 
145.21 	on planning and fiscal policy under paragraph 
145.22 	(g).
145.23 	(f) If the commissioner uses authority 
145.24 	granted under section 11, or similar authority 
145.25 	granted by a subsequent legislature, to 
145.26 	meet the state's TANF/MOE requirement 
145.27 	in a reporting period, the commissioner 
145.28 	shall inform the chairs of the appropriate 
145.29 	legislative committees about all transfers 
145.30 	made under that authority for this purpose.
145.31 	(g) If the commissioner determines that 
145.32 	nonfederal expenditures under paragraph 
145.33 	(a) are insufficient to meet TANF/MOE 
145.34 	expenditure requirements, and if the 
145.35 	legislature is not or will not be in 
146.1 	session to take timely action to avoid a 
146.2 	federal penalty, the commissioner may 
146.3 	report nonfederal expenditures from 
146.4 	other allowable sources as TANF/MOE 
146.5 	expenditures after the requirements of this 
146.6 	paragraph are met. The commissioner 
146.7 	may report nonfederal expenditures 
146.8 	in addition to those specified under 
146.9 	paragraph (a) as nonfederal TANF/MOE 
146.10 	expenditures, but only ten days after the 
146.11 	commissioner of finance has first submitted 
146.12 	the commissioner's recommendations for 
146.13 	additional allowable sources of nonfederal 
146.14 	TANF/MOE expenditures to the members of 
146.15 	the legislative commission on planning and 
146.16 	fiscal policy for their review.
146.17 	(h) The commissioner of finance shall not 
146.18 	incorporate any changes in federal TANF 
146.19 	expenditures or nonfederal expenditures for 
146.20 	TANF/MOE that may result from reporting 
146.21 	additional allowable sources of nonfederal 
146.22 	TANF/MOE expenditures under the interim 
146.23 	procedures in paragraph (g) into the February 
146.24 	or November forecasts required under 
146.25 	Minnesota Statutes, section 16A.103, unless 
146.26 	the commissioner of finance has approved 
146.27 	the additional sources of expenditures under 
146.28 	paragraph (g).
146.29 	(i) Minnesota Statutes, section 256.011, 
146.30 	subdivision 3, which requires that federal 
146.31 	grants or aids secured or obtained under that 
146.32 	subdivision be used to reduce any direct 
146.33 	appropriations provided by law, do not apply 
146.34 	if the grants or aids are federal TANF funds.
147.1 	(j) Notwithstanding section 14, paragraph 
147.2 	(a), clauses (1) to (6), and paragraphs (b) to 
147.3 	(j) expire June 30, 2007.
147.4 	Working Family Credit Expenditures as 
147.5 	TANF MOE. The commissioner may claim 
147.6 	as TANF maintenance of effort up to the 
147.7 	following amounts of working family credit 
147.8 	expenditures for the following fiscal years:
147.9 	(1) fiscal year 2004, $7,013,000;
147.10 	(2) fiscal year 2005, $25,133,000;
147.11 	(3) fiscal year 2006, $6,942,000; and
147.12 	(4) fiscal year 2007, $6,707,000.
147.13 	Fiscal Year 2003 Appropriations 
147.14 	Carryforward. Effective the day following 
147.15 	final enactment, notwithstanding Minnesota 
147.16 	Statutes, section 16A.28, or any other law to 
147.17 	the contrary, state agencies and constitutional 
147.18 	offices may carry forward unexpended 
147.19 	and unencumbered nongrant operating 
147.20 	balances from fiscal year 2003 general fund 
147.21 	appropriations into fiscal year 2004 to offset 
147.22 	general budget reductions.
147.23 	Transfer of Grant Balances. Effective 
147.24 	the day following final enactment, the 
147.25 	commissioner of human services, with 
147.26 	the approval of the commissioner of 
147.27 	finance and after notification of the chair 
147.28 	of the senate health, human services and 
147.29 	corrections budget division and the chair 
147.30 	of the house of representatives health 
147.31 	and human services finance committee, 
147.32 	may transfer unencumbered appropriation 
147.33 	balances for the biennium ending June 30, 
147.34 	2003, in fiscal year 2003 among the MFIP, 
148.1 	MFIP child care assistance under Minnesota 
148.2 	Statutes, section 119B.05, general assistance, 
148.3 	general assistance medical care, medical 
148.4 	assistance, Minnesota supplemental aid, 
148.5 	and group residential housing programs, 
148.6 	and the entitlement portion of the chemical 
148.7 	dependency consolidated treatment fund, and 
148.8 	between fiscal years of the biennium.
148.9 	TANF Appropriation Cancellation.
148.10 	Notwithstanding the provisions of Laws 
148.11 	2000, chapter 488, article 1, section 16, 
148.12 	any prior appropriations of TANF funds 
148.13 	to the department of trade and economic 
148.14 	development or to the job skills partnership 
148.15 	board or any transfers of TANF funds from 
148.16 	another agency to the department of trade 
148.17 	and economic development or to the job 
148.18 	skills partnership board are not available 
148.19 	until expended, and if unobligated as of June 
148.20 	30, 2003, these appropriations or transfers 
148.21 	shall cancel to the TANF fund.
148.22 	Shift County Payment. The commissioner 
148.23 	shall make up to 100 percent of the 
148.24 	calendar year 2005 payments to counties for 
148.25 	developmental disabilities semi-independent 
148.26 	living services grants, developmental 
148.27 	disabilities family support grants, and 
148.28 	adult mental health grants from fiscal year 
148.29 	2006 appropriations. This is a onetime 
148.30 	payment shift. Calendar year 2006 and future 
148.31 	payments for these grants are not affected by 
148.32 	this shift. This provision expires June 30, 
148.33 	2006.
148.34 	Capitation Rate Increase. Of the health care 
148.35 	access fund appropriations to the University 
149.1 	of Minnesota in the higher education 
149.2 	omnibus appropriation bill, $2,157,000 in 
149.3 	fiscal year 2004 and $2,157,000 in fiscal year 
149.4 	2005 are to be used to increase the capitation 
149.5 	payments underfor fiscal years beginning 
149.6 	July 1, 2003, and thereafter, $2,157,000 each 
149.7 	year shall be transferred to the commissioner 
149.8 	for purposes of Minnesota Statutes, section 
149.9 	256B.69. Notwithstanding the provisions of 
149.10 	section 14, this provision shall not expire.

149.11 	Sec. 75. ASTHMA COVERAGE DEMONSTRATION PROJECT.
 149.12 		Subdivision 1.Medical assistance coverage. The commissioner of human services 
149.13 	shall establish a demonstration project to provide additional medical assistance coverage 
149.14 	for a maximum of 200 American Indian children in Minneapolis, St. Paul, and Duluth 
149.15 	who are burdened by health disparities associated with the cumulative health impact of 
149.16 	toxic environmental exposures. Under this demonstration project, the additional medical 
149.17 	assistance coverage for this population must include, but is not limited to, the following 
149.18 	durable medical equipment: high efficiency particulate air (HEPA) cleaners, HEPA 
149.19 	vacuum cleaners, allergy bed and pillow encasements, high filtration filters for forced air 
149.20 	gas furnaces, and dehumidifiers with medical tubing to connect the appliance to a floor 
149.21 	drain, if the listed item is medically necessary to reduce asthma symptoms. Provision 
149.22 	of these items must be preceded by a home environmental assessment for triggers of 
149.23 	asthma and in-home asthma education on the proper medical management of asthma by a 
149.24 	Certified Asthma Educator or public health nurse with asthma management training.
149.25 		Subd. 2.Report. (a) Two years following implementation of the medical assistance 
149.26 	coverage demonstration project established under this section, the commissioner of health, 
149.27 	in collaboration with the Department of Human Services, must report to the legislature 
149.28 	on the number of asthma-related hospital admittances that occurred in the population of 
149.29 	children described in subdivision 1, before and after implementation of the demonstration 
149.30 	project, and whether the demonstration project had an impact on asthma-related school 
149.31 	absenteeism for this population of children.
149.32 	(b) The commissioner of health must seek nonstate funding to conduct this report. 
149.33 	The reporting requirement is contingent upon the availability of nonstate funds.

149.34 	Sec. 76. CLAIMS AND UTILIZATION DATA.
 150.1 	The commissioner of human services, in consultation with the Health Services 
150.2 	Policy Committee, shall develop and provide to the legislature by December 15, 2009, a 
150.3 	methodology and any draft legislation necessary to allow for the release, upon request, of 
150.4 	summary data as defined in Minnesota Statutes, section 13.02, subdivision 19, on claims 
150.5 	and utilization for medical assistance, general assistance medical care, and MinnesotaCare 
150.6 	enrollees at no charge to the University of Minnesota Medical School, the Mayo Medical 
150.7 	School, Northwestern Health Sciences University, the Institute for Clinical Systems 
150.8 	Improvement, and other research institutions, to conduct analyses of health care outcomes 
150.9 	and treatment effectiveness, provided the research institutions do not release private or 
150.10 	nonpublic data, or data for which dissemination is prohibited by law.

150.11 	Sec. 77. ADMINISTRATION OF PUBLICLY FUNDED HEALTH CARE 
150.12 	PROGRAMS.
 150.13 	(a) The commissioner of human services, in cooperation with the representatives 
150.14 	of county human services agencies and with input from organizations that advocate on 
150.15 	behalf of families and children, shall develop a plan that, to the extent feasible, seeks to 
150.16 	align standards, income and asset methodologies, and procedures for families and children 
150.17 	under medical assistance and MinnesotaCare. The commissioner shall evaluate the impact 
150.18 	of different approaches toward alignment on the number of potential medical assistance 
150.19 	and MinnesotaCare enrollees who are families and children, and on administrative, health 
150.20 	care, and other costs to the state. The commissioner shall present recommendations to the 
150.21 	legislative committees with jurisdiction over health care by September 15, 2010.
150.22 	(b) The commissioner shall report in detail to the chair of the Health Care and 
150.23 	Human Services Finance Committee of the house of representatives and to the chair of 
150.24 	the Health and Human Services Division of the Finance Committee of the senate, prior 
150.25 	to entering into any contracts involving counties for streamlined electronic enrollment 
150.26 	and eligibility determinations for publicly funded health care programs, if such contracts 
150.27 	would require payment from either the general fund, or the health care access fund, as 
150.28 	described in Minnesota Statutes, sections 295.58 and 297I.05.

150.29 	Sec. 78. COBRA PREMIUM STATE SUBSIDY.
 150.30 		Subdivision 1.Eligibility. (a) An individual and the individual's qualified 
150.31 	beneficiaries shall be eligible for a state premium subsidy equal to 35 percent of the 
150.32 	premiums the individual is required to pay for the continuation of health care coverage 
150.33 	under COBRA, if the individual and the individual's qualified beneficiaries:
151.1 	(1) are eligible for the 65 percent COBRA continuation premium subsidy for health 
151.2 	care coverage under the American Recovery and Reinvestment Act of 2009;
151.3 	(2) elect COBRA continuation health care coverage; and
151.4 	(3) are eligible for medical assistance under Minnesota Statutes, chapter 256B; 
151.5 	general assistance medical care under Minnesota Statutes, section 256D.03; or 
151.6 	MinnesotaCare under Minnesota Statutes, chapter 256L, except for the four-month barrier 
151.7 	requirement under Minnesota Statutes, section 256L.07, subdivision 3.
151.8 	(b) Eligibility for the state subsidy shall continue for as long as the individual 
151.9 	remains eligible for the COBRA premium subsidies provided under the American 
151.10 	Recovery and Reinvestment Act of 2009.
151.11 		Subd. 2.Subsidy. (a) The commissioner of human services shall pay 35 percent of 
151.12 	the COBRA premiums that the individual must pay for continuation health care coverage 
151.13 	for the individual and the individual's qualified beneficiaries, if the individual and the 
151.14 	individual's qualified beneficiaries meet the requirements in subdivision 1.
151.15 	(b) The state subsidy payment required under this section shall be made directly to 
151.16 	the entity to which the individual is required to make COBRA premium payments.
151.17 	(c) If any eligible individual has paid either the full amount of the COBRA premiums 
151.18 	or 35 percent of the COBRA premiums before the date of enactment of this section, the 
151.19 	individual is not entitled to a reimbursement of any premium paid.
151.20 		Subd. 3.Notification. (a) All employers and plan administrators who are required to 
151.21 	provide notice to all qualified individuals under the American Recovery and Reinvestment 
151.22 	Act of 2009 must include information to qualified individuals residing in Minnesota of 
151.23 	the availability of the state subsidy available under this section. The notice shall include 
151.24 	the eligibility requirements for the state subsidy and that the individual must apply to the 
151.25 	commissioner of human services to receive the state subsidy.
151.26 	(b) The commissioner of employment and economic development must inform an 
151.27 	applicant for unemployment benefits of the availability of a state subsidy if the applicant 
151.28 	elects COBRA continuation coverage and the applicant meets the eligibility requirements 
151.29 	of this section.
151.30 		Subd. 4.Exemption. Any individual who receives a state subsidy under this 
151.31 	section is exempt from the four-month requirement under Minnesota Statutes, section 
151.32 	256L.07, subdivision 3, if the individual or the individual's qualified beneficiaries apply 
151.33 	for MinnesotaCare after the individual no longer receives COBRA continuation coverage.
151.34 		Subd. 5.Expiration. This section expires December 31, 2010.

151.35 	Sec. 79. FEDERAL APPROVAL.
 152.1 	The commissioner of human services shall resubmit for federal approval the 
152.2 	elimination of depreciation for self-employed farmers in determining income eligibility 
152.3 	for MinnesotaCare passed in Laws 2007, chapter 147, article 5, section 19.

152.4 	Sec. 80. REPEALER.
 152.5 	Minnesota Statutes 2008, sections 256.962, subdivision 7; and 256L.17, subdivision 
152.6 	6, are repealed.

152.7 	ARTICLE 6
152.8 	TECHNICAL

152.9 	Section 1. Minnesota Statutes 2008, section 144A.46, subdivision 1, is amended to 
152.10 	read:
152.11 		Subdivision 1. License required. (a) A home care provider may not operate in the 
152.12 	state without a current license issued by the commissioner of health. A home care provider 
152.13 	may hold a separate license for each class of home care licensure. 
152.14 	(b) Within ten days after receiving an application for a license, the commissioner 
152.15 	shall acknowledge receipt of the application in writing. The acknowledgment must 
152.16 	indicate whether the application appears to be complete or whether additional information 
152.17 	is required before the application will be considered complete. Within 90 days after 
152.18 	receiving a complete application, the commissioner shall either grant or deny the license. 
152.19 	If an applicant is not granted or denied a license within 90 days after submitting a 
152.20 	complete application, the license must be deemed granted. An applicant whose license has 
152.21 	been deemed granted must provide written notice to the commissioner before providing a 
152.22 	home care service. 
152.23 	(c) Each application for a home care provider license, or for a renewal of a license, 
152.24 	shall be accompanied by a fee to be set by the commissioner under section 144.122. 
152.25 	(d) The commissioner of health, in consultation with the commissioner of human 
152.26 	services, shall provide recommendations to the legislature by February 15, 2009, for 
152.27 	provider standards for personal care assistant services as described in section 256B.0655
152.28 	256B.0659. 

152.29 	Sec. 2. Minnesota Statutes 2008, section 176.011, subdivision 9, is amended to read:
152.30 		Subd. 9. Employee. "Employee" means any person who performs services for 
152.31 	another for hire including the following: 
152.32 	(1) an alien; 
152.33 	(2) a minor; 
153.1 	(3) a sheriff, deputy sheriff, police officer, firefighter, county highway engineer, and 
153.2 	peace officer while engaged in the enforcement of peace or in the pursuit or capture of a 
153.3 	person charged with or suspected of crime; 
153.4 	(4) a person requested or commanded to aid an officer in arresting or retaking a 
153.5 	person who has escaped from lawful custody, or in executing legal process, in which 
153.6 	cases, for purposes of calculating compensation under this chapter, the daily wage of the 
153.7 	person shall be the prevailing wage for similar services performed by paid employees; 
153.8 	(5) a county assessor; 
153.9 	(6) an elected or appointed official of the state, or of a county, city, town, school 
153.10 	district, or governmental subdivision in the state. An officer of a political subdivision 
153.11 	elected or appointed for a regular term of office, or to complete the unexpired portion of a 
153.12 	regular term, shall be included only after the governing body of the political subdivision 
153.13 	has adopted an ordinance or resolution to that effect; 
153.14 	(7) an executive officer of a corporation, except those executive officers excluded 
153.15 	by section 176.041; 
153.16 	(8) a voluntary uncompensated worker, other than an inmate, rendering services in 
153.17 	state institutions under the commissioners of human services and corrections similar to 
153.18 	those of officers and employees of the institutions, and whose services have been accepted 
153.19 	or contracted for by the commissioner of human services or corrections as authorized by 
153.20 	law. In the event of injury or death of the worker, the daily wage of the worker, for the 
153.21 	purpose of calculating compensation under this chapter, shall be the usual wage paid at 
153.22 	the time of the injury or death for similar services in institutions where the services are 
153.23 	performed by paid employees; 
153.24 	(9) a voluntary uncompensated worker engaged in emergency management as 
153.25 	defined in section 12.03, subdivision 4, who is: 
153.26 	(i) registered with the state or any political subdivision of it, according to the 
153.27 	procedures set forth in the state or political subdivision emergency operations plan; and 
153.28 	(ii) acting under the direction and control of, and within the scope of duties approved 
153.29 	by, the state or political subdivision. 
153.30 	The daily wage of the worker, for the purpose of calculating compensation under this 
153.31 	chapter, shall be the usual wage paid at the time of the injury or death for similar services 
153.32 	performed by paid employees; 
153.33 	(10) a voluntary uncompensated worker participating in a program established by a 
153.34 	local social services agency. For purposes of this clause, "local social services agency" 
153.35 	means any agency established under section 393.01. In the event of injury or death of the 
153.36 	worker, the wage of the worker, for the purpose of calculating compensation under this 
154.1 	chapter, shall be the usual wage paid in the county at the time of the injury or death for 
154.2 	similar services performed by paid employees working a normal day and week; 
154.3 	(11) a voluntary uncompensated worker accepted by the commissioner of natural 
154.4 	resources who is rendering services as a volunteer pursuant to section 84.089. The daily 
154.5 	wage of the worker for the purpose of calculating compensation under this chapter, shall 
154.6 	be the usual wage paid at the time of injury or death for similar services performed by 
154.7 	paid employees; 
154.8 	(12) a voluntary uncompensated worker in the building and construction industry 
154.9 	who renders services for joint labor-management nonprofit community service projects. 
154.10 	The daily wage of the worker for the purpose of calculating compensation under this 
154.11 	chapter shall be the usual wage paid at the time of injury or death for similar services 
154.12 	performed by paid employees; 
154.13 	(13) a member of the military forces, as defined in section 190.05, while in state 
154.14 	active service, as defined in section 190.05, subdivision 5a. The daily wage of the member 
154.15 	for the purpose of calculating compensation under this chapter shall be based on the 
154.16 	member's usual earnings in civil life. If there is no evidence of previous occupation or 
154.17 	earning, the trier of fact shall consider the member's earnings as a member of the military 
154.18 	forces; 
154.19 	(14) a voluntary uncompensated worker, accepted by the director of the Minnesota 
154.20 	Historical Society, rendering services as a volunteer, pursuant to chapter 138. The daily 
154.21 	wage of the worker, for the purposes of calculating compensation under this chapter, 
154.22 	shall be the usual wage paid at the time of injury or death for similar services performed 
154.23 	by paid employees; 
154.24 	(15) a voluntary uncompensated worker, other than a student, who renders services 
154.25 	at the Minnesota State Academy for the Deaf or the Minnesota State Academy for the 
154.26 	Blind, and whose services have been accepted or contracted for by the commissioner of 
154.27 	education, as authorized by law. In the event of injury or death of the worker, the daily 
154.28 	wage of the worker, for the purpose of calculating compensation under this chapter, shall 
154.29 	be the usual wage paid at the time of the injury or death for similar services performed in 
154.30 	institutions by paid employees; 
154.31 	(16) a voluntary uncompensated worker, other than a resident of the veterans home, 
154.32 	who renders services at a Minnesota veterans home, and whose services have been 
154.33 	accepted or contracted for by the commissioner of veterans affairs, as authorized by law. 
154.34 	In the event of injury or death of the worker, the daily wage of the worker, for the purpose 
154.35 	of calculating compensation under this chapter, shall be the usual wage paid at the time of 
154.36 	the injury or death for similar services performed in institutions by paid employees; 
155.1 	(17) a worker performing services under section 256B.0655256B.0659 for a 
155.2 	recipient in the home of the recipient or in the community under section 256B.0625, 
155.3 	subdivision 19a, who is paid from government funds through a fiscal intermediary under 
155.4 	section 256B.0655, subdivision 7 256B.0659, subdivision 33. For purposes of maintaining 
155.5 	workers' compensation insurance, the employer of the worker is as designated in law 
155.6 	by the commissioner of the Department of Human Services, notwithstanding any other 
155.7 	law to the contrary;
155.8 	(18) students enrolled in and regularly attending the Medical School of the 
155.9 	University of Minnesota in the graduate school program or the postgraduate program. The 
155.10 	students shall not be considered employees for any other purpose. In the event of the 
155.11 	student's injury or death, the weekly wage of the student for the purpose of calculating 
155.12 	compensation under this chapter, shall be the annualized educational stipend awarded to 
155.13 	the student, divided by 52 weeks. The institution in which the student is enrolled shall 
155.14 	be considered the "employer" for the limited purpose of determining responsibility for 
155.15 	paying benefits under this chapter; 
155.16 	(19) a faculty member of the University of Minnesota employed for an academic 
155.17 	year is also an employee for the period between that academic year and the succeeding 
155.18 	academic year if: 
155.19 	(a) the member has a contract or reasonable assurance of a contract from the 
155.20 	University of Minnesota for the succeeding academic year; and 
155.21 	(b) the personal injury for which compensation is sought arises out of and in the 
155.22 	course of activities related to the faculty member's employment by the University of 
155.23 	Minnesota; 
155.24 	(20) a worker who performs volunteer ambulance driver or attendant services is an 
155.25 	employee of the political subdivision, nonprofit hospital, nonprofit corporation, or other 
155.26 	entity for which the worker performs the services. The daily wage of the worker for the 
155.27 	purpose of calculating compensation under this chapter shall be the usual wage paid at the 
155.28 	time of injury or death for similar services performed by paid employees; 
155.29 	(21) a voluntary uncompensated worker, accepted by the commissioner of 
155.30 	administration, rendering services as a volunteer at the Department of Administration. In 
155.31 	the event of injury or death of the worker, the daily wage of the worker, for the purpose of 
155.32 	calculating compensation under this chapter, shall be the usual wage paid at the time of the 
155.33 	injury or death for similar services performed in institutions by paid employees; 
155.34 	(22) a voluntary uncompensated worker rendering service directly to the Pollution 
155.35 	Control Agency. The daily wage of the worker for the purpose of calculating compensation 
156.1 	payable under this chapter is the usual going wage paid at the time of injury or death for 
156.2 	similar services if the services are performed by paid employees; 
156.3 	(23) a voluntary uncompensated worker while volunteering services as a first 
156.4 	responder or as a member of a law enforcement assistance organization while acting 
156.5 	under the supervision and authority of a political subdivision. The daily wage of the 
156.6 	worker for the purpose of calculating compensation payable under this chapter is the 
156.7 	usual going wage paid at the time of injury or death for similar services if the services 
156.8 	are performed by paid employees; 
156.9 	(24) a voluntary uncompensated member of the civil air patrol rendering service on 
156.10 	the request and under the authority of the state or any of its political subdivisions. The 
156.11 	daily wage of the member for the purposes of calculating compensation payable under this 
156.12 	chapter is the usual going wage paid at the time of injury or death for similar services if 
156.13 	the services are performed by paid employees; and 
156.14 	(25) a Minnesota Responds Medical Reserve Corps volunteer, as provided in 
156.15 	sections 145A.04 and 145A.06, responding at the request of or engaged in training 
156.16 	conducted by the commissioner of health. The daily wage of the volunteer for the purposes 
156.17 	of calculating compensation payable under this chapter is established in section 145A.06. 
156.18 	A person who qualifies under this clause and who may also qualify under another clause 
156.19 	of this subdivision shall receive benefits in accordance with this clause. 
156.20 	If it is difficult to determine the daily wage as provided in this subdivision, the trier 
156.21 	of fact may determine the wage upon which the compensation is payable. 

156.22 	Sec. 3. Minnesota Statutes 2008, section 245C.03, subdivision 2, is amended to read:
156.23 		Subd. 2.Personal care provider organizations. The commissioner shall conduct 
156.24 	background studies on any individual required under sections 256B.0651and 256B.0653
156.25 	to 256B.0656and 256B.0659 to have a background study completed under this chapter.

156.26 	Sec. 4. Minnesota Statutes 2008, section 245C.04, subdivision 3, is amended to read:
156.27 		Subd. 3.Personal care provider organizations. (a) The commissioner shall 
156.28 	conduct a background study of an individual required to be studied under section 245C.03, 
156.29 	subdivision 2, at least upon application for initial enrollment under sections 256B.0651
156.30 	and 256B.0653 to 256B.0656 and 256B.0659.
156.31 	(b) Organizations required to initiate background studies under sections 256B.0651
156.32 	and 256B.0653 to 256B.0656and 256B.0659 for individuals described in section 245C.03, 
156.33 	subdivision 2, must submit a completed background study form to the commissioner 
157.1 	before those individuals begin a position allowing direct contact with persons served 
157.2 	by the organization.

157.3 	Sec. 5. Minnesota Statutes 2008, section 245C.10, subdivision 3, is amended to read:
157.4 		Subd. 3.Personal care provider organizations. The commissioner shall recover 
157.5 	the cost of background studies initiated by a personal care provider organization under 
157.6 	sections 256B.0651and 256B.0653 to 256B.0656and 256B.0659 through a fee of no 
157.7 	more than $20 per study charged to the organization responsible for submitting the 
157.8 	background study form. The fees collected under this subdivision are appropriated to the 
157.9 	commissioner for the purpose of conducting background studies.

157.10 	Sec. 6. Minnesota Statutes 2008, section 256B.04, subdivision 16, is amended to read:
157.11 		Subd. 16. Personal care services. (a) Notwithstanding any contrary language in 
157.12 	this paragraph, the commissioner of human services and the commissioner of health shall 
157.13 	jointly promulgate rules to be applied to the licensure of personal care services provided 
157.14 	under the medical assistance program. The rules shall consider standards for personal care 
157.15 	services that are based on the World Institute on Disability's recommendations regarding 
157.16 	personal care services. These rules shall at a minimum consider the standards and 
157.17 	requirements adopted by the commissioner of health under section 144A.45, which the 
157.18 	commissioner of human services determines are applicable to the provision of personal 
157.19 	care services, in addition to other standards or modifications which the commissioner of 
157.20 	human services determines are appropriate. 
157.21 	The commissioner of human services shall establish an advisory group including 
157.22 	personal care consumers and providers to provide advice regarding which standards or 
157.23 	modifications should be adopted. The advisory group membership must include not less 
157.24 	than 15 members, of which at least 60 percent must be consumers of personal care services 
157.25 	and representatives of recipients with various disabilities and diagnoses and ages. At least 
157.26 	51 percent of the members of the advisory group must be recipients of personal care. 
157.27 	The commissioner of human services may contract with the commissioner of health 
157.28 	to enforce the jointly promulgated licensure rules for personal care service providers. 
157.29 	Prior to final promulgation of the joint rule the commissioner of human services 
157.30 	shall report preliminary findings along with any comments of the advisory group and a 
157.31 	plan for monitoring and enforcement by the Department of Health to the legislature by 
157.32 	February 15, 1992. 
157.33 	Limits on the extent of personal care services that may be provided to an individual 
157.34 	must be based on the cost-effectiveness of the services in relation to the costs of inpatient 
158.1 	hospital care, nursing home care, and other available types of care. The rules must 
158.2 	provide, at a minimum: 
158.3 	(1) that agencies be selected to contract with or employ and train staff to provide and 
158.4 	supervise the provision of personal care services; 
158.5 	(2) that agencies employ or contract with a qualified applicant that a qualified 
158.6 	recipient proposes to the agency as the recipient's choice of assistant; 
158.7 	(3) that agencies bill the medical assistance program for a personal care service 
158.8 	by a personal care assistant and supervision by a qualified professional supervising the 
158.9 	personal care assistant unless the recipient selects the fiscal agent option under section 
158.10 	256B.0655, subdivision 7 256B.0659, subdivision 33; 
158.11 	(4) that agencies establish a grievance mechanism; and 
158.12 	(5) that agencies have a quality assurance program. 
158.13 	(b) The commissioner may waive the requirement for the provision of personal care 
158.14 	services through an agency in a particular county, when there are less than two agencies 
158.15 	providing services in that county and shall waive the requirement for personal care 
158.16 	assistants required to join an agency for the first time during 1993 when personal care 
158.17 	services are provided under a relative hardship waiver under Minnesota Statutes 1992, 
158.18 	section 256B.0627, subdivision 4, paragraph (b), clause (7), and at least two agencies 
158.19 	providing personal care services have refused to employ or contract with the independent 
158.20 	personal care assistant. 

158.21 	Sec. 7. Minnesota Statutes 2008, section 256B.055, subdivision 12, is amended to read:
158.22 		Subd. 12. Disabled children. (a) A person is eligible for medical assistance if the 
158.23 	person is under age 19 and qualifies as a disabled individual under United States Code, 
158.24 	title 42, section 1382c(a), and would be eligible for medical assistance under the state 
158.25 	plan if residing in a medical institution, and the child requires a level of care provided in 
158.26 	a hospital, nursing facility, or intermediate care facility for persons with developmental 
158.27 	disabilities, for whom home care is appropriate, provided that the cost to medical 
158.28 	assistance under this section is not more than the amount that medical assistance would pay 
158.29 	for if the child resides in an institution. After the child is determined to be eligible under 
158.30 	this section, the commissioner shall review the child's disability under United States Code, 
158.31 	title 42, section 1382c(a) and level of care defined under this section no more often than 
158.32 	annually and may elect, based on the recommendation of health care professionals under 
158.33 	contract with the state medical review team, to extend the review of disability and level of 
158.34 	care up to a maximum of four years. The commissioner's decision on the frequency of 
158.35 	continuing review of disability and level of care is not subject to administrative appeal 
159.1 	under section 256.045. The county agency shall send a notice of disability review to the 
159.2 	enrollee six months prior to the date the recertification of disability is due. Nothing in this 
159.3 	subdivision shall be construed as affecting other redeterminations of medical assistance 
159.4 	eligibility under this chapter and annual cost-effective reviews under this section. 
159.5 	(b) For purposes of this subdivision, "hospital" means an institution as defined 
159.6 	in section 144.696, subdivision 3, 144.55, subdivision 3, or Minnesota Rules, part 
159.7 	4640.3600, and licensed pursuant to sections 144.50 to 144.58. For purposes of this 
159.8 	subdivision, a child requires a level of care provided in a hospital if the child is determined 
159.9 	by the commissioner to need an extensive array of health services, including mental health 
159.10 	services, for an undetermined period of time, whose health condition requires frequent 
159.11 	monitoring and treatment by a health care professional or by a person supervised by a 
159.12 	health care professional, who would reside in a hospital or require frequent hospitalization 
159.13 	if these services were not provided, and the daily care needs are more complex than 
159.14 	a nursing facility level of care. 
159.15 	A child with serious emotional disturbance requires a level of care provided in a 
159.16 	hospital if the commissioner determines that the individual requires 24-hour supervision 
159.17 	because the person exhibits recurrent or frequent suicidal or homicidal ideation or 
159.18 	behavior, recurrent or frequent psychosomatic disorders or somatopsychic disorders that 
159.19 	may become life threatening, recurrent or frequent severe socially unacceptable behavior 
159.20 	associated with psychiatric disorder, ongoing and chronic psychosis or severe, ongoing 
159.21 	and chronic developmental problems requiring continuous skilled observation, or severe 
159.22 	disabling symptoms for which office-centered outpatient treatment is not adequate, and 
159.23 	which overall severely impact the individual's ability to function. 
159.24 	(c) For purposes of this subdivision, "nursing facility" means a facility which 
159.25 	provides nursing care as defined in section 144A.01, subdivision 5, licensed pursuant to 
159.26 	sections 144A.02 to 144A.10, which is appropriate if a person is in active restorative 
159.27 	treatment; is in need of special treatments provided or supervised by a licensed nurse; or 
159.28 	has unpredictable episodes of active disease processes requiring immediate judgment 
159.29 	by a licensed nurse. For purposes of this subdivision, a child requires the level of care 
159.30 	provided in a nursing facility if the child is determined by the commissioner to meet 
159.31 	the requirements of the preadmission screening assessment document under section 
159.32 	256B.0911and the home care independent rating document under section 256B.0655, 
159.33 	subdivision 4, clause (3), adjusted to address age-appropriate standards for children age 18 
159.34 	and under, pursuant to section256B.0655, subdivision 3. 
159.35 	(d) For purposes of this subdivision, "intermediate care facility for persons with 
159.36 	developmental disabilities" or "ICF/MR" means a program licensed to provide services to 
160.1 	persons with developmental disabilities under section 252.28, and chapter 245A, and a 
160.2 	physical plant licensed as a supervised living facility under chapter 144, which together 
160.3 	are certified by the Minnesota Department of Health as meeting the standards in Code of 
160.4 	Federal Regulations, title 42, part 483, for an intermediate care facility which provides 
160.5 	services for persons with developmental disabilities who require 24-hour supervision 
160.6 	and active treatment for medical, behavioral, or habilitation needs. For purposes of this 
160.7 	subdivision, a child requires a level of care provided in an ICF/MR if the commissioner 
160.8 	finds that the child has a developmental disability in accordance with section 256B.092, 
160.9 	is in need of a 24-hour plan of care and active treatment similar to persons with 
160.10 	developmental disabilities, and there is a reasonable indication that the child will need 
160.11 	ICF/MR services. 
160.12 	(e) For purposes of this subdivision, a person requires the level of care provided 
160.13 	in a nursing facility if the person requires 24-hour monitoring or supervision and a plan 
160.14 	of mental health treatment because of specific symptoms or functional impairments 
160.15 	associated with a serious mental illness or disorder diagnosis, which meet severity criteria 
160.16 	for mental health established by the commissioner and published in March 1997 as 
160.17 	the Minnesota Mental Health Level of Care for Children and Adolescents with Severe 
160.18 	Emotional Disorders. 
160.19 	(f) The determination of the level of care needed by the child shall be made by 
160.20 	the commissioner based on information supplied to the commissioner by the parent or 
160.21 	guardian, the child's physician or physicians, and other professionals as requested by the 
160.22 	commissioner. The commissioner shall establish a screening team to conduct the level of 
160.23 	care determinations according to this subdivision. 
160.24 	(g) If a child meets the conditions in paragraph (b), (c), (d), or (e), the commissioner 
160.25 	must assess the case to determine whether: 
160.26 	(1) the child qualifies as a disabled individual under United States Code, title 42, 
160.27 	section 1382c(a), and would be eligible for medical assistance if residing in a medical 
160.28 	institution; and 
160.29 	(2) the cost of medical assistance services for the child, if eligible under this 
160.30 	subdivision, would not be more than the cost to medical assistance if the child resides in a 
160.31 	medical institution to be determined as follows: 
160.32 	(i) for a child who requires a level of care provided in an ICF/MR, the cost of 
160.33 	care for the child in an institution shall be determined using the average payment rate 
160.34 	established for the regional treatment centers that are certified as ICF's/MR; 
161.1 	(ii) for a child who requires a level of care provided in an inpatient hospital setting 
161.2 	according to paragraph (b), cost-effectiveness shall be determined according to Minnesota 
161.3 	Rules, part 9505.3520, items F and G; and 
161.4 	(iii) for a child who requires a level of care provided in a nursing facility according 
161.5 	to paragraph (c) or (e), cost-effectiveness shall be determined according to Minnesota 
161.6 	Rules, part 9505.3040, except that the nursing facility average rate shall be adjusted to 
161.7 	reflect rates which would be paid for children under age 16. The commissioner may 
161.8 	authorize an amount up to the amount medical assistance would pay for a child referred to 
161.9 	the commissioner by the preadmission screening team under section 256B.0911. 
161.10 	(h) Children eligible for medical assistance services under section 256B.055, 
161.11 	subdivision 12, as of June 30, 1995, must be screened according to the criteria in this 
161.12 	subdivision prior to January 1, 1996. Children found to be ineligible may not be removed 
161.13 	from the program until January 1, 1996. 

161.14 	Sec. 8. Minnesota Statutes 2008, section 256B.0621, subdivision 2, is amended to read:
161.15 		Subd. 2.Targeted case management; definitions. For purposes of subdivisions 3 
161.16 	to 10, the following terms have the meanings given them:
161.17 	(1) "home care service recipients" means those individuals receiving the following 
161.18 	services under sections 256B.0651 to 256B.0656 and 256B.0659: skilled nursing visits, 
161.19 	home health aide visits, private duty nursing, personal care assistants, or therapies 
161.20 	provided through a home health agency;
161.21 	(2) "home care targeted case management" means the provision of targeted case 
161.22 	management services for the purpose of assisting home care service recipients to gain 
161.23 	access to needed services and supports so that they may remain in the community;
161.24 	(3) "institutions" means hospitals, consistent with Code of Federal Regulations, title 
161.25 	42, section 440.10; regional treatment center inpatient services, consistent with section 
161.26 	245.474; nursing facilities; and intermediate care facilities for persons with developmental 
161.27 	disabilities;
161.28 	(4) "relocation targeted case management" includes the provision of both county 
161.29 	targeted case management and public or private vendor service coordination services 
161.30 	for the purpose of assisting recipients to gain access to needed services and supports if 
161.31 	they choose to move from an institution to the community. Relocation targeted case 
161.32 	management may be provided during the lesser of:
161.33 	(i) the last 180 consecutive days of an eligible recipient's institutional stay; or
161.34 	(ii) the limits and conditions which apply to federal Medicaid funding for this 
161.35 	service; and
162.1 	(5) "targeted case management" means case management services provided to help 
162.2 	recipients gain access to needed medical, social, educational, and other services and 
162.3 	supports.

162.4 	Sec. 9. Minnesota Statutes 2008, section 256B.0652, subdivision 3, is amended to read:
162.5 		Subd. 3.Assessment and prior authorization process. Effective January 1, 1996, 
162.6 	for purposes of providing informed choice, coordinating of local planning decisions, and 
162.7 	streamlining administrative requirements, the assessment and prior authorization process 
162.8 	for persons receiving both home care and home and community-based waivered services 
162.9 	for persons with developmental disabilities shall meet the requirements of sections 
162.10 	256B.0651and 256B.0653 to 256B.0656and 256B.0659 with the following exceptions:
162.11 	(a) Upon request for home care services and subsequent assessment by the public 
162.12 	health nurse under sections 256B.0651and 256B.0653 to 256B.0656 and 256B.0659, 
162.13 	the public health nurse shall participate in the screening process, as appropriate, and, 
162.14 	if home care services are determined to be necessary, participate in the development 
162.15 	of a service plan coordinating the need for home care and home and community-based 
162.16 	waivered services with the assigned county case manager, the recipient of services, and 
162.17 	the recipient's legal representative, if any.
162.18 	(b) The public health nurse shall give prior authorization for home care services 
162.19 	to the extent that home care services are:
162.20 	(1) medically necessary;
162.21 	(2) chosen by the recipient and their legal representative, if any, from the array of 
162.22 	home care and home and community-based waivered services available;
162.23 	(3) coordinated with other services to be received by the recipient as described 
162.24 	in the service plan; and
162.25 	(4) provided within the county's reimbursement limits for home care and home and 
162.26 	community-based waivered services for persons with developmental disabilities.
162.27 	(c) If the public health agency is or may be the provider of home care services to the 
162.28 	recipient, the public health agency shall provide the commissioner of human services with 
162.29 	a written plan that specifies how the assessment and prior authorization process will be 
162.30 	held separate and distinct from the provision of services.

162.31 	Sec. 10. Minnesota Statutes 2008, section 256B.0657, subdivision 2, is amended to 
162.32 	read:
162.33 		Subd. 2.Eligibility. (a) The self-directed supports option is available to a person 
162.34 	who:
163.1 	(1) is a recipient of medical assistance as determined under sections 256B.055, 
163.2 	256B.056, and 256B.057, subdivision 9;
163.3 	(2) is eligible for personal care assistant services under section 256B.0655
163.4 	256B.0659;
163.5 	(3) lives in the person's own apartment or home, which is not owned, operated, or 
163.6 	controlled by a provider of services not related by blood or marriage;
163.7 	(4) has the ability to hire, fire, supervise, establish staff compensation for, and 
163.8 	manage the individuals providing services, and to choose and obtain items, related 
163.9 	services, and supports as described in the participant's plan. If the recipient is not able to 
163.10 	carry out these functions but has a legal guardian or parent to carry them out, the guardian 
163.11 	or parent may fulfill these functions on behalf of the recipient; and
163.12 	(5) has not been excluded or disenrolled by the commissioner.
163.13 	(b) The commissioner may disenroll or exclude recipients, including guardians and 
163.14 	parents, under the following circumstances:
163.15 	(1) recipients who have been restricted by the Primary Care Utilization Review 
163.16 	Committee may be excluded for a specified time period; 
163.17 	(2) recipients who exit the self-directed supports option during the recipient's 
163.18 	service plan year shall not access the self-directed supports option for the remainder of 
163.19 	that service plan year; and
163.20 	(3) when the department determines that the recipient cannot manage recipient 
163.21 	responsibilities under the program.

163.22 	Sec. 11. Minnesota Statutes 2008, section 256B.0657, subdivision 6, is amended to 
163.23 	read:
163.24 		Subd. 6.Services covered. (a) Services covered under the self-directed supports 
163.25 	option include:
163.26 	(1) personal care assistant services under section 256B.0655 256B.0659; and 
163.27 	(2) items, related services, and supports, including assistive technology, that increase 
163.28 	independence or substitute for human assistance to the extent expenditures would 
163.29 	otherwise be used for human assistance.
163.30 	(b) Items, supports, and related services purchased under this option shall not be 
163.31 	considered home care services for the purposes of section 144A.43.

163.32 	Sec. 12. Minnesota Statutes 2008, section 256B.0657, subdivision 8, is amended to 
163.33 	read:
164.1 		Subd. 8.Self-directed budget requirements. The budget for the provision of the 
164.2 	self-directed service option shall be equal to the greater of either:
164.3 	(1) the annual amount of personal care assistant services under section 256B.0655
164.4 	256B.0659 that the recipient has used in the most recent 12-month period; or 
164.5 	(2) the amount determined using the consumer support grant methodology under 
164.6 	section 256.476, subdivision 11, except that the budget amount shall include the federal 
164.7 	and nonfederal share of the average service costs.

164.8 	Sec. 13. Minnesota Statutes 2008, section 256B.49, subdivision 17, is amended to read:
164.9 		Subd. 17.Cost of services and supports. (a) The commissioner shall ensure 
164.10 	that the average per capita expenditures estimated in any fiscal year for home and 
164.11 	community-based waiver recipients does not exceed the average per capita expenditures 
164.12 	that would have been made to provide institutional services for recipients in the absence 
164.13 	of the waiver.
164.14 	(b) The commissioner shall implement on January 1, 2002, one or more aggregate, 
164.15 	need-based methods for allocating to local agencies the home and community-based 
164.16 	waivered service resources available to support recipients with disabilities in need of 
164.17 	the level of care provided in a nursing facility or a hospital. The commissioner shall 
164.18 	allocate resources to single counties and county partnerships in a manner that reflects 
164.19 	consideration of:
164.20 	(1) an incentive-based payment process for achieving outcomes;
164.21 	(2) the need for a state-level risk pool;
164.22 	(3) the need for retention of management responsibility at the state agency level; and
164.23 	(4) a phase-in strategy as appropriate.
164.24 	(c) Until the allocation methods described in paragraph (b) are implemented, the 
164.25 	annual allowable reimbursement level of home and community-based waiver services 
164.26 	shall be the greater of:
164.27 	(1) the statewide average payment amount which the recipient is assigned under the 
164.28 	waiver reimbursement system in place on June 30, 2001, modified by the percentage of 
164.29 	any provider rate increase appropriated for home and community-based services; or
164.30 	(2) an amount approved by the commissioner based on the recipient's extraordinary 
164.31 	needs that cannot be met within the current allowable reimbursement level. The 
164.32 	increased reimbursement level must be necessary to allow the recipient to be discharged 
164.33 	from an institution or to prevent imminent placement in an institution. The additional 
164.34 	reimbursement may be used to secure environmental modifications; assistive technology 
164.35 	and equipment; and increased costs for supervision, training, and support services 
165.1 	necessary to address the recipient's extraordinary needs. The commissioner may approve 
165.2 	an increased reimbursement level for up to one year of the recipient's relocation from an 
165.3 	institution or up to six months of a determination that a current waiver recipient is at 
165.4 	imminent risk of being placed in an institution.
165.5 	(d) Beginning July 1, 2001, medically necessary private duty nursing services 
165.6 	will be authorized under this section as complex and regular care according to sections 
165.7 	256B.0651and 256B.0653 to 256B.0656 and 256B.0659. The rate established by the 
165.8 	commissioner for registered nurse or licensed practical nurse services under any home and 
165.9 	community-based waiver as of January 1, 2001, shall not be reduced.

165.10 	Sec. 14. Minnesota Statutes 2008, section 256B.501, subdivision 4a, is amended to 
165.11 	read:
165.12 		Subd. 4a.Inclusion of home care costs in waiver rates. The commissioner 
165.13 	shall adjust the limits of the established average daily reimbursement rates for waivered 
165.14 	services to include the cost of home care services that may be provided to waivered 
165.15 	services recipients. This adjustment must be used to maintain or increase services and 
165.16 	shall not be used by county agencies for inflation increases for waivered services vendors. 
165.17 	Home care services referenced in this section are those listed in section 256B.0651, 
165.18 	subdivision 2. The average daily reimbursement rates established in accordance with 
165.19 	the provisions of this subdivision apply only to the combined average, daily costs of 
165.20 	waivered and home care services and do not change home care limitations under sections 
165.21 	256B.0651and 256B.0653 to 256B.0656 and 256B.0659. Waivered services recipients 
165.22 	receiving home care as of June 30, 1992, shall not have the amount of their services 
165.23 	reduced as a result of this section.

165.24 	Sec. 15. Minnesota Statutes 2008, section 256G.02, subdivision 6, is amended to read:
165.25 		Subd. 6.Excluded time. "Excluded time" means:
165.26 	(a) any period an applicant spends in a hospital, sanitarium, nursing home, shelter 
165.27 	other than an emergency shelter, halfway house, foster home, semi-independent living 
165.28 	domicile or services program, residential facility offering care, board and lodging facility 
165.29 	or other institution for the hospitalization or care of human beings, as defined in section 
165.30 	144.50, 144A.01, or 245A.02, subdivision 14; maternity home, battered women's shelter, 
165.31 	or correctional facility; or any facility based on an emergency hold under sections 
165.32 	253B.05, subdivisions 1 and 2, and 253B.07, subdivision 6;
165.33 	(b) any period an applicant spends on a placement basis in a training and habilitation 
165.34 	program, including a rehabilitation facility or work or employment program as defined 
166.1 	in section 268A.01; or receiving personal care assistant services pursuant to section 
166.2 	256B.0655, subdivision 2 256B.0659; semi-independent living services provided under 
166.3 	section 252.275, and Minnesota Rules, parts 9525.0500 to 9525.0660; day training and 
166.4 	habilitation programs and assisted living services; and
166.5 	(c) any placement for a person with an indeterminate commitment, including 
166.6 	independent living.

166.7 	Sec. 16. Minnesota Statutes 2008, section 256I.05, subdivision 1a, is amended to read:
166.8 		Subd. 1a.Supplementary service rates. (a) Subject to the provisions of section 
166.9 	256I.04, subdivision 3, the county agency may negotiate a payment not to exceed $426.37 
166.10 	for other services necessary to provide room and board provided by the group residence 
166.11 	if the residence is licensed by or registered by the Department of Health, or licensed by 
166.12 	the Department of Human Services to provide services in addition to room and board, 
166.13 	and if the provider of services is not also concurrently receiving funding for services for 
166.14 	a recipient under a home and community-based waiver under title XIX of the Social 
166.15 	Security Act; or funding from the medical assistance program under section 256B.0655, 
166.16 	subdivision 2 256B.0659, for personal care services for residents in the setting; or residing 
166.17 	in a setting which receives funding under Minnesota Rules, parts 9535.2000 to 9535.3000. 
166.18 	If funding is available for other necessary services through a home and community-based 
166.19 	waiver, or personal care services under section 256B.0655, subdivision 2 256B.0659, 
166.20 	then the GRH rate is limited to the rate set in subdivision 1. Unless otherwise provided 
166.21 	in law, in no case may the supplementary service rate exceed $426.37. The registration 
166.22 	and licensure requirement does not apply to establishments which are exempt from state 
166.23 	licensure because they are located on Indian reservations and for which the tribe has 
166.24 	prescribed health and safety requirements. Service payments under this section may be 
166.25 	prohibited under rules to prevent the supplanting of federal funds with state funds. The 
166.26 	commissioner shall pursue the feasibility of obtaining the approval of the Secretary of 
166.27 	Health and Human Services to provide home and community-based waiver services under 
166.28 	title XIX of the Social Security Act for residents who are not eligible for an existing home 
166.29 	and community-based waiver due to a primary diagnosis of mental illness or chemical 
166.30 	dependency and shall apply for a waiver if it is determined to be cost-effective.
166.31 	(b) The commissioner is authorized to make cost-neutral transfers from the GRH 
166.32 	fund for beds under this section to other funding programs administered by the department 
166.33 	after consultation with the county or counties in which the affected beds are located. 
166.34 	The commissioner may also make cost-neutral transfers from the GRH fund to county 
166.35 	human service agencies for beds permanently removed from the GRH census under a plan 
167.1 	submitted by the county agency and approved by the commissioner. The commissioner 
167.2 	shall report the amount of any transfers under this provision annually to the legislature.
167.3 	(c) The provisions of paragraph (b) do not apply to a facility that has its 
167.4 	reimbursement rate established under section 256B.431, subdivision 4, paragraph (c).

167.5 	Sec. 17. Minnesota Statutes 2008, section 256J.45, subdivision 3, is amended to read:
167.6 		Subd. 3.Good cause exemptions for not attending orientation. (a) The county 
167.7 	agency shall not impose the sanction under section 256J.46 if it determines that the 
167.8 	participant has good cause for failing to attend orientation. Good cause exists when:
167.9 	(1) appropriate child care is not available;
167.10 	(2) the participant is ill or injured;
167.11 	(3) a family member is ill and needs care by the participant that prevents the 
167.12 	participant from attending orientation. For a caregiver with a child or adult in the 
167.13 	household who meets the disability or medical criteria for home care services under 
167.14 	section 256B.0655, subdivision 1c 256B.0659, or a home and community-based waiver 
167.15 	services program under chapter 256B, or meets the criteria for severe emotional 
167.16 	disturbance under section 245.4871, subdivision 6, or for serious and persistent mental 
167.17 	illness under section 245.462, subdivision 20, paragraph (c), good cause also exists when 
167.18 	an interruption in the provision of those services occurs which prevents the participant 
167.19 	from attending orientation;
167.20 	(4) the caregiver is unable to secure necessary transportation;
167.21 	(5) the caregiver is in an emergency situation that prevents orientation attendance;
167.22 	(6) the orientation conflicts with the caregiver's work, training, or school schedule; or
167.23 	(7) the caregiver documents other verifiable impediments to orientation attendance 
167.24 	beyond the caregiver's control.
167.25 	(b) Counties must work with clients to provide child care and transportation 
167.26 	necessary to ensure a caregiver has every opportunity to attend orientation.

167.27 	Sec. 18. Minnesota Statutes 2008, section 604A.33, subdivision 1, is amended to read:
167.28 		Subdivision 1.Application. This section applies to residential treatment programs 
167.29 	for children or group homes for children licensed under chapter 245A, residential 
167.30 	services and programs for juveniles licensed under section 241.021, providers licensed 
167.31 	pursuant to sections 144A.01 to 144A.33 or sections 144A.43 to  144A.47, personal care 
167.32 	provider organizations under section 256B.0655, subdivision 1g 256B.0659, providers 
167.33 	of day training and habilitation services under sections 252.40 to 252.46, board and 
167.34 	lodging facilities licensed under chapter 157, intermediate care facilities for persons with 
168.1 	developmental disabilities, and other facilities licensed to provide residential services to 
168.2 	persons with developmental disabilities.

168.3 	Sec. 19. Minnesota Statutes 2008, section 609.232, subdivision 11, is amended to read:
168.4 		Subd. 11.Vulnerable adult. "Vulnerable adult" means any person 18 years of 
168.5 	age or older who:
168.6 	(1) is a resident inpatient of a facility;
168.7 	(2) receives services at or from a facility required to be licensed to serve adults 
168.8 	under sections 245A.01 to 245A.15, except that a person receiving outpatient services for 
168.9 	treatment of chemical dependency or mental illness, or one who is committed as a sexual 
168.10 	psychopathic personality or as a sexually dangerous person under chapter 253B, is not 
168.11 	considered a vulnerable adult unless the person meets the requirements of clause (4);
168.12 	(3) receives services from a home care provider required to be licensed under section 
168.13 	144A.46; or from a person or organization that exclusively offers, provides, or arranges 
168.14 	for personal care assistant services under the medical assistance program as authorized 
168.15 	under sections 256B.04, subdivision 16, 256B.0625, subdivision 19a, 256B.0651, and 
168.16 	256B.0653 to 256B.0656 and 256B.0659; or
168.17 	(4) regardless of residence or whether any type of service is received, possesses a 
168.18 	physical or mental infirmity or other physical, mental, or emotional dysfunction:
168.19 	(i) that impairs the individual's ability to provide adequately for the individual's 
168.20 	own care without assistance, including the provision of food, shelter, clothing, health 
168.21 	care, or supervision; and
168.22 	(ii) because of the dysfunction or infirmity and the need for assistance, the individual 
168.23 	has an impaired ability to protect the individual from maltreatment.

168.24 	Sec. 20. Minnesota Statutes 2008, section 626.5572, subdivision 6, is amended to read:
168.25 		Subd. 6.Facility. (a) "Facility" means a hospital or other entity required to be 
168.26 	licensed under sections 144.50 to 144.58; a nursing home required to be licensed to 
168.27 	serve adults under section 144A.02; a residential or nonresidential facility required to 
168.28 	be licensed to serve adults under sections 245A.01 to 245A.16; a home care provider 
168.29 	licensed or required to be licensed under section 144A.46; a hospice provider licensed 
168.30 	under sections 144A.75 to 144A.755; or a person or organization that exclusively offers, 
168.31 	provides, or arranges for personal care assistant services under the medical assistance 
168.32 	program as authorized under sections 256B.04, subdivision 16, 256B.0625, subdivision 
168.33 	19a, 256B.0651, and 256B.0653 to 256B.0656, and 256B.0659.
169.1 	(b) For home care providers and personal care attendants, the term "facility" refers 
169.2 	to the provider or person or organization that exclusively offers, provides, or arranges for 
169.3 	personal care services, and does not refer to the client's home or other location at which 
169.4 	services are rendered.

169.5 	Sec. 21. Minnesota Statutes 2008, section 626.5572, subdivision 21, is amended to 
169.6 	read:
169.7 		Subd. 21. Vulnerable adult. "Vulnerable adult" means any person 18 years of 
169.8 	age or older who: 
169.9 	(1) is a resident or inpatient of a facility; 
169.10 	(2) receives services at or from a facility required to be licensed to serve adults 
169.11 	under sections 245A.01 to 245A.15, except that a person receiving outpatient services for 
169.12 	treatment of chemical dependency or mental illness, or one who is served in the Minnesota 
169.13 	sex offender program on a court-hold order for commitment, or is committed as a sexual 
169.14 	psychopathic personality or as a sexually dangerous person under chapter 253B, is not 
169.15 	considered a vulnerable adult unless the person meets the requirements of clause (4); 
169.16 	(3) receives services from a home care provider required to be licensed under section 
169.17 	144A.46; or from a person or organization that exclusively offers, provides, or arranges 
169.18 	for personal care assistant services under the medical assistance program as authorized 
169.19 	under sections 256B.04, subdivision 16, 256B.0625, subdivision 19a, 256B.0651, and
169.20 	256B.0653 to 256B.0656, and 256B.0659; or 
169.21 	(4) regardless of residence or whether any type of service is received, possesses a 
169.22 	physical or mental infirmity or other physical, mental, or emotional dysfunction: 
169.23 	(i) that impairs the individual's ability to provide adequately for the individual's 
169.24 	own care without assistance, including the provision of food, shelter, clothing, health 
169.25 	care, or supervision; and 
169.26 	(ii) because of the dysfunction or infirmity and the need for assistance, the individual 
169.27 	has an impaired ability to protect the individual from maltreatment. 

169.28 	ARTICLE 7
169.29 	CHEMICAL AND MENTAL HEALTH

169.30 	Section 1. Minnesota Statutes 2008, section 245.462, subdivision 18, is amended to 
169.31 	read:
169.32 		Subd. 18.Mental health professional. "Mental health professional" means a 
169.33 	person providing clinical services in the treatment of mental illness who is qualified in at 
169.34 	least one of the following ways:
170.1 	(1) in psychiatric nursing: a registered nurse who is licensed under sections 148.171
170.2 	to 148.285; and:
170.3 	(i) who is certified as a clinical specialist or as a nurse practitioner in adult or family 
170.4 	psychiatric and mental health nursing by a national nurse certification organization; or
170.5 	(ii) who has a master's degree in nursing or one of the behavioral sciences or related 
170.6 	fields from an accredited college or university or its equivalent, with at least 4,000 hours 
170.7 	of post-master's supervised experience in the delivery of clinical services in the treatment 
170.8 	of mental illness;
170.9 	(2) in clinical social work: a person licensed as an independent clinical social worker 
170.10 	under chapter 148D, or a person with a master's degree in social work from an accredited 
170.11 	college or university, with at least 4,000 hours of post-master's supervised experience in 
170.12 	the delivery of clinical services in the treatment of mental illness;
170.13 	(3) in psychology: an individual licensed by the Board of Psychology under sections 
170.14 	148.88 to 148.98 who has stated to the Board of Psychology competencies in the diagnosis 
170.15 	and treatment of mental illness;
170.16 	(4) in psychiatry: a physician licensed under chapter 147 and certified by the 
170.17 	American Board of Psychiatry and Neurology or eligible for board certification in 
170.18 	psychiatry;
170.19 	(5) in marriage and family therapy: the mental health professional must be a 
170.20 	marriage and family therapist licensed under sections 148B.29 to 148B.39 with at least 
170.21 	two years of post-master's supervised experience in the delivery of clinical services in 
170.22 	the treatment of mental illness; or
170.23 	(6) in licensed professional clinical counseling, the mental health professional 
170.24 	shall be a licensed professional clinical counselor under section 148B.5301 with at least 
170.25 	4,000 hours of postmaster's supervised experience in the delivery of clinical services in 
170.26 	the treatment of mental illness; or
170.27 	(7) in allied fields: a person with a master's degree from an accredited college or 
170.28 	university in one of the behavioral sciences or related fields, with at least 4,000 hours of 
170.29 	post-master's supervised experience in the delivery of clinical services in the treatment of 
170.30 	mental illness.

170.31 	Sec. 2. Minnesota Statutes 2008, section 245.470, subdivision 1, is amended to read:
170.32 		Subdivision 1.Availability of outpatient services. (a) County boards must provide 
170.33 	or contract for enough outpatient services within the county to meet the needs of adults 
170.34 	with mental illness residing in the county. Services may be provided directly by the 
170.35 	county through county-operated mental health centers or mental health clinics approved 
171.1 	by the commissioner under section 245.69, subdivision 2; by contract with privately 
171.2 	operated mental health centers or mental health clinics approved by the commissioner 
171.3 	under section 245.69, subdivision 2; by contract with hospital mental health outpatient 
171.4 	programs certified by the Joint Commission on Accreditation of Hospital Organizations; 
171.5 	or by contract with a licensed mental health professional as defined in section 245.462, 
171.6 	subdivision 18, clauses (1) to (4) (6). Clients may be required to pay a fee according to 
171.7 	section 245.481. Outpatient services include:  
171.8 	(1) conducting diagnostic assessments;
171.9 	(2) conducting psychological testing;
171.10 	(3) developing or modifying individual treatment plans;
171.11 	(4) making referrals and recommending placements as appropriate;
171.12 	(5) treating an adult's mental health needs through therapy;
171.13 	(6) prescribing and managing medication and evaluating the effectiveness of 
171.14 	prescribed medication; and
171.15 	(7) preventing placement in settings that are more intensive, costly, or restrictive 
171.16 	than necessary and appropriate to meet client needs.
171.17 	(b) County boards may request a waiver allowing outpatient services to be provided 
171.18 	in a nearby trade area if it is determined that the client can best be served outside the 
171.19 	county.

171.20 	Sec. 3. Minnesota Statutes 2008, section 245.4871, subdivision 27, is amended to read:
171.21 		Subd. 27.Mental health professional. "Mental health professional" means a 
171.22 	person providing clinical services in the diagnosis and treatment of children's emotional 
171.23 	disorders. A mental health professional must have training and experience in working with 
171.24 	children consistent with the age group to which the mental health professional is assigned. 
171.25 	A mental health professional must be qualified in at least one of the following ways:
171.26 	(1) in psychiatric nursing, the mental health professional must be a registered nurse 
171.27 	who is licensed under sections 148.171 to 148.285 and who is certified as a clinical 
171.28 	specialist in child and adolescent psychiatric or mental health nursing by a national nurse 
171.29 	certification organization or who has a master's degree in nursing or one of the behavioral 
171.30 	sciences or related fields from an accredited college or university or its equivalent, with 
171.31 	at least 4,000 hours of post-master's supervised experience in the delivery of clinical 
171.32 	services in the treatment of mental illness;
171.33 	(2) in clinical social work, the mental health professional must be a person licensed 
171.34 	as an independent clinical social worker under chapter 148D, or a person with a master's 
171.35 	degree in social work from an accredited college or university, with at least 4,000 hours of 
172.1 	post-master's supervised experience in the delivery of clinical services in the treatment 
172.2 	of mental disorders;
172.3 	(3) in psychology, the mental health professional must be an individual licensed by 
172.4 	the board of psychology under sections 148.88 to 148.98 who has stated to the board of 
172.5 	psychology competencies in the diagnosis and treatment of mental disorders;
172.6 	(4) in psychiatry, the mental health professional must be a physician licensed under 
172.7 	chapter 147 and certified by the American board of psychiatry and neurology or eligible 
172.8 	for board certification in psychiatry;
172.9 	(5) in marriage and family therapy, the mental health professional must be a 
172.10 	marriage and family therapist licensed under sections 148B.29 to 148B.39 with at least 
172.11 	two years of post-master's supervised experience in the delivery of clinical services in the 
172.12 	treatment of mental disorders or emotional disturbances; or
172.13 	(6) in licensed professional clinical counseling, the mental health professional shall 
172.14 	be a licensed professional clinical counselor under section 148B.5301 with at least 4,000 
172.15 	hours of postmaster's supervised experience in the delivery of clinical services in the 
172.16 	treatment of mental disorders or emotional disturbances; or
172.17 	(7) in allied fields, the mental health professional must be a person with a master's 
172.18 	degree from an accredited college or university in one of the behavioral sciences or related 
172.19 	fields, with at least 4,000 hours of post-master's supervised experience in the delivery of 
172.20 	clinical services in the treatment of emotional disturbances.

172.21 	Sec. 4. Minnesota Statutes 2008, section 245.488, subdivision 1, is amended to read:
172.22 		Subdivision 1.Availability of outpatient services. (a) County boards must provide 
172.23 	or contract for enough outpatient services within the county to meet the needs of each 
172.24 	child with emotional disturbance residing in the county and the child's family. Services 
172.25 	may be provided directly by the county through county-operated mental health centers or 
172.26 	mental health clinics approved by the commissioner under section 245.69, subdivision 2; 
172.27 	by contract with privately operated mental health centers or mental health clinics approved 
172.28 	by the commissioner under section 245.69, subdivision 2; by contract with hospital 
172.29 	mental health outpatient programs certified by the Joint Commission on Accreditation 
172.30 	of Hospital Organizations; or by contract with a licensed mental health professional as 
172.31 	defined in section 245.4871, subdivision 27, clauses (1) to (4) (6). A child or a child's 
172.32 	parent may be required to pay a fee based in accordance with section 245.481. Outpatient 
172.33 	services include:  
172.34 	(1) conducting diagnostic assessments;
172.35 	(2) conducting psychological testing;
173.1 	(3) developing or modifying individual treatment plans;
173.2 	(4) making referrals and recommending placements as appropriate;
173.3 	(5) treating the child's mental health needs through therapy; and
173.4 	(6) prescribing and managing medication and evaluating the effectiveness of 
173.5 	prescribed medication.
173.6 	(b) County boards may request a waiver allowing outpatient services to be provided 
173.7 	in a nearby trade area if it is determined that the child requires necessary and appropriate 
173.8 	services that are only available outside the county.
173.9 	(c) Outpatient services offered by the county board to prevent placement must be at 
173.10 	the level of treatment appropriate to the child's diagnostic assessment.

173.11 	Sec. 5. Minnesota Statutes 2008, section 254A.02, is amended by adding a subdivision 
173.12 	to read:
173.13 		Subd. 8a.Placing authority. "Placing authority" means a county, prepaid health 
173.14 	plan, or tribal governing board governed by Minnesota Rules, parts 9530.6600 to 
173.15 	9530.6655.

173.16 	Sec. 6. Minnesota Statutes 2008, section 254A.16, is amended by adding a subdivision 
173.17 	to read:
173.18 		Subd. 6.Monitoring. The commissioner shall gather and placing authorities shall 
173.19 	provide information to measure compliance with Minnesota Rules, parts 9530.6600 to 
173.20 	9530.6655. The commissioner shall specify the format for data collection to facilitate 
173.21 	tracking, aggregating, and using the information.

173.22 	Sec. 7. Minnesota Statutes 2008, section 254B.03, subdivision 1, is amended to read:
173.23 		Subdivision 1.Local agency duties. (a) Every local agency shall provide chemical 
173.24 	dependency services to persons residing within its jurisdiction who meet criteria 
173.25 	established by the commissioner for placement in a chemical dependency residential or 
173.26 	nonresidential treatment service. Chemical dependency money must be administered 
173.27 	by the local agencies according to law and rules adopted by the commissioner under 
173.28 	sections 14.001 to 14.69. 
173.29 	(b) In order to contain costs, the county board shall, with the approval of the 
173.30 	commissioner of human services,shall select eligible vendors of chemical dependency 
173.31 	services who can provide economical and appropriate treatment. Unless the local agency 
173.32 	is a social services department directly administered by a county or human services board, 
173.33 	the local agency shall not be an eligible vendor under section 254B.05. The commissioner 
174.1 	may approve proposals from county boards to provide services in an economical manner 
174.2 	or to control utilization, with safeguards to ensure that necessary services are provided. 
174.3 	If a county implements a demonstration or experimental medical services funding plan, 
174.4 	the commissioner shall transfer the money as appropriate. If a county selects a vendor 
174.5 	located in another state, the county shall ensure that the vendor is in compliance with the 
174.6 	rules governing licensure of programs located in the state.
174.7 	(c) A culturally specific vendor that provides assessments under a variance under 
174.8 	Minnesota Rules, part 9530.6610, shall be allowed to provide assessment services to 
174.9 	persons not covered by the variance.

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

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

174.15 	Sec. 9. Minnesota Statutes 2008, section 254B.03, is amended by adding a subdivision 
174.16 	to read:
174.17 		Subd. 9.Commissioner to select vendors and set rates. (a) Effective July 1, 2011, 
174.18 	the commissioner shall:
174.19 	(1) enter into agreements with eligible vendors that:
174.20 	(i) meet the standards in section 254B.05, subdivision 1;
174.21 	(ii) have good standing in all applicable licensure; and
174.22 	(iii) have a current approved provider agreement as a Minnesota health care program 
174.23 	provider; and
174.24 	(2) set rates for services reimbursed under this chapter.
174.25 	(b) When setting rates, the commissioner shall consider the complexity and the 
174.26 	acuity of the problems presented by the client.
174.27 	(c) When rates set under this section and rates set under section 254B.09, subdivision 
174.28 	8, apply to the same treatment placement, section 254B.09, subdivision 8, supersedes.

174.29 	Sec. 10. Minnesota Statutes 2008, section 254B.05, subdivision 1, is amended to read:
174.30 		Subdivision 1.Licensure required. Programs licensed by the commissioner are 
174.31 	eligible vendors. Hospitals may apply for and receive licenses to be eligible vendors, 
174.32 	notwithstanding the provisions of section 245A.03. American Indian programs located on 
174.33 	federally recognized tribal lands that provide chemical dependency primary treatment, 
175.1 	extended care, transitional residence, or outpatient treatment services, and are licensed by 
175.2 	tribal government are eligible vendors. Detoxification programs are not eligible vendors. 
175.3 	Programs that are not licensed as a chemical dependency residential or nonresidential 
175.4 	treatment program by the commissioner or by tribal government are not eligible vendors. 
175.5 	To be eligible for payment under the Consolidated Chemical Dependency Treatment Fund, 
175.6 	a vendor of a chemical dependency service must participate in the Drug and Alcohol 
175.7 	Abuse Normative Evaluation System and the treatment accountability plan.  
175.8 	Effective January 1, 2000, vendors of room and board are eligible for chemical 
175.9 	dependency fund payment if the vendor:
175.10 	(1) is certified by the county or tribal governing body as havinghas rules prohibiting 
175.11 	residents bringing chemicals into the facility or using chemicals while residing in the 
175.12 	facility and provide consequences for infractions of those rules;
175.13 	(2) has a current contract with a county or tribal governing body;
175.14 	(3) is determined to meet applicable health and safety requirements;
175.15 	(4) is not a jail or prison; and
175.16 	(5) is not concurrently receiving funds under chapter 256I for the recipient.

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

175.18 	Sec. 11. Minnesota Statutes 2008, section 254B.09, subdivision 2, is amended to read:
175.19 		Subd. 2.American Indian agreements. The commissioner may enter into 
175.20 	agreements with federally recognized tribal units to pay for chemical dependency 
175.21 	treatment services provided under Laws 1986, chapter 394, sections 8 to 20. The 
175.22 	agreements must clarify how the governing body of the tribal unit fulfills local agency 
175.23 	responsibilities regarding:
175.24 	(1) selection of eligible vendors under section 254B.03, subdivision 1;  
175.25 	(2) negotiation of agreements that establish vendor services and rates for programs 
175.26 	located on the tribal governing body's reservation;
175.27 	(3)(1) the form and manner of invoicing; and
175.28 	(4)(2) provide that only invoices for eligible vendors according to section 254B.05
175.29 	will be included in invoices sent to the commissioner for payment, to the extent that 
175.30 	money allocated under subdivisions 4 and 5 is used.  

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

175.32 	Sec. 12. [254B.11] MAXIMUM RATES.
176.1 	The commissioner shall publish maximum rates for vendors of the consolidated 
176.2 	chemical dependency treatment fund by July 1 of each year for implementation the 
176.3 	following January 1. Rates for calendar year 2010 must not exceed 185 percent of the 
176.4 	average rate on January 1, 2009, for each group of vendors with similar attributes. Unless 
176.5 	a new rate methodology is developed under section 254B.12, rates for services provided on 
176.6 	and after July 1, 2011, must not exceed 160 percent of the average rate on January 1, 2009, 
176.7 	for each group of vendors with similar attributes. Payment for services provided by Indian 
176.8 	Health Services or by agencies operated by Indian tribes for medical assistance-eligible 
176.9 	individuals must be governed by the applicable federal rate methodology.

176.10 	Sec. 13. [254B.12] RATE METHODOLOGY.
176.11 	The commissioner shall, with broad-based stakeholder input, develop a 
176.12 	recommendation and present a report to the 2011 legislature, including proposed 
176.13 	legislation for a new rate methodology for the consolidated chemical dependency 
176.14 	treatment fund. The new methodology must replace county-negotiated rates with a 
176.15 	uniform statewide methodology that must include a graduated reimbursement scale based 
176.16 	on the patients' level of acuity and complexity.

176.17 	Sec. 14. Minnesota Statutes 2008, section 256B.0622, subdivision 2, is amended to 
176.18 	read:
176.19 		Subd. 2.Definitions. For purposes of this section, the following terms have the 
176.20 	meanings given them.
176.21 	(a) "Intensive nonresidential rehabilitative mental health services" means adult 
176.22 	rehabilitative mental health services as defined in section 256B.0623, subdivision 2, 
176.23 	paragraph (a), except that these services are provided by a multidisciplinary staff using 
176.24 	a total team approach consistent with assertive community treatment, the Fairweather 
176.25 	Lodge treatment model, as defined by the standards established by the National Coalition 
176.26 	for Community Living, and other evidence-based practices, and directed to recipients with 
176.27 	a serious mental illness who require intensive services.
176.28 	(b) "Intensive residential rehabilitative mental health services" means short-term, 
176.29 	time-limited services provided in a residential setting to recipients who are in need of 
176.30 	more restrictive settings and are at risk of significant functional deterioration if they do 
176.31 	not receive these services. Services are designed to develop and enhance psychiatric 
176.32 	stability, personal and emotional adjustment, self-sufficiency, and skills to live in a more 
176.33 	independent setting. Services must be directed toward a targeted discharge date with 
177.1 	specified client outcomes and must be consistent with the Fairweather Lodge treatment 
177.2 	model as defined in paragraph (a), and other evidence-based practices.
177.3 	(c) "Evidence-based practices" are nationally recognized mental health services that 
177.4 	are proven by substantial research to be effective in helping individuals with serious 
177.5 	mental illness obtain specific treatment goals.
177.6 	(d) "Overnight staff" means a member of the intensive residential rehabilitative 
177.7 	mental health treatment team who is responsible during hours when recipients are 
177.8 	typically asleep.
177.9 	(e) "Treatment team" means all staff who provide services under this section to 
177.10 	recipients. At a minimum, this includes the clinical supervisor, mental health professionals 
177.11 	as defined in section 245.462, subdivision 18, clauses (1) to (5) (6); mental health 
177.12 	practitioners as defined in section 245.462, subdivision 17; mental health rehabilitation 
177.13 	workers under section 256B.0623, subdivision 5, clause (3); and certified peer specialists 
177.14 	under section 256B.0615.

177.15 	Sec. 15. Minnesota Statutes 2008, section 256B.0623, subdivision 5, is amended to 
177.16 	read:
177.17 		Subd. 5.Qualifications of provider staff. Adult rehabilitative mental health 
177.18 	services must be provided by qualified individual provider staff of a certified provider 
177.19 	entity. Individual provider staff must be qualified under one of the following criteria:
177.20 	(1) a mental health professional as defined in section 245.462, subdivision 18, 
177.21 	clauses (1) to (5) (6). If the recipient has a current diagnostic assessment by a licensed 
177.22 	mental health professional as defined in section 245.462, subdivision 18, clauses (1) to (5)
177.23 	(6), recommending receipt of adult mental health rehabilitative services, the definition of 
177.24 	mental health professional for purposes of this section includes a person who is qualified 
177.25 	under section 245.462, subdivision 18, clause (6) (7), and who holds a current and valid 
177.26 	national certification as a certified rehabilitation counselor or certified psychosocial 
177.27 	rehabilitation practitioner; 
177.28 	(2) a mental health practitioner as defined in section 245.462, subdivision 17. The 
177.29 	mental health practitioner must work under the clinical supervision of a mental health 
177.30 	professional; 
177.31 	(3) a certified peer specialist under section 256B.0615. The certified peer specialist 
177.32 	must work under the clinical supervision of a mental health professional; or
177.33 	(4) a mental health rehabilitation worker. A mental health rehabilitation worker 
177.34 	means a staff person working under the direction of a mental health practitioner or mental 
177.35 	health professional and under the clinical supervision of a mental health professional in 
178.1 	the implementation of rehabilitative mental health services as identified in the recipient's 
178.2 	individual treatment plan who:
178.3 	(i) is at least 21 years of age;
178.4 	(ii) has a high school diploma or equivalent;
178.5 	(iii) has successfully completed 30 hours of training during the past two years in all 
178.6 	of the following areas: recipient rights, recipient-centered individual treatment planning, 
178.7 	behavioral terminology, mental illness, co-occurring mental illness and substance abuse, 
178.8 	psychotropic medications and side effects, functional assessment, local community 
178.9 	resources, adult vulnerability, recipient confidentiality; and
178.10 	(iv) meets the qualifications in subitem (A) or (B):
178.11 	(A) has an associate of arts degree in one of the behavioral sciences or human 
178.12 	services, or is a registered nurse without a bachelor's degree, or who within the previous 
178.13 	ten years has:
178.14 	(1) three years of personal life experience with serious and persistent mental illness;
178.15 	(2) three years of life experience as a primary caregiver to an adult with a serious 
178.16 	mental illness or traumatic brain injury; or
178.17 	(3) 4,000 hours of supervised paid work experience in the delivery of mental health 
178.18 	services to adults with a serious mental illness or traumatic brain injury; or
178.19 	(B)(1) is fluent in the non-English language or competent in the culture of the 
178.20 	ethnic group to which at least 20 percent of the mental health rehabilitation worker's 
178.21 	clients belong;
178.22 	(2) receives during the first 2,000 hours of work, monthly documented individual 
178.23 	clinical supervision by a mental health professional;
178.24 	(3) has 18 hours of documented field supervision by a mental health professional 
178.25 	or practitioner during the first 160 hours of contact work with recipients, and at least six 
178.26 	hours of field supervision quarterly during the following year;
178.27 	(4) has review and cosignature of charting of recipient contacts during field 
178.28 	supervision by a mental health professional or practitioner; and
178.29 	(5) has 40 hours of additional continuing education on mental health topics during 
178.30 	the first year of employment.

178.31 	Sec. 16. Minnesota Statutes 2008, section 256B.0624, subdivision 5, is amended to 
178.32 	read:
178.33 		Subd. 5.Mobile crisis intervention staff qualifications. For provision of adult 
178.34 	mental health mobile crisis intervention services, a mobile crisis intervention team is 
178.35 	comprised of at least two mental health professionals as defined in section 245.462, 
179.1 	subdivision 18, clauses (1) to (5) (6), or a combination of at least one mental health 
179.2 	professional and one mental health practitioner as defined in section 245.462, subdivision 
179.3 	17, with the required mental health crisis training and under the clinical supervision of 
179.4 	a mental health professional on the team. The team must have at least two people with 
179.5 	at least one member providing on-site crisis intervention services when needed. Team 
179.6 	members must be experienced in mental health assessment, crisis intervention techniques, 
179.7 	and clinical decision-making under emergency conditions and have knowledge of local 
179.8 	services and resources. The team must recommend and coordinate the team's services 
179.9 	with appropriate local resources such as the county social services agency, mental health 
179.10 	services, and local law enforcement when necessary. 

179.11 	Sec. 17. Minnesota Statutes 2008, section 256B.0624, subdivision 8, is amended to 
179.12 	read:
179.13 		Subd. 8.Adult crisis stabilization staff qualifications. (a) Adult mental health 
179.14 	crisis stabilization services must be provided by qualified individual staff of a qualified 
179.15 	provider entity. Individual provider staff must have the following qualifications:
179.16 	(1) be a mental health professional as defined in section 245.462, subdivision 18, 
179.17 	clauses (1) to (5) (6); 
179.18 	(2) be a mental health practitioner as defined in section 245.462, subdivision 17. 
179.19 	The mental health practitioner must work under the clinical supervision of a mental health 
179.20 	professional; or 
179.21 	(3) be a mental health rehabilitation worker who meets the criteria in section 
179.22 	256B.0623, subdivision 5, clause (3); works under the direction of a mental health 
179.23 	practitioner as defined in section 245.462, subdivision 17, or under direction of a 
179.24 	mental health professional; and works under the clinical supervision of a mental health 
179.25 	professional. 
179.26 	(b) Mental health practitioners and mental health rehabilitation workers must have 
179.27 	completed at least 30 hours of training in crisis intervention and stabilization during 
179.28 	the past two years.

179.29 	Sec. 18. Minnesota Statutes 2008, section 256B.0625, subdivision 42, is amended to 
179.30 	read:
179.31 		Subd. 42.Mental health professional. Notwithstanding Minnesota Rules, part 
179.32 	9505.0175, subpart 28, the definition of a mental health professional shall include a person 
179.33 	who is qualified as specified in section 245.462, subdivision 18, clause clauses  (5) and (6); 
180.1 	or 245.4871, subdivision 27, clause clauses  (5) and (6), for the purpose of this section and 
180.2 	Minnesota Rules, parts 9505.0170 to 9505.0475. 

180.3 	Sec. 19. Minnesota Statutes 2008, section 256B.0943, subdivision 1, is amended to 
180.4 	read:
180.5 		Subdivision 1.Definitions. For purposes of this section, the following terms have 
180.6 	the meanings given them.
180.7 	(a) "Children's therapeutic services and supports" means the flexible package of 
180.8 	mental health services for children who require varying therapeutic and rehabilitative 
180.9 	levels of intervention. The services are time-limited interventions that are delivered using 
180.10 	various treatment modalities and combinations of services designed to reach treatment 
180.11 	outcomes identified in the individual treatment plan.
180.12 	(b) "Clinical supervision" means the overall responsibility of the mental health 
180.13 	professional for the control and direction of individualized treatment planning, service 
180.14 	delivery, and treatment review for each client. A mental health professional who is an 
180.15 	enrolled Minnesota health care program provider accepts full professional responsibility 
180.16 	for a supervisee's actions and decisions, instructs the supervisee in the supervisee's work, 
180.17 	and oversees or directs the supervisee's work.
180.18 	(c) "County board" means the county board of commissioners or board established 
180.19 	under sections 402.01 to 402.10 or 471.59.  
180.20 	(d) "Crisis assistance" has the meaning given in section 245.4871, subdivision 9a.  
180.21 	(e) "Culturally competent provider" means a provider who understands and can 
180.22 	utilize to a client's benefit the client's culture when providing services to the client. A 
180.23 	provider may be culturally competent because the provider is of the same cultural or 
180.24 	ethnic group as the client or the provider has developed the knowledge and skills through 
180.25 	training and experience to provide services to culturally diverse clients.
180.26 	(f) "Day treatment program" for children means a site-based structured program 
180.27 	consisting of group psychotherapy for more than three individuals and other intensive 
180.28 	therapeutic services provided by a multidisciplinary team, under the clinical supervision 
180.29 	of a mental health professional.
180.30 	(g) "Diagnostic assessment" has the meaning given in section 245.4871, subdivision 
180.31 	11.  
180.32 	(h) "Direct service time" means the time that a mental health professional, mental 
180.33 	health practitioner, or mental health behavioral aide spends face-to-face with a client 
180.34 	and the client's family. Direct service time includes time in which the provider obtains 
180.35 	a client's history or provides service components of children's therapeutic services and 
181.1 	supports. Direct service time does not include time doing work before and after providing 
181.2 	direct services, including scheduling, maintaining clinical records, consulting with others 
181.3 	about the client's mental health status, preparing reports, receiving clinical supervision 
181.4 	directly related to the client's psychotherapy session, and revising the client's individual 
181.5 	treatment plan.
181.6 	(i) "Direction of mental health behavioral aide" means the activities of a mental 
181.7 	health professional or mental health practitioner in guiding the mental health behavioral 
181.8 	aide in providing services to a client. The direction of a mental health behavioral aide 
181.9 	must be based on the client's individualized treatment plan and meet the requirements in 
181.10 	subdivision 6, paragraph (b), clause (5).
181.11 	(j) "Emotional disturbance" has the meaning given in section 245.4871, subdivision 
181.12 	15. For persons at least age 18 but under age 21, mental illness has the meaning given in 
181.13 	section 245.462, subdivision 20, paragraph (a).  
181.14 	(k) "Individual behavioral plan" means a plan of intervention, treatment, and 
181.15 	services for a child written by a mental health professional or mental health practitioner, 
181.16 	under the clinical supervision of a mental health professional, to guide the work of the 
181.17 	mental health behavioral aide.
181.18 	(l) "Individual treatment plan" has the meaning given in section 245.4871, 
181.19 	subdivision 21.  
181.20 	(m) "Mental health professional" means an individual as defined in section 245.4871, 
181.21 	subdivision 27, clauses (1) to (5) (6), or tribal vendor as defined in section 256B.02, 
181.22 	subdivision 7, paragraph (b).  
181.23 	(n) "Preschool program" means a day program licensed under Minnesota Rules, 
181.24 	parts 9503.0005 to 9503.0175, and enrolled as a children's therapeutic services and 
181.25 	supports provider to provide a structured treatment program to a child who is at least 33 
181.26 	months old but who has not yet attended the first day of kindergarten.
181.27 	(o) "Skills training" means individual, family, or group training designed to improve 
181.28 	the basic functioning of the child with emotional disturbance and the child's family in the 
181.29 	activities of daily living and community living, and to improve the social functioning of the 
181.30 	child and the child's family in areas important to the child's maintaining or reestablishing 
181.31 	residency in the community. Individual, family, and group skills training must:
181.32 	(1) consist of activities designed to promote skill development of the child and the 
181.33 	child's family in the use of age-appropriate daily living skills, interpersonal and family 
181.34 	relationships, and leisure and recreational services;
182.1 	(2) consist of activities that will assist the family's understanding of normal child 
182.2 	development and to use parenting skills that will help the child with emotional disturbance 
182.3 	achieve the goals outlined in the child's individual treatment plan; and
182.4 	(3) promote family preservation and unification, promote the family's integration 
182.5 	with the community, and reduce the use of unnecessary out-of-home placement or 
182.6 	institutionalization of children with emotional disturbance.

182.7 	Sec. 20. Minnesota Statutes 2008, section 256B.0625, subdivision 47, is amended to 
182.8 	read:
182.9 		Subd. 47.Treatment foster care services. Effective July 1, 2007 2011, and subject 
182.10 	to federal approval, medical assistance covers treatment foster care services according to 
182.11 	section 256B.0946.

182.12 	Sec. 21. Minnesota Statutes 2008, section 256B.0943, subdivision 12, is amended to 
182.13 	read:
182.14 		Subd. 12.Excluded services. The following services are not eligible for medical 
182.15 	assistance payment as children's therapeutic services and supports:
182.16 	(1) service components of children's therapeutic services and supports 
182.17 	simultaneously provided by more than one provider entity unless prior authorization is 
182.18 	obtained;
182.19 	(2) treatment by multiple providers within the same agency at the same clock time;
182.20 	(3) children's therapeutic services and supports provided in violation of medical 
182.21 	assistance policy in Minnesota Rules, part 9505.0220;
182.22 	(3) (4) mental health behavioral aide services provided by a personal care assistant 
182.23 	who is not qualified as a mental health behavioral aide and employed by a certified 
182.24 	children's therapeutic services and supports provider entity;
182.25 	(4)(5) service components of CTSS that are the responsibility of a residential or 
182.26 	program license holder, including foster care providers under the terms of a service 
182.27 	agreement or administrative rules governing licensure; 
182.28 	(5)(6) adjunctive activities that may be offered by a provider entity but are not 
182.29 	otherwise covered by medical assistance, including:
182.30 	(i) a service that is primarily recreation oriented or that is provided in a setting that 
182.31 	is not medically supervised. This includes sports activities, exercise groups, activities 
182.32 	such as craft hours, leisure time, social hours, meal or snack time, trips to community 
182.33 	activities, and tours;
183.1 	(ii) a social or educational service that does not have or cannot reasonably be 
183.2 	expected to have a therapeutic outcome related to the client's emotional disturbance;
183.3 	(iii) consultation with other providers or service agency staff about the care or 
183.4 	progress of a client;
183.5 	(iv) prevention or education programs provided to the community; and
183.6 	(v) treatment for clients with primary diagnoses of alcohol or other drug abuse; and
183.7 	(6)(7) activities that are not direct service time.

183.8 	Sec. 22. Minnesota Statutes 2008, section 256B.0944, is amended by adding a 
183.9 	subdivision to read:
183.10 		Subd. 4a.Alternative provider standards. If a provider entity demonstrates that, 
183.11 	due to geographic or other barriers, it is not feasible to provide mobile crisis intervention 
183.12 	services 24 hours a day, seven days a week, according to the standards in subdivision 4, 
183.13 	paragraph (b), clause (1), the commissioner may approve a crisis response provider based 
183.14 	on an alternative plan proposed by a provider entity. The alternative plan must:
183.15 	(1) result in increased access and a reduction in disparities in the availability of 
183.16 	crisis services; and
183.17 	(2) provide mobile services outside of the usual nine-to-five office hours and on 
183.18 	weekends and holidays.

183.19 	Sec. 23. Minnesota Statutes 2008, section 256B.0947, subdivision 1, is amended to 
183.20 	read:
183.21 		Subdivision 1.Scope. Subject to federal approval Effective November 1, 2010, and 
183.22 	subject to federal approval, medical assistance covers medically necessary, intensive 
183.23 	nonresidential rehabilitative mental health services as defined in subdivision 2, for 
183.24 	recipients as defined in subdivision 3, when the services are provided by an entity meeting 
183.25 	the standards in this section.

183.26 	Sec. 24. Minnesota Statutes 2008, section 256J.08, subdivision 73a, is amended to read:
183.27 		Subd. 73a.Qualified professional. (a) For physical illness, injury, or incapacity, 
183.28 	a "qualified professional" means a licensed physician, a physician's assistant, a nurse 
183.29 	practitioner, or a licensed chiropractor.
183.30 	(b) For developmental disability and intelligence testing, a "qualified professional" 
183.31 	means an individual qualified by training and experience to administer the tests necessary 
183.32 	to make determinations, such as tests of intellectual functioning, assessments of adaptive 
183.33 	behavior, adaptive skills, and developmental functioning. These professionals include 
184.1 	licensed psychologists, certified school psychologists, or certified psychometrists working 
184.2 	under the supervision of a licensed psychologist.
184.3 	(c) For learning disabilities, a "qualified professional" means a licensed psychologist 
184.4 	or school psychologist with experience determining learning disabilities.
184.5 	(d) For mental health, a "qualified professional" means a licensed physician or a 
184.6 	qualified mental health professional. A "qualified mental health professional" means:
184.7 	(1) for children, in psychiatric nursing, a registered nurse who is licensed under 
184.8 	sections 148.171 to 148.285, and who is certified as a clinical specialist in child 
184.9 	and adolescent psychiatric or mental health nursing by a national nurse certification 
184.10 	organization or who has a master's degree in nursing or one of the behavioral sciences 
184.11 	or related fields from an accredited college or university or its equivalent, with at least 
184.12 	4,000 hours of post-master's supervised experience in the delivery of clinical services in 
184.13 	the treatment of mental illness;
184.14 	(2) for adults, in psychiatric nursing, a registered nurse who is licensed under 
184.15 	sections 148.171 to 148.285, and who is certified as a clinical specialist in adult psychiatric 
184.16 	and mental health nursing by a national nurse certification organization or who has a 
184.17 	master's degree in nursing or one of the behavioral sciences or related fields from an 
184.18 	accredited college or university or its equivalent, with at least 4,000 hours of post-master's 
184.19 	supervised experience in the delivery of clinical services in the treatment of mental illness;
184.20 	(3) in clinical social work, a person licensed as an independent clinical social worker 
184.21 	under chapter 148D, or a person with a master's degree in social work from an accredited 
184.22 	college or university, with at least 4,000 hours of post-master's supervised experience in 
184.23 	the delivery of clinical services in the treatment of mental illness;
184.24 	(4) in psychology, an individual licensed by the Board of Psychology under sections 
184.25 	148.88 to 148.98, who has stated to the Board of Psychology competencies in the 
184.26 	diagnosis and treatment of mental illness;
184.27 	(5) in psychiatry, a physician licensed under chapter 147 and certified by the 
184.28 	American Board of Psychiatry and Neurology or eligible for board certification in 
184.29 	psychiatry; and
184.30 	(6) in marriage and family therapy, the mental health professional must be a 
184.31 	marriage and family therapist licensed under sections 148B.29 to 148B.39, with at least 
184.32 	two years of post-master's supervised experience in the delivery of clinical services in the 
184.33 	treatment of mental illness; and
184.34 	(7) in licensed professional clinical counseling, the mental health professional 
184.35 	shall be a licensed professional clinical counselor under section 148B.5301 with at least 
185.1 	4,000 hours of postmaster's supervised experience in the delivery of clinical services in 
185.2 	the treatment of mental illness.

185.3 	Sec. 25. AUTISM SPECTRUM DISORDER TASK FORCE.
 185.4 	(a) The Autism Spectrum Disorder Task Force is composed of 15 members, 
185.5 	appointed as follows:
185.6 	(1) two members of the senate appointed by the Subcommittee on Committees of the 
185.7 	Committee on Rules and Administration, one of whom must be a member of the minority;
185.8 	(2) two members of the house of representatives, one from the majority party, 
185.9 	appointed by the speaker of the house, and one from the minority party, appointed by 
185.10 	the minority leader;
185.11 	(3) two members appointed by the legislature, with regard to geographic diversity in 
185.12 	the state, who are parents of children with autism spectrum disorder (ASD); one member 
185.13 	shall be appointed by the senate Subcommittee on Committees of the Committee on 
185.14 	Rules and Administration making appointments for the senate; and one member shall be 
185.15 	appointed by the speaker of the house making the appointments for the house;
185.16 	(4) one member appointed by the Minnesota chapter of the American Academy of 
185.17 	Pediatrics who is a general primary care pediatrician; 
185.18 	(5) one member appointed by the Minnesota Academy of Family Physicians who is 
185.19 	a family practice physician;
185.20 	(6) one member appointed by the Minnesota Psychological Association who is a 
185.21 	neuropsychologist;
185.22 	(7) one member appointed by the directors of public school student support services;
185.23 	(8) one member appointed by the Somali American Autism Foundation;
185.24 	(9) one member appointed by the ARC of Minnesota;
185.25 	(10) one member appointed by the Autism Society of Minnesota;
185.26 	(11) one member appointed by the Parent Advocacy Coalition for Educational 
185.27 	Rights; and
185.28 	(12) one member appointed by the Minnesota Council of Health Plans.
185.29 	Appointments must be made by September 1, 2009. The Legislative Coordinating 
185.30 	Commission shall provide meeting space for the task force. The senate member appointed 
185.31 	by the minority leader of the senate shall convene the first meeting of the task force no 
185.32 	later than October 1, 2009. The task force shall elect a chair at the first meeting.
185.33 	(b) If federal or state funding is available, the commissioners of education, 
185.34 	employment and economic development, health, and human services shall provide 
185.35 	assistance to the task force.
186.1 	(c) The task force shall develop recommendations and report on the following topics:
186.2 	(1) ways to improve services provided by all state and political subdivisions;
186.3 	(2) sources of public and private funding available for treatment and ways to 
186.4 	improve efficiency in the use of these funds;
186.5 	(3) methods to improve coordination in the delivery of service between public 
186.6 	and private agencies, health providers, and schools, and to address any geographic 
186.7 	discrepancies in the delivery of services;
186.8 	(4) increasing the availability of and the training for medical providers and educators 
186.9 	who identify and provide services to individuals with ASD; and
186.10 	(5) treatment options supported by peer-reviewed, established scientific research 
186.11 	for individuals with ASD.
186.12 	(d) The task force shall coordinate with existing efforts at the Departments of 
186.13 	Education, Health, Human Services, and Employment and Economic Development 
186.14 	related to ASD.
186.15 	(e) By January 15 of each year, the task force shall provide a report regarding its 
186.16 	findings and consideration of the topics listed under paragraph (c), and the action taken 
186.17 	under paragraph (d), including draft legislation if necessary, to the chairs and ranking 
186.18 	minority members of the legislative committees with jurisdiction over health and human 
186.19 	services.
186.20 	(f) This section expires June 30, 2011.

186.21 	Sec. 26. STATE-COUNTY CHEMICAL HEALTH CARE HOME PILOT 
186.22 	PROJECT.
 186.23 		Subdivision 1.Establishment; purpose. There is established a state-county 
186.24 	chemical health care home pilot project. The purpose of the pilot project is for the 
186.25 	Department of Human Services and counties to authentically and creatively work in 
186.26 	partnership to redesign the current chemical health service delivery system in a way 
186.27 	that promotes greater accountability, productivity, and results in the delivery of state 
186.28 	chemical dependency services. The pilot project or projects must look to provide 
186.29 	appropriate flexibility in a way that ensures timely access to needed services as well 
186.30 	as better aligning systems and services to offer the most appropriate level of chemical 
186.31 	health care services to the client. This may include, but is not limited to, looking into new 
186.32 	governance agreements, performance agreements, or service level agreements. Pilot 
186.33 	projects must maintain eligibility requirements for the consolidated chemical dependency 
186.34 	treatment fund, continue to meet the requirements of Minnesota Rules, parts 9530.6600 to 
186.35 	9530.6655 (also known as Rule 25) and Minnesota Rules, parts 9530.6405 to 9530.6505 
187.1 	(also known as Rule 31), and must not put at risk current and future federal funding toward 
187.2 	chemical health-related services in the state of Minnesota. 
187.3 		Subd. 2.Workgroup; report. A workgroup must be convened on or before July 
187.4 	15, 2009, consisting of representatives from the Department of Human Services and 
187.5 	potential participating counties to develop draft proposals for pilot projects meeting the 
187.6 	requirements of this section. The workgroup shall report back to the legislative committees 
187.7 	with jurisdiction over chemical health by January 15, 2010, for potential approval of one 
187.8 	metro and one nonmetro county pilot project to be implemented beginning July 10, 2010.
187.9 		Subd. 3.Report. The Department of Human Services shall evaluate the efficacy and 
187.10 	feasibility of the pilot projects and report the results of that evaluation to the legislative 
187.11 	committees having jurisdiction over chemical health by June 30, 2011. Expansion of pilot 
187.12 	projects may occur only if the department's report finds the pilot projects effective.
187.13 		Subd. 4.Expiration. This section expires June 30, 2012.

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

187.15 	ARTICLE 8
187.16 	CONTINUING CARE

187.17 	Section 1. Minnesota Statutes 2008, section 144.0724, subdivision 2, is amended to 
187.18 	read:
187.19 		Subd. 2.Definitions. For purposes of this section, the following terms have the 
187.20 	meanings given.
187.21 	(a) "Assessment reference date" means the last day of the minimum data set 
187.22 	observation period. The date sets the designated endpoint of the common observation 
187.23 	period, and all minimum data set items refer back in time from that point.
187.24 	(b) "Case mix index" means the weighting factors assigned to the RUG-III 
187.25 	classifications.
187.26 	(c) "Index maximization" means classifying a resident who could be assigned to 
187.27 	more than one category, to the category with the highest case mix index.
187.28 	(d) "Minimum data set" means the assessment instrument specified by the Centers for 
187.29 	Medicare and Medicaid Services and designated by the Minnesota Department of Health.
187.30 	(e) "Representative" means a person who is the resident's guardian or conservator, 
187.31 	the person authorized to pay the nursing home expenses of the resident, a representative 
187.32 	of the nursing home ombudsman's office whose assistance has been requested, or any 
187.33 	other individual designated by the resident.
188.1 	(f) "Resource utilization groups" or "RUG" means the system for grouping a nursing 
188.2 	facility's residents according to their clinical and functional status identified in data 
188.3 	supplied by the facility's minimum data set.
188.4 	(g) "Activities of daily living" means grooming, dressing, bathing, transferring, 
188.5 	mobility, positioning, eating, and toileting.
188.6 	(h) "Nursing facility level of care determination" means the assessment process 
188.7 	that results in a determination of a resident's or prospective resident's need for nursing 
188.8 	facility level of care as established in subdivision 11 for purposes of medical assistance 
188.9 	payment of long-term care services for:
188.10 	(1) nursing facility services under section 256B.434 or 256B.441;
188.11 	(2) elderly waiver services under section 256B.0915;
188.12 	(3) CADI and TBI waiver services under section 256B.49; and
188.13 	(4) state payment of alternative care services under section 256B.0913.

188.14 	EFFECTIVE DATE. The section is effective January 1, 2011.

188.15 	Sec. 2. Minnesota Statutes 2008, section 144.0724, subdivision 4, is amended to read:
188.16 		Subd. 4.Resident assessment schedule. (a) A facility must conduct and 
188.17 	electronically submit to the commissioner of health case mix assessments that conform 
188.18 	with the assessment schedule defined by Code of Federal Regulations, title 42, section 
188.19 	483.20, and published by the United States Department of Health and Human Services, 
188.20 	Centers for Medicare and Medicaid Services, in the Long Term Care Assessment 
188.21 	Instrument User's Manual, version 2.0, October 1995, and subsequent clarifications made 
188.22 	in the Long-Term Care Assessment Instrument Questions and Answers, version 2.0, 
188.23 	August 1996. The commissioner of health may substitute successor manuals or question 
188.24 	and answer documents published by the United States Department of Health and Human 
188.25 	Services, Centers for Medicare and Medicaid Services, to replace or supplement the 
188.26 	current version of the manual or document.
188.27 	(b) The assessments used to determine a case mix classification for reimbursement 
188.28 	include the following:
188.29 	(1) a new admission assessment must be completed by day 14 following admission;
188.30 	(2) an annual assessment must be completed within 366 days of the last 
188.31 	comprehensive assessment;
188.32 	(3) a significant change assessment must be completed within 14 days of the 
188.33 	identification of a significant change; and
188.34 	(4) the second quarterly assessment following either a new admission assessment, 
188.35 	an annual assessment, or a significant change assessment, and all quarterly assessments 
189.1 	beginning October 1, 2006. Each quarterly assessment must be completed within 92 
189.2 	days of the previous assessment.
189.3 	(c) In addition to the assessments listed in paragraph (b), the assessments used to 
189.4 	determine nursing facility level of care include the following:
189.5 	(1) preadmission screening completed under section 256B.0911, subdivision 4a, 
189.6 	by a county, tribe, or managed care organization under contract with the Department 
189.7 	of Human Services; and
189.8 	(2) a face-to-face long-term care consultation assessment completed under section 
189.9 	256B.0911, subdivision 3a, 3b, or 4d, by a county, tribe, or managed care organization 
189.10 	under contract with the Department of Human Services.

189.11 	EFFECTIVE DATE. The section is effective January 1, 2011.

189.12 	Sec. 3. Minnesota Statutes 2008, section 144.0724, subdivision 8, is amended to read:
189.13 		Subd. 8.Request for reconsideration of resident classifications. (a) The resident, 
189.14 	or resident's representative, or the nursing facility or boarding care home may request that 
189.15 	the commissioner of health reconsider the assigned reimbursement classification. The 
189.16 	request for reconsideration must be submitted in writing to the commissioner within 
189.17 	30 days of the day the resident or the resident's representative receives the resident 
189.18 	classification notice. The request for reconsideration must include the name of the 
189.19 	resident, the name and address of the facility in which the resident resides, the reasons for 
189.20 	the reconsideration, the requested classification changes, and documentation supporting 
189.21 	the requested classification. The documentation accompanying the reconsideration request 
189.22 	is limited to documentation which establishes that the needs of the resident at the time of 
189.23 	the assessment justify a classification which is different than the classification established 
189.24 	by the commissioner of health.
189.25 	(b) Upon request, the nursing facility must give the resident or the resident's 
189.26 	representative a copy of the assessment form and the other documentation that was given 
189.27 	to the commissioner of health to support the assessment findings. The nursing facility 
189.28 	shall also provide access to and a copy of other information from the resident's record that 
189.29 	has been requested by or on behalf of the resident to support a resident's reconsideration 
189.30 	request. A copy of any requested material must be provided within three working days of 
189.31 	receipt of a written request for the information. If a facility fails to provide the material 
189.32 	within this time, it is subject to the issuance of a correction order and penalty assessment 
189.33 	under sections 144.653 and 144A.10. Notwithstanding those sections, any correction order 
189.34 	issued under this subdivision must require that the nursing facility immediately comply 
189.35 	with the request for information and that as of the date of the issuance of the correction 
190.1 	order, the facility shall forfeit to the state a $100 fine for the first day of noncompliance, and 
190.2 	an increase in the $100 fine by $50 increments for each day the noncompliance continues. 
190.3 	(c) In addition to the information required under paragraphs (a) and (b), a 
190.4 	reconsideration request from a nursing facility must contain the following information: (i) 
190.5 	the date the reimbursement classification notices were received by the facility; (ii) the date 
190.6 	the classification notices were distributed to the resident or the resident's representative; 
190.7 	and (iii) a copy of a notice sent to the resident or to the resident's representative. This 
190.8 	notice must inform the resident or the resident's representative that a reconsideration of the 
190.9 	resident's classification is being requested, the reason for the request, that the resident's 
190.10 	rate will change if the request is approved by the commissioner, the extent of the change, 
190.11 	that copies of the facility's request and supporting documentation are available for review, 
190.12 	and that the resident also has the right to request a reconsideration. If the facility fails to 
190.13 	provide the required information with the reconsideration request, the request must be 
190.14 	denied, and the facility may not make further reconsideration requests on that specific 
190.15 	reimbursement classification.
190.16 	(d) Reconsideration by the commissioner must be made by individuals not involved 
190.17 	in reviewing the assessment, audit, or reconsideration that established the disputed 
190.18 	classification. The reconsideration must be based upon the initial assessment and upon the 
190.19 	information provided to the commissioner under paragraphs (a) and (b). If necessary for 
190.20 	evaluating the reconsideration request, the commissioner may conduct on-site reviews. 
190.21 	Within 15 working days of receiving the request for reconsideration, the commissioner 
190.22 	shall affirm or modify the original resident classification. The original classification 
190.23 	must be modified if the commissioner determines that the assessment resulting in the 
190.24 	classification did not accurately reflect the needs or assessment characteristics of the 
190.25 	resident at the time of the assessment. The resident and the nursing facility or boarding 
190.26 	care home shall be notified within five working days after the decision is made. A decision 
190.27 	by the commissioner under this subdivision is the final administrative decision of the 
190.28 	agency for the party requesting reconsideration.
190.29 	(e) The resident classification established by the commissioner shall be the 
190.30 	classification that applies to the resident while the request for reconsideration is pending.
190.31 	If a request for reconsideration applies to an assessment used to determine nursing facility 
190.32 	level of care under subdivision 4, paragraph (c), the resident shall continue to be eligible 
190.33 	for nursing facility level of care while the request for reconsideration is pending.
190.34 	(f) The commissioner may request additional documentation regarding a 
190.35 	reconsideration necessary to make an accurate reconsideration determination.

190.36 	EFFECTIVE DATE. The section is effective January 1, 2011.

191.1 	Sec. 4. Minnesota Statutes 2008, section 144.0724, is amended by adding a subdivision 
191.2 	to read:
191.3 		Subd. 11.Nursing facility level of care. (a) For purposes of medical assistance 
191.4 	payment of long-term care services, a recipient must be determined, using assessments 
191.5 	defined in subdivision 4, to meet one of the following nursing facility level of care criteria:
191.6 	(1) the person needs the assistance of another person or constant supervision to begin 
191.7 	and complete at least four of the following activities of living: bathing, bed mobility, 
191.8 	dressing, eating, grooming, toileting, transferring, and walking; 
191.9 	(2) the person needs the assistance of another person or constant supervision to begin 
191.10 	and complete toileting, transferring, or positioning and the assistance cannot be scheduled;
191.11 	(3) the person has significant difficulty with memory, using information, daily 
191.12 	decision making, or behavioral needs that require intervention;
191.13 	(4) the person has had a qualifying nursing facility stay of at least 90 days; or
191.14 	(5) the person is determined to be at risk for nursing facility admission or 
191.15 	readmission through a face-to-face long-term care consultation assessment as specified 
191.16 	in section 256B.0911, subdivision 3a, 3b, or 4d, by a county, tribe, or managed care 
191.17 	organization under contract with the Department of Human Services. The person is 
191.18 	considered at risk under this clause if the person currently lives alone or will live alone 
191.19 	upon discharge and also meets one of the following criteria:
191.20 	(i) the person has experienced a fall resulting in a fracture;
191.21 	(ii) the person has been determined to be at risk of maltreatment or neglect, 
191.22 	including self-neglect; or
191.23 	(iii) the person has a sensory impairment that substantially impacts functional ability 
191.24 	and maintenance of a community residence.
191.25 	(b) The assessment used to establish medical assistance payment for nursing facility 
191.26 	services must be the most recent assessment performed under subdivision 4, paragraph 
191.27 	(b), that occurred no more than 90 calendar days before the effective date of medical 
191.28 	assistance eligibility for payment of long-term care services. In no case shall medical 
191.29 	assistance payment for long-term care services occur prior to the date of the determination 
191.30 	of nursing facility level of care.
191.31 	(c) The assessment used to establish medical assistance payment for long-term care 
191.32 	services provided under sections 256B.0915 and 256B.49 and alternative care payment 
191.33 	for services provided under section 256B.0913 must be the most recent face-to-face 
191.34 	assessment performed under section 256B.0911, subdivision 3a, that occurred no more 
191.35 	than 60 calendar days before the effective date of medical assistance eligibility for 
191.36 	payment of long-term care services.

192.1 	EFFECTIVE DATE. The section is effective January 1, 2011.

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

192.8 	EFFECTIVE DATE. The section is effective January 1, 2011.

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

192.16 	Sec. 7. Minnesota Statutes 2008, section 144A.44, subdivision 2, is amended to read:
192.17 		Subd. 2.Interpretation and enforcement of rights. These rights are established 
192.18 	for the benefit of persons who receive home care services. "Home care services" means 
192.19 	home care services as defined in section 144A.43, subdivision 3, and unlicensed personal 
192.20 	care assistance services, including services covered by medical assistance under section 
192.21 	256B.0625, subdivision 19a. A home care provider may not require a person to surrender 
192.22 	these rights as a condition of receiving services. A guardian or conservator or, when there 
192.23 	is no guardian or conservator, a designated person, may seek to enforce these rights. This 
192.24 	statement of rights does not replace or diminish other rights and liberties that may exist 
192.25 	relative to persons receiving home care services, persons providing home care services, or 
192.26 	providers licensed under Laws 1987, chapter 378. A copy of these rights must be provided 
192.27 	to an individual at the time home care services, including personal care assistance 
192.28 	services, are initiated. The copy shall also contain the address and phone number of the 
192.29 	Office of Health Facility Complaints and the Office of Ombudsman for Long-Term Care 
192.30 	and a brief statement describing how to file a complaint with these offices. Information 
192.31 	about how to contact the Office of Ombudsman for Long-Term Care shall be included in 
192.32 	notices of change in client fees and in notices where home care providers initiate transfer 
192.33 	or discontinuation of services. 

193.1 	Sec. 8. Minnesota Statutes 2008, section 245A.03, is amended by adding a subdivision 
193.2 	to read:
193.3 		Subd. 7.Licensing moratorium. (a) The commissioner shall not issue an 
193.4 	initial license for child foster care licensed under Minnesota Rules, parts 2960.3000 to 
193.5 	2960.3340, or adult foster care licensed under Minnesota Rules, parts 9555.5105 to 
193.6 	9555.6265, under this chapter for a physical location that will not be the primary residence 
193.7 	of the license holder for the entire period of licensure. If a license is issued during this 
193.8 	moratorium, and the license holder changes the license holder's primary residence away 
193.9 	from the physical location of the foster care license, the commissioner shall revoke the 
193.10 	license according to section 245A.07. Exceptions to the moratorium include:
193.11 	(1) foster care settings that are required to be registered under chapter 144D;
193.12 	(2) foster care licenses replacing foster care licenses in existence on the effective 
193.13 	date of this section and determined to be needed by the commissioner under paragraph (b);
193.14 	(3) new foster care licenses determined to be needed by the commissioner under 
193.15 	paragraph (b) for the closure of a nursing facility, ICF/MR, or regional treatment center;
193.16 	(4) new foster care licenses determined to be needed by the commissioner under 
193.17 	paragraph (b) for persons requiring hospital level care; or
193.18 	(5) new foster care licenses determined to be needed by the commissioner for the 
193.19 	transition of people from personal care assistance to the home and community-based 
193.20 	services.
193.21 	(b) The commissioner shall determine the need for newly licensed foster care homes 
193.22 	as defined under this subdivision. As part of the determination, the commissioner shall 
193.23 	consider the availability of foster care capacity in the area which the licensee seeks to 
193.24 	operate, and the recommendation of the local county board. The determination by the 
193.25 	commissioner must be final. A determination of need is not required for a change in 
193.26 	ownership at the same address.
193.27 	(c) Residential settings that would otherwise be subject to the moratorium established 
193.28 	in paragraph (a), that are in the process of receiving an adult or child foster care license as 
193.29 	of July 1, 2009, shall be allowed to continue to complete the process of receiving an adult 
193.30 	or child foster care license. For this paragraph, all of the following conditions must be met 
193.31 	to be considered in process of receiving an adult or child foster care license:
193.32 	(1) participants have made decisions to move into the residential setting, including 
193.33 	documentation in each participant's care plan;
193.34 	(2) the provider has purchased housing or has made a financial investment in the 
193.35 	property;
194.1 	(3) the lead agency has approved the plans, including costs for the residential setting 
194.2 	for each individual;
194.3 	(4) the completion of the licensing process, including all necessary inspections, is 
194.4 	the only remaining component prior to being able to provide services; and
194.5 	(5) the needs of the individuals cannot be met within the existing capacity in that 
194.6 	county.
194.7 	To qualify for the process under this paragraph, the lead agency must submit 
194.8 	documentation to the commissioner by August 1, 2009, that all of the above criteria are 
194.9 	met.
194.10 	(d) The commissioner shall study the effects of the license moratorium under this 
194.11 	subdivision and shall report back to the legislature by January 15, 2011.

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

194.13 	Sec. 9. Minnesota Statutes 2008, section 245A.11, is amended by adding a subdivision 
194.14 	to read:
194.15 		Subd. 8.Community residential setting license. (a) The commissioner shall 
194.16 	establish provider standards for residential support services that integrate service standards 
194.17 	and the residential setting under one license. The commissioner shall propose statutory 
194.18 	language and an implementation plan for licensing requirements for residential support 
194.19 	services to the legislature by January 15, 2011.
194.20 	(b) Providers licensed under chapter 245B, and providing, contracting, or arranging 
194.21 	for services in settings licensed as adult foster care under Minnesota Rules, parts 
194.22 	9555.5105 to 9555.6265, or child foster care under Minnesota Rules, parts 2960.3000 to 
194.23 	2960.3340; and meeting the provisions of section 256B.092, subdivision 11, paragraph 
194.24 	(b), must be required to obtain a community residential setting license.

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

194.32 	Sec. 11. Minnesota Statutes 2008, section 252.50, subdivision 1, is amended to read:
195.1 		Subdivision 1. Community-based programs established. The commissioner 
195.2 	shall establish a system of state-operated, community-based programs for persons with 
195.3 	developmental disabilities. For purposes of this section, "state-operated, community-based 
195.4 	program" means a program administered by the state to provide treatment and habilitation 
195.5 	in noninstitutional community settings to persons with developmental disabilities. 
195.6 	Employees of the programs, except clients who work within and benefit from these 
195.7 	treatment and habilitation programs, must be state employees under chapters 43A and 
195.8 	179A. Although any clients who work within and benefit from these treatment and 
195.9 	habilitation programs are not employees under chapters 43A and 179A, the Department 
195.10 	of Human Services may consider clients who work within and benefit from these 
195.11 	programs employees for federal tax purposes. The establishment of state-operated, 
195.12 	community-based programs must be within the context of a comprehensive definition of 
195.13 	the role of state-operated services in the state. The role of state-operated services must 
195.14 	be defined within the context of a comprehensive system of services for persons with 
195.15 	developmental disabilities. State-operated, community-based programs may include, but 
195.16 	are not limited to, community group homes, foster care, supportive living services, day 
195.17 	training and habilitation programs, and respite care arrangements. The commissioner 
195.18 	may operate the pilot projects established under Laws 1985, First Special Session 
195.19 	chapter 9, article 1, section 2, subdivision 6, and shall, within the limits of available 
195.20 	appropriations, establish additional state-operated, community-based programs for 
195.21 	persons with developmental disabilities. State-operated, community-based programs may 
195.22 	accept admissions from regional treatment centers, from the person's own home, or from 
195.23 	community programs. State-operated, community-based programs offering day program 
195.24 	services may be provided for persons with developmental disabilities who are living in 
195.25 	state-operated, community-based residential programs until July 1, 2000. No later than 
195.26 	1994, the commissioner, together with family members, counties, advocates, employee 
195.27 	representatives, and other interested parties, shall begin planning so that by July 1, 2000, 
195.28 	state-operated, community-based residential facilities will be in compliance with section 
195.29 	252.41, subdivision 9. 

195.30 	Sec. 12. Minnesota Statutes 2008, section 256.01, is amended by adding a subdivision 
195.31 	to read:
195.32 		Subd. 29.State medical review team. (a) To ensure the timely processing of 
195.33 	determinations of disability by the commissioner's state medical review team under 
195.34 	sections 256B.055, subdivision 7, paragraph (b), 256B.057, subdivision 9, paragraph 
195.35 	(j), and 256B.055, subdivision 12, the commissioner shall review all medical evidence 
196.1 	submitted by county agencies with a referral and seek additional information from 
196.2 	providers, applicants, and enrollees to support the determination of disability where 
196.3 	necessary. Disability shall be determined according to the rules of title XVI and title 
196.4 	XIX of the Social Security Act and pertinent rules and policies of the Social Security 
196.5 	Administration.
196.6 	(b) Prior to a denial or withdrawal of a requested determination of disability due 
196.7 	to insufficient evidence, the commissioner shall (1) ensure that the missing evidence is 
196.8 	necessary and appropriate to a determination of disability, and (2) assist applicants and 
196.9 	enrollees to obtain the evidence, including, but not limited to, medical examinations 
196.10 	and electronic medical records.
196.11 	(c) The commissioner shall provide the chairs of the legislative committees with 
196.12 	jurisdiction over health and human services finance and budget the following information 
196.13 	on the activities of the state medical review team by February 1, 2010, and annually 
196.14 	thereafter:
196.15 	(1) the number of applications to the state medical review team that were denied, 
196.16 	approved, or withdrawn;
196.17 	(2) the average length of time from receipt of the application to a decision;
196.18 	(3) the number of appeals and appeal results;
196.19 	(4) for applicants, their age, health coverage at the time of application, hospitalization 
196.20 	history within three months of application, and whether an application for Social Security 
196.21 	or Supplemental Security Income benefits is pending; and 
196.22 	(5) specific information on the medical certification, licensure, or other credentials 
196.23 	of the person or persons performing the medical review determinations and length of 
196.24 	time in that position.

196.25 	Sec. 13. [256.0281] INTERAGENCY DATA EXCHANGE.
196.26 	The Department of Human Services, the Department of Health, and the Office of the 
196.27 	Ombudsman for Mental Health and Developmental Disabilities may establish interagency 
196.28 	agreements governing the electronic exchange of data on providers and individuals 
196.29 	collected, maintained, or used by each agency when such exchange is outlined by each 
196.30 	agency in an interagency agreement to accomplish the purposes in clauses (1) to (4):
196.31 	(1) to improve provider enrollment processes for home and community-based 
196.32 	services and state plan home care services;
196.33 	(2) to improve quality management of providers between state agencies;
196.34 	(3) to establish and maintain provider eligibility to participate as providers under 
196.35 	Minnesota health care programs; or
197.1 	(4) to meet the quality assurance reporting requirements under federal law under 
197.2 	section 1915(c) of the Social Security Act related to home and community-based waiver 
197.3 	programs.
197.4 	Each interagency agreement must include provisions to ensure anonymity of individuals, 
197.5 	including mandated reporters, and must outline the specific uses of and access to shared 
197.6 	data within each agency. Electronic interfaces between source data systems developed 
197.7 	under these interagency agreements must incorporate these provisions as well as other 
197.8 	HIPPA provisions related to individual data.

197.9 	Sec. 14. Minnesota Statutes 2008, section 256.476, subdivision 5, is amended to read:
197.10 		Subd. 5. Reimbursement, allocations, and reporting. (a) For the purpose of 
197.11 	transferring persons to the consumer support grant program from the family support 
197.12 	program and personal care assistant services, home health aide services, or private duty 
197.13 	nursing services, the amount of funds transferred by the commissioner between the 
197.14 	family support program account, the medical assistance account, or the consumer support 
197.15 	grant account shall be based on each county's participation in transferring persons to the 
197.16 	consumer support grant program from those programs and services. 
197.17 	(b) At the beginning of each fiscal year, county allocations for consumer support 
197.18 	grants shall be based on: 
197.19 	(1) the number of persons to whom the county board expects to provide consumer 
197.20 	supports grants; 
197.21 	(2) their eligibility for current program and services; 
197.22 	(3) the amount of nonfederal dollars monthly grant levels allowed under subdivision 
197.23 	11; and 
197.24 	(4) projected dates when persons will start receiving grants. County allocations shall 
197.25 	be adjusted periodically by the commissioner based on the actual transfer of persons or 
197.26 	service openings, and the nonfederal dollars monthly grant levels associated with those 
197.27 	persons or service openings, to the consumer support grant program. 
197.28 	(c) The amount of funds transferred by the commissioner from the medical 
197.29 	assistance account for an individual may be changed if it is determined by the county or its 
197.30 	agent that the individual's need for support has changed. 
197.31 	(d) The authority to utilize funds transferred to the consumer support grant account 
197.32 	for the purposes of implementing and administering the consumer support grant program 
197.33 	will not be limited or constrained by the spending authority provided to the program 
197.34 	of origination. 
198.1 	(e) The commissioner may use up to five percent of each county's allocation, as 
198.2 	adjusted, for payments for administrative expenses, to be paid as a proportionate addition 
198.3 	to reported direct service expenditures. 
198.4 	(f) The county allocation for each person or the person's legal representative or other 
198.5 	authorized representative cannot exceed the amount allowed under subdivision 11. 
198.6 	(g) The commissioner may recover, suspend, or withhold payments if the county 
198.7 	board, local agency, or grantee does not comply with the requirements of this section. 
198.8 	(h) Grant funds unexpended by consumers shall return to the state once a year. The 
198.9 	annual return of unexpended grant funds shall occur in the quarter following the end of 
198.10 	the state fiscal year. 

198.11 	Sec. 15. Minnesota Statutes 2008, section 256.476, subdivision 11, is amended to read:
198.12 		Subd. 11.Consumer support grant program after July 1, 2001. (a) Effective 
198.13 	July 1, 2001, the commissioner shall allocate consumer support grant resources to 
198.14 	serve additional individuals based on a review of Medicaid authorization and payment 
198.15 	information of persons eligible for a consumer support grant from the most recent fiscal 
198.16 	year. The commissioner shall use the following methodology to calculate maximum 
198.17 	allowable monthly consumer support grant levels:
198.18 	(1) For individuals whose program of origination is medical assistance home care 
198.19 	under sections 256B.0651 and 256B.0653 to 256B.0656, the maximum allowable monthly 
198.20 	grant levels are calculated by:
198.21 	(i) determining the nonfederal share 50 percent of the average service authorization 
198.22 	for each home care rating;
198.23 	(ii) calculating the overall ratio of actual payments to service authorizations by 
198.24 	program;
198.25 	(iii) applying the overall ratio to the average service authorization level of each 
198.26 	home care rating;
198.27 	(iv) adjusting the result for any authorized rate increases provided by the legislature; 
198.28 	and
198.29 	(v) adjusting the result for the average monthly utilization per recipient.
198.30 	(2) The commissioner may review and evaluate the methodology to reflect changes 
198.31 	in the home care program's overall ratio of actual payments to service authorizations
198.32 	programs.
198.33 	(b) Effective January 1, 2004, persons previously receiving exception grants will 
198.34 	have their grants calculated using the methodology in paragraph (a), clause (1). If a person 
198.35 	currently receiving an exception grant wishes to have their home care rating reevaluated, 
199.1 	they may request an assessment as defined in section 256B.0651, subdivision 1, paragraph 
199.2 	(b).

199.3 	Sec. 16. Minnesota Statutes 2008, section 256.975, subdivision 7, is amended to read:
199.4 		Subd. 7.Consumer information and assistance and long-term care options 
199.5 	counseling; senior linkage Senior LinkAge Line. (a) The Minnesota Board on Aging 
199.6 	shall operate a statewide information and assistance service to aid older Minnesotans and 
199.7 	their families in making informed choices about long-term care options and health care 
199.8 	benefits. Language services to persons with limited English language skills may be made 
199.9 	available. The service, known as Senior LinkAge Line, must be available during business 
199.10 	hours through a statewide toll-free number and must also be available through the Internet.
199.11 	(b) The service must assist provide long-term care options counseling by assisting
199.12 	older adults, caregivers, and providers in accessing information  and options counseling 
199.13 	about choices in long-term care services that are purchased through private providers or 
199.14 	available through public options. The service must:
199.15 	(1) develop a comprehensive database that includes detailed listings in both 
199.16 	consumer- and provider-oriented formats;
199.17 	(2) make the database accessible on the Internet and through other telecommunication 
199.18 	and media-related tools;
199.19 	(3) link callers to interactive long-term care screening tools and make these tools 
199.20 	available through the Internet by integrating the tools with the database;
199.21 	(4) develop community education materials with a focus on planning for long-term 
199.22 	care and evaluating independent living, housing, and service options;
199.23 	(5) conduct an outreach campaign to assist older adults and their caregivers in 
199.24 	finding information on the Internet and through other means of communication;
199.25 	(6) implement a messaging system for overflow callers and respond to these callers 
199.26 	by the next business day;
199.27 	(7) link callers with county human services and other providers to receive more 
199.28 	in-depth assistance and consultation related to long-term care options;
199.29 	(8) link callers with quality profiles for nursing facilities and other providers 
199.30 	developed by the commissioner of health; and
199.31 	(9) incorporate information about housing with services and consumer rights 
199.32 	within the MinnesotaHelp.info network long-term care database to facilitate consumer 
199.33 	comparison of services and costs among housing with services establishments and with 
199.34 	other in-home services and to support financial self-sufficiency as long as possible. 
199.35 	Housing with services establishments and their arranged home care providers shall provide 
200.1 	information to the commissioner of human services that is consistent with information 
200.2 	required by the commissioner of health under section 144G.06, the Uniform Consumer 
200.3 	Information Guide. The commissioner of human services shall provide the data to the 
200.4 	Minnesota Board on Aging for inclusion in the MinnesotaHelp.info network long-term 
200.5 	care database.;
200.6 	(10) provide long-term care options counseling. Long-term care options counselors 
200.7 	shall:
200.8 	(i) for individuals not eligible for case management under a public program or public 
200.9 	funding source, provide interactive decision support under which consumers, family 
200.10 	members, or other helpers are supported in their deliberations to determine appropriate 
200.11 	long-term care choices in the context of the consumer's needs, preferences, values, and 
200.12 	individual circumstances, including implementing a community support plan;
200.13 	(ii) provide Web-based educational information and collateral written materials to 
200.14 	familiarize consumers, family members, or other helpers with the long-term care basics, 
200.15 	issues to be considered, and the range of options available in the community;
200.16 	(iii) provide long-term care futures planning, which means providing assistance to 
200.17 	individuals who anticipate having long-term care needs to develop a plan for the more 
200.18 	distant future; and
200.19 	(iv) provide expertise in benefits and financing options for long-term care, including 
200.20 	Medicare, long-term care insurance, tax or employer-based incentives, reverse mortgages, 
200.21 	private pay options, and ways to access low or no-cost services or benefits through 
200.22 	volunteer-based or charitable programs; and
200.23 	(11) using risk management and support planning protocols, provide long-term care 
200.24 	options counseling to current residents of nursing homes deemed appropriate for discharge 
200.25 	by the commissioner. In order to meet this requirement, the commissioner shall provide 
200.26 	designated Senior LinkAge Line contact centers with a list of nursing home residents 
200.27 	appropriate for discharge planning via a secure Web portal. Senior LinkAge Line shall 
200.28 	provide these residents, if they indicate a preference to receive long-term care options 
200.29 	counseling, with initial assessment, review of risk factors, independent living support 
200.30 	consultation, or referral to:
200.31 	(i) services under section 256B.0911, subdivision 3;
200.32 	(ii) designated care coordinators of contracted entities under section 256B.035 for 
200.33 	persons who are enrolled in a managed care plan; or
200.34 	(iii) the long-term care consultation team for those who are appropriate for relocation 
200.35 	service coordination due to high-risk factors or psychological or physical disability.
201.1 	(c) The Minnesota Board on Aging shall conduct an evaluation of the effectiveness 
201.2 	of the statewide information and assistance, and submit this evaluation to the legislature 
201.3 	by December 1, 2002. The evaluation must include an analysis of funding adequacy, gaps 
201.4 	in service delivery, continuity in information between the service and identified linkages, 
201.5 	and potential use of private funding to enhance the service.

201.6 	Sec. 17. Minnesota Statutes 2008, section 256B.055, subdivision 7, is amended to read:
201.7 		Subd. 7.Aged, blind, or disabled persons. (a) Medical assistance may be paid for 
201.8 	a person who meets the categorical eligibility requirements of the supplemental security 
201.9 	income program or, who would meet those requirements except for excess income or 
201.10 	assets, and who meets the other eligibility requirements of this section.
201.11 	(b) Following a determination that the applicant is not aged or blind and does not 
201.12 	meet any other category of eligibility for medical assistance and has not been determined 
201.13 	disabled by the Social Security Administration, applicants under this subdivision shall be 
201.14 	referred to the commissioner's state medical review team for a determination of disability. 

201.15 	Sec. 18. Minnesota Statutes 2008, section 256B.0625, subdivision 6a, is amended to 
201.16 	read:
201.17 		Subd. 6a.Home health services. Home health services are those services specified 
201.18 	in Minnesota Rules, part 9505.0295 and sections 256B.0651 and 256B.0653. Medical 
201.19 	assistance covers home health services at a recipient's home residence. Medical assistance 
201.20 	does not cover home health services for residents of a hospital, nursing facility, or 
201.21 	intermediate care facility, unless the commissioner of human services has prior authorized 
201.22 	skilled nurse visits for less than 90 days for a resident at an intermediate care facility for 
201.23 	persons with developmental disabilities, to prevent an admission to a hospital or nursing 
201.24 	facility or unless a resident who is otherwise eligible is on leave from the facility and the 
201.25 	facility either pays for the home health services or forgoes the facility per diem for the 
201.26 	leave days that home health services are used. Home health services must be provided by 
201.27 	a Medicare certified home health agency. All nursing and home health aide services must 
201.28 	be provided according to sections 256B.0651 to 256B.0656256B.0653.

201.29 	Sec. 19. Minnesota Statutes 2008, section 256B.0625, subdivision 7, is amended to 
201.30 	read:
201.31 		Subd. 7.Private duty nursing. Medical assistance covers private duty nursing 
201.32 	services in a recipient's home. Recipients who are authorized to receive private duty 
201.33 	nursing services in their home may use approved hours outside of the home during hours 
202.1 	when normal life activities take them outside of their home. To use private duty nursing 
202.2 	services at school, the recipient or responsible party must provide written authorization in 
202.3 	the care plan identifying the chosen provider and the daily amount of services to be used at 
202.4 	school. Medical assistance does not cover private duty nursing services for residents of a 
202.5 	hospital, nursing facility, intermediate care facility, or a health care facility licensed by the 
202.6 	commissioner of health, except as authorized in section 256B.64 for ventilator-dependent 
202.7 	recipients in hospitals or unless a resident who is otherwise eligible is on leave from the 
202.8 	facility and the facility either pays for the private duty nursing services or forgoes the 
202.9 	facility per diem for the leave days that private duty nursing services are used. Total hours 
202.10 	of service and payment allowed for services outside the home cannot exceed that which is 
202.11 	otherwise allowed in an in-home setting according to sections 256B.0651 and 256B.0653
202.12 	256B.0654 to 256B.0656. All private duty nursing services must be provided according to 
202.13 	the limits established under sections 256B.0651 and 256B.0653 to 256B.0656. Private 
202.14 	duty nursing services may not be reimbursed if the nurse is the  family foster care provider 
202.15 	of a recipient who is under age 18, unless allowed under section 256B.0654, subdivision 4.

202.16 	Sec. 20. Minnesota Statutes 2008, section 256B.0625, subdivision 19a, is amended to 
202.17 	read:
202.18 		Subd. 19a.Personal care assistant assistance  services. Medical assistance covers 
202.19 	personal care assistant assistance  services in a recipient's home. Effective January 1, 
202.20 	2010, to qualify for personal care assistant assistance  services, a recipient must require 
202.21 	assistance and be determined dependent in one activity of daily living as defined in section 
202.22 	256B.0659, subdivision 1, paragraph (b), or in a Level I behavior as defined in section 
202.23 	256B.0659, subdivision 1, paragraph (c). Beginning July 1, 2011, to qualify for personal 
202.24 	care assistance services, a recipient must require assistance and be determined dependent 
202.25 	in at least two activities of daily living as defined in section 256B.0659. Recipients or 
202.26 	responsible parties must be able to identify the recipient's needs, direct and evaluate task 
202.27 	accomplishment, and provide for health and safety. Approved hours may be used outside 
202.28 	the home when normal life activities take them outside the home. To use personal care 
202.29 	assistant assistance  services at school, the recipient or responsible party must provide 
202.30 	written authorization in the care plan identifying the chosen provider and the daily amount 
202.31 	of services to be used at school. Total hours for services, whether actually performed 
202.32 	inside or outside the recipient's home, cannot exceed that which is otherwise allowed for 
202.33 	personal care assistant assistance  services in an in-home setting according to sections 
202.34 	256B.0651and 256B.0653 to 256B.0656. Medical assistance does not cover personal care 
202.35 	assistant assistance  services for residents of a hospital, nursing facility, intermediate care 
203.1 	facility, health care facility licensed by the commissioner of health, or unless a resident 
203.2 	who is otherwise eligible is on leave from the facility and the facility either pays for the 
203.3 	personal care assistant assistance  services or forgoes the facility per diem for the leave 
203.4 	days that personal care assistant assistance  services are used. All personal care assistant
203.5 	assistance  services must be provided according to sections 256B.0651and 256B.0653
203.6 	to 256B.0656. Personal care assistant assistance  services may not be reimbursed if the 
203.7 	personal care assistant is the spouse or legalpaid guardian of the recipient or the parent of 
203.8 	a recipient under age 18, or the responsible party or the family foster care provider of a 
203.9 	recipient who cannot direct the recipient's own care unless, in the case of a foster care 
203.10 	provider, a county or state case manager visits the recipient as needed, but not less than 
203.11 	every six months, to monitor the health and safety of the recipient and to ensure the goals 
203.12 	of the care plan are met. Parents of adult recipients, adult children of the recipient or 
203.13 	adult siblings of the recipient may be reimbursed for personal care assistant services, 
203.14 	if they are granted a waiver under sections 256B.0651 and 256B.0653 to 256B.0656. 
203.15 	Notwithstanding the provisions of section 256B.0655, subdivision 2, paragraph (b), clause 
203.16 	(4) 256B.0659, the noncorporate legal unpaid guardian or conservator of an adult, who is 
203.17 	not the responsible party and not the personal care provider organization, may be granted a 
203.18 	hardship waiver under sections 256B.0651 and 256B.0653 to 256B.0656, to be reimbursed 
203.19 	to provide personal care assistant assistance  services to the recipient if the guardian or 
203.20 	conservator meets all criteria for a personal care assistant according to section 256B.0659, 
203.21 	and shall not be considered to have a service provider interest for purposes of participation 
203.22 	on the screening team under section 256B.092, subdivision 7.

203.23 	Sec. 21. Minnesota Statutes 2008, section 256B.0625, subdivision 19c, is amended to 
203.24 	read:
203.25 		Subd. 19c.Personal care. Medical assistance covers personal care assistant
203.26 	assistance  services provided by an individual who is qualified to provide the services 
203.27 	according to subdivision 19a and sections 256B.0651and 256B.0653 to 256B.0656, 
203.28 	where the services have a statement of need by a physician, provided in accordance with 
203.29 	a plan, and are supervised by the recipient or a qualified professional. The physician's 
203.30 	statement of need for personal care assistant services shall be documented on a form 
203.31 	approved by the commissioner and include the diagnosis or condition of the person that 
203.32 	results in a need for personal care assistant services and be updated when the person's 
203.33 	medical condition requires a change, but at least annually if the need for personal care 
203.34 	assistant services is ongoing.
204.1 	"Qualified professional" means a mental health professional as defined in section 245.462, 
204.2 	subdivision 18, or 245.4871, subdivision 27; or a registered nurse as defined in sections 
204.3 	148.171 to 148.285, or a licensed social worker as defined in section 148B.21, or a 
204.4 	qualified developmental disabilities specialist under section 245B.07, subdivision 4. 
204.5 	As part of the assessment, the county public health nurse will assist the recipient or 
204.6 	responsible party to identify the most appropriate person to provide supervision of the 
204.7 	personal care assistant. The qualified professional shall perform the duties described
204.8 	required in Minnesota Rules, part 9505.0335, subpart 4 section 256B.0659.

204.9 	Sec. 22. Minnesota Statutes 2008, section 256B.0641, subdivision 3, is amended to 
204.10 	read:
204.11 		Subd. 3.Facility in receivership. Subdivision 2 does not apply to the change of 
204.12 	ownership of a facility to a nonrelated organization while the facility to be sold, transferred 
204.13 	or reorganized is in receivership under section 144A.14, 144A.15, 245A.12, or 245A.13, 
204.14 	and the commissioner during the receivership has not determined the need to place 
204.15 	residents of the facility into a newly constructed or newly established facility. Nothing 
204.16 	in this subdivision limits the liability of a former owner.

204.17 	Sec. 23. Minnesota Statutes 2008, section 256B.0651, is amended to read:
204.18 	256B.0651 HOME CARE SERVICES.
204.19 		Subdivision 1.Definitions. (a) "Activities of daily living" includes eating, toileting, 
204.20 	grooming, dressing, bathing, transferring, mobility, and positioning For the purposes of 
204.21 	sections 256B.0651 to 256B.0656 and 256B.0659, the terms in paragraphs (b) to (g) 
204.22 	have the meanings given.
204.23 	(b) "Activities of daily living" has the meaning given in section 256B.0659, 
204.24 	subdivision 1, paragraph (b).
204.25 	(c) "Assessment" means a review and evaluation of a recipient's need for home care 
204.26 	services conducted in person. Assessments for home health agency services shall be 
204.27 	conducted by a home health agency nurse. Assessments for medical assistance home care 
204.28 	services for developmental disability and alternative care services for developmentally 
204.29 	disabled home and community-based waivered recipients may be conducted by the county 
204.30 	public health nurse to ensure coordination and avoid duplication. Assessments must be 
204.31 	completed on forms provided by the commissioner within 30 days of a request for home 
204.32 	care services by a recipient or responsible party.
204.33 	(c) (d) "Home care services" means a health service, determined by the commissioner 
204.34 	as medically necessary, that is ordered by a physician and documented in a service plan 
205.1 	that is reviewed by the physician at least once every 60 days for the provision of home 
205.2 	health services, or private duty nursing, or at least once every 365 days for personal care. 
205.3 	Home care services are provided to the recipient at the recipient's residence that is a 
205.4 	place other than a hospital or long-term care facility or as specified in section 256B.0625
205.5 	means medical assistance covered services that are home health agency services, including 
205.6 	skilled nurse visits; home health aide visits; physical therapy, occupational therapy, 
205.7 	respiratory therapy, and language-speech pathology therapy; private duty nursing; and 
205.8 	personal care assistance.
205.9 	(e) "Home residence," effective January 1, 2010, means a residence owned or rented 
205.10 	by the recipient either alone, with roommates of the recipient's choosing, or with an unpaid 
205.11 	responsible party or legal representative; or a family foster home where the license holder 
205.12 	lives with the recipient and is not paid to provide home care services for the recipient 
205.13 	except as allowed under sections 256B.0651, subdivision 9, and 256B.0654, subdivision 4.
205.14 	(d) (f) "Medically necessary" has the meaning given in Minnesota Rules, parts 
205.15 	9505.0170 to 9505.0475.
205.16 	(e) "Telehomecare" means the use of telecommunications technology by a home 
205.17 	health care professional to deliver home health care services, within the professional's 
205.18 	scope of practice, to a patient located at a site other than the site where the practitioner 
205.19 	is located.
205.20 	(g) "Ventilator-dependent" means an individual who receives mechanical ventilation 
205.21 	for life support at least six hours per day and is expected to be or has been dependent on a 
205.22 	ventilator for at least 30 consecutive days.
205.23 		Subd. 2.Services covered. Home care services covered under this section and 
205.24 	sections 256B.0653 256B.0652  to 256B.0656 and 256B.0659 include:
205.25 	(1) nursing services under section sections256B.0625, subdivision 6a, and 
205.26 	256B.0653;
205.27 	(2) private duty nursing services under section sections256B.0625, subdivision 
205.28 	7, and 256B.0654;
205.29 	(3) home health services under section sections256B.0625, subdivision 6a, and 
205.30 	256B.0653;
205.31 	(4) personal care assistant assistance  services under section sections256B.0625, 
205.32 	subdivision 19a, and 256B.0659;
205.33 	(5) supervision of personal care assistant assistance  services provided by a qualified 
205.34 	professional under section sections256B.0625, subdivision 19a, and 256B.0659;
205.35 	(6) qualified professional of personal care assistant services under the fiscal 
205.36 	intermediary option as specified in section 256B.0655, subdivision 7;
206.1 	(7) face-to-face assessments by county public health nurses for services under 
206.2 	section sections256B.0625, subdivision 19a, 256B.0655, and 256B.0659; and
206.3 	(8) (7) service updates and review of temporary increases for personal care assistant
206.4 	assistance  services by the county public health nurse for services under section sections
206.5 	256B.0625, subdivision 19a, and 256B.0659.
206.6 		Subd. 3.Noncovered home care services. The following home care services are 
206.7 	not eligible for payment under medical assistance:
206.8 	(1) skilled nurse visits for the sole purpose of supervision of the home health aide;
206.9 	(2) a skilled nursing visit:
206.10 	(i) only for the purpose of monitoring medication compliance with an established 
206.11 	medication program for a recipient; or
206.12 	(ii) to administer or assist with medication administration, including injections, 
206.13 	prefilling syringes for injections, or oral medication set-up of an adult recipient, when as 
206.14 	determined and documented by the registered nurse, the need can be met by an available 
206.15 	pharmacy or the recipient is physically and mentally able to self-administer or prefill 
206.16 	a medication;
206.17 	(3) home care services to a recipient who is eligible for covered services under the 
206.18 	Medicare program or any other insurance held by the recipient;
206.19 	(4) services to other members of the recipient's household;
206.20 	(5) a visit made by a skilled nurse solely to train other home health agency workers;
206.21 	(6) any home care service included in the daily rate of the community-based 
206.22 	residential facility where the recipient is residing;
206.23 	(7) nursing and rehabilitation therapy services that are reasonably accessible to a 
206.24 	recipient outside the recipient's place of residence, excluding the assessment, counseling 
206.25 	and education, and personal assistant care;
206.26 	(8) any home health agency service, excluding personal care assistant services and 
206.27 	private duty nursing services, which are performed in a place other than the recipient's 
206.28 	residence; and
206.29 	(9) Medicare evaluation or administrative nursing visits on dual-eligible recipients 
206.30 	that do not qualify for Medicare visit billing.
206.31 	(1) services provided in a nursing facility, hospital, or intermediate care facility with 
206.32 	exceptions in section 256B.0653;
206.33 	(2) services for the sole purpose of monitoring medication compliance with an 
206.34 	established medication program for a recipient;
206.35 	(3) home care services for covered services under the Medicare program or any other 
206.36 	insurance held by the recipient;
207.1 	(4) services to other members of the recipient's household;
207.2 	(5) any home care service included in the daily rate of the community-based 
207.3 	residential facility where the recipient is residing;
207.4 	(6) nursing and rehabilitation therapy services that are reasonably accessible to a 
207.5 	recipient outside the recipient's place of residence, excluding the assessment, counseling 
207.6 	and education, and personal assistance care; or
207.7 	(7) Medicare evaluation or administrative nursing visits on dual-eligible recipients 
207.8 	that do not qualify for Medicare visit billing.
207.9 		Subd. 4.Prior Authorization; exceptions. All home care services above the limits 
207.10 	in subdivision 11 must receive the commissioner's prior authorization before services 
207.11 	begin, except when:
207.12 	(1) the home care services were required to treat an emergency medical condition 
207.13 	that if not immediately treated could cause a recipient serious physical or mental disability, 
207.14 	continuation of severe pain, or death. The provider must request retroactive authorization 
207.15 	no later than five working days after giving the initial service. The provider must be able 
207.16 	to substantiate the emergency by documentation such as reports, notes, and admission or 
207.17 	discharge histories;
207.18 	(2) the home care services were provided on or after the date on which the recipient's 
207.19 	eligibility began, but before the date on which the recipient was notified that the case was 
207.20 	opened. Authorization will be considered if the request is submitted by the provider 
207.21 	within 20 working days of the date the recipient was notified that the case was opened;
207.22 	a recipient's medical assistance eligibility has lapsed, is then retroactively reinstated, 
207.23 	and an authorization for home care services is completed based on the date of a current 
207.24 	assessment, eligibility, and request for authorization;
207.25 	(3) a third-party payor for home care services has denied or adjusted a payment. 
207.26 	Authorization requests must be submitted by the provider within 20 working days of the 
207.27 	notice of denial or adjustment. A copy of the notice must be included with the request;
207.28 	(4) the commissioner has determined that a county or state human services agency 
207.29 	has made an error; or
207.30 	(5) the professional nurse determines an immediate need for up to 40 skilled nursing 
207.31 	or home health aide visits per calendar year and submits a request for authorization within 
207.32 	20 working days of the initial service date, and medical assistance is determined to be 
207.33 	the appropriate payer. if a recipient enrolled in managed care experiences a temporary 
207.34 	disenrollment from a health plan, the commissioner shall accept the current health plan 
207.35 	authorization for personal care assistance services for up to 60 days. The request must 
207.36 	be received within the first 30 days of the disenrollment. If the recipient's reenrollment 
208.1 	in managed care is after the 60 days and before 90 days, the provider shall request an 
208.2 	additional 30-day extension of the current health plan authorization, for a total limit of 
208.3 	90 days from the time of disenrollment.
208.4 		Subd. 5.Retroactive authorization. A request for retroactive authorization will be 
208.5 	evaluated according to the same criteria applied to prior authorization requests.
208.6 		Subd. 6.Prior Authorization. (a) The commissioner, or the commissioner's 
208.7 	designee, shall review the assessment, service update, request for temporary services, 
208.8 	request for flexible use option, service plan, and any additional information that is 
208.9 	submitted. The commissioner shall, within 30 days after receiving a complete request, 
208.10 	assessment, and service plan, authorize home care services as follows: provided in this 
208.11 	section.
208.12 	(a) Home health services.(b) All Home health services provided by a home health 
208.13 	aide including skilled nurse visits and home health aide visits must be prior authorized 
208.14 	by the commissioner or the commissioner's designee. Prior Authorization must be based 
208.15 	on medical necessity and cost-effectiveness when compared with other care options. 
208.16 	The commissioner must receive the request for authorization of skilled nurse visits and 
208.17 	home health aide visits within 20 working days of the start of service. When home health 
208.18 	services are used in combination with personal care and private duty nursing, the cost of 
208.19 	all home care services shall be considered for cost-effectiveness. The commissioner shall 
208.20 	limit home health aide visits to no more than one visit each per day. The commissioner, or 
208.21 	the commissioner's designee, may authorize up to two skilled nurse visits per day.
208.22 	(b) Ventilator-dependent recipients.(c) If the recipient is ventilator-dependent, the 
208.23 	monthly medical assistance authorization for home care services shall not exceed what the 
208.24 	commissioner would pay for care at the highest cost hospital designated as a long-term 
208.25 	hospital under the Medicare program. For purposes of this paragraph, home care services 
208.26 	means all direct care services provided in the home that would be included in the payment 
208.27 	for care at the long-term hospital. "Ventilator-dependent" means an individual who 
208.28 	receives mechanical ventilation for life support at least six hours per day and is expected 
208.29 	to be or has been dependent for at least 30 consecutive days. Recipients who meet the 
208.30 	definition of ventilator dependent and the EN home care rating and utilize a combination 
208.31 	of home care services are limited up to a total of 24 hours of home care services per day. 
208.32 	Additional hours may be authorized when a recipient's assessment indicates a need for two 
208.33 	staff to perform activities. Additional time is limited to four hours per day.
208.34 		Subd. 7.Prior Authorization; time limits. (a) The commissioner or the 
208.35 	commissioner's designee shall determine the time period for which a prior an authorization 
208.36 	shall be effective and, if flexible use has been requested, whether to allow the flexible use 
209.1 	option. If the recipient continues to require home care services beyond the duration of 
209.2 	the prior authorization, the home care provider must request a new prior authorization. 
209.3 	A personal care provider agency must request a new personal care assistant assistance 
209.4 	 services assessment, or service update if allowed, at least 60 days prior to the end of 
209.5 	the current prior authorization time period. The request for the assessment must be 
209.6 	made on a form approved by the commissioner. Under no circumstances, other than the 
209.7 	exceptions in subdivision 4, shall a prior An authorization must be valid prior to the date 
209.8 	the commissioner receives the request or for no more than 12 months.
209.9 	(b) The amount and type of personal care assistance services authorized based 
209.10 	upon the assessment and service plan must remain in effect for the recipient whether 
209.11 	the recipient chooses a different provider or enrolls or disenrolls from a managed care 
209.12 	plan under section 256B.0659, unless the service needs of the recipient change and new 
209.13 	assessment is warranted under section 256B.0655, subdivision 1b.
209.14 	(c) A recipient who appeals a reduction in previously authorized home care 
209.15 	services may continue previously authorized services, other than temporary services 
209.16 	under subdivision 8, pending an appeal under section 256.045. The commissioner must 
209.17 	provide ensure that the recipient has a copy of the most recent service plan that contains 
209.18 	 a detailed explanation of why the authorized serviceswhich areas of covered personal 
209.19 	care assistance tasks are reduced in amount from those requested by the home care 
209.20 	provider, and provide notice of the amount of time per day reduced, and the reasons for 
209.21 	the reduction in the recipient's notice of denial, termination, or reduction.
209.22 		Subd. 8.Prior Authorization requests; temporary services. The agency nurse, 
209.23 	the independently enrolled private duty nurse, or county public health nurse may request 
209.24 	a temporary authorization for home care services by telephone. The commissioner may 
209.25 	approve a temporary level of home care services based on the assessment, and service 
209.26 	or care plan information, and primary payer coverage determination information as 
209.27 	required. Authorization for a temporary level of home care services including nurse 
209.28 	supervision is limited to the time specified by the commissioner, but shall not exceed 
209.29 	45 days, unless extended because the county public health nurse has not completed the 
209.30 	required assessment and service plan, or the commissioner's determination has not been 
209.31 	made. The level of services authorized under this provision shall have no bearing on a 
209.32 	future prior authorization.
209.33 		Subd. 9.Prior Authorization for foster care setting. (a) Home care services 
209.34 	provided in an adult or child foster care setting must receive prior authorization by the 
209.35 	department commissioner according to the limits established in subdivision 11.
209.36 	(b) The commissioner may not authorize:
210.1 	(1) home care services that are the responsibility of the foster care provider under 
210.2 	the terms of the foster care placement agreement, difficulty of care rate as of January 1, 
210.3 	2010, and administrative rules;
210.4 	(2) personal care assistant assistance  services when the foster care license holder is 
210.5 	also the personal care provider or personal care assistant unless the recipient can direct the 
210.6 	recipient's own care, or case management is provided as required in section 256B.0625, 
210.7 	subdivision 19a, unless the foster home is the licensed provider's primary residence as 
210.8 	defined in section 256B.0625, subdivision 19a; or
210.9 	(3) personal care assistant services when the responsible party is an employee of, or 
210.10 	under contract with, or has any direct or indirect financial relationship with the personal 
210.11 	care provider or personal care assistant, unless case management is provided as required 
210.12 	in section 256B.0625, subdivision 19a; or
210.13 	(4) (3) personal care assistant and private duty nursing services when the number
210.14 	of foster care residents licensed capacity is greater than four unless the county responsible 
210.15 	for the recipient's foster placement made the placement prior to April 1, 1992, requests 
210.16 	that personal care assistant and private duty nursing services be provided, and case 
210.17 	management is provided as required in section 256B.0625, subdivision 19a.
210.18 		Subd. 10.Limitation on payments. Medical assistance payments for home care 
210.19 	services shall be limited according to subdivisions 4 to 12 and sections 256B.0654, 
210.20 	subdivision 2, and 256B.0655, subdivisions 3 and 4.
210.21 		Subd. 11.Limits on services without prior authorization. A recipient may receive 
210.22 	the following home care services during a calendar year:
210.23 	(1) up to two face-to-face assessments to determine a recipient's need for personal 
210.24 	care assistant assistance  services;
210.25 	(2) one service update done to determine a recipient's need for personal care assistant
210.26 	assistance  services; and
210.27 	(3) up to nine face-to-face skilled nurse visits.
210.28 		Subd. 12.Approval of home care services. The commissioner or the 
210.29 	commissioner's designee shall determine the medical necessity of home care services, 
210.30 	the level of caregiver according to subdivision 2, and the institutional comparison 
210.31 	according to subdivisions 4 to 12 and sections 256B.0654, subdivision 2, and256B.0655, 
210.32 	subdivisions 3 and 4, and 256B.0659, the cost-effectiveness of services, and the amount, 
210.33 	scope, and duration of home care services reimbursable by medical assistance, based 
210.34 	on the assessment, primary payer coverage determination information as required, the 
210.35 	service plan, the recipient's age, the cost of services, the recipient's medical condition, and 
211.1 	diagnosis or disability. The commissioner may publish additional criteria for determining 
211.2 	medical necessity according to section 256B.04.
211.3 		Subd. 13.Recovery of excessive payments. The commissioner shall seek 
211.4 	monetary recovery from providers of payments made for services which exceed the limits 
211.5 	established in this section and sections 256B.0653 to 256B.0656, and 256B.0659. This 
211.6 	subdivision does not apply to services provided to a recipient at the previously authorized 
211.7 	level pending an appeal under section 256.045, subdivision 10.
211.8 		Subd. 14.Referrals to Medicare providers required. Home care providers that 
211.9 	do not participate in or accept Medicare assignment must refer and document the referral 
211.10 	of dual-eligible recipients to Medicare providers when Medicare is determined to be the 
211.11 	appropriate payer for services and supplies and equipment. Providers must be terminated 
211.12 	from participation in the medical assistance program for failure to make these referrals.
211.13 		Subd. 15.Quality assurance for program integrity. The commissioner shall 
211.14 	establish an ongoing quality assurance process for home care services to monitor program 
211.15 	integrity, including provider standards and training, consumer surveys, and random 
211.16 	reviews of documentation.
211.17 		Subd. 16.Oversight of enrolled providers. The commissioner has the authority to 
211.18 	request proof of documentation of meeting provider standards, quality standards of care, 
211.19 	correct billing practices, and other information. Failure to comply with or to provide access 
211.20 	and information to demonstrate compliance with laws, rules, or policies may result in 
211.21 	suspension, denial, or termination of the provider agency's enrollment with the department.

211.22 	Sec. 24. Minnesota Statutes 2008, section 256B.0652, is amended to read:
211.23 	256B.0652 PRIOR AUTHORIZATION AND REVIEW OF HOME CARE 
211.24 	SERVICES.
211.25 		Subdivision 1.State coordination. The commissioner shall supervise the 
211.26 	coordination of the prior authorization and review of home care services that are 
211.27 	reimbursed by medical assistance.
211.28 		Subd. 2.Duties. (a) The commissioner may contract with or employ qualified 
211.29 	registered nurses and necessary support staff, or contract with qualified agencies, to 
211.30 	provide home care prior authorization and review services for medical assistance 
211.31 	recipients who are receiving home care services.
211.32 	(b) Reimbursement for the prior authorization function shall be made through the 
211.33 	medical assistance administrative authority. The state shall pay the nonfederal share. 
211.34 	The functions will be to:
212.1 	(1) assess the recipient's individual need for services required to be cared for safely 
212.2 	in the community;
212.3 	(2) ensure that a service care plan that meets the recipient's needs is developed 
212.4 	by the appropriate agency or individual;
212.5 	(3) ensure cost-effectiveness and nonduplication of medical assistance home care 
212.6 	services;
212.7 	(4) recommend the approval or denial of the use of medical assistance funds to pay 
212.8 	for home care services;
212.9 	(5) reassess the recipient's need for and level of home care services at a frequency 
212.10 	determined by the commissioner; and
212.11 	(6) conduct on-site assessments when determined necessary by the commissioner 
212.12 	and recommend changes to care plans that will provide more efficient and appropriate 
212.13 	home care; and
212.14 	(7) on the department's Web site:
212.15 	(i) provide a link to MinnesotaHelp.info for a list of enrolled home care agencies 
212.16 	with the following information: main office address, contact information for the agency, 
212.17 	counties in which services are provided, type of home care services provided, whether 
212.18 	the personal care assistance choice option is offered, types of qualified professionals 
212.19 	employed, number of personal care assistants employed, and data on staff turnover; and
212.20 	(ii) post data on home care services including information from both fee-for-service 
212.21 	and managed care plans on recipients as available.
212.22 	(c) In addition, the commissioner or the commissioner's designee may:
212.23 	(1) review care plans, service plans,  and reimbursement data for utilization of 
212.24 	services that exceed community-based standards for home care, inappropriate home care 
212.25 	services, medical necessity, home care services that do not meet quality of care standards, 
212.26 	or unauthorized services and make appropriate referrals within the department or to other 
212.27 	appropriate entities based on the findings;
212.28 	(2) assist the recipient in obtaining services necessary to allow the recipient to 
212.29 	remain safely in or return to the community;
212.30 	(3) coordinate home care services with other medical assistance services under 
212.31 	section 256B.0625;
212.32 	(4) assist the recipient with problems related to the provision of home care services;
212.33 	(5) assure the quality of home care services; and
212.34 	(6) assure that all liable third-party payers including, but not limited to, Medicare 
212.35 	have been used prior to medical assistance for home care services, including but not 
213.1 	limited to, home health agency, elected hospice benefit, waivered services, alternative care 
213.2 	program services, and personal care services.
213.3 	(d) For the purposes of this section, "home care services" means medical assistance 
213.4 	services defined under section 256B.0625, subdivisions 6a, 7, and 19a.
213.5 		Subd. 3.Assessment and prior authorization process for persons receiving 
213.6 	personal care assistance and developmental disabilities services. Effective January 1, 
213.7 	1996, For purposes of providing informed choice, coordinating of local planning decisions, 
213.8 	and streamlining administrative requirements, the assessment and prior authorization 
213.9 	process for persons receiving both home care and home and community-based waivered 
213.10 	services for persons with developmental disabilities shall meet the requirements of 
213.11 	sections 256B.0651 and 256B.0653 to 256B.0656 with the following exceptions:
213.12 	(a) Upon request for home care services and subsequent assessment by the public 
213.13 	health nurse under sections 256B.0651 and 256B.0653 to 256B.0656, the public health 
213.14 	nurse shall participate in the screening process, as appropriate, and, if home care 
213.15 	services are determined to be necessary, participate in the development of a service plan 
213.16 	coordinating the need for home care and home and community-based waivered services 
213.17 	with the assigned county case manager, the recipient of services, and the recipient's legal 
213.18 	representative, if any.
213.19 	(b) The public health nurse shall give prior authorization for home care services 
213.20 	to the extent that home care services are:
213.21 	(1) medically necessary;
213.22 	(2) chosen by the recipient and their legal representative, if any, from the array of 
213.23 	home care and home and community-based waivered services available;
213.24 	(3) coordinated with other services to be received by the recipient as described 
213.25 	in the service plan; and
213.26 	(4) provided within the county's reimbursement limits for home care and home and 
213.27 	community-based waivered services for persons with developmental disabilities.
213.28 	(c) If the public health agency is or may be the provider of home care services to the 
213.29 	recipient, the public health agency shall provide the commissioner of human services with 
213.30 	a written plan that specifies how the assessment and prior authorization process will be 
213.31 	held separate and distinct from the provision of services.

213.32 	Sec. 25. Minnesota Statutes 2008, section 256B.0653, is amended to read:
213.33 	256B.0653 HOME HEALTH AGENCY COVERED SERVICES.
214.1 		Subdivision 1.Homecare; skilled nurse visits Scope.  "Skilled nurse visits" are 
214.2 	provided in a recipient's residence under a plan of care or service plan that specifies a level 
214.3 	of care which the nurse is qualified to provide. These services are:
214.4 	(1) nursing services according to the written plan of care or service plan and accepted 
214.5 	standards of medical and nursing practice in accordance with chapter 148;
214.6 	(2) services which due to the recipient's medical condition may only be safely and 
214.7 	effectively provided by a registered nurse or a licensed practical nurse;
214.8 	(3) assessments performed only by a registered nurse; and
214.9 	(4) teaching and training the recipient, the recipient's family, or other caregivers 
214.10 	requiring the skills of a registered nurse or licensed practical nurse. This section applies to 
214.11 	home health agency services including, home health aide, skilled nursing visits, physical 
214.12 	therapy, occupational therapy, respiratory therapy, and speech language pathology therapy.
214.13 		Subd. 2.Telehomecare; skilled nurse visits Definitions.  Medical assistance 
214.14 	covers skilled nurse visits according to section 256B.0625, subdivision 6a, provided via 
214.15 	telehomecare, for services which do not require hands-on care between the home care 
214.16 	nurse and recipient. The provision of telehomecare must be made via live, two-way 
214.17 	interactive audiovisual technology and may be augmented by utilizing store-and-forward 
214.18 	technologies. Store-and-forward technology includes telehomecare services that do not 
214.19 	occur in real time via synchronous transmissions, and that do not require a face-to-face 
214.20 	encounter with the recipient for all or any part of any such telehomecare visit. Individually 
214.21 	identifiable patient data obtained through real-time or store-and-forward technology must 
214.22 	be maintained as health records according to sections 144.291 to 144.298. If the video 
214.23 	is used for research, training, or other purposes unrelated to the care of the patient, the 
214.24 	identity of the patient must be concealed. A communication between the home care nurse 
214.25 	and recipient that consists solely of a telephone conversation, facsimile, electronic mail, or 
214.26 	a consultation between two health care practitioners, is not to be considered a telehomecare 
214.27 	visit. Multiple daily skilled nurse visits provided via telehomecare are allowed. Coverage 
214.28 	of telehomecare is limited to two visits per day. All skilled nurse visits provided via 
214.29 	telehomecare must be prior authorized by the commissioner or the commissioner's 
214.30 	designee and will be covered at the same allowable rate as skilled nurse visits provided 
214.31 	in-person. For the purposes of this section, the following terms have the meanings given.
214.32 	(a) "Assessment" means an evaluation of the recipient's medical need for home 
214.33 	health agency services by a registered nurse or appropriate therapist that is conducted 
214.34 	within 30 days of a request.
215.1 	(b) "Home care therapies" means occupational, physical, and respiratory therapy 
215.2 	and speech-language pathology services provided in the home by a Medicare certified 
215.3 	home health agency.
215.4 	(c) "Home health agency services" means services delivered in the recipient's home 
215.5 	residence, except as specified in section 256B.0625, by a home health agency to a recipient 
215.6 	with medical needs due to illness, disability, or physical conditions.
215.7 	(d) "Home health aide" means an employee of a home health agency who completes 
215.8 	medically oriented tasks written in the plan of care for a recipient.
215.9 	(e) "Home health agency" means a home care provider agency that is 
215.10 	Medicare-certified.
215.11 	(f) "Occupational therapy services" mean the services defined in Minnesota Rules, 
215.12 	part 9505.0390.
215.13 	(g) "Physical therapy services" mean the services defined in Minnesota Rules, part 
215.14 	9505.0390.
215.15 	(h) "Respiratory therapy services" mean the services defined in chapter 147C and 
215.16 	Minnesota Rules, part 4668.0003, subpart 37.
215.17 	(i) "Speech-language pathology services" mean the services defined in Minnesota 
215.18 	Rules, part 9505.0390.
215.19 	(j) "Skilled nurse visit" means a professional nursing visit to complete nursing tasks 
215.20 	required due to a recipient's medical condition that can only be safely provided by a 
215.21 	professional nurse to restore and maintain optimal health.
215.22 	(k) "Store-and-forward technology" means telehomecare services that do not occur 
215.23 	in real time via synchronous transmissions such as diabetic and vital sign monitoring.
215.24 	(l) "Telehomecare" means the use of telecommunications technology via 
215.25 	live, two-way interactive audiovisual technology which may be augmented by 
215.26 	store-and-forward technology.
215.27 	(m) "Telehomecare skilled nurse visit" means a visit by a professional nurse to 
215.28 	deliver a skilled nurse visit to a recipient located at a site other than the site where the 
215.29 	nurse is located and is used in combination with face-to-face skilled nurse visits to 
215.30 	adequately meet the recipient's needs.
215.31 		Subd. 3.Therapies through home health agencies Home health aide visits.
 215.32 	(a) Medical assistance covers physical therapy and related services, including specialized 
215.33 	maintenance therapy. Services provided by a physical therapy assistant shall be 
215.34 	reimbursed at the same rate as services performed by a physical therapist when the 
215.35 	services of the physical therapy assistant are provided under the direction of a physical 
215.36 	therapist who is on the premises. Services provided by a physical therapy assistant that are 
216.1 	provided under the direction of a physical therapist who is not on the premises shall be 
216.2 	reimbursed at 65 percent of the physical therapist rate. Direction of the physical therapy 
216.3 	assistant must be provided by the physical therapist as described in Minnesota Rules, part 
216.4 	9505.0390, subpart 1, item B. The physical therapist and physical therapist assistant may 
216.5 	not both bill for services provided to a recipient on the same day.
216.6 	(b) Medical assistance covers occupational therapy and related services, including 
216.7 	specialized maintenance therapy. Services provided by an occupational therapy assistant 
216.8 	shall be reimbursed at the same rate as services performed by an occupational therapist 
216.9 	when the services of the occupational therapy assistant are provided under the direction of 
216.10 	the occupational therapist who is on the premises. Services provided by an occupational 
216.11 	therapy assistant under the direction of an occupational therapist who is not on the 
216.12 	premises shall be reimbursed at 65 percent of the occupational therapist rate. Direction 
216.13 	of the occupational therapy assistant must be provided by the occupational therapist as 
216.14 	described in Minnesota Rules, part 9505.0390, subpart 1, item B. The occupational 
216.15 	therapist and occupational therapist assistant may not both bill for services provided 
216.16 	to a recipient on the same day.
216.17 	(a) Home health aide visits must be provided by a certified home health aide 
216.18 	using a written plan of care that is updated in compliance with Medicare regulations. 
216.19 	A home health aide shall provide hands-on personal care, perform simple procedures 
216.20 	as an extension of therapy or nursing services, and assist in instrumental activities of 
216.21 	daily living as defined in section 256B.0659. Home health aide visits must be provided 
216.22 	in the recipient's home.
216.23 	(b) All home health aide visits must have authorization under section 256B.0652. 
216.24 	The commissioner shall limit home health aide visits to no more than one visit per day 
216.25 	per recipient.
216.26 	(c) Home health aides must be supervised by a registered nurse or an appropriate 
216.27 	therapist when providing services that are an extension of therapy.
216.28 		Subd. 4.Skilled nurse visit services. (a) Skilled nurse visit services must be 
216.29 	provided by a registered nurse or a licensed practical nurse under the supervision of a 
216.30 	registered nurse, according to the written plan of care and accepted standards of medical 
216.31 	and nursing practice according to chapter 148. Skilled nurse visit services must be ordered 
216.32 	by a physician and documented in a plan of care that is reviewed and approved by the 
216.33 	ordering physician at least once every 60 days. All skilled nurse visits must be medically 
216.34 	necessary and provided in the recipient's home residence except as allowed under section 
216.35 	256B.0625, subdivision 6a.
217.1 	(b) Skilled nurse visits include face-to-face and telehomecare visits with a limit of 
217.2 	up to two visits per day per recipient. All visits must be based on assessed needs.
217.3 	(c) Telehomecare skilled nurse visits are allowed when the recipient's health status 
217.4 	can be accurately measured and assessed without a need for a face-to-face, hands-on 
217.5 	encounter. All telehomecare skilled nurse visits must have authorization and are paid at 
217.6 	the same allowable rates as face-to-face skilled nurse visits.
217.7 	(d) The provision of telehomecare must be made via live, two-way interactive 
217.8 	audiovisual technology and may be augmented by utilizing store-and-forward 
217.9 	technologies. Individually identifiable patient data obtained through real-time or 
217.10 	store-and-forward technology must be maintained as health records according to sections 
217.11 	144.291 to 144.298. If the video is used for research, training, or other purposes unrelated 
217.12 	to the care of the patient, the identity of the patient must be concealed.
217.13 	(e) Authorization for skilled nurse visits must be completed under section 
217.14 	256B.0652. A total of nine face-to-face skilled nurses visits per calendar year do not 
217.15 	require authorization. All telehomecare skilled nurse visits require authorization.
217.16 		Subd. 5.Home care therapies. (a) Home care therapies include the following: 
217.17 	physical therapy, occupational therapy, respiratory therapy, and speech and language 
217.18 	pathology therapy services.
217.19 	(b) Home care therapies must be:
217.20 	(1) provided in the recipient's residence after it has been determined the recipient is 
217.21 	unable to access outpatient therapy;
217.22 	(2) prescribed, ordered, or referred by a physician and documented in a plan of care 
217.23 	and reviewed, according to Minnesota Rules, part 9505.0390;
217.24 	(3) assessed by an appropriate therapist; and
217.25 	(4) provided by a Medicare-certified home health agency enrolled as a Medicaid 
217.26 	provider agency.
217.27 	(c) Restorative and specialized maintenance therapies must be provided according to 
217.28 	Minnesota Rules, part 9505.0390. Physical and occupational therapy assistants may be 
217.29 	used as allowed under Minnesota Rules, part 9505.0390, subpart 1, item B.
217.30 	(d) For both physical and occupational therapies, the therapist and the therapist's 
217.31 	assistant may not both bill for services provided to a recipient on the same day.
217.32 		Subd. 6.Noncovered home health agency services. The following are not eligible 
217.33 	for payment under medical assistance as a home health agency service:
217.34 	(1) telehomecare skilled nurses services that is communication between the home 
217.35 	care nurse and recipient that consists solely of a telephone conversation, facsimile, 
217.36 	electronic mail, or a consultation between two health care practitioners;
218.1 	(2) the following skilled nurse visits:
218.2 	(i) for the purpose of monitoring medication compliance with an established 
218.3 	medication program for a recipient;
218.4 	(ii) administering or assisting with medication administration, including injections, 
218.5 	prefilling syringes for injections, or oral medication setup of an adult recipient, when, 
218.6 	as determined and documented by the registered nurse, the need can be met by an 
218.7 	available pharmacy or the recipient or a family member is physically and mentally able 
218.8 	to self-administer or prefill a medication;
218.9 	(iii) services done for the sole purpose of supervision of the home health aide or 
218.10 	personal care assistant;
218.11 	(iv) services done for the sole purpose to train other home health agency workers;
218.12 	(v) services done for the sole purpose of blood samples or lab draw when the 
218.13 	recipient is able to access these services outside the home; and
218.14 	(vi) Medicare evaluation or administrative nursing visits required by Medicare;
218.15 	(3) home health aide visits when the following activities are the sole purpose for the 
218.16 	visit: companionship, socialization, household tasks, transportation, and education; and
218.17 	(4) home care therapies provided in other settings such as a clinic, day program, or as 
218.18 	an inpatient or when the recipient can access therapy outside of the recipient's residence.

218.19 	Sec. 26. Minnesota Statutes 2008, section 256B.0654, is amended to read:
218.20 	256B.0654 PRIVATE DUTY NURSING.
218.21 		Subdivision 1.Definitions. (a) "Assessment" means a review and evaluation of a 
218.22 	recipient's need for home care services conducted in person. Assessments for private duty 
218.23 	nursing shall be conducted by a registered private duty nurse. Assessments for medical 
218.24 	assistance home care services for developmental disabilities and alternative care services 
218.25 	for developmentally disabled home and community-based waivered recipients may be 
218.26 	conducted by the county public health nurse to ensure coordination and avoid duplication.
218.27 	(b) (a) "Complex and regular private duty nursing care" means:
218.28 	(1) complex care is private duty nursing services provided to recipients who are 
218.29 	ventilator dependent or for whom a physician has certified that were it not for private duty 
218.30 	nursing the recipient would meet the criteria for inpatient hospital intensive care unit 
218.31 	(ICU) level of care; and
218.32 	(2) regular care is private duty nursing provided to all other recipients.
218.33 	(b) "Private duty nursing" means ongoing professional nursing services by a 
218.34 	registered or licensed practical nurse including assessment, professional nursing tasks, and 
219.1 	education, based on an assessment and physician orders to maintain or restore optimal 
219.2 	health of the recipient.
219.3 	(c) "Private duty nursing agency" means a medical assistance enrolled provider 
219.4 	licensed under chapter 144A to provide private duty nursing services.
219.5 	(d) "Regular private duty nursing" means nursing services provided to a recipient 
219.6 	who is considered stable and not at an inpatient hospital intensive care unit level of care, 
219.7 	but may have episodes of instability that are not life threatening.
219.8 	(e) "Shared private duty nursing" means the provision of nursing services by a 
219.9 	private duty nurse to two recipients at the same time and in the same setting.
219.10 		Subd. 2.Authorization; private duty nursing services. (a) All private duty 
219.11 	nursing services shall be prior authorized by the commissioner or the commissioner's 
219.12 	designee. Prior Authorization for private duty nursing services shall be based on 
219.13 	medical necessity and cost-effectiveness when compared with alternative care options. 
219.14 	The commissioner may authorize medically necessary private duty nursing services in 
219.15 	quarter-hour units when:
219.16 	(1) the recipient requires more individual and continuous care than can be provided 
219.17 	during a skilled nurse visit; or
219.18 	(2) the cares are outside of the scope of services that can be provided by a home 
219.19 	health aide or personal care assistant.
219.20 	(b) The commissioner may authorize:
219.21 	(1) up to two times the average amount of direct care hours provided in nursing 
219.22 	facilities statewide for case mix classification "K" as established by the annual cost report 
219.23 	submitted to the department by nursing facilities in May 1992;
219.24 	(2) private duty nursing in combination with other home care services up to the total 
219.25 	cost allowed under section 256B.0655, subdivision 4;
219.26 	(3) up to 16 hours per day if the recipient requires more nursing than the maximum 
219.27 	number of direct care hours as established in clause (1) and the recipient meets the hospital 
219.28 	admission criteria established under Minnesota Rules, parts 9505.0501 to 9505.0540.
219.29 	(c) The commissioner may authorize up to 16 hours per day of medically necessary 
219.30 	private duty nursing services or up to 24 hours per day of medically necessary private duty 
219.31 	nursing services until such time as the commissioner is able to make a determination of 
219.32 	eligibility for recipients who are cooperatively applying for home care services under 
219.33 	the community alternative care program developed under section 256B.49, or until it is 
219.34 	determined by the appropriate regulatory agency that a health benefit plan is or is not 
219.35 	required to pay for appropriate medically necessary health care services. Recipients 
219.36 	or their representatives must cooperatively assist the commissioner in obtaining this 
220.1 	determination. Recipients who are eligible for the community alternative care program 
220.2 	may not receive more hours of nursing under this section and sections 256B.0651, 
220.3 	256B.0653, 256B.0655, and256B.0656, and 256B.0659 than would otherwise be 
220.4 	authorized under section 256B.49.
220.5 		Subd. 2a.Private duty nursing services. (a) Private duty nursing services must 
220.6 	be used:
220.7 	(1) in the recipient's home or outside the home when normal life activities require;
220.8 	(2) when the recipient requires more individual and continuous care than can be 
220.9 	provided during a skilled nurse visit; and
220.10 	(3) when the care required is outside of the scope of services that can be provided by 
220.11 	a home health aide or personal care assistant.
220.12 	(b) Private duty nursing services must be:
220.13 	(1) assessed by a registered nurse on a form approved by the commissioner;
220.14 	(2) ordered by a physician and documented in a plan of care that is reviewed by the 
220.15 	physician at least once every 60 days; and
220.16 	(3) authorized by the commissioner under section 256B.0652.
220.17 		Subd. 2b.Noncovered private duty nursing services. Private duty nursing 
220.18 	services do not cover the following:
220.19 	(1) nursing services by a nurse who is the family foster care provider of a person 
220.20 	who has not reached 18 years of age unless allowed under subdivision 4;
220.21 	(2) nursing services to more than two persons receiving shared private duty nursing 
220.22 	services from a private duty nurse in a single setting; and
220.23 	(3) nursing services provided by a registered nurse or licensed practical nurse who is 
220.24 	the recipient's legal guardian or related to the recipient as spouse, parent, or family foster 
220.25 	parent whether by blood, marriage, or adoption except as specified in section 256B.0652, 
220.26 	subdivision 4.
220.27 		Subd. 3.Shared private duty nursing care option. (a) Medical assistance 
220.28 	payments for shared private duty nursing services by a private duty nurse shall be limited 
220.29 	according to this subdivision. For the purposes of this section and sections 256B.0651, 
220.30 	256B.0653, 256B.0655, and 256B.0656, "private duty nursing agency" means an agency 
220.31 	licensed under chapter 144A to provide private duty nursing services. Unless otherwise 
220.32 	provided in this subdivision, all other statutory and regulatory provisions relating to 
220.33 	private duty nursing services apply to shared private duty nursing services. Nothing in 
220.34 	this subdivision shall be construed to reduce the total number of private duty nursing 
220.35 	hours authorized for an individual recipient.
221.1 	(b) Recipients of private duty nursing services may share nursing staff and the 
221.2 	commissioner shall provide a rate methodology for shared private duty nursing. For two 
221.3 	persons sharing nursing care, the rate paid to a provider shall not exceed 1.5 times the 
221.4 	regular private duty nursing rates paid for serving a single individual by a registered nurse 
221.5 	or licensed practical nurse. These rates apply only to situations in which both recipients 
221.6 	are present and receive shared private duty nursing care on the date for which the service 
221.7 	is billed. No more than two persons may receive shared private duty nursing services 
221.8 	from a private duty nurse in a single setting.
221.9 	(c) (b) Shared private duty nursing care is the provision of nursing services by a 
221.10 	private duty nurse to two medical assistance eligible recipients at the same time and in 
221.11 	the same setting. This subdivision does not apply when a private duty nurse is caring for 
221.12 	multiple recipients in more than one setting.
221.13 	(c) For the purposes of this subdivision, "setting" means:
221.14 	(1) the home residence or foster care home of one of the individual recipients as 
221.15 	defined in section 256B.0651; or
221.16 	(2) a child care program licensed under chapter 245A or operated by a local school 
221.17 	district or private school; or
221.18 	(3) an adult day care service licensed under chapter 245A; or
221.19 	(4) outside the home residence or foster care home of one of the recipients when 
221.20 	normal life activities take the recipients outside the home.
221.21 	This subdivision does not apply when a private duty nurse is caring for multiple 
221.22 	recipients in more than one setting.
221.23 	(d) The private duty nursing agency must offer the recipient the option of shared or 
221.24 	one-on-one private duty nursing services. The recipient may withdraw from participating 
221.25 	in a shared service arrangement at any time.
221.26 	(d) (e) The recipient or the recipient's legal representative, and the recipient's 
221.27 	physician, in conjunction with the home health care private duty nursing agency, shall 
221.28 	determine:
221.29 	(1) whether shared private duty nursing care is an appropriate option based on the 
221.30 	individual needs and preferences of the recipient; and
221.31 	(2) the amount of shared private duty nursing services authorized as part of the 
221.32 	overall authorization of nursing services.
221.33 	(e) (f) The recipient or the recipient's legal representative, in conjunction with the 
221.34 	private duty nursing agency, shall approve the setting, grouping, and arrangement of 
221.35 	shared private duty nursing care based on the individual needs and preferences of the 
222.1 	recipients. Decisions on the selection of recipients to share services must be based on the 
222.2 	ages of the recipients, compatibility, and coordination of their care needs.
222.3 	(f) (g) The following items must be considered by the recipient or the recipient's 
222.4 	legal representative and the private duty nursing agency, and documented in the recipient's 
222.5 	health service record:
222.6 	(1) the additional training needed by the private duty nurse to provide care to 
222.7 	two recipients in the same setting and to ensure that the needs of the recipients are met 
222.8 	appropriately and safely;
222.9 	(2) the setting in which the shared private duty nursing care will be provided;
222.10 	(3) the ongoing monitoring and evaluation of the effectiveness and appropriateness 
222.11 	of the service and process used to make changes in service or setting;
222.12 	(4) a contingency plan which accounts for absence of the recipient in a shared private 
222.13 	duty nursing setting due to illness or other circumstances;
222.14 	(5) staffing backup contingencies in the event of employee illness or absence; and
222.15 	(6) arrangements for additional assistance to respond to urgent or emergency care 
222.16 	needs of the recipients.
222.17 	(g) The provider must offer the recipient or responsible party the option of shared or 
222.18 	one-on-one private duty nursing services. The recipient or responsible party can withdraw 
222.19 	from participating in a shared service arrangement at any time.
222.20 	(h) The private duty nursing agency must document the following in the 
222.21 	health service record for each individual recipient sharing private duty nursing care
222.22 	The documentation for shared private duty nursing must be on a form approved by 
222.23 	the commissioner for each individual recipient sharing private duty nursing. The 
222.24 	documentation must be part of the recipient's health service record and include:
222.25 	(1) permission by the recipient or the recipient's legal representative for the 
222.26 	maximum number of shared nursing care hours per week chosen by the recipient and 
222.27 	permission for shared private duty nursing services provided in and outside the recipient's 
222.28 	home residence;
222.29 	(2) permission by the recipient or the recipient's legal representative for shared 
222.30 	private duty nursing services provided outside the recipient's residence;
222.31 	(3) permission by the recipient or the recipient's legal representative for others to 
222.32 	receive shared private duty nursing services in the recipient's residence;
222.33 	(4) revocation by the recipient or the recipient's legal representative of for the shared 
222.34 	private duty nursing care authorization, or the shared care to be provided to others in the 
222.35 	recipient's residence, or the shared private duty nursing services to be provided outside
222.36 	permission, or services provided to others in and outside the recipient's residence; and
223.1 	(5) (3) daily documentation of the shared private duty nursing services provided by 
223.2 	each identified private duty nurse, including:
223.3 	(i) the names of each recipient receiving shared private duty nursing services 
223.4 	together;
223.5 	(ii) the setting for the shared services, including the starting and ending times that 
223.6 	the recipient received shared private duty nursing care; and
223.7 	(iii) notes by the private duty nurse regarding changes in the recipient's condition, 
223.8 	problems that may arise from the sharing of private duty nursing services, and scheduling 
223.9 	and care issues.
223.10 	(i) Unless otherwise provided in this subdivision, all other statutory and regulatory 
223.11 	provisions relating to private duty nursing services apply to shared private duty nursing 
223.12 	services.
223.13 	Nothing in this subdivision shall be construed to reduce the total number of private 
223.14 	duty nursing hours authorized for an individual recipient under subdivision 2.
223.15 	(i) The commissioner shall provide a rate methodology for shared private duty 
223.16 	nursing. For two persons sharing nursing care, the rate paid to a provider must not exceed 
223.17 	1.5 times the regular private duty nursing rates paid for serving a single individual by a 
223.18 	registered nurse or licensed practical nurse. These rates apply only to situations in which 
223.19 	both recipients are present and receive shared private duty nursing care on the date for 
223.20 	which the service is billed.
223.21 		Subd. 4.Hardship criteria; private duty nursing. (a) Payment is allowed for 
223.22 	extraordinary services that require specialized nursing skills and are provided by parents 
223.23 	of minor children, family foster parents, spouses, and legal guardians who are providing 
223.24 	private duty nursing care under the following conditions:
223.25 	(1) the provision of these services is not legally required of the parents, spouses, 
223.26 	or legal guardians;
223.27 	(2) the services are necessary to prevent hospitalization of the recipient; and
223.28 	(3) the recipient is eligible for state plan home care or a home and community-based 
223.29 	waiver and one of the following hardship criteria are met:
223.30 	(i) the parent, spouse, or legal guardian resigns from a part-time or full-time job to 
223.31 	provide nursing care for the recipient; or
223.32 	(ii) the parent, spouse, or legal guardian goes from a full-time to a part-time job with 
223.33 	less compensation to provide nursing care for the recipient; or
223.34 	(iii) the parent, spouse, or legal guardian takes a leave of absence without pay to 
223.35 	provide nursing care for the recipient; or
224.1 	(iv) because of labor conditions, special language needs, or intermittent hours of 
224.2 	care needed, the parent, spouse, or legal guardian is needed in order to provide adequate 
224.3 	private duty nursing services to meet the medical needs of the recipient.
224.4 	(b) Private duty nursing may be provided by a parent, spouse, family foster parent, 
224.5 	or legal guardian who is a nurse licensed in Minnesota. Private duty nursing services 
224.6 	provided by a parent, spouse, family foster parent, or legal guardian cannot be used in 
224.7 	lieu of nursing services covered and available under liable third-party payors, including 
224.8 	Medicare. The private duty nursing provided by a parent, spouse, family foster parent, or 
224.9 	legal guardian must be included in the service plan agreement. Authorized skilled nursing 
224.10 	services for a single recipient or recipients with the same residence and provided by the 
224.11 	parent, spouse, family foster parent, or legal guardian may not exceed 50 percent of the 
224.12 	total approved nursing hours, or eight hours per day, whichever is less, up to a maximum 
224.13 	of 40 hours per week. A parent or parents, spouse, family foster parent, or legal guardian 
224.14 	shall not provide more than 40 hours of services in a seven-day period. For parents, family 
224.15 	foster parents, and legal guardians, 40 hours is the total amount allowed regardless of the 
224.16 	number of children or adults who receive services. Nothing in this subdivision precludes 
224.17 	the parent's, spouse's, or legal guardian's obligation of assuming the nonreimbursed family 
224.18 	responsibilities of emergency backup caregiver and primary caregiver.
224.19 	(c) A parent, family foster parent,  or a spouse may not be paid to provide private 
224.20 	duty nursing care if:
224.21 	(1) the parent or spouse fails to pass a criminal background check according to 
224.22 	chapter 245C, or if;
224.23 	(2) it has been determined by the home health private duty nursing agency, the 
224.24 	case manager, or the physician that the private duty nursing care provided by the parent, 
224.25 	family foster parent, spouse, or legal guardian is unsafe; or
224.26 	(3) the parent, family foster parent, spouse, or legal guardian do not follow physician 
224.27 	orders.
224.28 	(d) For purposes of this section, "assessment" means a review and evaluation of a 
224.29 	recipient's need for home care services conducted in person. Assessments for private duty 
224.30 	nursing must be conducted by a registered nurse.

224.31 	Sec. 27. Minnesota Statutes 2008, section 256B.0655, subdivision 1b, is amended to 
224.32 	read:
224.33 		Subd. 1b.Assessment. "Assessment" means a review and evaluation of a recipient's 
224.34 	need for home care services conducted in person. Assessments for personal care assistant 
224.35 	services shall be conducted by the county public health nurse or a certified public 
225.1 	health nurse under contract with the county. A face-to-face An in-person assessment 
225.2 	must include: documentation of health status, determination of need, evaluation of 
225.3 	service effectiveness, identification of appropriate services, service plan development 
225.4 	or modification, coordination of services, referrals and follow-up to appropriate payers 
225.5 	and community resources, completion of required reports, recommendation of service 
225.6 	authorization, and consumer education. Once the need for personal care assistant 
225.7 	services is determined under this section or sections 256B.0651, 256B.0653, 256B.0654, 
225.8 	and 256B.0656, the county public health nurse or certified public health nurse under 
225.9 	contract with the county is responsible for communicating this recommendation to the 
225.10 	commissioner and the recipient. A face-to-face assessment for personal care assistant 
225.11 	services is conducted on those recipients who have never had a county public health 
225.12 	nurse assessment. A face-to-face An in-person assessment must occur at least annually or 
225.13 	when there is a significant change in the recipient's condition or when there is a change 
225.14 	in the need for personal care assistant services. A service update may substitute for 
225.15 	the annual face-to-face assessment when there is not a significant change in recipient 
225.16 	condition or a change in the need for personal care assistant service. A service update 
225.17 	may be completed by telephone, used when there is no need for an increase in personal 
225.18 	care assistant services, and used for two consecutive assessments if followed by a 
225.19 	face-to-face assessment. A service update must be completed on a form approved by the 
225.20 	commissioner. A service update or review for temporary increase includes a review of 
225.21 	initial baseline data, evaluation of service effectiveness, redetermination of service need, 
225.22 	modification of service plan and appropriate referrals, update of initial forms, obtaining 
225.23 	service authorization, and on going consumer education. Assessments must be completed 
225.24 	on forms provided by the commissioner within 30 days of a request for home care services 
225.25 	by a recipient or responsible party or personal care provider agency.

225.26 	Sec. 28. Minnesota Statutes 2008, section 256B.0655, subdivision 4, is amended to 
225.27 	read:
225.28 		Subd. 4.Prior Authorization; personal care assistance and qualified 
225.29 	professional. The commissioner, or the commissioner's designee, shall review the 
225.30 	assessment, service update, request for temporary services, request for flexible use option, 
225.31 	service plan, and any additional information that is submitted. The commissioner shall, 
225.32 	within 30 days after receiving a complete request, assessment, and service plan, authorize 
225.33 	home care services as follows:
225.34 	(1) (a) All personal care assistant assistance  services and, supervision by a 
225.35 	qualified professional, if requested by the recipient, and additional services beyond the 
226.1 	limits established in section 256B.0651, subdivision 11, must be prior authorized by 
226.2 	the commissioner or the commissioner's designee before services begin except for the 
226.3 	assessments established in section sections256B.0651, subdivision 11, and 256B.0911.
226.4 	The authorization for personal care assistance and qualified professional services under 
226.5 	section 256B.0659 must be completed within 30 days after receiving a complete request.
226.6 	(b) The amount of personal care assistant assistance  services authorized must be 
226.7 	based on the recipient's home care rating. The home care rating shall be determined by 
226.8 	the commissioner or the commissioner's designee based on information submitted to the 
226.9 	commissioner identifying the following:
226.10 	(1) total number of dependencies of activities of daily living as defined in section 
226.11 	256B.0659;
226.12 	(2) number of complex health-related functions as defined in section 256B.0659; and
226.13 	(3) number of behavior descriptions as defined in section 256B.0659.
226.14 	(c) The methodology to determine total time for personal care assistance services for 
226.15 	each home care rating is based on the median paid units per day for each home care rating 
226.16 	from fiscal year 2007 data for the personal care assistance program. Each home care rating 
226.17 	has a base level of hours assigned. Additional time is added through the assessment and 
226.18 	identification of the following:
226.19 	(1) 30 additional minutes per day for a dependency in each critical activity of daily 
226.20 	living as defined in section 256B.0659;
226.21 	(2) 30 additional minutes per day for each complex health-related function as 
226.22 	defined in section 256B.0659; and
226.23 	(3) 30 additional minutes per day for each behavior issue as defined in section 
226.24 	256B.0659.
226.25 	(d) A limit of 96 units of qualified professional supervision may be authorized for 
226.26 	each recipient receiving personal care assistance services. A request to the commissioner 
226.27 	to exceed this total in a calendar year must be requested by the personal care provider 
226.28 	agency on a form approved by the commissioner.
226.29 	A child may not be found to be dependent in an activity of daily living if because 
226.30 	of the child's age an adult would either perform the activity for the child or assist the 
226.31 	child with the activity and the amount of assistance needed is similar to the assistance 
226.32 	appropriate for a typical child of the same age. Based on medical necessity, the 
226.33 	commissioner may authorize:
226.34 	(A) up to two times the average number of direct care hours provided in nursing 
226.35 	facilities for the recipient's comparable case mix level; or
227.1 	(B) up to three times the average number of direct care hours provided in nursing 
227.2 	facilities for recipients who have complex medical needs or are dependent in at least seven 
227.3 	activities of daily living and need physical assistance with eating or have a neurological 
227.4 	diagnosis; or
227.5 	(C) up to 60 percent of the average reimbursement rate, as of July 1, 1991, for care 
227.6 	provided in a regional treatment center for recipients who have Level I behavior, plus any 
227.7 	inflation adjustment as provided by the legislature for personal care service; or
227.8 	(D) up to the amount the commissioner would pay, as of July 1, 1991, plus any 
227.9 	inflation adjustment provided for home care services, for care provided in a regional 
227.10 	treatment center for recipients referred to the commissioner by a regional treatment center 
227.11 	preadmission evaluation team. For purposes of this clause, home care services means 
227.12 	all services provided in the home or community that would be included in the payment 
227.13 	to a regional treatment center; or
227.14 	(E) up to the amount medical assistance would reimburse for facility care for 
227.15 	recipients referred to the commissioner by a preadmission screening team established 
227.16 	under section 256B.0911 or 256B.092; and
227.17 	(F) a reasonable amount of time for the provision of supervision by a qualified 
227.18 	professional of personal care assistant services, if a qualified professional is requested by 
227.19 	the recipient or responsible party.
227.20 	(2) The number of direct care hours shall be determined according to the annual cost 
227.21 	report submitted to the department by nursing facilities. The average number of direct care 
227.22 	hours, as established by May 1, 1992, shall be calculated and incorporated into the home 
227.23 	care limits on July 1, 1992. These limits shall be calculated to the nearest quarter hour.
227.24 	(3) The home care rating shall be determined by the commissioner or the 
227.25 	commissioner's designee based on information submitted to the commissioner by the 
227.26 	county public health nurse on forms specified by the commissioner. The home care rating 
227.27 	shall be a combination of current assessment tools developed under sections 256B.0911
227.28 	and 256B.501 with an addition for seizure activity that will assess the frequency and 
227.29 	severity of seizure activity and with adjustments, additions, and clarifications that are 
227.30 	necessary to reflect the needs and conditions of recipients who need home care including 
227.31 	children and adults under 65 years of age. The commissioner shall establish these forms 
227.32 	and protocols under this section and sections 256B.0651, 256B.0653, 256B.0654, and 
227.33 	256B.0656 and shall use an advisory group, including representatives of recipients, 
227.34 	providers, and counties, for consultation in establishing and revising the forms and 
227.35 	protocols.
228.1 	(4) A recipient shall qualify as having complex medical needs if the care required is 
228.2 	difficult to perform and because of recipient's medical condition requires more time than 
228.3 	community-based standards allow or requires more skill than would ordinarily be required 
228.4 	and the recipient needs or has one or more of the following:
228.5 	(A) daily tube feedings;
228.6 	(B) daily parenteral therapy;
228.7 	(C) wound or decubiti care;
228.8 	(D) postural drainage, percussion, nebulizer treatments, suctioning, tracheotomy 
228.9 	care, oxygen, mechanical ventilation;
228.10 	(E) catheterization;
228.11 	(F) ostomy care;
228.12 	(G) quadriplegia; or
228.13 	(H) other comparable medical conditions or treatments the commissioner determines 
228.14 	would otherwise require institutional care.
228.15 	(5) A recipient shall qualify as having Level I behavior if there is reasonable 
228.16 	supporting evidence that the recipient exhibits, or that without supervision, observation, or 
228.17 	redirection would exhibit, one or more of the following behaviors that cause, or have the 
228.18 	potential to cause:
228.19 	(A) injury to the recipient's own body;
228.20 	(B) physical injury to other people; or
228.21 	(C) destruction of property.
228.22 	(6) Time authorized for personal care relating to Level I behavior in paragraph 
228.23 	(5), clauses (A) to (C), shall be based on the predictability, frequency, and amount of 
228.24 	intervention required.
228.25 	(7) A recipient shall qualify as having Level II behavior if the recipient exhibits on a 
228.26 	daily basis one or more of the following behaviors that interfere with the completion of 
228.27 	personal care assistant services under subdivision 2, paragraph (a):
228.28 	(A) unusual or repetitive habits;
228.29 	(B) withdrawn behavior; or
228.30 	(C) offensive behavior.
228.31 	(8) A recipient with a home care rating of Level II behavior in paragraph (7), clauses 
228.32 	(A) to (C), shall be rated as comparable to a recipient with complex medical needs under 
228.33 	paragraph (4). If a recipient has both complex medical needs and Level II behavior, the 
228.34 	home care rating shall be the next complex category up to the maximum rating under 
228.35 	paragraph (1), clause (B).

229.1 	EFFECTIVE DATE. The amendments to paragraphs (a) and (b) are effective 
229.2 	January 1, 2010.

229.3 	Sec. 29. Minnesota Statutes 2008, section 256B.0657, subdivision 8, is amended to 
229.4 	read:
229.5 		Subd. 8.Self-directed budget requirements. The budget for the provision of the 
229.6 	self-directed service option shall be equal to the greater of either established based on:
229.7 	(1) the annual amount of personal care assistant services under section 256B.0655
229.8 	that the recipient has used in the most recent 12-month period assessed personal care 
229.9 	assistance units, not to exceed the maximum number of personal care assistance units 
229.10 	available, as determined by section 256B.0655; or and
229.11 	(2) the amount determined using the consumer support grant methodology under 
229.12 	section 256.476, subdivision 11, except that the budget amount shall include the federal 
229.13 	and nonfederal share of the average service costs. the personal care assistance unit rate:
229.14 	(i) with a reduction to the unit rate to pay for a program administrator as defined in 
229.15 	subdivision 10; and
229.16 	(ii) an additional adjustment to the unit rate as needed to ensure cost neutrality for 
229.17 	the state.

229.18 	Sec. 30. Minnesota Statutes 2008, section 256B.0657, is amended by adding a 
229.19 	subdivision to read:
229.20 		Subd. 12.Enrollment and evaluation. Enrollment in the self-directed supports 
229.21 	option is available to current personal care assistance recipients upon annual personal care 
229.22 	assistance reassessment, with a maximum enrollment of 1,000 people in the first fiscal 
229.23 	year of implementation and an additional 1,000 people in the second fiscal year.  The 
229.24 	commissioner shall evaluate the self-directed supports option during the first two years of 
229.25 	implementation and make any necessary changes prior to the option becoming available 
229.26 	statewide.

229.27 	Sec. 31. [256B.0659] PERSONAL CARE ASSISTANCE PROGRAM.
229.28 		Subdivision 1.Definitions. (a) For the purposes of this section, the terms defined in 
229.29 	paragraphs (b) to (p) have the meanings given unless otherwise provided in text.
229.30 	(b) "Activities of daily living" means grooming, dressing, bathing, transferring, 
229.31 	mobility, positioning, eating, and toileting.
229.32 	(c) "Behavior," effective January 1, 2010, means a category to determine the home 
229.33 	care rating and is based on the criteria found in this section. "Level I behavior" means 
230.1 	physical aggression towards self, others, or destruction of property that requires the 
230.2 	immediate response of another person.
230.3 	(d) "Complex health-related needs," effective January 1, 2010, means a category to 
230.4 	determine the home care rating and is based on the criteria found in this section.
230.5 	(e) "Critical activities of daily living," effective January 1, 2010, means transferring, 
230.6 	mobility, eating, and toileting.
230.7 	(f) "Dependency in activities of daily living" means a person requires assistance to 
230.8 	begin and complete one or more of the activities of daily living.
230.9 	(g) "Health-related procedures and tasks" means procedures and tasks that can 
230.10 	be delegated or assigned by a licensed health care professional under state law to be 
230.11 	performed by a personal care assistant.
230.12 	(h) "Instrumental activities of daily living" means activities to include meal planning 
230.13 	and preparation; basic assistance with paying bills; shopping for food, clothing, and 
230.14 	other essential items; performing household tasks integral to the personal care assistance 
230.15 	services; communication by telephone and other media; and traveling, including to 
230.16 	medical appointments and to participate in the community.
230.17 	(i) "Managing employee" has the same definition as Code of Federal Regulations, 
230.18 	title 42, section 455.
230.19 	(j) "Qualified professional" means a professional providing supervision of personal 
230.20 	care assistance services and staff as defined in section 256B.0625, subdivision 19c.
230.21 	(k) "Personal care assistance provider agency" means a medical assistance enrolled 
230.22 	provider that provides or assists with providing personal care assistance services and 
230.23 	includes personal care assistance provider organizations, personal care assistance choice 
230.24 	agency, class A licensed nursing agency, and Medicare-certified home health agency.
230.25 	(l) "Personal care assistant" or "PCA" means an individual employed by a personal 
230.26 	care assistance agency who provides personal care assistance services.
230.27 	(m) "Personal care assistance care plan" means a written description of personal 
230.28 	care assistance services developed by the personal care assistance provider according 
230.29 	to the service plan.
230.30 	(n) "Responsible party" means an individual who is capable of providing the support 
230.31 	necessary to assist the recipient to live in the community.
230.32 	(o) "Self-administered medication" means medication taken orally, by injection or 
230.33 	insertion, or applied topically without the need for assistance.
230.34 	(p) "Service plan" means a written summary of the assessment and description of the 
230.35 	services needed by the recipient.
231.1 		Subd. 2.Personal care assistance services; covered services. (a) The personal 
231.2 	care assistance services eligible for payment include services and supports furnished 
231.3 	to an individual, as needed, to assist in:
231.4 	(1) activities of daily living;
231.5 	(2) health-related procedures and tasks;
231.6 	(3) observation and redirection of behaviors; and
231.7 	(4) instrumental activities of daily living.
231.8 	(b) Activities of daily living include the following covered services:
231.9 	(1) dressing, including assistance with choosing, application, and changing of 
231.10 	clothing and application of special appliances, wraps, or clothing;
231.11 	(2) grooming, including assistance with basic hair care, oral care, shaving, applying 
231.12 	cosmetics and deodorant, and care of eyeglasses and hearing aids. Nail care is included, 
231.13 	except for recipients who are diabetic or have poor circulation;
231.14 	(3) bathing, including assistance with basic personal hygiene and skin care;
231.15 	(4) eating, including assistance with hand washing and application of orthotics 
231.16 	required for eating, transfers, and feeding;
231.17 	(5) transfers, including assistance with transferring the recipient from one seating or 
231.18 	reclining area to another;
231.19 	(6) mobility, including assistance with ambulation, including use of a wheelchair. 
231.20 	Mobility does not include providing transportation for a recipient;
231.21 	(7) positioning, including assistance with positioning or turning a recipient for 
231.22 	necessary care and comfort; and
231.23 	(8) toileting, including assistance with helping recipient with bowel or bladder 
231.24 	elimination and care including transfers, mobility, positioning, feminine hygiene, use of 
231.25 	toileting equipment or supplies, cleansing the perineal area, inspection of the skin, and 
231.26 	adjusting clothing.
231.27 	(c) Health-related procedures and tasks include the following covered services:
231.28 	(1) range of motion and passive exercise to maintain a recipient's strength and 
231.29 	muscle functioning;
231.30 	(2) assistance with self-administered medication as defined by this section, including 
231.31 	reminders to take medication, bringing medication to the recipient, and assistance with 
231.32 	opening medication under the direction of the recipient or responsible party;
231.33 	(3) interventions for seizure disorders, including monitoring and observation; and
231.34 	(4) other activities considered within the scope of the personal care service and 
231.35 	meeting the definition of health-related procedures and tasks under this section.
232.1 	(d) A personal care assistant may provide health-related procedures and tasks 
232.2 	associated with the complex health-related needs of a recipient if the procedures and 
232.3 	tasks meet the definition of health-related procedures and tasks under this section and the 
232.4 	personal care assistant is trained by a qualified professional and demonstrates competency 
232.5 	to safely complete the procedures and tasks. Delegation of health-related procedures and 
232.6 	tasks and all training must be documented in the personal care assistance care plan and the 
232.7 	recipient's and personal care assistant's files.
232.8 	(e) Effective January 1, 2010, for a personal care assistant to provide the 
232.9 	health-related procedures and tasks of tracheostomy suctioning and services to recipients 
232.10 	on ventilator support there must be:
232.11 	(1) delegation and training by a registered nurse, certified or licensed respiratory 
232.12 	therapist, or a physician;
232.13 	(2) utilization of clean rather than sterile procedure;
232.14 	(3) specialized training about the health-related procedures and tasks and equipment, 
232.15 	including ventilator operation and maintenance;
232.16 	(4) individualized training regarding the needs of the recipient; and
232.17 	(5) supervision by a qualified professional who is a registered nurse.
232.18 	(f) Effective January 1, 2010, a personal care assistant may observe and redirect the 
232.19 	recipient for episodes where there is a need for redirection due to behaviors. Training of 
232.20 	the personal care assistant must occur based on the needs of the recipient, the personal 
232.21 	care assistance care plan, and any other support services provided.
232.22 	(g) Instrumental activities of daily living under subdivision 1, paragraph (h).
232.23 		Subd. 3.Noncovered personal care assistance services. (a) Personal care 
232.24 	assistance services are not eligible for medical assistance payment under this section 
232.25 	when provided:
232.26 	(1) by the recipient's spouse, parent of a recipient under the age of 18, paid legal 
232.27 	guardian, licensed foster provider, except as allowed under section 256B.0651, subdivision 
232.28 	9a, or responsible party;
232.29 	(2) in lieu of other staffing options in a residential or child care setting;
232.30 	(3) solely as a child care or babysitting service; or
232.31 	(4) without authorization by the commissioner or the commissioner's designee.
232.32 	(b) The following personal care services are not eligible for medical assistance 
232.33 	payment under this section when provided in residential settings:
232.34 	(1) effective January 1, 2010, when the provider of home care services who is not 
232.35 	related by blood, marriage, or adoption owns or otherwise controls the living arrangement, 
232.36 	including licensed or unlicensed services; or
233.1 	(2) when personal care assistance services are the responsibility of a residential or 
233.2 	program license holder under the terms of a service agreement and administrative rules.
233.3 	(c) Other specific tasks not covered under paragraph (a) or (b) that are not eligible 
233.4 	for medical assistance reimbursement for personal care assistance services under this 
233.5 	section include:
233.6 	(1) sterile procedures;
233.7 	(2) injections of fluids and medications into veins, muscles, or skin;
233.8 	(3) home maintenance or chore services;
233.9 	(4) homemaker services not an integral part of assessed personal care assistance 
233.10 	services needed by a recipient;
233.11 	(5) application of restraints or implementation of procedures under section 245.825;
233.12 	(6) instrumental activities of daily living for children under the age of 18; and
233.13 	(7) assessments for personal care assistance services by personal care assistance 
233.14 	provider agencies or by independently enrolled registered nurses.
233.15 		Subd. 4.Assessment for personal care assistance services. (a) An assessment 
233.16 	as defined in section 256B.0655, subdivision 1b, must be completed for personal care 
233.17 	assistance services.
233.18 	(b) The following limitations apply to the assessment:
233.19 	(1) a person must be assessed as dependent in an activity of daily living based 
233.20 	on the person's need, on a daily basis, for:
233.21 	(i) cueing and constant supervision to complete the task; or
233.22 	(ii) hands-on assistance to complete the task; and
233.23 	(2) a child may not be found to be dependent in an activity of daily living if because 
233.24 	of the child's age an adult would either perform the activity for the child or assist the child 
233.25 	with the activity. Assistance needed is the assistance appropriate for a typical child of 
233.26 	the same age.
233.27 	(c) Assessment for complex health-related needs must meet the criteria in this 
233.28 	paragraph. During the assessment process, a recipient qualifies as having complex 
233.29 	health-related needs if the recipient has one or more of the interventions that are ordered by 
233.30 	a physician, specified in a personal care assistance care plan, and found in the following:
233.31 	(1) tube feedings requiring:
233.32 	(i) a gastro/jejunostomy tube; or
233.33 	(ii) continuous tube feeding lasting longer than 12 hours per day;
233.34 	(2) wounds described as:
233.35 	(i) stage III or stage IV;
233.36 	(ii) multiple wounds;
234.1 	(iii) requiring sterile or clean dressing changes or a wound vac; or
234.2 	(iv) open lesions such as burns, fistulas, tube sites, or ostomy sites that require 
234.3 	specialized care;
234.4 	(3) parenteral therapy described as:
234.5 	(i) IV therapy more than two times per week lasting longer than four hours for 
234.6 	each treatment; or
234.7 	(ii) total parenteral nutrition (TPN) daily;
234.8 	(4) respiratory interventions including:
234.9 	(i) oxygen required more than eight hours per day;
234.10 	(ii) respiratory vest more than one time per day;
234.11 	(iii) bronchial drainage treatments more than two times per day;
234.12 	(iv) sterile or clean suctioning more than six times per day;
234.13 	(v) dependence on another to apply respiratory ventilation augmentation devises 
234.14 	such as BiPAP and CPAP; and
234.15 	(vi) ventilator dependence under section 256B.0652;
234.16 	(5) insertion and maintenance of catheter including:
234.17 	(i) sterile catheter changes more than one time per month;
234.18 	(ii) clean self-catheterization more than six times per day; or
234.19 	(iii) bladder irrigations;
234.20 	(6) bowel program more than two times per week requiring more than 30 minutes to 
234.21 	perform each time;
234.22 	(7) neurological intervention including:
234.23 	(i) seizures more than two times per week and requiring significant physical 
234.24 	assistance to maintain safety; or
234.25 	(ii) swallowing disorders diagnosed by a physician and requiring specialized 
234.26 	assistance from another on a daily basis; and
234.27 	(8) other congenital or acquired diseases creating a need for significantly increased 
234.28 	direct hands-on assistance and interventions in six to eight activities of daily living.
234.29 	(d) An assessment of behaviors must meet the criteria in this paragraph. A recipient 
234.30 	qualifies as having a need for assistance due to behaviors if the recipient's behavior requires 
234.31 	assistance at least four times per week and shows one or more of the following behaviors:
234.32 	(1) physical aggression towards self or others, or destruction of property that requires 
234.33 	the immediate response of another person;
234.34 	(2) increased vulnerability due to cognitive deficits or socially inappropriate 
234.35 	behavior; or
234.36 	(3) verbally aggressive and resistive to care.
235.1 		Subd. 5.Service, support planning, and referral. (a) The assessor, with the 
235.2 	recipient or responsible party, shall review the assessment information and determine 
235.3 	referrals for other payers, services, and community supports as appropriate.
235.4 	(b) The recipient must be referred for evaluation, services, or supports that are 
235.5 	appropriate to help meet the recipient's needs including, but not limited to, the following 
235.6 	circumstances:
235.7 	(1) when there is another payer who is responsible to provide the service to meet 
235.8 	the recipient's needs;
235.9 	(2) when the recipient qualifies for assistance due to mental illness or behaviors 
235.10 	under this section, a referral for a mental health diagnostic and functional assessment 
235.11 	must be completed, or referral must be made for other specific mental health services or 
235.12 	other community services;
235.13 	(3) when the recipient is eligible for medical assistance and meets medical assistance 
235.14 	eligibility for a home health aide or skilled nurse visit;
235.15 	(4) when the recipient would benefit from an evaluation for another service; and
235.16 	(5) when there is a more appropriate service to meet the assessed needs.
235.17 	(c) The reimbursement rates for public health nurse visits that relate to the provision 
235.18 	of personal care assistance services under this section and section 256B.0625, subdivision 
235.19 	19a, are:
235.20 	(1) $210.50 for a face-to-face assessment visit;
235.21 	(2) $105.25 for each service update; and
235.22 	(3) $105.25 for each request for a temporary service increase.
235.23 	(d) The rates specified in paragraph (c) must be adjusted to reflect provider rate 
235.24 	increases for personal care assistance services that are approved by the legislature for the 
235.25 	fiscal year ending June 30, 2000, and subsequent fiscal years. Any requirements applied 
235.26 	by the legislature to provider rate increases for personal care assistance services also 
235.27 	apply to adjustments under this paragraph.
235.28 	(e) Effective July 1, 2008, the payment rate for an assessment under this section and 
235.29 	section 256B.0651 shall be reduced by 25 percent when the assessment is not completed 
235.30 	on time and the service agreement documentation is not submitted in time to continue 
235.31 	services. The commissioner shall reduce the amount of the claim for those assessments 
235.32 	that are not submitted on time.
235.33 		Subd. 6.Service plan. The service plan must be completed by the assessor with the 
235.34 	recipient and responsible party on a form determined by the commissioner and include 
235.35 	a summary of the assessment with a description of the need, authorized amount, and 
235.36 	expected outcomes and goals of personal care assistance services. The recipient and 
236.1 	the provider chosen by the recipient or responsible party must be given a copy of the 
236.2 	completed service plan within ten working days of the assessment. The recipient or 
236.3 	responsible party must be given information by the assessor about the options in the 
236.4 	personal care assistance program to allow for review and decision making.
236.5 		Subd. 7.Personal care assistance care plan. (a) Each recipient must have a 
236.6 	current personal care assistance care plan based on the service plan in subdivision 6 that is 
236.7 	developed by the qualified professional with the recipient and responsible party. A copy of 
236.8 	the most current personal care assistance care plan is required to be in the recipient's home 
236.9 	and in the recipient's file at the provider agency.
236.10 	(b) The personal care assistance care plan must have the following components:
236.11 	(1) start and end date of the care plan;
236.12 	(2) recipient demographic information, including name and telephone number;
236.13 	(3) emergency numbers, procedures, and a description of measures to address 
236.14 	identified safety and vulnerability issues, including a backup staffing plan;
236.15 	(4) name of responsible party and instructions for contact;
236.16 	(5) description of the recipient's individualized needs for assistance with activities of 
236.17 	daily living, instrumental activities of daily living, health-related tasks, and behaviors; and
236.18 	(6) dated signatures of recipient or responsible party and qualified professional.
236.19 	(c) The personal care assistance care plan must have instructions and comments 
236.20 	about the recipient's needs for assistance and any special instructions or procedures 
236.21 	required. The month-to-month plan for the use of personal care assistance services is part 
236.22 	of the personal care assistance care plan. The personal care assistance care plan must 
236.23 	be completed within the first week after start of services with a personal care provider 
236.24 	agency and must be updated as needed when there is a change in need for personal care 
236.25 	assistance services. A new personal care assistance care plan is required annually at the 
236.26 	time of the reassessment.
236.27 		Subd. 8.Communication with recipient's physician. The personal care assistance 
236.28 	program requires communication with the recipient's physician about a recipient's assessed 
236.29 	needs for personal care assistance services. The commissioner shall work with the state 
236.30 	medical director to develop options for communication with the recipient's physician.
236.31 		Subd. 9.Responsible party; generally. (a) "Responsible party," effective January 
236.32 	1, 2010, means an individual who is capable of providing the support necessary to assist 
236.33 	the recipient to live in the community.
236.34 	(b) A responsible party must be 18 years of age, actively participate in planning and 
236.35 	directing of personal care assistance services, and attend all assessments for the recipient.
236.36 	(c) A responsible party must not be the:
237.1 	(1) personal care assistant;
237.2 	(2) home care provider agency owner or staff; or
237.3 	(3) county staff acting as part of employment.
237.4 	(d) A licensed family foster parent who lives with the recipient may be the 
237.5 	responsible party as long as the family foster parent meets the other responsible party 
237.6 	requirements.
237.7 	(e) A responsible party is required when:
237.8 	(1) the person is a minor according to section 524.5-102, subdivision 10;
237.9 	(2) the person is an incapacitated adult according to section 524.5-102, subdivision 
237.10 	6, resulting in a court-appointed guardian; or
237.11 	(3) the assessment according to section 256B.0655, subdivision 1b, determines that 
237.12 	the recipient is in need of a responsible party to direct the recipient's care.
237.13 	(f) There may be two persons designated as the responsible party for reasons such 
237.14 	as divided households and court-ordered custodies. Each person named as responsible 
237.15 	party must meet the program criteria and responsibilities.
237.16 	(g) The recipient or the recipient's legal representative shall appoint a responsible 
237.17 	party if necessary to direct and supervise the care provided to the recipient. The 
237.18 	responsible party must be identified at the time of assessment and listed on the recipient's 
237.19 	service agreement and personal care assistance care plan.
237.20 		Subd. 10.Responsible party; duties; delegation. (a) A responsible party shall 
237.21 	enter into a written agreement with a personal care assistance provider agency, on a form 
237.22 	determined by the commissioner, to perform the following duties:
237.23 	(1) be available while care is provided in a method agreed upon by the individual 
237.24 	or the individual's legal representative and documented in the recipient's personal care 
237.25 	assistance care plan;
237.26 	(2) monitor personal care assistance services to ensure the recipient's personal care 
237.27 	assistance care plan is being followed; and
237.28 	(3) review and sign personal care assistance time sheets after services are provided 
237.29 	to provide verification of the personal care assistance services.
237.30 	Failure to provide the support required by the recipient must result in a referral to the 
237.31 	county common entry point.
237.32 	(b) Responsible parties who are parents of minors or guardians of minors or 
237.33 	incapacitated persons may delegate the responsibility to another adult who is not the 
237.34 	personal care assistant during a temporary absence of at least 24 hours but not more 
237.35 	than six months. The person delegated as a responsible party must be able to meet the 
237.36 	definition of the responsible party, except that the delegated responsible party is required 
238.1 	to reside with the recipient only while serving as the responsible party. The responsible 
238.2 	party must ensure that the delegate performs the functions of the responsible party, is 
238.3 	identified at the time of the assessment, and is listed on the personal care assistance 
238.4 	care plan. The responsible party must communicate to the personal care assistance 
238.5 	provider agency about the need for a delegate responsible party, including the name of the 
238.6 	delegated responsible party, dates the delegated responsible party will be living with the 
238.7 	recipient, and contact numbers.
238.8 		Subd. 11.Personal care assistant; requirements. (a) A personal care assistant 
238.9 	must meet the following requirements:
238.10 	(1) be at least 18 years of age with the exception of persons who are 16 or 17 years 
238.11 	of age with these additional requirements:
238.12 	(i) supervision by a qualified professional every 60 days; and
238.13 	(ii) employment by only one personal care assistance provider agency responsible 
238.14 	for compliance with current labor laws;
238.15 	(2) be employed by a personal care assistance provider agency;
238.16 	(3) enroll with the department as a personal care assistant after clearing a background 
238.17 	study. Before a personal care assistant provides services, the personal care assistance 
238.18 	provider agency must initiate a background study on the personal care assistant under 
238.19 	chapter 245C, and the personal care assistance provider agency must have received a 
238.20 	notice from the commissioner that the personal care assistant is:
238.21 	(i) not disqualified under section 245C.14; or
238.22 	(ii) is disqualified, but the personal care assistant has received a set aside of the 
238.23 	disqualification under section 245C.22;
238.24 	(4) be able to effectively communicate with the recipient and personal care 
238.25 	assistance provider agency;
238.26 	(5) be able to provide covered personal care assistance services according to the 
238.27 	recipient's personal care assistance care plan, respond appropriately to recipient needs, 
238.28 	and report changes in the recipient's condition to the supervising qualified professional 
238.29 	or physician;
238.30 	(6) not be a consumer of personal care assistance services;
238.31 	(7) maintain daily written records including, but not limited to, time sheets under 
238.32 	subdivision 12;
238.33 	(8) effective January 1, 2010, complete standardized training as determined by the 
238.34 	commissioner before completing enrollment. Personal care assistant training must include 
238.35 	successful completion of the following training components: basic first aid, vulnerable 
238.36 	adult, child maltreatment, OSHA universal precautions, basic roles and responsibilities of 
239.1 	personal care assistants including information about assistance with lifting and transfers 
239.2 	for recipients, emergency preparedness, orientation to positive behavioral practices, fraud 
239.3 	issues, and completion of time sheets. Upon completion of the training components, 
239.4 	the personal care assistant must demonstrate the competency to provide assistance to 
239.5 	recipients;
239.6 	(9) complete training and orientation on the needs of the recipient within the first 
239.7 	seven days after the services begin; and
239.8 	(10) be limited to providing and being paid for up to 310 hours per month of personal 
239.9 	care assistance services regardless of the number of recipients being served or the number 
239.10 	of personal care assistance provider agencies enrolled with.
239.11 	(b) A legal guardian may be a personal care assistant if the guardian is not being paid 
239.12 	for the guardian services and meets the criteria for personal care assistants in paragraph (a).
239.13 	(c) Effective January 1, 2010, persons who do not qualify as a personal care assistant 
239.14 	include parents and stepparents of minors, spouses, paid legal guardians, family foster 
239.15 	care providers, except as otherwise allowed in section 256B.0625, subdivision 19a, or 
239.16 	staff of a residential setting.
239.17 		Subd. 12.Documentation of personal care assistance services provided. (a) 
239.18 	Personal care assistance services for a recipient must be documented daily by each personal 
239.19 	care assistant, on a time sheet form approved by the commissioner. All documentation 
239.20 	may be Web-based, electronic, or paper documentation. The completed form must be 
239.21 	submitted on a monthly basis to the provider and kept in the recipient's health record.
239.22 	(b) The activity documentation must correspond to the personal care assistance care 
239.23 	plan and be reviewed by the qualified professional.
239.24 	(c) The personal care assistant time sheet must be on a form approved by the 
239.25 	commissioner documenting time the personal care assistant provides services in the home. 
239.26 	The following criteria must be included in the time sheet:
239.27 	(1) full name of personal care assistant and individual provider number;
239.28 	(2) provider name and telephone numbers;
239.29 	(3) full name of recipient;
239.30 	(4) consecutive dates, including month, day, and year, and arrival and departure 
239.31 	time with a.m. or p.m. notations;
239.32 	(5) signatures of recipient or the responsible party;
239.33 	(6) personal signature of the personal care assistant;
239.34 	(7) any shared care provided, if applicable;
239.35 	(8) a statement that it is a federal crime to provide false information on personal 
239.36 	care service billings for medical assistance payments; and
240.1 	(9) dates and location of recipient stays in a hospital, care facility, or incarceration.
240.2 		Subd. 13.Qualified professional; qualifications. (a) The qualified professional 
240.3 	must be employed by a personal care assistance provider agency and meet the definition 
240.4 	under section 256B.0625, subdivision 19c. Before a qualified professional provides 
240.5 	services, the personal care assistance provider agency must initiate a background study on 
240.6 	the qualified professional under chapter 245C, and the personal care assistance provider 
240.7 	agency must have received a notice from the commissioner that the qualified professional:
240.8 	(1) is not disqualified under section 245C.14; or
240.9 	(2) is disqualified, but the qualified professional has received a set aside of the 
240.10 	disqualification under section 245C.22.
240.11 	(b) The qualified professional shall perform the duties of training, supervision, and 
240.12 	evaluation of the personal care assistance staff and evaluation of the effectiveness of 
240.13 	personal care assistance services. The qualified professional shall:
240.14 	(1) develop and monitor with the recipient a personal care assistance care plan based 
240.15 	on the service plan and individualized needs of the recipient;
240.16 	(2) develop and monitor with the recipient a monthly plan for the use of personal 
240.17 	care assistance services;
240.18 	(3) review documentation of personal care assistance services provided;
240.19 	(4) provide training and ensure competency for the personal care assistant in the 
240.20 	individual needs of the recipient; and
240.21 	(5) document all training, communication, evaluations, and needed actions to 
240.22 	improve performance of the personal care assistants.
240.23 	(c) The qualified professional shall complete the provider training with basic 
240.24 	information about the personal care assistance program approved by the commissioner 
240.25 	within six months of the date hired by a personal care assistance provider agency. 
240.26 	Qualified professionals who have completed the required trainings as an employee with a 
240.27 	personal care assistance provider agency do not need to repeat the required trainings if they 
240.28 	are hired by another agency, if they have completed the training within the last three years.
240.29 		Subd. 14.Qualified professional; duties. (a) Effective January 1, 2010, all personal 
240.30 	care assistants must be supervised by a qualified professional.
240.31 	(b) Through direct training, observation, return demonstrations, and consultation 
240.32 	with the staff and the recipient, the qualified professional must ensure and document 
240.33 	that the personal care assistant is:
240.34 	(1) capable of providing the required personal care assistance services;
240.35 	(2) knowledgeable about the plan of personal care assistance services before services 
240.36 	are performed; and
241.1 	(3) able to identify conditions that should be immediately brought to the attention of 
241.2 	the qualified professional.
241.3 	(c) The qualified professional shall evaluate the personal care assistant within the 
241.4 	first 14 days of starting to provide services for a recipient except for the personal care 
241.5 	assistance choice option under subdivision 19, paragraph (a), clause (4). The qualified 
241.6 	professional shall evaluate the personal care assistance services for a recipient through 
241.7 	direct observation of a personal care assistant's work:
241.8 	(1) at least every 90 days thereafter for the first year of a recipient's services; and
241.9 	(2) every 120 days after the first year of a recipient's service or whenever needed for 
241.10 	response to a recipient's request for increased supervision of the personal care assistance 
241.11 	staff.
241.12 	(d) Communication with the recipient is a part of the evaluation process of the 
241.13 	personal care assistance staff.
241.14 	(e) At each supervisory visit, the qualified professional shall evaluate personal care 
241.15 	assistance services including the following information:
241.16 	(1) satisfaction level of the recipient with personal care assistance services;
241.17 	(2) review of the month-to-month plan for use of personal care assistance services;
241.18 	(3) review of documentation of personal care assistance services provided;
241.19 	(4) whether the personal care assistance services are meeting the goals of the service 
241.20 	as stated in the personal care assistance care plan and service plan;
241.21 	(5) a written record of the results of the evaluation and actions taken to correct any 
241.22 	deficiencies in the work of a personal care assistant; and
241.23 	(6) revision of the personal care assistance care plan as necessary in consultation 
241.24 	with the recipient or responsible party, to meet the needs of the recipient.
241.25 	(f) The qualified professional shall complete the required documentation in the 
241.26 	agency recipient and employee files and the recipient's home, including the following 
241.27 	documentation:
241.28 	(1) the personal care assistance care plan based on the service plan and individualized 
241.29 	needs of the recipient;
241.30 	(2) a month-to-month plan for use of personal care assistance services;
241.31 	(3) changes in need of the recipient requiring a change to the level of service and the 
241.32 	personal care assistance care plan;
241.33 	(4) evaluation results of supervision visits and identified issues with personal care 
241.34 	assistance staff with actions taken;
241.35 	(5) all communication with the recipient and personal care assistance staff; and
241.36 	(6) hands-on training or individualized training for the care of the recipient.
242.1 	(g) The documentation in paragraph (f) must be done on agency forms.
242.2 	(h) The services that are not eligible for payment as qualified professional services 
242.3 	include:
242.4 	(1) direct professional nursing tasks that could be assessed and authorized as skilled 
242.5 	nursing tasks;
242.6 	(2) supervision of personal care assistance completed by telephone;
242.7 	(3) agency administrative activities;
242.8 	(4) training other than the individualized training required to provide care for a 
242.9 	recipient; and
242.10 	(5) any other activity that is not described in this section.
242.11 		Subd. 15.Flexible use. (a) "Flexible use" means the scheduled use of authorized 
242.12 	hours of personal care assistance services, which vary within a service authorization 
242.13 	period covering no more than six months, in order to more effectively meet the needs and 
242.14 	schedule of the recipient. Each 12-month service agreement is divided into two six-month 
242.15 	authorization date spans. No more than 75 percent of the total authorized units for a 
242.16 	12-month service agreement may be used in a six-month date span.
242.17 	(b) Authorization of flexible use occurs during the authorization process under 
242.18 	section 256B.0652. The flexible use of authorized hours does not increase the total 
242.19 	amount of authorized hours available to a recipient. The commissioner shall not authorize 
242.20 	additional personal care assistance services to supplement a service authorization that 
242.21 	is exhausted before the end date under a flexible service use plan, unless the assessor 
242.22 	determines a change in condition and a need for increased services is established. 
242.23 	Authorized hours not used within the six-month period must not be carried over to another 
242.24 	time period.
242.25 	(c) A recipient who has terminated personal care assistance services before the end 
242.26 	of the 12-month authorization period must not receive additional hours upon reapplying 
242.27 	during the same 12-month authorization period, except if a change in condition is 
242.28 	documented. Services must be prorated for the remainder of the 12-month authorization 
242.29 	period based on the first six-month assessment.
242.30 	(d) The recipient, responsible party, and qualified professional must develop a 
242.31 	written month-to-month plan of the projected use of personal care assistance services that 
242.32 	is part of the personal care assistance care plan and ensures:
242.33 	(1) that the health and safety needs of the recipient are met throughout both date 
242.34 	spans of the authorization period; and
242.35 	(2) that the total authorized amount of personal care assistance services for each date 
242.36 	span must not be used before the end of each date span in the authorization period.
243.1 	(e) The personal care assistance provider agency shall monitor the use of personal 
243.2 	care assistance services to ensure health and safety needs of the recipient are met 
243.3 	throughout both date spans of the authorization period. The commissioner or the 
243.4 	commissioner's designee shall provide written notice to the provider and the recipient or 
243.5 	responsible party when a recipient is at risk of exceeding the personal care assistance 
243.6 	services prior to the end of the six-month period.
243.7 	(f) Misuse and abuse of the flexible use of personal care assistance services resulting 
243.8 	in the overuse of units in a manner where the recipient will not have enough units to meet 
243.9 	their needs for assistance and ensure health and safety for the entire six-month date span 
243.10 	may lead to an action by the commissioner. The commissioner may take action including, 
243.11 	but not limited to: (1) restricting recipients to service authorizations of no more than one 
243.12 	month in duration; (2) requiring the recipient to have a responsible party; and (3) requiring 
243.13 	a qualified professional to monitor and report services on a monthly basis.
243.14 		Subd. 16.Shared services. (a) Medical assistance payments for shared personal 
243.15 	care assistance services are limited according to this subdivision.
243.16 	(b) Shared service is the provision of personal care assistance services by a personal 
243.17 	care assistant to two or three recipients, eligible for medical assistance, who voluntarily 
243.18 	enter into an agreement to receive services at the same time and in the same setting.
243.19 	(c) For the purposes of this subdivision, "setting" means:
243.20 	(1) the home residence or family foster care home of one or more of the individual 
243.21 	recipients; or
243.22 	(2) a child care program licensed under chapter 245A or operated by a local school 
243.23 	district or private school.
243.24 	(d) Shared personal care assistance services follow the same criteria for covered 
243.25 	services as subdivision 2.
243.26 	(e) Noncovered shared personal care assistance services include the following:
243.27 	(1) services for more than three recipients by one personal care assistant at one time;
243.28 	(2) staff requirements for child care programs under chapter 245C;
243.29 	(3) caring for multiple recipients in more than one setting;
243.30 	(4) additional units of personal care assistance based on the selection of the option; 
243.31 	and
243.32 	(5) use of more than one personal care assistance provider agency for the shared 
243.33 	care services.
243.34 	(f) The option of shared personal care assistance is elected by the recipient or the 
243.35 	responsible party with the assistance of the assessor. The option must be determined 
243.36 	appropriate based on the ages of the recipients, compatibility, and coordination of their 
244.1 	assessed care needs. The recipient or the responsible party, in conjunction with the 
244.2 	qualified professional, shall arrange the setting and grouping of shared services based 
244.3 	on the individual needs and preferences of the recipients. The personal care assistance 
244.4 	provider agency shall offer the recipient or the responsible party the option of shared or 
244.5 	one-on-one personal care assistance services or a combination of both. The recipient or 
244.6 	the responsible party may withdraw from participating in a shared services arrangement at 
244.7 	any time.
244.8 	(g) Authorization for the shared service option must be determined by the 
244.9 	commissioner based on the criteria that the shared service is appropriate to meet all of the 
244.10 	recipients' needs and their health and safety is maintained. The authorization of shared 
244.11 	services is part of the overall authorization of personal care assistance services. Nothing 
244.12 	in this subdivision must be construed to reduce the total number of hours authorized for 
244.13 	an individual recipient.
244.14 	(h) A personal care assistant providing shared personal care assistance services must:
244.15 	(1) receive training specific for each recipient served; and
244.16 	(2) follow all required documentation requirements for time and services provided.
244.17 	(i) A qualified professional shall:
244.18 	(1) evaluate the ability of the personal care assistant to provide services for all of 
244.19 	the recipients in a shared setting;
244.20 	(2) visit the shared setting as services are being provided at least once every six 
244.21 	months or whenever needed for response to a recipient's request for increased supervision 
244.22 	of the personal care assistance staff;
244.23 	(3) provide ongoing monitoring and evaluation of the effectiveness and 
244.24 	appropriateness of the shared services;
244.25 	(4) develop a contingency plan with each of the recipients which accounts for 
244.26 	absence of the recipient in a share services setting due to illness or other circumstances;
244.27 	(5) obtain permission from each of the recipients who are sharing a personal care 
244.28 	assistant for number of shared hours for services provided inside and outside the home 
244.29 	residence; and
244.30 	(6) document the training completed by the personal care assistants specific to the 
244.31 	shared setting and recipients sharing services.
244.32 		Subd. 17.Shared services; rates. The commissioner shall provide a rate system for 
244.33 	shared personal care assistance services. For two persons sharing services, the rate paid 
244.34 	to a provider must not exceed one and one-half times the rate paid for serving a single 
244.35 	individual, and for three persons sharing services, the rate paid to a provider must not 
245.1 	exceed twice the rate paid for serving a single individual. These rates apply only when all 
245.2 	of the criteria for the shared care personal care assistance service have been met.
245.3 		Subd. 18.Personal care assistance choice option; generally. (a) The 
245.4 	commissioner may allow a recipient of personal care assistance services to use a fiscal 
245.5 	intermediary to assist the recipient in paying and accounting for medically necessary 
245.6 	covered personal care assistance services. Unless otherwise provided in this section, all 
245.7 	other statutory and regulatory provisions relating to personal care assistance services apply 
245.8 	to a recipient using the personal care assistance choice option.
245.9 	(b) Personal care assistance choice is an option of the personal care assistance 
245.10 	program that allows the recipient who receives personal care assistance services to be 
245.11 	responsible for the hiring, training, scheduling, and firing of personal care assistants. This 
245.12 	program offers greater control and choice for the recipient in who provides the personal 
245.13 	care assistance service and when the service is scheduled. The recipient or the recipient's 
245.14 	responsible party must choose a personal care assistance choice provider agency as 
245.15 	a fiscal intermediary. This personal care assistance choice provider agency manages 
245.16 	payroll, invoices the state, is responsible for all payroll related taxes and insurance, and is 
245.17 	responsible for providing the consumer training and support in managing the recipient's 
245.18 	personal care assistance services.
245.19 		Subd. 19.Personal care assistance choice option; qualifications; duties. (a) 
245.20 	Under personal care assistance choice, the recipient or responsible party shall:
245.21 	(1) recruit, hire, schedule, and terminate personal care assistants and a qualified 
245.22 	professional;
245.23 	(2) develop a personal care assistance care plan based on the assessed needs 
245.24 	and addressing the health and safety of the recipient with the assistance of a qualified 
245.25 	professional as needed;
245.26 	(3) orient and train the personal care assistant with assistance as needed from the 
245.27 	qualified professional;
245.28 	(4) effective January 1, 2010, supervise and evaluate the personal care assistant with 
245.29 	the qualified professional, who is required to visit the recipient at least every 180 days;
245.30 	(5) monitor and verify in writing and report to the personal care assistance choice 
245.31 	agency the number of hours worked by the personal care assistant and the qualified 
245.32 	professional;
245.33 	(6) engage in an annual face-to-face reassessment to determine continuing eligibility 
245.34 	and service authorization; and
245.35 	(7) use the same personal care assistance choice provider agency if shared personal 
245.36 	assistance care is being used.
246.1 	(b) The personal care assistance choice provider agency shall:
246.2 	(1) meet all personal care assistance provider agency standards;
246.3 	(2) enter into a written agreement with the recipient, responsible party, and personal 
246.4 	care assistants;
246.5 	(3) not be related as a parent, child, sibling, or spouse to the recipient, qualified 
246.6 	professional, or the personal care assistant; and
246.7 	(4) ensure arm's-length transactions without undue influence or coercion with the 
246.8 	recipient and personal care assistant.
246.9 	(c) The duties of the personal care assistance choice provider agency are to:
246.10 	(1) be the employer of the personal care assistant and the qualified professional for 
246.11 	employment law and related regulations including, but not limited to, purchasing and 
246.12 	maintaining workers' compensation, unemployment insurance, surety and fidelity bonds, 
246.13 	and liability insurance, and submit any or all necessary documentation including, but not 
246.14 	limited to, workers' compensation and unemployment insurance;
246.15 	(2) bill the medical assistance program for personal care assistance services and 
246.16 	qualified professional services;
246.17 	(3) request and complete background studies that comply with the requirements for 
246.18 	personal care assistants and qualified professionals;
246.19 	(4) pay the personal care assistant and qualified professional based on actual hours 
246.20 	of services provided;
246.21 	(5) withhold and pay all applicable federal and state taxes;
246.22 	(6) verify and keep records of hours worked by the personal care assistant and 
246.23 	qualified professional;
246.24 	(7) make the arrangements and pay taxes and other benefits, if any; and comply with 
246.25 	any legal requirements for a Minnesota employer;
246.26 	(8) enroll in the medical assistance program as a personal care assistance choice 
246.27 	agency; and
246.28 	(9) enter into a written agreement as specified in subdivision 20 before services 
246.29 	are provided.
246.30 		Subd. 20.Personal care assistance choice option; administration. (a) Before 
246.31 	services commence under the personal care assistance choice option, and annually 
246.32 	thereafter, the personal care assistance choice provider agency, recipient, or responsible 
246.33 	party, each personal care assistant, and the qualified professional shall enter into a written 
246.34 	agreement. The agreement must include at a minimum:
246.35 	(1) duties of the recipient, qualified professional, personal care assistant, and 
246.36 	personal care assistance choice provider agency;
247.1 	(2) salary and benefits for the personal care assistant and the qualified professional;
247.2 	(3) administrative fee of the personal care assistance choice provider agency and 
247.3 	services paid for with that fee, including background study fees;
247.4 	(4) grievance procedures to respond to complaints;
247.5 	(5) procedures for hiring and terminating the personal care assistant; and
247.6 	(6) documentation requirements including, but not limited to, time sheets, activity 
247.7 	records, and the personal care assistance care plan.
247.8 	(b) Effective January 1, 2010, except for the administrative fee of the personal care 
247.9 	assistance choice provider agency as reported on the written agreement, the remainder 
247.10 	of the rates paid to the personal care assistance choice provider agency must be used to 
247.11 	pay for the salary and benefits for the personal care assistant or the qualified professional. 
247.12 	The provider agency must use a minimum of 72.5 percent of the revenue generated by 
247.13 	the medical assistance rate for personal care assistance services for employee personal 
247.14 	care assistant wages and benefits.
247.15 	(c) The commissioner shall deny, revoke, or suspend the authorization to use the 
247.16 	personal care assistance choice option if:
247.17 	(1) it has been determined by the qualified professional or public health nurse that 
247.18 	the use of this option jeopardizes the recipient's health and safety;
247.19 	(2) the parties have failed to comply with the written agreement specified in this 
247.20 	subdivision;
247.21 	(3) the use of the option has led to abusive or fraudulent billing for personal care 
247.22 	assistance services; or
247.23 	(4) the department terminates the personal care assistance choice option.
247.24 	(d) The recipient or responsible party may appeal the commissioner's decision in 
247.25 	paragraph (c) according to section 256.045. The denial, revocation, or suspension to 
247.26 	use the personal care assistance choice option must not affect the recipient's authorized 
247.27 	level of personal care assistance services.
247.28 		Subd. 21.Requirements for initial enrollment of personal care assistance 
247.29 	provider agencies. (a) All personal care assistance provider agencies must provide, at the 
247.30 	time of enrollment as a personal care assistance provider agency in a format determined 
247.31 	by the commissioner, information and documentation that includes, but is not limited to, 
247.32 	the following:
247.33 	(1) the personal care assistance provider agency's current contact information 
247.34 	including address, telephone number, and e-mail address;
247.35 	(2) proof of surety bond coverage in the amount of $50,000 or ten percent of the 
247.36 	provider's payments from Medicaid in the previous year, whichever is less;
248.1 	(3) proof of fidelity bond coverage in the amount of $20,000;
248.2 	(4) proof of workers' compensation insurance coverage;
248.3 	(5) a description of the personal care assistance provider agency's organization 
248.4 	identifying the names of all owners, managing employees, staff, board of directors, and 
248.5 	the affiliations of the directors, owners, or staff to other service providers;
248.6 	(6) a copy of the personal care assistance provider agency's written policies and 
248.7 	procedures including: hiring of employees; training requirements; service delivery; 
248.8 	and employee and consumer safety including process for notification and resolution 
248.9 	of consumer grievances, identification and prevention of communicable diseases, and 
248.10 	employee misconduct;
248.11 	(7) copies of all other forms the personal care assistance provider agency uses in 
248.12 	the course of daily business including, but not limited to:
248.13 	(i) a copy of the personal care assistance provider agency's time sheet if the time 
248.14 	sheet varies from the standard time sheet for personal care assistance services approved 
248.15 	by the commissioner, and a letter requesting approval of the personal care assistance 
248.16 	provider agency's nonstandard time sheet;
248.17 	(ii) the personal care assistance provider agency's template for the personal care 
248.18 	assistance care plan; and
248.19 	(iii) the personal care assistance provider agency's template and the written 
248.20 	agreement in subdivision 20 for recipients using the personal care assistance choice 
248.21 	option, if applicable;
248.22 	(8) a list of all trainings and classes that the personal care assistance provider agency 
248.23 	requires of its staff providing personal care assistance services;
248.24 	(9) documentation that the personal care assistance provider agency and staff have 
248.25 	successfully completed all the training required by this section; 
248.26 	(10) documentation of the agency's marketing practices;
248.27 	(11) disclosure of ownership, leasing, or management of all residential properties 
248.28 	that is used or could be used for providing home care services; and 
248.29 	(12) documentation that the agency will use the following percentages of revenue 
248.30 	generated from the medical assistance rate paid for personal care assistance services 
248.31 	for employee personal care assistant wages and benefits: 72.5 percent of revenue in the 
248.32 	personal care assistance choice option and 72.5 percent of revenue from other personal 
248.33 	care assistance providers.
248.34 	(b) Personal care assistance provider agencies shall provide the information specified 
248.35 	in paragraph (a) to the commissioner at the time the personal care assistance provider 
248.36 	agency enrolls as a vendor or upon request from the commissioner. The commissioner 
249.1 	shall collect the information specified in paragraph (a) from all personal care assistance 
249.2 	providers beginning upon enactment of this section.
249.3 	(c) All personal care assistance provider agencies shall complete mandatory training 
249.4 	as determined by the commissioner before enrollment as a provider. Personal care 
249.5 	assistance provider agencies are required to send all owners, qualified professionals 
249.6 	employed by the agency, and all other managing employees to the initial and subsequent 
249.7 	trainings. Personal care assistance provider agency billing staff shall complete training 
249.8 	about personal care assistance program financial management. This training is effective 
249.9 	upon enactment of this section. Any personal care assistance provider agency enrolled 
249.10 	before that date shall, if it has not already, complete the provider training within 18 months 
249.11 	of the effective date of this section. Any new owners, new qualified professionals, and new 
249.12 	managing employees are required to complete mandatory training as a requisite of hiring.
249.13 		Subd. 22.Annual review for personal care providers. (a) All personal care 
249.14 	assistance provider agencies shall resubmit, on an annual basis, the information specified 
249.15 	in subdivision 21, in a format determined by the commissioner, and provide a copy of the 
249.16 	personal care assistance provider agency's most current version of its grievance policies 
249.17 	and procedures along with a written record of grievances and resolutions of the grievances 
249.18 	that the personal care assistance provider agency has received in the previous year and any 
249.19 	other information requested by the commissioner.
249.20 	(b) The commissioner shall send annual review notification to personal care 
249.21 	assistance provider agencies 30 days prior to renewal. The notification must:
249.22 	(1) list the materials and information the personal care assistance provider agency is 
249.23 	required to submit;
249.24 	(2) provide instructions on submitting information to the commissioner; and
249.25 	(3) provide a due date by which the commissioner must receive the requested 
249.26 	information.
249.27 	Personal care assistance provider agencies shall submit required documentation for 
249.28 	annual review within 30 days of notification from the commissioner. If no documentation 
249.29 	is submitted, the personal care assistance provider agency enrollment number must be 
249.30 	terminated or suspended.
249.31 	(c) Personal care assistance provider agencies also currently licensed under 
249.32 	Minnesota Rules, part 4668.0012, as a class A provider or currently certified for 
249.33 	participation in Medicare as a home health agency are deemed in compliance with 
249.34 	the personal care assistance requirements for enrollment, annual review process, and 
249.35 	documentation.
250.1 		Subd. 23.Enrollment requirements following termination. (a) A terminated 
250.2 	personal care assistance provider agency, including all named individuals on the current 
250.3 	enrollment disclosure form and known or discovered affiliates of the personal care 
250.4 	assistance provider agency, is not eligible to enroll as a personal care assistance provider 
250.5 	agency for two years following the termination.
250.6 	(b) After the two-year period in paragraph (a), if the provider seeks to reenroll 
250.7 	as a personal care assistance provider agency, the personal care assistance provider 
250.8 	agency must be placed on a one-year probation period, beginning after completion of 
250.9 	the following:
250.10 	(1) the department's provider trainings under this section; and
250.11 	(2) initial enrollment requirements under subdivision 21.
250.12 	(c) During the probationary period the commissioner shall complete site visits and 
250.13 	request submission of documentation to review compliance with program policy.
250.14 		Subd. 24.Personal care assistance provider agency; general duties. A personal 
250.15 	care assistance provider agency shall:
250.16 	(1) enroll as a Medicaid provider meeting all provider standards, including 
250.17 	completion of the required provider training;
250.18 	(2) comply with general medical assistance coverage requirements;
250.19 	(3) demonstrate compliance with law and policies of the personal care assistance 
250.20 	program to be determined by the commissioner;
250.21 	(4) comply with background study requirements;
250.22 	(5) verify and keep records of hours worked by the personal care assistant and 
250.23 	qualified professional;
250.24 	(6) market agency services only through printed information in brochures and on 
250.25 	Web sites and not engage in any agency-initiated direct contact or marketing in person, by 
250.26 	phone, or other electronic means to potential recipients, guardians, or family members;
250.27 	(7) pay the personal care assistant and qualified professional based on actual hours 
250.28 	of services provided;
250.29 	(8) withhold and pay all applicable federal and state taxes;
250.30 	(9) effective January 1, 2010, document that the agency uses a minimum of 72.5 
250.31 	percent of the revenue generated by the medical assistance rate for personal care assistance 
250.32 	services for employee personal care assistant wages and benefits;
250.33 	(10) make the arrangements and pay unemployment insurance, taxes, workers' 
250.34 	compensation, liability insurance, and other benefits, if any;
250.35 	(11) enter into a written agreement under subdivision 20 before services are provided;
251.1 	(12) report suspected neglect and abuse to the common entry point according to 
251.2 	section 256B.0651; 
251.3 	(13) provide the recipient with a copy of the home care bill of rights at start of 
251.4 	service; and
251.5 	(14) request reassessments at least 60 days prior to the end of the current 
251.6 	authorization for personal care assistance services, on forms provided by the commissioner.
251.7 		Subd. 25.Personal care assistance provider agency; background studies.
 251.8 	Personal care assistance provider agencies enrolled to provide personal care assistance 
251.9 	services under the medical assistance program shall comply with the following:
251.10 	(1) owners who have a five percent interest or more and all managing employees 
251.11 	are subject to a background study as provided in chapter 245C. This applies to currently 
251.12 	enrolled personal care assistance provider agencies and those agencies seeking enrollment 
251.13 	as a personal care assistance provider agency. Managing employee has the same meaning 
251.14 	as Code of Federal Regulations, title 42, section 455. An organization is barred from 
251.15 	enrollment if:
251.16 	(i) the organization has not initiated background studies on owners and managing 
251.17 	employees; or
251.18 	(ii) the organization has initiated background studies on owners and managing 
251.19 	employees, but the commissioner has sent the organization a notice that an owner or 
251.20 	managing employee of the organization has been disqualified under section 245C.14, 
251.21 	and the owner or managing employee has not received a set aside of the disqualification 
251.22 	under section 245C.22;
251.23 	(2) a background study must be initiated and completed for all qualified 
251.24 	professionals; and
251.25 	(3) a background study must be initiated and completed for all personal care 
251.26 	assistants.
251.27 		Subd. 26.Personal care assistance provider agency; communicable disease 
251.28 	prevention. A personal care assistance provider agency shall establish and implement 
251.29 	policies and procedures for prevention, control, and investigation of infections and 
251.30 	communicable diseases according to current nationally recognized infection control 
251.31 	practices or guidelines established by the United States Centers for Disease Control and 
251.32 	Prevention, as well as applicable regulations of other federal or state agencies.
251.33 		Subd. 27.Personal care assistance provider agency; ventilator training. The 
251.34 	personal care assistance provider agency is required to provide training for the personal 
251.35 	care assistant responsible for working with a recipient who is ventilator dependent. All 
251.36 	training must be administered by a respiratory therapist, nurse, or physician. Qualified 
252.1 	professional supervision by a nurse must be completed and documented on file in the 
252.2 	personal care assistant's employment record and the recipient's health record. If offering 
252.3 	personal care services to a ventilator-dependent recipient, the personal care assistance 
252.4 	provider agency shall demonstrate the ability to:
252.5 	(1) train the personal care assistant;
252.6 	(2) supervise the personal care assistant in ventilator operation and maintenance; and
252.7 	(3) supervise the recipient and responsible party in ventilator operation and 
252.8 	maintenance.
252.9 		Subd. 28.Personal care assistance provider agency; required documentation.
 252.10 	Required documentation must be completed and kept in the personal care assistance 
252.11 	provider agency file or the recipient's home residence. The required documentation 
252.12 	consists of:
252.13 	(1) employee files, including:
252.14 	(i) applications for employment;
252.15 	(ii) background study requests and results;
252.16 	(iii) orientation records about the agency policies;
252.17 	(iv) trainings completed with demonstration of competence;
252.18 	(v) supervisory visits;
252.19 	(vi) evaluations of employment; and
252.20 	(vii) signature on fraud statement;
252.21 	(2) recipient files, including:
252.22 	(i) demographics;
252.23 	(ii) emergency contact information and emergency backup plan;
252.24 	(iii) personal care assistance service plan;
252.25 	(iv) personal care assistance care plan;
252.26 	(v) month-to-month service use plan;
252.27 	(vi) all communication records;
252.28 	(vii) start of service information, including the written agreement with recipient; and
252.29 	(viii) date the home care bill of rights was given to the recipient;
252.30 	(3) agency policy manual, including:
252.31 	(i) policies for employment and termination;
252.32 	(ii) grievance policies with resolution of consumer grievances;
252.33 	(iii) staff and consumer safety;
252.34 	(iv) staff misconduct; and
252.35 	(v) staff hiring, service delivery, staff and consumer safety, staff misconduct, and 
252.36 	resolution of consumer grievances; 
253.1 	(4) time sheets for each personal care assistant along with completed activity sheets 
253.2 	for each recipient served; and
253.3 	(5) agency marketing and advertising materials and documentation of marketing 
253.4 	activities and costs.
253.5 		Subd. 29.Transitional assistance. The commissioner, counties, health plans, 
253.6 	tribes, and personal care assistance providers shall work together to provide transitional 
253.7 	assistance for recipients and families to come into compliance with the new requirements 
253.8 	of this section and ensure the personal care assistance services are not provided by the 
253.9 	housing provider.
253.10 		Subd. 30.Notice of service changes to recipients. The commissioner must provide:
253.11 	(1) by October 31, 2009, information to recipients likely to be affected that (i) 
253.12 	describes the changes to the personal care assistance program that may result in the 
253.13 	loss of access to personal care assistance services, and (ii) includes resources to obtain 
253.14 	further information; and
253.15 	(2) notice of changes in medical assistance home care services to each affected 
253.16 	recipient at least 30 days before the effective date of the change.
253.17 	The notice shall include how to get further information on the changes, how to get help to 
253.18 	obtain other services, a list of community resources, and appeal rights. Notwithstanding 
253.19 	section 256.045, a recipient may request continued services pending appeal within the 
253.20 	time period allowed to request an appeal.

253.21 	EFFECTIVE DATE. Subdivisions 4, 22, and 27 are effective January 1, 2010.

253.22 	Sec. 32. Minnesota Statutes 2008, section 256B.0911, subdivision 1, is amended to 
253.23 	read:
253.24 		Subdivision 1.Purpose and goal. (a) The purpose of long-term care consultation 
253.25 	services is to assist persons with long-term or chronic care needs in making long-term 
253.26 	care decisions and selecting options that meet their needs and reflect their preferences. 
253.27 	The availability of, and access to, information and other types of assistance, including 
253.28 	assessment and support planning, is also intended to prevent or delay certified nursing 
253.29 	facility placements and to provide transition assistance after admission. Further, the goal 
253.30 	of these services is to contain costs associated with unnecessary certified nursing facility 
253.31 	admissions. Long-term consultation services must be available to any person regardless 
253.32 	of public program eligibility. The commissionerscommissioner of human services and 
253.33 	health shall seek to maximize use of available federal and state funds and establish the 
253.34 	broadest program possible within the funding available.
254.1 	(b) These services must be coordinated with serviceslong-term care options 
254.2 	counseling provided under section 256.975, subdivision 7, and with services provided by 
254.3 	other public and private agencies in the communitysection 256.01, subdivision 24, for 
254.4 	telephone assistance and follow up and to offer a variety of cost-effective alternatives to 
254.5 	persons with disabilities and elderly persons. The county or tribal agency or managed 
254.6 	care plan providing long-term care consultation services shall encourage the use of 
254.7 	volunteers from families, religious organizations, social clubs, and similar civic and 
254.8 	service organizations to provide community-based services.

254.9 	Sec. 33. Minnesota Statutes 2008, section 256B.0911, subdivision 1a, is amended to 
254.10 	read:
254.11 		Subd. 1a.Definitions. For purposes of this section, the following definitions apply:
254.12 	(a) "Long-term care consultation services" means:
254.13 	(1) providing information and education to the general public regarding availability 
254.14 	of the services authorized under this section;
254.15 	(2) an intake process that provides access to the services described in this section;
254.16 	(3) assessment of the health, psychological, and social needs of referred individuals;
254.17 	(4) assistance in identifying services needed to maintain an individual in the least 
254.18 	restrictivemost inclusive environment;
254.19 	(5)(2) providing recommendations on cost-effective community services that are 
254.20 	available to the individual;
254.21 	(6)(3) development of an individual's person-centered community support plan;
254.22 	(7)(4) providing information regarding eligibility for Minnesota health care 
254.23 	programs;
254.24 	(5) face-to-face long-term care consultation assessments, which may be completed 
254.25 	in a hospital, nursing facility, intermediate care facility for persons with developmental 
254.26 	disabilities (ICF/DDs), regional treatment centers, or the person's current or planned 
254.27 	residence;
254.28 	(8) preadmission(6) federally mandated screening to determine the need for 
254.29 	a nursing facilityinstitutional level of care under section 256B.0911, subdivision 4, 
254.30 	paragraph (a);
254.31 	(9) preliminary(7) determination of Minnesota health care programshome and 
254.32 	community-based waiver service eligibility including level of care determination for 
254.33 	individuals who need a nursing facilityan institutional level of care as defined under 
254.34 	section 144.0724, subdivision 11, or 256B.092, service eligibility including state plan 
254.35 	home care services identified in section 256B.0625, subdivisions 6, 7, and 19, paragraphs 
255.1 	(a) and (c), based on assessment and support plan development with appropriate referrals 
255.2 	for final determination;
255.3 	(10)(8) providing recommendations for nursing facility placement when there are 
255.4 	no cost-effective community services available; and
255.5 	(11)(9) assistance to transition people back to community settings after facility 
255.6 	admission.
255.7 	(b) "Long-term options counseling" means the services provided by the linkage 
255.8 	lines as mandated by sections 256.01 and 256.975, subdivision 7, and also includes 
255.9 	telephone assistance and follow up once a long-term care consultation assessment has 
255.10 	been completed. 
255.11 	(b) (c) "Minnesota health care programs" means the medical assistance program 
255.12 	under chapter 256B and the alternative care program under section 256B.0913.
255.13 	(d) "Lead agencies" means counties or a collaboration of counties, tribes, and health 
255.14 	plans administering long-term care consultation assessment and support planning services.

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

255.16 	Sec. 34. Minnesota Statutes 2008, section 256B.0911, is amended by adding a 
255.17 	subdivision to read:
255.18 		Subd. 2b.Certified assessors. (a) Beginning January 1, 2011, each lead agency 
255.19 	shall use certified assessors who have completed training and certification process 
255.20 	determined by the commissioner in subdivision 2c. Certified assessors shall demonstrate 
255.21 	best practices in assessment and support planning including person-centered planning 
255.22 	principals and have a common set of skills that must ensure consistency and equitable 
255.23 	access to services statewide. Assessors must be part of a multidisciplinary team of 
255.24 	professionals that includes public health nurses, social workers, and other professionals 
255.25 	as defined in paragraph (b). For persons with complex health care needs, a public health 
255.26 	nurse or registered nurse from a multidisciplinary team must be consulted.
255.27 	(b) Certified assessors are persons with a minimum of a bachelor's degree in social 
255.28 	work, nursing with a public health nursing certificate, or other closely related field with at 
255.29 	least one year of home and community-based experience or a two-year registered nursing 
255.30 	degree with at least three years of home and community-based experience that have 
255.31 	received training and certification specific to assessment and consultation for long-term 
255.32 	care services in the state.

255.33 	Sec. 35. Minnesota Statutes 2008, section 256B.0911, is amended by adding a 
255.34 	subdivision to read:
256.1 		Subd. 2c.Assessor training and certification. The commissioner shall develop a 
256.2 	curriculum and an assessor certification process to begin no later than January 1, 2010. 
256.3 	All existing lead agency staff designated to provide the services defined in subdivision 
256.4 	1a must be certified by December 30, 2010. Each lead agency is required to ensure that 
256.5 	they have sufficient numbers of certified assessors to provide long-term consultation 
256.6 	assessment and support planning within the timelines and parameters of the service by 
256.7 	January 1, 2011. Certified assessors are required to be recertified every three years.

256.8 	Sec. 36. Minnesota Statutes 2008, section 256B.0911, subdivision 3, is amended to 
256.9 	read:
256.10 		Subd. 3.Long-term care consultation team. (a) Until January 1, 2011, a long-term 
256.11 	care consultation team shall be established by the county board of commissioners. Each 
256.12 	local consultation team shall consist of at least one social worker and at least one public 
256.13 	health nurse from their respective county agencies. The board may designate public 
256.14 	health or social services as the lead agency for long-term care consultation services. If a 
256.15 	county does not have a public health nurse available, it may request approval from the 
256.16 	commissioner to assign a county registered nurse with at least one year experience in 
256.17 	home care to participate on the team. Two or more counties may collaborate to establish 
256.18 	a joint local consultation team or teams.
256.19 	(b) The team is responsible for providing long-term care consultation services to 
256.20 	all persons located in the county who request the services, regardless of eligibility for 
256.21 	Minnesota health care programs.
256.22 	(c) The commissioner shall allow arrangements and make recommendations that 
256.23 	encourage counties to collaborate to establish joint local long-term care consultation teams 
256.24 	to ensure that long-term care consultations are done within the timelines and parameters 
256.25 	of the service. This includes integrated service models as required in subdivision 1, 
256.26 	paragraph (b).

256.27 	Sec. 37. Minnesota Statutes 2008, section 256B.0911, subdivision 3a, is amended to 
256.28 	read:
256.29 		Subd. 3a.Assessment and support planning. (a) Persons requesting assessment, 
256.30 	services planning, or other assistance intended to support community-based living, 
256.31 	including persons who need assessment in order to determine waiver or alternative 
256.32 	care program eligibility, must be visited by a long-term care consultation team within 
256.33 	ten working15 calendar days after the date on which an assessment was requested or 
256.34 	recommended. After January 1, 2011, these requirements also apply to personal care 
257.1 	assistance services, private duty nursing, and home health agency services, on timelines 
257.2 	established in subdivision 5. Face-to-face  assessments must be conducted according 
257.3 	to paragraphs (b) to (i).
257.4 	(b) The county may utilize a team of either the social worker or public health nurse, 
257.5 	or both,. After January 1, 2011, lead agencies shall use certified assessors  to conduct the 
257.6 	assessment in a face-to-face interview. The consultation team members must confer 
257.7 	regarding the most appropriate care for each individual screened or assessed.
257.8 	(c) The long-term care consultation team must assess the health and social needs of 
257.9 	the person assessment must be comprehensive and include a person-centered assessment 
257.10 	of the health, psychological, functional, environmental, and social needs of referred 
257.11 	individuals and provide information necessary to develop a support plan that meets the 
257.12 	consumers needs, using an assessment form provided by the commissioner.
257.13 	(d) The team must conduct the assessment must be conducted in a face-to-face 
257.14 	interview with the person being assessed and the person's legal representative, if applicable
257.15 	as required by legally executed documents, and other individuals as requested by the 
257.16 	person, who can provide information on the needs, strengths, and preferences of the 
257.17 	person necessary to develop a support plan that ensures the person's health and safety, but 
257.18 	who is not a provider of service or has any financial interest in the provision of services.
257.19 	(e) The team must provide the person, or the person's legal representative, must 
257.20 	be provided with written recommendations for facility- or community-based services. 
257.21 	The team must documentor institutional care that include documentation that the most 
257.22 	cost-effective alternatives available were offered to the individual. For purposes of 
257.23 	this requirement, "cost-effective alternatives" means community services and living 
257.24 	arrangements that cost the same as or less than nursing facility institutional care.
257.25 	(f) If the person chooses to use community-based services, the team must provide 
257.26 	the person or the person's legal representative must be provided with a written community 
257.27 	support plan, regardless of whether the individual is eligible for Minnesota health care 
257.28 	programs. TheA person may request assistance in developing a community support plan 
257.29 	 identifying community supports without participating in a complete assessment. Upon 
257.30 	a request for assistance identifying community support, the person must be transferred 
257.31 	or referred to the services available under sections 256.975, subdivision 7, and 256.01, 
257.32 	subdivision 24, for telephone assistance and follow up.
257.33 	(g) The person has the right to make the final decision between nursing 
257.34 	facility institutional placement and community placement after the screening team's 
257.35 	recommendation recommendations have been provided, except as provided in subdivision 
257.36 	4a, paragraph (c).
258.1 	(h) The team must give the person receiving assessment or support planning, or 
258.2 	the person's legal representative, materials, and forms supplied by the commissioner 
258.3 	containing the following information:
258.4 	(1) the need for and purpose of preadmission screening if the person selects nursing 
258.5 	facility placement;
258.6 	(2) the role of the long-term care consultation assessment and support planning in 
258.7 	waiver and alternative care program eligibility determination;
258.8 	(3) information about Minnesota health care programs;
258.9 	(4) the person's freedom to accept or reject the recommendations of the team;
258.10 	(5) the person's right to confidentiality under the Minnesota Government Data 
258.11 	Practices Act, chapter 13;
258.12 	(6) the long-term care consultant's decision regarding the person's need for nursing 
258.13 	facility institutional level of care as determined under criteria established in section 
258.14 	144.0724, subdivision 11, or 256B.092; and
258.15 	(7) the person's right to appeal the decision regarding the need for nursing facility 
258.16 	level of care or the county's final decisions regarding public programs eligibility according 
258.17 	to section 256.045, subdivision 3.
258.18 	(i) Face-to-face assessment completed as part of eligibility determination for 
258.19 	the alternative care, elderly waiver, community alternatives for disabled individuals, 
258.20 	community alternative care, and traumatic brain injury waiver programs under sections 
258.21 	256B.0915, 256B.0917, and 256B.49 is valid to establish service eligibility for no more 
258.22 	than 60 calendar days after the date of assessment. The effective eligibility start date 
258.23 	for these programs can never be prior to the date of assessment. If an assessment was 
258.24 	completed more than 60 days before the effective waiver or alternative care program 
258.25 	eligibility start date, assessment and support plan information must be updated in a 
258.26 	face-to-face visit and documented in the department's Medicaid Management Information 
258.27 	System (MMIS). The effective date of program eligibility in this case cannot be prior to 
258.28 	the date the updated assessment is completed.

258.29 	Sec. 38. Minnesota Statutes 2008, section 256B.0911, subdivision 3b, is amended to 
258.30 	read:
258.31 		Subd. 3b.Transition assistance. (a) A long-term care consultation team shall 
258.32 	provide assistance to persons residing in a nursing facility, hospital, regional treatment 
258.33 	center, or intermediate care facility for persons with developmental disabilities who 
258.34 	request or are referred for assistance. Transition assistance must include assessment, 
258.35 	community support plan development, referrals to long-term care options counseling 
259.1 	under section 256B.975, subdivision 10, for community support plan implementation and 
259.2 	to Minnesota health care programs, and referrals to programs that provide assistance 
259.3 	with housing. Transition assistance must also include information about the Centers for 
259.4 	Independent Living and the Senior LinkAge Line, and about other organizations that 
259.5 	can provide assistance with relocation efforts, and information about contacting these 
259.6 	organizations to obtain their assistance and support. 
259.7 	(b) The county shall develop transition processes with institutional social workers 
259.8 	and discharge planners to ensure that:
259.9 	(1) persons admitted to facilities receive information about transition assistance 
259.10 	that is available;
259.11 	(2) the assessment is completed for persons within ten working days of the date of 
259.12 	request or recommendation for assessment; and
259.13 	(3) there is a plan for transition and follow-up for the individual's return to the 
259.14 	community. The plan must require notification of other local agencies when a person 
259.15 	who may require assistance is screened by one county for admission to a facility located 
259.16 	in another county.
259.17 	(c) If a person who is eligible for a Minnesota health care program is admitted to a 
259.18 	nursing facility, the nursing facility must include a consultation team member or the case 
259.19 	manager in the discharge planning process.

259.20 	Sec. 39. Minnesota Statutes 2008, section 256B.0911, subdivision 3c, is amended to 
259.21 	read:
259.22 		Subd. 3c.Transition to housing with services. (a) Housing with services 
259.23 	establishments offering or providing assisted living under chapter 144G shall inform 
259.24 	all prospective residents of the availability of and contact information for transitional 
259.25 	consultation services under this subdivision prior to executing a lease or contract with the 
259.26 	prospective resident. The purpose of transitional long-term care consultation is to support 
259.27 	persons with current or anticipated long-term care needs in making informed choices 
259.28 	among options that include the most cost-effective and least restrictive settings, and to 
259.29 	delay spenddown to eligibility for publicly funded programs by connecting people to 
259.30 	alternative services in their homes before transition to housing with services. Regardless 
259.31 	of the consultation, prospective residents maintain the right to choose housing with 
259.32 	services or assisted living if that option is their preference.
259.33 	(b) Transitional consultation services are provided as determined by the 
259.34 	commissioner of human services in partnership with county long-term care consultation 
259.35 	units, and the Area Agencies on Aging, and are a combination of telephone-based 
260.1 	and in-person assistance provided under models developed by the commissioner. The 
260.2 	consultation shall be performed in a manner that provides objective and complete 
260.3 	information. Transitional consultation must be provided within five working days of the 
260.4 	request of the prospective resident as follows:
260.5 	(1) the consultation must be provided by a qualified professional as determined by 
260.6 	the commissioner;
260.7 	(2) the consultation must include a review of the prospective resident's reasons for 
260.8 	considering assisted living, the prospective resident's personal goals, a discussion of the 
260.9 	prospective resident's immediate and projected long-term care needs, and alternative 
260.10 	community services or assisted living settings that may meet the prospective resident's 
260.11 	needs; and
260.12 	(3) the prospective resident shall be informed of the availability of long-term care 
260.13 	consultation services described in subdivision 3a that are available at no charge to the 
260.14 	prospective resident to assist the prospective resident in assessment and planning to meet 
260.15 	the prospective resident's long-term care needs. The Senior LinkAge Line and long-term 
260.16 	care consultation team shall give the highest priority to referrals who are at highest risk of 
260.17 	nursing facility placement or as needed for determining eligibility.

260.18 	Sec. 40. Minnesota Statutes 2008, section 256B.0911, subdivision 4a, is amended to 
260.19 	read:
260.20 		Subd. 4a.Preadmission screening activities related to nursing facility 
260.21 	admissions. (a) All applicants to Medicaid certified nursing facilities, including certified 
260.22 	boarding care facilities, must be screened prior to admission regardless of income, assets, 
260.23 	or funding sources for nursing facility care, except as described in subdivision 4b. The 
260.24 	purpose of the screening is to determine the need for nursing facility level of care as 
260.25 	described in paragraph (d) and to complete activities required under federal law related to 
260.26 	mental illness and developmental disability as outlined in paragraph (b).
260.27 	(b) A person who has a diagnosis or possible diagnosis of mental illness or 
260.28 	developmental disability must receive a preadmission screening before admission 
260.29 	regardless of the exemptions outlined in subdivision 4b, paragraph (b), to identify the need 
260.30 	for further evaluation and specialized services, unless the admission prior to screening is 
260.31 	authorized by the local mental health authority or the local developmental disabilities case 
260.32 	manager, or unless authorized by the county agency according to Public Law 101-508.
260.33 	The following criteria apply to the preadmission screening:
261.1 	(1) the county must use forms and criteria developed by the commissioner to identify 
261.2 	persons who require referral for further evaluation and determination of the need for 
261.3 	specialized services; and
261.4 	(2) the evaluation and determination of the need for specialized services must be 
261.5 	done by:
261.6 	(i) a qualified independent mental health professional, for persons with a primary or 
261.7 	secondary diagnosis of a serious mental illness; or
261.8 	(ii) a qualified developmental disability professional, for persons with a primary or 
261.9 	secondary diagnosis of developmental disability. For purposes of this requirement, a 
261.10 	qualified developmental disability professional must meet the standards for a qualified 
261.11 	developmental disability professional under Code of Federal Regulations, title 42, section 
261.12 	483.430.
261.13 	(c) The local county mental health authority or the state developmental disability 
261.14 	authority under Public Law Numbers 100-203 and 101-508 may prohibit admission to a 
261.15 	nursing facility if the individual does not meet the nursing facility level of care criteria or 
261.16 	needs specialized services as defined in Public Law Numbers 100-203 and 101-508. For 
261.17 	purposes of this section, "specialized services" for a person with developmental disability 
261.18 	means active treatment as that term is defined under Code of Federal Regulations, title 
261.19 	42, section 483.440 (a)(1).
261.20 	(d) The determination of the need for nursing facility level of care must be made 
261.21 	according to criteria established in section 144.0724, subdivision 11, and 256B.092, 
261.22 	using forms developed by the commissioner. In assessing a person's needs, consultation 
261.23 	team members shall have a physician available for consultation and shall consider the 
261.24 	assessment of the individual's attending physician, if any. The individual's physician must 
261.25 	be included if the physician chooses to participate. Other personnel may be included on 
261.26 	the team as deemed appropriate by the county.

261.27 	EFFECTIVE DATE. The section is effective January 1, 2011.

261.28 	Sec. 41. Minnesota Statutes 2008, section 256B.0911, subdivision 5, is amended to 
261.29 	read:
261.30 		Subd. 5.Administrative activity. The commissioner shall minimize the number 
261.31 	of forms required in the provision of long-term care consultation services and shall 
261.32 	limit the screening document to items necessary for community support plan approval, 
261.33 	reimbursement, program planning, evaluation, and policy development streamline the 
261.34 	processes, including timelines for when assessments need to be completed, required to 
261.35 	provide the services in this section and shall implement integrated solutions to automate 
262.1 	the business processes to the extent necessary for community support plan approval, 
262.2 	reimbursement, program planning, evaluation, and policy development.

262.3 	Sec. 42. Minnesota Statutes 2008, section 256B.0911, subdivision 6, is amended to 
262.4 	read:
262.5 		Subd. 6.Payment for long-term care consultation services. (a) The total payment 
262.6 	for each county must be paid monthly by certified nursing facilities in the county. The 
262.7 	monthly amount to be paid by each nursing facility for each fiscal year must be determined 
262.8 	by dividing the county's annual allocation for long-term care consultation services by 12 
262.9 	to determine the monthly payment and allocating the monthly payment to each nursing 
262.10 	facility based on the number of licensed beds in the nursing facility. Payments to counties 
262.11 	in which there is no certified nursing facility must be made by increasing the payment 
262.12 	rate of the two facilities located nearest to the county seat.
262.13 	(b) The commissioner shall include the total annual payment determined under 
262.14 	paragraph (a) for each nursing facility reimbursed under section 256B.431 or 256B.434
262.15 	according to section 256B.431, subdivision 2b, paragraph (g).
262.16 	(c) In the event of the layaway, delicensure and decertification, or removal from 
262.17 	layaway of 25 percent or more of the beds in a facility, the commissioner may adjust 
262.18 	the per diem payment amount in paragraph (b) and may adjust the monthly payment 
262.19 	amount in paragraph (a). The effective date of an adjustment made under this paragraph 
262.20 	shall be on or after the first day of the month following the effective date of the layaway, 
262.21 	delicensure and decertification, or removal from layaway.
262.22 	(d) Payments for long-term care consultation services are available to the county 
262.23 	or counties to cover staff salaries and expenses to provide the services described in 
262.24 	subdivision 1a. The county shall employ, or contract with other agencies to employ, within 
262.25 	the limits of available funding, sufficient personnel to provide long-term care consultation 
262.26 	services while meeting the state's long-term care outcomes and objectives as defined in 
262.27 	section 256B.0917, subdivision 1. The county shall be accountable for meeting local 
262.28 	objectives as approved by the commissioner in the biennial home and community-based 
262.29 	services quality assurance plan on a form provided by the commissioner.
262.30 	(e) Notwithstanding section 256B.0641, overpayments attributable to payment of the 
262.31 	screening costs under the medical assistance program may not be recovered from a facility.
262.32 	(f) The commissioner of human services shall amend the Minnesota medical 
262.33 	assistance plan to include reimbursement for the local consultation teams.
262.34 	(g) The county may bill, as case management services, assessments, support 
262.35 	planning, and follow-along provided to persons determined to be eligible for case 
263.1 	management under Minnesota health care programs. No individual or family member 
263.2 	shall be charged for an initial assessment or initial support plan development provided 
263.3 	under subdivision 3a or 3b.
263.4 	(h) The commissioner shall develop an alternative payment methodology for 
263.5 	long-term care consultation services that includes the funding available under this 
263.6 	subdivision, and sections 256B.092 and 256B.0659. In developing the new payment 
263.7 	methodology, the commissioner shall consider the maximization of federal funding for 
263.8 	this activity.

263.9 	Sec. 43. Minnesota Statutes 2008, section 256B.0911, subdivision 7, is amended to 
263.10 	read:
263.11 		Subd. 7.Reimbursement for certified nursing facilities. (a) Medical assistance 
263.12 	reimbursement for nursing facilities shall be authorized for a medical assistance recipient 
263.13 	only if a preadmission screening has been conducted prior to admission or the county has 
263.14 	authorized an exemption. Medical assistance reimbursement for nursing facilities shall 
263.15 	not be provided for any recipient who the local screener has determined does not meet the 
263.16 	level of care criteria for nursing facility placement in section 144.0724, subdivision 11, or, 
263.17 	if indicated, has not had a level II OBRA evaluation as required under the federal Omnibus 
263.18 	Budget Reconciliation Act of 1987 completed unless an admission for a recipient with 
263.19 	mental illness is approved by the local mental health authority or an admission for a 
263.20 	recipient with developmental disability is approved by the state developmental disability 
263.21 	authority.
263.22 	(b) The nursing facility must not bill a person who is not a medical assistance 
263.23 	recipient for resident days that preceded the date of completion of screening activities as 
263.24 	required under subdivisions 4a, 4b, and 4c. The nursing facility must include unreimbursed 
263.25 	resident days in the nursing facility resident day totals reported to the commissioner.

263.26 	EFFECTIVE DATE. The section is effective January 1, 2011.

263.27 	Sec. 44. Minnesota Statutes 2008, section 256B.0913, subdivision 4, is amended to 
263.28 	read:
263.29 		Subd. 4.Eligibility for funding for services for nonmedical assistance recipients.
 263.30 	(a) Funding for services under the alternative care program is available to persons who 
263.31 	meet the following criteria:
263.32 	(1) the person has been determined by a community assessment under section 
263.33 	256B.0911 to be a person who would require the level of care provided in a nursing 
263.34 	facility, but for the provision of services under the alternative care program. Effective 
264.1 	January 1, 2011, this determination must be made according to the criteria established in 
264.2 	section 144.0724, subdivision 11;
264.3 	(2) the person is age 65 or older;
264.4 	(3) the person would be eligible for medical assistance within 135 days of admission 
264.5 	to a nursing facility;
264.6 	(4) the person is not ineligible for the payment of long-term care services by the 
264.7 	medical assistance program due to an asset transfer penalty under section 256B.0595 or 
264.8 	equity interest in the home exceeding $500,000 as stated in section 256B.056;
264.9 	(5) the person needs long-term care services that are not funded through other state 
264.10 	or federal funding;
264.11 	(6) except for individuals described in clause (7), the monthly cost of the alternative 
264.12 	care services funded by the program for this person does not exceed 75 percent of the 
264.13 	monthly limit described under section 256B.0915, subdivision 3a. This monthly limit 
264.14 	does not prohibit the alternative care client from payment for additional services, but in no 
264.15 	case may the cost of additional services purchased under this section exceed the difference 
264.16 	between the client's monthly service limit defined under section 256B.0915, subdivision 
264.17 	3, and the alternative care program monthly service limit defined in this paragraph. If 
264.18 	care-related supplies and equipment or environmental modifications and adaptations are or 
264.19 	will be purchased for an alternative care services recipient, the costs may be prorated on a 
264.20 	monthly basis for up to 12 consecutive months beginning with the month of purchase. 
264.21 	If the monthly cost of a recipient's other alternative care services exceeds the monthly 
264.22 	limit established in this paragraph, the annual cost of the alternative care services shall be 
264.23 	determined. In this event, the annual cost of alternative care services shall not exceed 12 
264.24 	times the monthly limit described in this paragraph; and
264.25 	(7) for individuals assigned a case mix classification A as described under section 
264.26 	256B.0915, subdivision 3a, paragraph (a), with (i) no dependencies in activities of daily 
264.27 	living, (ii) only one dependency in bathing, dressing, grooming, or walking, or (iii) a 
264.28 	dependency score of less than three if eating is the only dependency as determined by an 
264.29 	assessment performed under section 256B.0911, the monthly cost of alternative care 
264.30 	services funded by the program cannot exceed $600 per month for all new participants 
264.31 	enrolled in the program on or after July 1, 2009. This monthly limit shall be applied to 
264.32 	all other participants who meet this criteria at reassessment. This monthly limit shall be 
264.33 	increased annually as described in section 256B.0915, subdivision 3a, paragraph (a). This 
264.34 	monthly limit does not prohibit the alternative care client from payment for additional 
264.35 	services, but in no case may the cost of additional services purchased exceed the difference 
265.1 	between the client's monthly service limit defined in this clause and the limit described in 
265.2 	clause (6) for case mix classification A; and
265.3 	(8) the person is making timely payments of the assessed monthly fee.
265.4 	A person is ineligible if payment of the fee is over 60 days past due, unless the person 
265.5 	agrees to:
265.6 	(i) the appointment of a representative payee;
265.7 	(ii) automatic payment from a financial account;
265.8 	(iii) the establishment of greater family involvement in the financial management of 
265.9 	payments; or
265.10 	(iv) another method acceptable to the lead agency to ensure prompt fee payments.
265.11 	The lead agency may extend the client's eligibility as necessary while making 
265.12 	arrangements to facilitate payment of past-due amounts and future premium payments. 
265.13 	Following disenrollment due to nonpayment of a monthly fee, eligibility shall not be 
265.14 	reinstated for a period of 30 days.
265.15 	(b) Alternative care funding under this subdivision is not available for a person 
265.16 	who is a medical assistance recipient or who would be eligible for medical assistance 
265.17 	without a spenddown or waiver obligation. A person whose initial application for medical 
265.18 	assistance and the elderly waiver program is being processed may be served under the 
265.19 	alternative care program for a period up to 60 days. If the individual is found to be eligible 
265.20 	for medical assistance, medical assistance must be billed for services payable under the 
265.21 	federally approved elderly waiver plan and delivered from the date the individual was 
265.22 	found eligible for the federally approved elderly waiver plan. Notwithstanding this 
265.23 	provision, alternative care funds may not be used to pay for any service the cost of which: 
265.24 	(i) is payable by medical assistance; (ii) is used by a recipient to meet a waiver obligation; 
265.25 	or (iii) is used to pay a medical assistance income spenddown for a person who is eligible 
265.26 	to participate in the federally approved elderly waiver program under the special income 
265.27 	standard provision.
265.28 	(c) Alternative care funding is not available for a person who resides in a licensed 
265.29 	nursing home, certified boarding care home, hospital, or intermediate care facility, except 
265.30 	for case management services which are provided in support of the discharge planning 
265.31 	process for a nursing home resident or certified boarding care home resident to assist with 
265.32 	a relocation process to a community-based setting.
265.33 	(d) Alternative care funding is not available for a person whose income is greater 
265.34 	than the maintenance needs allowance under section 256B.0915, subdivision 1d, but equal 
265.35 	to or less than 120 percent of the federal poverty guideline effective July 1 in the fiscal 
266.1 	year for which alternative care eligibility is determined, who would be eligible for the 
266.2 	elderly waiver with a waiver obligation.

266.3 	Sec. 45. Minnesota Statutes 2008, section 256B.0915, subdivision 3a, is amended to 
266.4 	read:
266.5 		Subd. 3a. Elderly waiver cost limits. (a) The monthly limit for the cost of 
266.6 	waivered services to an individual elderly waiver client except for individuals described 
266.7 	in paragraph (b) shall be the weighted average monthly nursing facility rate of the case 
266.8 	mix resident class to which the elderly waiver client would be assigned under Minnesota 
266.9 	Rules, parts 9549.0050 to 9549.0059, less the recipient's maintenance needs allowance 
266.10 	as described in subdivision 1d, paragraph (a), until the first day of the state fiscal year in 
266.11 	which the resident assessment system as described in section 256B.438 for nursing home 
266.12 	rate determination is implemented. Effective on the first day of the state fiscal year in 
266.13 	which the resident assessment system as described in section 256B.438 for nursing home 
266.14 	rate determination is implemented and the first day of each subsequent state fiscal year, the 
266.15 	monthly limit for the cost of waivered services to an individual elderly waiver client shall 
266.16 	be the rate of the case mix resident class to which the waiver client would be assigned 
266.17 	under Minnesota Rules, parts 9549.0050 to 9549.0059, in effect on the last day of the 
266.18 	previous state fiscal year, adjusted by the greater of any legislatively adopted home and 
266.19 	community-based services percentage rate increase or the average statewide percentage 
266.20 	increase in nursing facility payment rates. 
266.21 	(b) The monthly limit for the cost of waivered services to an individual elderly 
266.22 	waiver client assigned to a case mix classification A under paragraph (a) with (1) no 
266.23 	dependencies in activities of daily living, (2) only one dependency in bathing, dressing, 
266.24 	grooming, or walking, or (3) a dependency score of less than three if eating is the only 
266.25 	dependency, shall be the lower of the case mix classification amount for case mix A as 
266.26 	determined under paragraph (a) or the case mix classification amount for case mix A 
266.27 	effective on October 1, 2008, per month for all new participants enrolled in the program 
266.28 	on or after July 1, 2009. This monthly limit shall be applied to all other participants who 
266.29 	meet this criteria at reassessment.
266.30 	(c)  If extended medical supplies and equipment or environmental modifications are 
266.31 	or will be purchased for an elderly waiver client, the costs may be prorated for up to 
266.32 	12 consecutive months beginning with the month of purchase. If the monthly cost of a 
266.33 	recipient's waivered services exceeds the monthly limit established in paragraph (a) or (b), 
266.34 	the annual cost of all waivered services shall be determined. In this event, the annual cost 
267.1 	of all waivered services shall not exceed 12 times the monthly limit of waivered services 
267.2 	as described in paragraph (a) or (b). 

267.3 	Sec. 46. Minnesota Statutes 2008, section 256B.0915, subdivision 3e, is amended to 
267.4 	read:
267.5 		Subd. 3e.Customized living service rate. (a) Payment for customized living 
267.6 	services shall be a monthly rate negotiated and authorized by the lead agency within the 
267.7 	parameters established by the commissioner. The payment agreement must delineate the 
267.8 	services that have been customized for each recipient and specify the amount of each 
267.9 	component service included in the recipient's customized living service to be provided
267.10 	plan. The lead agency shall ensure that there is a documented need for allwithin the 
267.11 	parameters established by the commissioner for all component customized living services 
267.12 	authorized. Customized living services must not include rent or raw food costs.
267.13 	(b) The negotiated payment rate must be based on the amount of component services 
267.14 	to be provided utilizing component rates established by the commissioner. Counties and 
267.15 	tribes shall use tools issued by the commissioner to develop and document customized 
267.16 	living service plans and rates.
267.17 	Negotiated (c) Component service rates must not exceed payment rates for 
267.18 	comparable elderly waiver or medical assistance services and must reflect economies of 
267.19 	scale. Customized living services must not include rent or raw food costs.
267.20 	(b)(d) The individualized monthly negotiated authorized payment for the 
267.21 	customized living services service plan shall not exceed the nonfederal share, in effect 
267.22 	on July 1 of the state fiscal year for which the rate limit is being calculated, 50 percent
267.23 	of the greater of either the statewide or any of the geographic groups' weighted average 
267.24 	monthly nursing facility rate of the case mix resident class to which the elderly waiver 
267.25 	eligible client would be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, 
267.26 	less the maintenance needs allowance as described in subdivision 1d, paragraph (a), until 
267.27 	the July 1 of the state fiscal year in which the resident assessment system as described 
267.28 	in section 256B.438 for nursing home rate determination is implemented. Effective on 
267.29 	July 1 of the state fiscal year in which the resident assessment system as described in 
267.30 	section 256B.438 for nursing home rate determination is implemented and July 1 of each 
267.31 	subsequent state fiscal year, the individualized monthly negotiated authorized payment 
267.32 	for the services described in this clause shall not exceed the limit described in this clause
267.33 	which was in effect on June 30 of the previous state fiscal year and which has been 
267.34 	adjusted by the greater of any legislatively adopted home and community-based services 
267.35 	cost-of-living percentage increase or any legislatively adopted statewide percent rate 
268.1 	increase for nursing facilities updated annually based on legislatively adopted changes to 
268.2 	all service rate maximums for home and community-based service providers.
268.3 	(c)(e) Customized living services are delivered by a provider licensed by the 
268.4 	Department of Health as a class A or class F home care provider and provided in a 
268.5 	building that is registered as a housing with services establishment under chapter 144D.

268.6 	Sec. 47. Minnesota Statutes 2008, section 256B.0915, subdivision 3h, is amended to 
268.7 	read:
268.8 		Subd. 3h.Service rate limits; 24-hour customized living services. (a) The 
268.9 	payment rates rate  for 24-hour customized living services is a monthly rate negotiated 
268.10 	and authorized by the lead agency within the parameters established by the commissioner 
268.11 	of human services. The payment agreement must delineate the services that have been 
268.12 	customized for each recipient and specify the amount of each component service included 
268.13 	in each recipient's customized living service to be provided plan. The lead agency 
268.14 	shall ensure that there is a documented need within the parameters established by the 
268.15 	commissioner for all component customized living services authorized. The lead agency 
268.16 	shall not authorize 24-hour customized living services unless there is a documented need 
268.17 	for 24-hour supervision.
268.18 	(b) For purposes of this section, "24-hour supervision" means that the recipient 
268.19 	requires assistance due to needs related to one or more of the following:
268.20 	(1) intermittent assistance with toileting, positioning,  or transferring;
268.21 	(2) cognitive or behavioral issues;
268.22 	(3) a medical condition that requires clinical monitoring; or
268.23 	(4) other conditions or needs as defined by the commissioner of human services for 
268.24 	all new participants enrolled in the program on or after January 1, 2011, and all other 
268.25 	participants at their first reassessment after January 1, 2011, dependency in at least two 
268.26 	of the following activities of daily living as determined by assessment under section 
268.27 	256B.0911: bathing; dressing; grooming; walking; or eating; and  needs medication 
268.28 	management and at least 50 hours of service per month. The lead agency shall ensure that 
268.29 	the frequency and mode of supervision of the recipient and the qualifications of staff 
268.30 	providing supervision are described and meet the needs of the recipient. Customized 
268.31 	living services must not include rent or raw food costs.
268.32 	(c) The negotiated payment rate for 24-hour customized living services must be 
268.33 	based on the amount of component services to be provided utilizing component rates 
268.34 	established by the commissioner. Counties and tribes will use tools issued by the 
268.35 	commissioner to develop and document customized living plans and authorize rates.
269.1 	Negotiated (d) Component service rates must not exceed payment rates for 
269.2 	comparable elderly waiver or medical assistance services and must reflect economies 
269.3 	of scale.
269.4 	(e) The individually negotiated authorized 24-hour customized living payments, 
269.5 	in combination with the payment for other elderly waiver services, including case 
269.6 	management, must not exceed the recipient's community budget cap specified in 
269.7 	subdivision 3a. Customized living services must not include rent or raw food costs.
269.8 	(f) The individually authorized 24-hour customized living payment rates shall not 
269.9 	exceed the 95 percentile of statewide monthly authorizations for 24-hour customized 
269.10 	living services in effect and in the Medicaid management information systems on March 
269.11 	31, 2009, for each case mix resident class under Minnesota Rules, parts 9549.0050 
269.12 	to 9549.0059, to which elderly waiver service clients are assigned. When there are 
269.13 	fewer than 50 authorizations in effect in the case mix resident class, the commissioner 
269.14 	shall multiply the calculated service payment rate maximum for the A classification by 
269.15 	the standard weight for that classification under Minnesota Rules, parts 9549.0050 to 
269.16 	9549.0059, to determine the applicable payment rate maximum. Service payment rate 
269.17 	maximums shall be updated annually based on legislatively adopted changes to all service 
269.18 	rates for home and community-based service providers.
269.19 	(g) Notwithstanding the requirements of paragraphs (d) and (f), the commissioner 
269.20 	may establish alternative payment rate systems for 24-hour customized living services in 
269.21 	housing with services establishments which are freestanding buildings with a capacity of 
269.22 	16 or fewer, by applying a single hourly rate for covered component services provided 
269.23 	in either:
269.24 	(1) licensed corporate adult foster homes; or
269.25 	(2) specialized dementia care units which meet the requirements of section 144D.065 
269.26 	and in which:
269.27 	(i) each resident is offered the option of having their own apartment; or
269.28 	(ii) the units are licensed as board and lodge establishments with maximum capacity 
269.29 	of eight residents, and which meet the requirements of Minnesota Rules, part 9555.6205, 
269.30 	subparts 1, 2, 3, and 4, item A.

269.31 	Sec. 48. Minnesota Statutes 2008, section 256B.0915, subdivision 5, is amended to 
269.32 	read:
269.33 		Subd. 5.Assessments and reassessments for waiver clients. (a) Each client 
269.34 	shall receive an initial assessment of strengths, informal supports, and need for services 
269.35 	in accordance with section 256B.0911, subdivisions 3, 3a, and 3b. A reassessment of a 
270.1 	client served under the elderly waiver must be conducted at least every 12 months and at 
270.2 	other times when the case manager determines that there has been significant change in 
270.3 	the client's functioning. This may include instances where the client is discharged from 
270.4 	the hospital. There must be a determination that the client requires nursing facility level of 
270.5 	care as defined in section 144.0724, subdivision 11, at initial and subsequent assessments 
270.6 	to initiate and maintain participation in the waiver program.
270.7 	(b) Regardless of other assessments identified in section 144.0724, subdivision 
270.8 	4, as appropriate to determine nursing facility level of care for purposes of medical 
270.9 	assistance payment for nursing facility services, only face-to-face assessments conducted 
270.10 	according to section 256B.0911, subdivisions 3a and 3b, that result in a nursing facility 
270.11 	level of care determination will be accepted for purposes of initial and ongoing access to 
270.12 	waiver service payment.

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

270.14 	Sec. 49. Minnesota Statutes 2008, section 256B.0915, is amended by adding a 
270.15 	subdivision to read:
270.16 		Subd. 10.Waiver payment rates; managed care organizations. The 
270.17 	commissioner shall adjust the elderly waiver capitation payment rates for managed care 
270.18 	organizations paid under section 256B.69, subdivisions 6a and 23, to reflect the maximum 
270.19 	service rate limits for customized living services and 24-hour customized living services 
270.20 	under subdivisions 3e and 3h for the contract period beginning October 1, 2009. Medical 
270.21 	assistance rates paid to customized living providers by managed care organizations 
270.22 	under this section shall not exceed the maximum service rate limits determined by the 
270.23 	commissioner under subdivisions 3e and 3h.

270.24 	Sec. 50. Minnesota Statutes 2008, section 256B.0916, subdivision 2, is amended to 
270.25 	read:
270.26 		Subd. 2.Distribution of funds; partnerships. (a) Beginning with fiscal year 2000, 
270.27 	the commissioner shall distribute all funding available for home and community-based 
270.28 	waiver services for persons with developmental disabilities to individual counties or to 
270.29 	groups of counties that form partnerships to jointly plan, administer, and authorize funding 
270.30 	for eligible individuals. The commissioner shall encourage counties to form partnerships 
270.31 	that have a sufficient number of recipients and funding to adequately manage the risk 
270.32 	and maximize use of available resources.
271.1 	(b) Counties must submit a request for funds and a plan for administering the 
271.2 	program as required by the commissioner. The plan must identify the number of clients to 
271.3 	be served, their ages, and their priority listing based on:
271.4 	(1) requirements in Minnesota Rules, part 9525.1880; and
271.5 	(2) unstable living situations due to the age or incapacity of the primary caregiver;
271.6 	statewide priorities identified in section 256B.092, subdivision 12.
271.7 	(3) the need for services to avoid out-of-home placement of children;
271.8 	(4) the need to serve persons affected by private sector ICF/MR closures; and
271.9 	(5) the need to serve persons whose consumer support grant exception amount 
271.10 	was eliminated in 2004.
271.11 	The plan must also identify changes made to improve services to eligible persons and to 
271.12 	improve program management.
271.13 	(c) In allocating resources to counties, priority must be given to groups of counties 
271.14 	that form partnerships to jointly plan, administer, and authorize funding for eligible 
271.15 	individuals and to counties determined by the commissioner to have sufficient waiver 
271.16 	capacity to maximize resource use.
271.17 	(d) Within 30 days after receiving the county request for funds and plans, the 
271.18 	commissioner shall provide a written response to the plan that includes the level of 
271.19 	resources available to serve additional persons.
271.20 	(e) Counties are eligible to receive medical assistance administrative reimbursement 
271.21 	for administrative costs under criteria established by the commissioner.

271.22 	Sec. 51. Minnesota Statutes 2008, section 256B.0917, is amended by adding a 
271.23 	subdivision to read:
271.24 		Subd. 14.Essential community supports grants. (a) The purpose of the essential 
271.25 	community supports grant program is to provide targeted services to persons 65 years and 
271.26 	older who need essential community support, but whose needs do not meet the level of 
271.27 	care required for nursing facility placement under section 144.0724, subdivision 11.
271.28 	(b) Within the limits of the appropriation and not to exceed $400 per person per 
271.29 	month, funding must be available to a person who:
271.30 	(1) is age 65 or older;
271.31 	(2) is not eligible for medical assistance;
271.32 	(3) would otherwise be financially eligible for the alternative care program under 
271.33 	section 256B.0913, subdivision 4;
271.34 	(4) has received a community assessment under section 256B.0911, subdivision 3a 
271.35 	or 3b, and does not require the level of care provided in a nursing facility;
272.1 	(5) has a community support plan; and
272.2 	(6) has been determined by a community assessment under section 256B.0911, 
272.3 	subdivision 3a or 3b, to be a person who would require provision of at least one of the 
272.4 	following services, as defined in the approved elderly waiver plan, in order to maintain 
272.5 	their community residence:
272.6 	(i) caregiver support;
272.7 	(ii) homemaker;
272.8 	(iii) chore; or
272.9 	(iv) a personal emergency response device or system.
272.10 	(c) The person receiving any of the essential community supports in this subdivision 
272.11 	must also receive service coordination as part of their community support plan.
272.12 	(d) A person who has been determined to be eligible for an essential community 
272.13 	support grant must be reassessed at least annually and continue to meet the criteria in 
272.14 	paragraph (b) to remain eligible for an essential community support grant.
272.15 	(e) The commissioner shall allocate grants to counties and tribes under contract with 
272.16 	the department based upon the historic use of the medical assistance elderly waiver and 
272.17 	alternative care grant programs and other criteria as determined by the commissioner.

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

272.19 	Sec. 52. Minnesota Statutes 2008, section 256B.092, subdivision 8a, is amended to 
272.20 	read:
272.21 		Subd. 8a.County concurrence. (a) If the county of financial responsibility wishes 
272.22 	to place a person in another county for services, the county of financial responsibility shall 
272.23 	seek concurrence from the proposed county of service and the placement shall be made 
272.24 	cooperatively between the two counties. Arrangements shall be made between the two 
272.25 	counties for ongoing social service, including annual reviews of the person's individual 
272.26 	service plan. The county where services are provided may not make changes in the 
272.27 	person's service plan without approval by the county of financial responsibility.
272.28 	(b) When a person has been screened and authorized for services in an intermediate 
272.29 	care facility for persons with developmental disabilities or for home and community-based 
272.30 	services for persons with developmental disabilities, the case manager shall assist that 
272.31 	person in identifying a service provider who is able to meet the needs of the person 
272.32 	according to the person's individual service plan. If the identified service is to be provided 
272.33 	in a county other than the county of financial responsibility, the county of financial 
272.34 	responsibility shall request concurrence of the county where the person is requesting to 
272.35 	receive the identified services. The county of service may refuse to concur if:
273.1 	(1) it can demonstrate that the provider is unable to provide the services identified in 
273.2 	the person's individual service plan as services that are needed and are to be provided; or
273.3 	(2) in the case of an intermediate care facility for persons with developmental 
273.4 	disabilities, there has been no authorization for admission by the admission review team 
273.5 	as required in section 256B.0926; or.
273.6 	(3) in the case of home and community-based services for persons with 
273.7 	developmental disabilities, the county of service can demonstrate that the prospective 
273.8 	provider has failed to substantially comply with the terms of a past contract or has had a 
273.9 	prior contract terminated within the last 12 months for failure to provide adequate services, 
273.10 	or has received a notice of intent to terminate the contract.
273.11 	(c) The county of service shall notify the county of financial responsibility of 
273.12 	concurrence or refusal to concur no later than 20 working days following receipt of the 
273.13 	written request. Unless other mutually acceptable arrangements are made by the involved 
273.14 	county agencies, the county of financial responsibility is responsible for costs of social 
273.15 	services and the costs associated with the development and maintenance of the placement. 
273.16 	The county of service may request that the county of financial responsibility purchase 
273.17 	case management services from the county of service or from a contracted provider 
273.18 	of case management when the county of financial responsibility is not providing case 
273.19 	management as defined in this section and rules adopted under this section, unless other 
273.20 	mutually acceptable arrangements are made by the involved county agencies. Standards 
273.21 	for payment limits under this section may be established by the commissioner. Financial 
273.22 	disputes between counties shall be resolved as provided in section 256G.09.

273.23 	Sec. 53. Minnesota Statutes 2008, section 256B.092, is amended by adding a 
273.24 	subdivision to read:
273.25 		Subd. 11.Residential support services. (a) Upon federal approval, there is 
273.26 	established a new service called residential support that is available on the CAC, CADI, 
273.27 	DD, and TBI waivers. Existing waiver service descriptions must be modified to the extent 
273.28 	necessary to ensure there is no duplication between other services. Residential support 
273.29 	services must be provided by vendors licensed as a community residential setting as 
273.30 	defined in section 245A.11, subdivision 8.
273.31 	(b) Residential support services must meet the following criteria:
273.32 	(1) providers of residential support services must own or control the residential site;
273.33 	(2) the residential site must not be the primary residence of the license holder;
273.34 	(3) the residential site must have a designated program supervisor responsible for 
273.35 	program oversight, development, and implementation of policies and procedures;
274.1 	(4) the provider of residential support services must provide supervision, training, 
274.2 	and assistance as described in the person's community support plan; and
274.3 	(5) the provider of residential support services must meet the requirements of 
274.4 	licensure and additional requirements of the person's community support plan.
274.5 	(c) Providers of residential support services that meet the definition in paragraph (a) 
274.6 	must be registered using a process determined by the commissioner beginning July 1, 2009.

274.7 	Sec. 54. Minnesota Statutes 2008, section 256B.092, is amended by adding a 
274.8 	subdivision to read:
274.9 		Subd. 12.Waivered services statewide priorities. (a) The commissioner shall 
274.10 	establish statewide priorities for individuals on the waiting list for developmental 
274.11 	disabilities (DD) waiver services, as of January 1, 2010. The statewide priorities must 
274.12 	include, but are not limited to, individuals who continue to have a need for waiver services 
274.13 	after they have maximized the use of state plan services and other funding resources, 
274.14 	including natural supports, prior to accessing waiver services, and who meet at least one 
274.15 	of the following criteria:
274.16 	(1) have unstable living situations due to the age, incapacity, or sudden loss of 
274.17 	the primary caregivers;
274.18 	(2) are moving from an institution due to bed closures;
274.19 	(3) experience a sudden closure of their current living arrangement;
274.20 	(4) require protection from confirmed abuse, neglect, or exploitation;
274.21 	(5) experience a sudden change in need that can  no longer be met through state plan 
274.22 	services or other funding resources alone; or
274.23 	(6) meet other priorities established by the department.
274.24 	(b) When allocating resources to lead agencies, the commissioner must take into 
274.25 	consideration the number of individuals waiting who meet statewide priorities and the 
274.26 	lead agencies' current use of waiver funds and existing service options.
274.27 	(c) The commissioner shall evaluate the impact of the use of statewide priorities and 
274.28 	provide recommendations to the legislature on whether to continue the use of statewide 
274.29 	priorities in the November 1, 2011, annual report required by the commissioner in sections 
274.30 	256B.0916, subdivision 7, and 256B.49, subdivision 21.

274.31 	Sec. 55. [256B.0948] FOSTER CARE RATE LIMITS.
274.32 	The commissioner shall decrease by five percent rates for adult foster care and 
274.33 	supportive living services that are reimbursed under section 256B.092 or 256B.49, and 
274.34 	are above the 95th percentile of the statewide rates for the service. The reduction in rates 
275.1 	shall take into account the acuity of individuals served based on the methodology used to 
275.2 	allocate dollars to local lead agency budgets, and assure that affected service rates are not 
275.3 	reduced below the rate level represented by the above percentile due to this rate change. 
275.4 	Lead agency contracts for services specified in this section shall be amended to implement 
275.5 	these rate changes for services rendered on or after July 1, 2009. The commissioner shall 
275.6 	make corresponding reductions to waiver allocations and capitated rates.

275.7 	Sec. 56. Minnesota Statutes 2008, section 256B.37, subdivision 1, is amended to read:
275.8 		Subdivision 1.Subrogation. Upon furnishing medical assistance or alternative 
275.9 	care services under section 256B.0913 to any person who has private accident or health 
275.10 	care coverage, or receives or has a right to receive health or medical care from any 
275.11 	type of organization or entity, or has a cause of action arising out of an occurrence that 
275.12 	necessitated the payment of medical assistance, the state agency or the state agency's agent 
275.13 	shall be subrogated, to the extent of the cost of medical care furnished, to any rights the 
275.14 	person may have under the terms of the coverage, or against the organization or entity 
275.15 	providing or liable to provide health or medical care, or under the cause of action.
275.16 	The right of subrogation created in this section includes all portions of the cause 
275.17 	of action, notwithstanding any settlement allocation or apportionment that purports to 
275.18 	dispose of portions of the cause of action not subject to subrogation.

275.19 	Sec. 57. Minnesota Statutes 2008, section 256B.37, subdivision 5, is amended to read:
275.20 		Subd. 5.Private benefits to be used first. Private accident and health care coverage 
275.21 	including Medicare for medical services is primary coverage and must be exhausted before 
275.22 	medical assistance is or alternative care services are paid for medical services including 
275.23 	home health care, personal care assistant services, hospice, supplies and equipment, or 
275.24 	services covered under a Centers for Medicare and Medicaid Services waiver. When a 
275.25 	person who is otherwise eligible for medical assistance has private accident or health care 
275.26 	coverage, including Medicare or a prepaid health plan, the private health care benefits 
275.27 	available to the person must be used first and to the fullest extent.

275.28 	Sec. 58. Minnesota Statutes 2008, section 256B.434, subdivision 4, is amended to read:
275.29 		Subd. 4.Alternate rates for nursing facilities. (a) For nursing facilities which 
275.30 	have their payment rates determined under this section rather than section 256B.431, the 
275.31 	commissioner shall establish a rate under this subdivision. The nursing facility must enter 
275.32 	into a written contract with the commissioner.
276.1 	(b) A nursing facility's case mix payment rate for the first rate year of a facility's 
276.2 	contract under this section is the payment rate the facility would have received under 
276.3 	section 256B.431.
276.4 	(c) A nursing facility's case mix payment rates for the second and subsequent years 
276.5 	of a facility's contract under this section are the previous rate year's contract payment 
276.6 	rates plus an inflation adjustment and, for facilities reimbursed under this section or 
276.7 	section 256B.431, an adjustment to include the cost of any increase in Health Department 
276.8 	licensing fees for the facility taking effect on or after July 1, 2001. The index for the 
276.9 	inflation adjustment must be based on the change in the Consumer Price Index-All Items 
276.10 	(United States City average) (CPI-U) forecasted by the commissioner of finance's national 
276.11 	economic consultant, as forecasted in the fourth quarter of the calendar year preceding 
276.12 	the rate year. The inflation adjustment must be based on the 12-month period from the 
276.13 	midpoint of the previous rate year to the midpoint of the rate year for which the rate is 
276.14 	being determined. For the rate years beginning on July 1, 1999, July 1, 2000, July 1, 2001, 
276.15 	July 1, 2002, July 1, 2003, July 1, 2004, July 1, 2005, July 1, 2006, July 1, 2007, July 1, 
276.16 	2008, October 1, 2009, and October 1, 2010, October 1, 2011, and October 1, 2012. This 
276.17 	paragraph shall apply only to the property-related payment rate, except that adjustments 
276.18 	to include the cost of any increase in Health Department licensing fees taking effect on 
276.19 	or after July 1, 2001, shall be provided. Beginning in 2005, adjustment to the property 
276.20 	payment rate under this section and section 256B.431 shall be effective on October 1. 
276.21 	In determining the amount of the property-related payment rate adjustment under this 
276.22 	paragraph, the commissioner shall determine the proportion of the facility's rates that are 
276.23 	property-related based on the facility's most recent cost report. 
276.24 	(d) The commissioner shall develop additional incentive-based payments of up to 
276.25 	five percent above a facility's operating payment rate for achieving outcomes specified 
276.26 	in a contract. The commissioner may solicit contract amendments and implement those 
276.27 	which, on a competitive basis, best meet the state's policy objectives. The commissioner 
276.28 	shall limit the amount of any incentive payment and the number of contract amendments 
276.29 	under this paragraph to operate the incentive payments within funds appropriated for this 
276.30 	purpose. The contract amendments may specify various levels of payment for various 
276.31 	levels of performance. Incentive payments to facilities under this paragraph may be in the 
276.32 	form of time-limited rate adjustments or onetime supplemental payments. In establishing 
276.33 	the specified outcomes and related criteria, the commissioner shall consider the following 
276.34 	state policy objectives:
276.35 	(1) successful diversion or discharge of residents to the residents' prior home or other 
276.36 	community-based alternatives;
277.1 	(2) adoption of new technology to improve quality or efficiency; 
277.2 	(3) improved quality as measured in the Nursing Home Report Card; 
277.3 	(4) reduced acute care costs; and
277.4 	(5) any additional outcomes proposed by a nursing facility that the commissioner 
277.5 	finds desirable.
277.6 	(e) Notwithstanding the threshold in section 256B.431, subdivision 16, facilities that 
277.7 	take action to come into compliance with existing or pending requirements of the life 
277.8 	safety code provisions or federal regulations governing sprinkler systems must receive 
277.9 	reimbursement for the costs associated with compliance if all of the following conditions 
277.10 	are met:
277.11 	(1) the expenses associated with compliance occurred on or after January 1, 2005, 
277.12 	and before December 31, 2008;
277.13 	(2) the costs were not otherwise reimbursed under subdivision 4f or section 
277.14 	144A.071 or 144A.073; and
277.15 	(3) the total allowable costs reported under this paragraph are  less than the minimum 
277.16 	threshold established under section 256B.431, subdivision 15, paragraph (e), and 
277.17 	subdivision 16.
277.18 	The commissioner shall use money appropriated for this purpose to provide to qualifying 
277.19 	nursing facilities a rate adjustment beginning October 1, 2007, and ending September 30, 
277.20 	2008. Nursing facilities that have spent money or anticipate the need to spend money 
277.21 	to satisfy the most recent life safety code requirements by (1) installing a sprinkler 
277.22 	system or (2) replacing all or portions of an existing sprinkler system may submit to the 
277.23 	commissioner by June 30, 2007, on a form provided by the commissioner the actual 
277.24 	costs of a completed project or the estimated costs, based on a project bid, of a planned 
277.25 	project. The commissioner shall calculate a rate adjustment equal to the allowable 
277.26 	costs of the project divided by the resident days reported for the report year ending 
277.27 	September 30, 2006. If the costs from all projects exceed the appropriation for this 
277.28 	purpose, the commissioner shall allocate the money appropriated on a pro rata basis 
277.29 	to the qualifying facilities by reducing the rate adjustment determined for each facility 
277.30 	by an equal percentage. Facilities that used estimated costs when requesting the rate 
277.31 	adjustment shall report to the commissioner by January 31, 2009, on the use of this 
277.32 	money on a form provided by the commissioner. If the nursing facility fails to provide 
277.33 	the report, the commissioner shall recoup the money paid to the facility for this purpose. 
277.34 	If the facility reports expenditures allowable under this subdivision that are less than 
277.35 	the amount received in the facility's annualized rate adjustment, the commissioner shall 
277.36 	recoup the difference.

278.1 	Sec. 59. Minnesota Statutes 2008, section 256B.434, is amended by adding a 
278.2 	subdivision to read:
278.3 		Subd. 21.Payment of post-PERA pension benefit costs. Nursing facilities that 
278.4 	convert or converted after September 30, 2006, from public to private ownership shall 
278.5 	have a portion of their post-PERA pension costs treated as a component of the historic 
278.6 	operating rate. Effective for the rate years beginning on or after October 1, 2009, and prior 
278.7 	to October 1, 2016, the commissioner shall determine the pension costs to be included 
278.8 	in the facility's base for determining rates under this section by using the following 
278.9 	formula: post-privatization pension benefit costs as a percent of salary shall be determined 
278.10 	from either the cost report for the first full reporting year after privatization or the most 
278.11 	recent report year available, whichever is later. This percentage shall be applied to the 
278.12 	salary costs of the alternative payment system base rate year to determine the allowable 
278.13 	amount of pension costs. The adjustments provided for in sections 256B.431, 256B.434, 
278.14 	256B.441, and any other law enacted after the base rate year and prior to the year for 
278.15 	which rates are being determined shall be applied to the allowable amount. The adjusted 
278.16 	allowable amount shall be added to the operating rate effective the first rate year PERA 
278.17 	ceases to remain as a pass-through component of the rate.

278.18 	Sec. 60. Minnesota Statutes 2008, section 256B.437, subdivision 6, is amended to read:
278.19 		Subd. 6.Planned closure rate adjustment. (a) The commissioner of human 
278.20 	services shall calculate the amount of the planned closure rate adjustment available under 
278.21 	subdivision 3, paragraph (b), for up to 5,140 beds according to clauses (1) to (4):
278.22 	(1) the amount available is the net reduction of nursing facility beds multiplied 
278.23 	by $2,080;
278.24 	(2) the total number of beds in the nursing facility or facilities receiving the planned 
278.25 	closure rate adjustment must be identified;
278.26 	(3) capacity days are determined by multiplying the number determined under 
278.27 	clause (2) by 365; and
278.28 	(4) the planned closure rate adjustment is the amount available in clause (1), divided 
278.29 	by capacity days determined under clause (3).
278.30 	(b) A planned closure rate adjustment under this section is effective on the first day 
278.31 	of the month following completion of closure of the facility designated for closure in the 
278.32 	application and becomes part of the nursing facility's total operating payment rate.
278.33 	(c) Applicants may use the planned closure rate adjustment to allow for a property 
278.34 	payment for a new nursing facility or an addition to an existing nursing facility or as an 
278.35 	operating payment rate adjustment. Applications approved under this subdivision are 
279.1 	exempt from other requirements for moratorium exceptions under section 144A.073, 
279.2 	subdivisions 2 and 3.
279.3 	(d) Upon the request of a closing facility, the commissioner must allow the facility a 
279.4 	closure rate adjustment as provided under section 144A.161, subdivision 10.
279.5 	(e) A facility that has received a planned closure rate adjustment may reassign it 
279.6 	to another facility that is under the same ownership at any time within three years of its 
279.7 	effective date. The amount of the adjustment shall be computed according to paragraph (a).
279.8 	(f) If the per bed dollar amount specified in paragraph (a), clause (1), is increased, 
279.9 	the commissioner shall recalculate planned closure rate adjustments for facilities that 
279.10 	delicense beds under this section on or after July 1, 2001, to reflect the increase in the per 
279.11 	bed dollar amount. The recalculated planned closure rate adjustment shall be effective 
279.12 	from the date the per bed dollar amount is increased.
279.13 	(g) For planned closures approved after June 30, 2009, the commissioner of human 
279.14 	services shall calculate the amount of the planned closure rate adjustment available under 
279.15 	subdivision 3, paragraph (b), according to paragraph (a), clauses (1) to (4).

279.16 	Sec. 61. Minnesota Statutes 2008, section 256B.441, subdivision 55, is amended to 
279.17 	read:
279.18 		Subd. 55.Phase-in of rebased operating payment rates.  (a) For the rate years 
279.19 	beginning October 1, 2008, to October 1, 2015, the operating payment rate calculated 
279.20 	under this section shall be phased in by blending the operating rate with the operating 
279.21 	payment rate determined under section 256B.434. For purposes of this subdivision, the 
279.22 	rate to be used that is determined under section 256B.434 shall not include the portion of 
279.23 	the operating payment rate related to performance-based incentive payments under section 
279.24 	256B.434, subdivision 4, paragraph (d). For the rate year beginning October 1, 2008, the 
279.25 	operating payment rate for each facility shall be 13 percent of the operating payment rate 
279.26 	from this section, and 87 percent of the operating payment rate from section 256B.434. 
279.27 	For the rate year period beginning October 1, 2009, through September 30, 2013, the 
279.28 	operating payment rate for each facility shall be 14 percent of the operating payment rate 
279.29 	from this section, and 86 percent of the operating payment rate from section 256B.434. 
279.30 	For the rate year beginning October 1, 2010, the operating payment rate for each facility 
279.31 	shall be 14 percent of the operating payment rate from this section, and 86 percent of the 
279.32 	operating payment rate from section 256B.434. For the rate year beginning October 1, 
279.33 	2011, the operating payment rate for each facility shall be 31 percent of the operating 
279.34 	payment rate from this section, and 69 percent of the operating payment rate from section 
279.35 	256B.434. For the rate year beginning October 1, 2012, the operating payment rate for 
280.1 	each facility shall be 48 percent of the operating payment rate from this section, and 52 
280.2 	percent of the operating payment rate from section 256B.434. For the rate year beginning 
280.3 	October 1, 2013, the operating payment rate for each facility shall be 65 percent of the 
280.4 	operating payment rate from this section, and 35 percent of the operating payment rate 
280.5 	from section 256B.434. For the rate year beginning October 1, 2014, the operating 
280.6 	payment rate for each facility shall be 82 percent of the operating payment rate from this 
280.7 	section, and 18 percent of the operating payment rate from section 256B.434. For the rate 
280.8 	year beginning October 1, 2015, the operating payment rate for each facility shall be the 
280.9 	operating payment rate determined under this section. The blending of operating payment 
280.10 	rates under this section shall be performed separately for each RUG's class.
280.11 	(b) For the rate year beginning October 1, 2008, the commissioner shall apply limits 
280.12 	to the operating payment rate increases under paragraph (a) by creating a minimum 
280.13 	percentage increase and a maximum percentage increase.
280.14 	(1) Each nursing facility that receives a blended October 1, 2008, operating payment 
280.15 	rate increase under paragraph (a) of less than one percent, when compared to its operating 
280.16 	payment rate on September 30, 2008, computed using rates with RUG's weight of 1.00, 
280.17 	shall receive a rate adjustment of one percent.
280.18 	(2) The commissioner shall determine a maximum percentage increase that will 
280.19 	result in savings equal to the cost of allowing the minimum increase in clause (1). Nursing 
280.20 	facilities with a blended October 1, 2008, operating payment rate increase under paragraph 
280.21 	(a) greater than the maximum percentage increase determined by the commissioner, when 
280.22 	compared to its operating payment rate on September 30, 2008, computed using rates with 
280.23 	a RUG's weight of 1.00, shall receive the maximum percentage increase.
280.24 	(3) Nursing facilities with a blended October 1, 2008, operating payment rate 
280.25 	increase under paragraph (a) greater than one percent and less than the maximum 
280.26 	percentage increase determined by the commissioner, when compared to its operating 
280.27 	payment rate on September 30, 2008, computed using rates with a RUG's weight of 1.00, 
280.28 	shall receive the blended October 1, 2008, operating payment rate increase determined 
280.29 	under paragraph (a).
280.30 	(4) The October 1, 2009, through October 1, 2015, operating payment rate for 
280.31 	facilities receiving the maximum percentage increase determined in clause (2) shall be 
280.32 	the amount determined under paragraph (a) less the difference between the amount 
280.33 	determined under paragraph (a) for October 1, 2008, and the amount allowed under clause 
280.34 	(2). This rate restriction does not apply to rate increases provided in any other section.
280.35 	(c) A portion of the funds received under this subdivision that are in excess of 
280.36 	operating payment rates that a facility would have received under section 256B.434, as 
281.1 	determined in accordance with clauses (1) to (3), shall be subject to the requirements in 
281.2 	section 256B.434, subdivision 19, paragraphs (b) to (h).
281.3 	(1) Determine the amount of additional funding available to a facility, which shall be 
281.4 	equal to total medical assistance resident days from the most recent reporting year times 
281.5 	the difference between the blended rate determined in paragraph (a) for the rate year being 
281.6 	computed and the blended rate for the prior year.
281.7 	(2) Determine the portion of all operating costs, for the most recent reporting year, 
281.8 	that are compensation related. If this value exceeds 75 percent, use 75 percent.
281.9 	(3) Subtract the amount determined in clause (2) from 75 percent.
281.10 	(4) The portion of the fund received under this subdivision that shall be subject to 
281.11 	the requirements in section 256B.434, subdivision 19, paragraphs (b) to (h), shall equal 
281.12 	the amount determined in clause (1) times the amount determined in clause (3).

281.13 	Sec. 62. Minnesota Statutes 2008, section 256B.441, subdivision 58, is amended to 
281.14 	read:
281.15 		Subd. 58.Implementation delay. Within six months prior to the effective date of 
281.16 	(1) rebasing of property payment rates under subdivision 1; (2) quality-based rate limits 
281.17 	under subdivision 50; and (3) the removal of planned closure rate adjustments and single 
281.18 	bed room incentives from external fixed costs under subdivision 53, the commissioner 
281.19 	shall compare the average operating cost for all facilities combined from the most recent 
281.20 	cost reports to the average medical assistance operating payment rates for all facilities 
281.21 	combined from the same time period. Each provision shall not go into effect until the 
281.22 	average medical assistance operating payment rate is at least 92 percent of the average 
281.23 	operating cost. The rebasing of property payment rates under subdivision 1, and the 
281.24 	removal of planned closure rate adjustments and single-bed room incentives from external 
281.25 	fixed costs under subdivision 53 shall not go into effect until 82 percent of the operating 
281.26 	payment rate from this section is phased in as described in subdivision 55.

281.27 	Sec. 63. Minnesota Statutes 2008, section 256B.441, is amended by adding a 
281.28 	subdivision to read:
281.29 		Subd. 59.Single-bed payments for medical assistance recipients. Effective 
281.30 	October 1, 2009, the amount paid for a private room under Minnesota Rules, part 
281.31 	9549.0070, subpart 3, is reduced from 115 percent to 111.5 percent.

281.32 	Sec. 64. Minnesota Statutes 2008, section 256B.49, is amended by adding a 
281.33 	subdivision to read:
282.1 		Subd. 11a.Waivered services waiting list. (a) The commissioner shall establish 
282.2 	statewide priorities for individuals on the waiting list for CAC, CADI, and TBI waiver 
282.3 	services, as of January 1, 2010. The statewide priorities must include, but are not limited 
282.4 	to, individuals who continue to have a need for waiver services after they have maximized 
282.5 	the use of state plan services and other funding resources, including natural supports, prior 
282.6 	to accessing waiver services, and who meet at least one of the following criteria:
282.7 	(1) have unstable living situations due to the age, incapacity, or sudden loss of 
282.8 	the primary caregivers;
282.9 	(2) are moving from an institution due to bed closures;
282.10 	(3) experience a sudden closure of their current living arrangement;
282.11 	(4) require protection from confirmed abuse, neglect, or exploitation;
282.12 	(5) experience a sudden change in need that can  no longer be met through state plan 
282.13 	services or other funding resources alone; or
282.14 	(6) meet other priorities established by the department.
282.15 	(b) When allocating resources to lead agencies, the commissioner must take into 
282.16 	consideration the number of individuals waiting who meet statewide priorities and the 
282.17 	lead agencies' current use of waiver funds and existing service options.
282.18 	(c) The commissioner shall evaluate the impact of the use of statewide priorities and 
282.19 	provide recommendations to the legislature on whether to continue the use of statewide 
282.20 	priorities in the November 1, 2011, annual report required by the commissioner in sections 
282.21 	256B.0916, subdivision 7, and 256B.49, subdivision 21.

282.22 	Sec. 65. Minnesota Statutes 2008, section 256B.49, subdivision 12, is amended to read:
282.23 		Subd. 12.Informed choice. Persons who are determined likely to require the level 
282.24 	of care provided in a nursing facility as determined under sections 144.0724, subdivision 
282.25 	11, and 256B.0911, or hospital shall be informed of the home and community-based 
282.26 	support alternatives to the provision of inpatient hospital services or nursing facility 
282.27 	services. Each person must be given the choice of either institutional or home and 
282.28 	community-based services using the provisions described in section 256B.77, subdivision 
282.29 	2, paragraph (p).

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

282.31 	Sec. 66. Minnesota Statutes 2008, section 256B.49, subdivision 13, is amended to read:
282.32 		Subd. 13.Case management. (a) Each recipient of a home and community-based 
282.33 	waiver shall be provided case management services by qualified vendors as described 
283.1 	in the federally approved waiver application. The case management service activities 
283.2 	provided will include:
283.3 	(1) assessing the needs of the individual within 20 working days of a recipient's 
283.4 	request;
283.5 	(2) developing the written individual service plan within ten working days after the 
283.6 	assessment is completed;
283.7 	(3) informing the recipient or the recipient's legal guardian or conservator of service 
283.8 	options;
283.9 	(4) assisting the recipient in the identification of potential service providers;
283.10 	(5) assisting the recipient to access services;
283.11 	(6) coordinating, evaluating, and monitoring of the services identified in the service 
283.12 	plan;
283.13 	(7) completing the annual reviews of the service plan; and
283.14 	(8) informing the recipient or legal representative of the right to have assessments 
283.15 	completed and service plans developed within specified time periods, and to appeal county 
283.16 	action or inaction under section 256.045, subdivision 3, including the determination of 
283.17 	nursing facility level of care. 
283.18 	(b) The case manager may delegate certain aspects of the case management service 
283.19 	activities to another individual provided there is oversight by the case manager. The case 
283.20 	manager may not delegate those aspects which require professional judgment including 
283.21 	assessments, reassessments, and care plan development.

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

283.23 	Sec. 67. Minnesota Statutes 2008, section 256B.49, subdivision 14, is amended to read:
283.24 		Subd. 14.Assessment and reassessment. (a) Assessments of each recipient's 
283.25 	strengths, informal support systems, and need for services shall be completed within 
283.26 	20 working days of the recipient's request. Reassessment of each recipient's strengths, 
283.27 	support systems, and need for services shall be conducted at least every 12 months and at 
283.28 	other times when there has been a significant change in the recipient's functioning.
283.29 	(b) There must be a determination that the client requires a hospital level of care or a 
283.30 	nursing facility level of care as defined in section 144.0724, subdivision 11, at initial and 
283.31 	subsequent assessments to initiate and maintain participation in the waiver program.
283.32 	(c) Regardless of other assessments identified in section 144.0724, subdivision 4, as 
283.33 	appropriate to determine nursing facility level of care for purposes of medical assistance 
283.34 	payment for nursing facility services, only face-to-face assessments conducted according 
283.35 	to section 256B.0911, subdivisions 3a, 3b, and 4d, that result in a hospital level of care 
284.1 	determination or a nursing facility level of care determination must be accepted for 
284.2 	purposes of initial and ongoing access to waiver services payment.
284.3 	(d) Persons with developmental disabilities who apply for services under the nursing 
284.4 	facility level waiver programs shall be screened for the appropriate level of care according 
284.5 	to section 256B.092.
284.6 	(c)(e) Recipients who are found eligible for home and community-based services 
284.7 	under this section before their 65th birthday may remain eligible for these services after 
284.8 	their 65th birthday if they continue to meet all other eligibility factors.

284.9 	EFFECTIVE DATE. The section is effective January 1, 2011.

284.10 	Sec. 68. Minnesota Statutes 2008, section 256B.49, is amended by adding a 
284.11 	subdivision to read:
284.12 		Subd. 22.Residential support services. For the purposes of this section, the 
284.13 	provisions of section 256B.092, subdivision 11, are controlling.

284.14 	Sec. 69. [256B.4912] HOME AND COMMUNITY-BASED WAIVERS; 
284.15 	PROVIDERS AND PAYMENT.
284.16 		Subdivision 1.Provider qualifications. For the home and community-based 
284.17 	waivers providing services to seniors and individuals with disabilities, the commissioner 
284.18 	shall establish:
284.19 	(1) agreements with enrolled waiver service providers to ensure providers meet 
284.20 	qualifications defined in the waiver plans;
284.21 	(2) regular reviews of provider qualifications; and
284.22 	(3) processes to gather the necessary information to determine provider 
284.23 	qualifications.
284.24 	By July 2010, staff that provide direct contact, as defined in section 245C.02, subdivision 
284.25 	11, that are employees of waiver service providers must meet the requirements of chapter 
284.26 	245C prior to providing waiver services and as part of ongoing enrollment. Upon federal 
284.27 	approval, this requirement must also apply to consumer-directed community supports.
284.28 		Subd. 2.Rate-setting methodologies. The commissioner shall establish 
284.29 	statewide rate-setting methodologies that meet federal waiver requirements for home 
284.30 	and community-based waiver services for individuals with disabilities. The rate-setting 
284.31 	methodologies must abide by the principles of transparency and equitability across the 
284.32 	state. The methodologies must involve a uniform process of structuring rates for each 
284.33 	service and must promote quality and participant choice.

285.1 	Sec. 70. Minnesota Statutes 2008, section 256B.5011, subdivision 2, is amended to 
285.2 	read:
285.3 		Subd. 2.Contract provisions. (a) The service contract with each intermediate 
285.4 	care facility must include provisions for:
285.5 	(1) modifying payments when significant changes occur in the needs of the 
285.6 	consumers;
285.7 	(2) the establishment and use of a quality improvement plan. Using criteria and 
285.8 	options for performance measures developed by the commissioner, each intermediate care 
285.9 	facility must identify a minimum of one performance measure on which to focus its efforts 
285.10 	for quality improvement during the contract period;
285.11 	(3) appropriate and necessary statistical information required by the commissioner;
285.12 	(4) (3) annual aggregate facility financial information; and
285.13 	(5) (4) additional requirements for intermediate care facilities not meeting the 
285.14 	standards set forth in the service contract.
285.15 	(b) The commissioner of human services and the commissioner of health, in 
285.16 	consultation with representatives from counties, advocacy organizations, and the provider 
285.17 	community, shall review the consolidated standards under chapter 245B and the supervised 
285.18 	living facility rule under Minnesota Rules, chapter 4665, to determine what provisions 
285.19 	in Minnesota Rules, chapter 4665, may be waived by the commissioner of health for 
285.20 	intermediate care facilities in order to enable facilities to implement the performance 
285.21 	measures in their contract and provide quality services to residents without a duplication 
285.22 	of or increase in regulatory requirements.

285.23 	Sec. 71. Minnesota Statutes 2008, section 256B.5012, is amended by adding a 
285.24 	subdivision to read:
285.25 		Subd. 8.ICF/MR rate decreases effective July 1, 2009. Effective July 1, 2009, 
285.26 	the commissioner shall decrease each facility reimbursed under this section operating 
285.27 	payment adjustments equal to 2.58 percent of the operating payment rates in effect on 
285.28 	June 30, 2009. For each facility, the commissioner shall implement the rate reduction, 
285.29 	based on occupied beds, using the percentage specified in this subdivision multiplied by 
285.30 	the total payment rate, including the variable rate but excluding the property-related 
285.31 	payment rate, in effect on the preceding date. The total rate reduction shall include the 
285.32 	adjustment provided in section 256B.502, subdivision 7.

285.33 	Sec. 72. Minnesota Statutes 2008, section 256B.69, subdivision 5a, is amended to read:
286.1 		Subd. 5a.Managed care contracts. (a) Managed care contracts under this section 
286.2 	and sections 256L.12 and 256D.03, shall be entered into or renewed on a calendar year 
286.3 	basis beginning January 1, 1996. Managed care contracts which were in effect on June 
286.4 	30, 1995, and set to renew on July 1, 1995, shall be renewed for the period July 1, 1995 
286.5 	through December 31, 1995 at the same terms that were in effect on June 30, 1995. The 
286.6 	commissioner may issue separate contracts with requirements specific to services to 
286.7 	medical assistance recipients age 65 and older.
286.8 	(b) A prepaid health plan providing covered health services for eligible persons 
286.9 	pursuant to chapters 256B, 256D, and 256L, is responsible for complying with the terms 
286.10 	of its contract with the commissioner. Requirements applicable to managed care programs 
286.11 	under chapters 256B, 256D, and 256L, established after the effective date of a contract 
286.12 	with the commissioner take effect when the contract is next issued or renewed.
286.13 	(c) Effective for services rendered on or after January 1, 2003, the commissioner 
286.14 	shall withhold five percent of managed care plan payments under this section for the 
286.15 	prepaid medical assistance and general assistance medical care programs pending 
286.16 	completion of performance targets. Each performance target must be quantifiable, 
286.17 	objective, measurable, and reasonably attainable, except in the case of a performance 
286.18 	target based on a federal or state law or rule. Criteria for assessment of each performance 
286.19 	target must be outlined in writing prior to the contract effective date. The managed 
286.20 	care plan must demonstrate, to the commissioner's satisfaction, that the data submitted 
286.21 	regarding attainment of the performance target is accurate. The commissioner shall 
286.22 	periodically change the administrative measures used as performance targets in order 
286.23 	to improve plan performance across a broader range of administrative services. The 
286.24 	performance targets must include measurement of plan efforts to contain spending 
286.25 	on health care services and administrative activities. The commissioner may adopt 
286.26 	plan-specific performance targets that take into account factors affecting only one plan, 
286.27 	including characteristics of the plan's enrollee population. The withheld funds must be 
286.28 	returned no sooner than July of the following year if performance targets in the contract 
286.29 	are achieved. The commissioner may exclude special demonstration projects under 
286.30 	subdivision 23. A managed care plan or a county-based purchasing plan under section 
286.31 	256B.692 may include as admitted assets under section 62D.044 any amount withheld 
286.32 	under this paragraph that is reasonably expected to be returned.
286.33 	(d)(1) Effective for services rendered on or after January 1, 2009, the commissioner 
286.34 	shall withhold three percent of managed care plan payments under this section for the 
286.35 	prepaid medical assistance and general assistance medical care programs. The withheld 
287.1 	funds must be returned no sooner than July 1 and no later than July 31 of the following 
287.2 	year. The commissioner may exclude special demonstration projects under subdivision 23.
287.3 	(2) A managed care plan or a county-based purchasing plan under section 256B.692 
287.4 	may include as admitted assets under section 62D.044 any amount withheld under 
287.5 	this paragraph. The return of the withhold under this paragraph is not subject to the 
287.6 	requirements of paragraph (c).
287.7 	(e) Effective for services provided on or after January 1, 2010, the commissioner 
287.8 	shall require that managed care plans use the assessment and authorization processes, 
287.9 	forms, timelines, standards, documentation, and data reporting requirements, protocols, 
287.10 	billing processes, and policies consistent with medical assistance fee-for-service or the 
287.11 	Department of Human Services contract requirements consistent with medical assistance 
287.12 	fee-for-service or the Department of Human Services contract requirements for all 
287.13 	personal care assistance services under section 256B.0659.

287.14 	Sec. 73. Minnesota Statutes 2008, section 256D.44, subdivision 5, is amended to read:
287.15 		Subd. 5.Special needs. In addition to the state standards of assistance established in 
287.16 	subdivisions 1 to 4, payments are allowed for the following special needs of recipients of 
287.17 	Minnesota supplemental aid who are not residents of a nursing home, a regional treatment 
287.18 	center, or a group residential housing facility.
287.19 	(a) The county agency shall pay a monthly allowance for medically prescribed 
287.20 	diets if the cost of those additional dietary needs cannot be met through some other 
287.21 	maintenance benefit. The need for special diets or dietary items must be prescribed by 
287.22 	a licensed physician. Costs for special diets shall be determined as percentages of the 
287.23 	allotment for a one-person household under the thrifty food plan as defined by the United 
287.24 	States Department of Agriculture. The types of diets and the percentages of the thrifty 
287.25 	food plan that are covered are as follows:
287.26 	(1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;
287.27 	(2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent 
287.28 	of thrifty food plan;
287.29 	(3) controlled protein diet, less than 40 grams and requires special products, 125 
287.30 	percent of thrifty food plan;
287.31 	(4) low cholesterol diet, 25 percent of thrifty food plan;
287.32 	(5) high residue diet, 20 percent of thrifty food plan;
287.33 	(6) pregnancy and lactation diet, 35 percent of thrifty food plan;
287.34 	(7) gluten-free diet, 25 percent of thrifty food plan;
287.35 	(8) lactose-free diet, 25 percent of thrifty food plan;
288.1 	(9) antidumping diet, 15 percent of thrifty food plan;
288.2 	(10) hypoglycemic diet, 15 percent of thrifty food plan; or
288.3 	(11) ketogenic diet, 25 percent of thrifty food plan.
288.4 	(b) Payment for nonrecurring special needs must be allowed for necessary home 
288.5 	repairs or necessary repairs or replacement of household furniture and appliances using 
288.6 	the payment standard of the AFDC program in effect on July 16, 1996, for these expenses, 
288.7 	as long as other funding sources are not available.
288.8 	(c) A fee for guardian or conservator service is allowed at a reasonable rate 
288.9 	negotiated by the county or approved by the court. This rate shall not exceed five percent 
288.10 	of the assistance unit's gross monthly income up to a maximum of $100 per month. If the 
288.11 	guardian or conservator is a member of the county agency staff, no fee is allowed.
288.12 	(d) The county agency shall continue to pay a monthly allowance of $68 for 
288.13 	restaurant meals for a person who was receiving a restaurant meal allowance on June 1, 
288.14 	1990, and who eats two or more meals in a restaurant daily. The allowance must continue 
288.15 	until the person has not received Minnesota supplemental aid for one full calendar month 
288.16 	or until the person's living arrangement changes and the person no longer meets the criteria 
288.17 	for the restaurant meal allowance, whichever occurs first.
288.18 	(e) A fee of ten percent of the recipient's gross income or $25, whichever is less, 
288.19 	is allowed for representative payee services provided by an agency that meets the 
288.20 	requirements under SSI regulations to charge a fee for representative payee services. This 
288.21 	special need is available to all recipients of Minnesota supplemental aid regardless of 
288.22 	their living arrangement.
288.23 	(f)(1) Notwithstanding the language in this subdivision, an amount equal to the 
288.24 	maximum allotment authorized by the federal Food Stamp Program for a single individual 
288.25 	which is in effect on the first day of July of each year will be added to the standards of 
288.26 	assistance established in subdivisions 1 to 4 for adults under the age of 65 who qualify 
288.27 	as shelter needy and are: (i) relocating from an institution, or an adult mental health 
288.28 	residential treatment program under section 256B.0622; (ii) eligible for the self-directed 
288.29 	supports option as defined under section 256B.0657, subdivision 2; or (iii) home and 
288.30 	community-based waiver recipients living in their own home or rented or leased apartment 
288.31 	which is not owned, operated, or controlled by a provider of service not related by blood 
288.32 	or marriage.
288.33 	(2) Notwithstanding subdivision 3, paragraph (c), an individual eligible for the 
288.34 	shelter needy benefit under this paragraph is considered a household of one. An eligible 
288.35 	individual who receives this benefit prior to age 65 may continue to receive the benefit 
288.36 	after the age of 65.
289.1 	(3) "Shelter needy" means that the assistance unit incurs monthly shelter costs that 
289.2 	exceed 40 percent of the assistance unit's gross income before the application of this 
289.3 	special needs standard. "Gross income" for the purposes of this section is the applicant's or 
289.4 	recipient's income as defined in section 256D.35, subdivision 10, or the standard specified 
289.5 	in subdivision 3, paragraph (a) or (b), whichever is greater. A recipient of a federal or 
289.6 	state housing subsidy, that limits shelter costs to a percentage of gross income, shall not be 
289.7 	considered shelter needy for purposes of this paragraph.
289.8 	(g) Notwithstanding this subdivision, recipients of home and community-based 
289.9 	services may relocate to services without 24-hour supervision and receive the equivalent 
289.10 	of the recipient's group residential housing allocation in Minnesota supplemental 
289.11 	assistance shelter needy funding if the cost of the services and housing is equal to or less 
289.12 	than provided to the recipient in home and community-based services and the relocation is 
289.13 	the recipient's choice and is approved by the recipient or guardian.
289.14 	(h) To access housing and services as provided in paragraph (g), the recipient may 
289.15 	choose housing that may or may not be owned, operated, or controlled by the recipient's 
289.16 	service provider.
289.17 	(i) The provisions in paragraphs (g) and (h) are effective to June 30, 2011. The 
289.18 	commissioner shall assess the development of publicly owned housing, other housing 
289.19 	alternatives, and whether a public equity housing fund may be established that would 
289.20 	maintain the state's interest, to the extent paid from group residential housing and 
289.21 	Minnesota supplemental aid shelter needy funds in provider-owned housing so that when 
289.22 	sold, the state would recover its share for a public equity fund to be used for future public 
289.23 	needs under this chapter. The commissioner shall report findings and recommendations to 
289.24 	the legislative committees and budget divisions with jurisdiction over health and human 
289.25 	services policy and financing by January 15, 2012. 
289.26 	(j) In selecting prospective services needed by recipients for whom home and 
289.27 	community-based services have been authorized, the recipient and the recipient's guardian 
289.28 	shall first consider alternatives to home and community-based services. Minnesota 
289.29 	supplemental aid shelter needy funding for recipients who utilize Minnesota supplemental 
289.30 	aid shelter needy funding as provided in this section shall remain permanent unless the 
289.31 	recipient with the recipient's guardian later chooses to access home and community-based 
289.32 	services.

289.33 	Sec. 74. Minnesota Statutes 2008, section 626.556, subdivision 3c, is amended to read:
289.34 		Subd. 3c.Local welfare agency, Department of Human Services or Department 
289.35 	of Health responsible for assessing or investigating reports of maltreatment. (a) 
290.1 	The county local welfare agency is the agency responsible for assessing or investigating 
290.2 	allegations of maltreatment in child foster care, family child care, and legally unlicensed 
290.3 	child care and in, juvenile correctional facilities licensed under section 241.021 located 
290.4 	in the local welfare agency's county, and unlicensed personal care assistance provider 
290.5 	organizations providing services and receiving reimbursements under chapter 256B. 
290.6 	(b) The Department of Human Services is the agency responsible for assessing or 
290.7 	investigating allegations of maltreatment in facilities licensed under chapters 245A and 
290.8 	245B, except for child foster care and family child care.
290.9 	(c) The Department of Health is the agency responsible for assessing or investigating 
290.10 	allegations of child maltreatment in facilities licensed under sections  144.50 to  144.58, 
290.11 	and in unlicensed home health care  and 144A.46. 
290.12 	(d) The commissioners of human services, public safety, and education must 
290.13 	jointly submit a written report by January 15, 2007, to the education policy and finance 
290.14 	committees of the legislature recommending the most efficient and effective allocation 
290.15 	of agency responsibility for assessing or investigating reports of maltreatment and must 
290.16 	specifically address allegations of maltreatment that currently are not the responsibility 
290.17 	of a designated agency. 

290.18 	Sec. 75. Minnesota Statutes 2008, section 626.5572, subdivision 13, is amended to 
290.19 	read:
290.20 		Subd. 13.Lead agency. "Lead agency" is the primary administrative agency 
290.21 	responsible for investigating reports made under section 626.557.  
290.22 	(a) The Department of Health is the lead agency for the facilities which are licensed 
290.23 	or are required to be licensed as hospitals, home care providers, nursing homes, residential 
290.24 	care homes, or boarding care homes.
290.25 	(b) The Department of Human Services is the lead agency for the programs licensed 
290.26 	or required to be licensed as adult day care, adult foster care, programs for people with 
290.27 	developmental disabilities, mental health programs, or chemical health programs, or 
290.28 	personal care provider organizations.
290.29 	(c) The county social service agency or its designee is the lead agency for all 
290.30 	other reports, including reports involving vulnerable adults receiving services from an 
290.31 	unlicensed personal care provider organization under section 256B.0659.

290.32 	Sec. 76. DEVELOPMENT OF ALTERNATIVE SERVICES.
 290.33 	The commissioner of human services, in consultation with advocates, consumers, 
290.34 	and legislators, shall develop alternative services to personal care assistance services for 
291.1 	persons with mental health and other behavioral challenges who can benefit from other 
291.2 	services that more appropriately meet their needs and assist them in living independently 
291.3 	in the community. In the development of these services, the commissioner shall:
291.4 	(1) take into consideration ways in which these alternative services will qualify for 
291.5 	federal financial participation; and 
291.6 	(2) analyze a variety of alternatives, including but not limited to a 1915(i) state 
291.7 	plan option.
291.8 	The commissioner shall report to the legislature by January 15, 2011, with plans for 
291.9 	implementation of these services by July 1, 2011.

291.10 	Sec. 77. 30-DAY NOTICE REQUIRED.
 291.11 	Notwithstanding any contrary provision in law, persons impacted by amendments 
291.12 	in this article to Minnesota Statutes, sections 256B.0625, subdivision 19c; 256B.0655, 
291.13 	subdivision 4; 256B.0659; and 256B.0911, subdivision 1, must be given a 30-day notice 
291.14 	of action by the commissioner. This section expires July 1, 2011.

291.15 	Sec. 78. COLA COMPENSATION REQUIREMENTS.
 291.16 	Effective July 1, 2009, providers who received rate increases under Laws 2007, 
291.17 	chapter 147, article 7, section 71, as amended by Laws 2008, chapter 363, article 15, 
291.18 	section 17, and Minnesota Statutes, section 256B.5012, subdivision 7, for state fiscal years 
291.19 	2008 and 2009 are no longer required to continue or retain employee compensation or 
291.20 	wage-related increases required by those sections. This paragraph shall not apply to 
291.21 	employees covered by a collective bargaining agreement.

291.22 	Sec. 79. PROVIDER RATE AND GRANT REDUCTIONS.
 291.23 	(a) The commissioner of human services shall decrease grants, allocations, 
291.24 	reimbursement rates, or rate limits, as applicable, by 2.58 percent effective July 1, 2009, 
291.25 	for services rendered on or after that date. County or tribal contracts for services specified 
291.26 	in this section must be amended to pass through these rate reductions within 60 days of 
291.27 	the effective date of the decrease and must be retroactive from the effective date of the 
291.28 	rate decrease.
291.29 	(b) The annual rate decreases described in this section must be provided to:
291.30 	(1) home and community-based waivered services for persons with developmental 
291.31 	disabilities or related conditions, including consumer-directed community supports, under 
291.32 	Minnesota Statutes, section 256B.501;
292.1 	(2) home and community-based waivered services for the elderly, including 
292.2 	consumer-directed community supports, under Minnesota Statutes, section 256B.0915;
292.3 	(3) waivered services under community alternatives for disabled individuals, 
292.4 	including consumer-directed community supports, under Minnesota Statutes, section 
292.5 	256B.49;
292.6 	(4) community alternative care waivered services, including consumer-directed 
292.7 	community supports, under Minnesota Statutes, section 256B.49;
292.8 	(5) traumatic brain injury waivered services, including consumer-directed 
292.9 	community supports, under Minnesota Statutes, section 256B.49;
292.10 	(6) nursing services and home health services under Minnesota Statutes, section 
292.11 	256B.0625, subdivision 6a;
292.12 	(7) personal care services and qualified professional supervision of personal care 
292.13 	services under Minnesota Statutes, section 256B.0625, subdivisions 6a and 19a;
292.14 	(8) private duty nursing services under Minnesota Statutes, section 256B.0625, 
292.15 	subdivision 7;
292.16 	(9) day training and habilitation services for adults with developmental disabilities 
292.17 	or related conditions under Minnesota Statutes, sections 252.40 to 252.46, including the 
292.18 	additional cost of rate adjustments on day training and habilitation services, provided as a 
292.19 	social service under Minnesota Statutes, section 256M.60;
292.20 	(10) alternative care services under Minnesota Statutes, section 256B.0913;
292.21 	(11) the group residential housing supplementary service rate under Minnesota 
292.22 	Statutes, section 256I.05, subdivision 1a;
292.23 	(12) semi-independent living services (SILS) under Minnesota Statutes, section 
292.24 	252.275, including SILS funding under county social services grants formerly funded 
292.25 	under Minnesota Statutes, chapter 256I;
292.26 	(13) community support services for deaf and hard-of-hearing adults with mental 
292.27 	illness who use or wish to use sign language as their primary means of communication 
292.28 	under Minnesota Statutes, section 256.01, subdivision 2; and deaf and hard-of-hearing 
292.29 	grants under Minnesota Statutes, sections 256C.233 and 256C.25; Laws 1985, chapter 9; 
292.30 	and Laws 1997, First Special Session chapter 5, section 20;
292.31 	(14) physical therapy services under Minnesota Statutes, sections 256B.0625, 
292.32 	subdivision 8, and 256D.03, subdivision 4;
292.33 	(15) occupational therapy services under Minnesota Statutes, sections 256B.0625, 
292.34 	subdivision 8a, and 256D.03, subdivision 4;
292.35 	(16) speech-language therapy services under Minnesota Statutes, section 256D.03, 
292.36 	subdivision 4, and Minnesota Rules, part 9505.0390;
293.1 	(17) respiratory therapy services under Minnesota Statutes, section 256D.03, 
293.2 	subdivision 4, and Minnesota Rules, part 9505.0295;
293.3 	(18) consumer support grants under Minnesota Statutes, section 256.476;
293.4 	(19) family support grants under Minnesota Statutes, section 252.32;
293.5 	(20) aging grants under Minnesota Statutes, sections 256.975 to 256.977, 256B.0917, 
293.6 	and 256B.0928;
293.7 	(21) disability linkage line grants under Minnesota Statutes, section 256.01, 
293.8 	subdivision 24; and
293.9 	(22) housing access grants under Minnesota Statutes, section 256B.0658.
293.10 	(c) A managed care plan receiving state payments for the services in this section 
293.11 	must include these decreases in their payments to providers effective on October 1 
293.12 	following the effective date of the rate decrease.

293.13 	Sec. 80. RECOMMENDATIONS FOR PERSONAL CARE ASSISTANCE 
293.14 	SERVICES CHANGES, CONSULTATION WITH STAKEHOLDERS, AND DATA 
293.15 	REPORTING.
 293.16 	The commissioner shall:
293.17 	(1) consult with existing stakeholder groups convened under the commissioner's 
293.18 	authority, including the home and community-based expert services panel beginning in 
293.19 	August 2009 on implementation of the changes in the personal care assistance program, 
293.20 	assistance for recipients whose services and housing must change, alternative services 
293.21 	for those whose personal care assistance services are terminated or reduced, costs for 
293.22 	those whose services will change, data on the effects of the changes in the personal care 
293.23 	assistance program for recipients, and ongoing data on personal care assistance services 
293.24 	for public reporting; and
293.25 	(2) report data on the training developed and delivered for all types of participants in 
293.26 	the personal care assistance program, audit and financial integrity measures and results, 
293.27 	information developed for consumers and responsible parties, available demographic, 
293.28 	health care service use, and housing information about individuals who no longer qualify 
293.29 	for personal care assistance, and quality assurance measures and results to the legislative 
293.30 	committees with jurisdiction over health and human services policy and finance by 
293.31 	January 15, 2010, and January 15, 2011.

293.32 	Sec. 81. ESTABLISHING A SINGLE SET OF STANDARDS.
 293.33 	(a) The commissioner of human services shall consult with disability service 
293.34 	providers, advocates, counties, and consumer families to develop a single set of standards 
294.1 	governing services for people with disabilities receiving services under the home and 
294.2 	community-based waiver services program to replace all or portions of existing laws and 
294.3 	rules including, but not limited to, data practices, licensure of facilities and providers, 
294.4 	background studies, reporting of maltreatment of minors, reporting of maltreatment of 
294.5 	vulnerable adults, and the psychotropic medication checklist. The standards must:
294.6 	(1) enable optimum consumer choice;
294.7 	(2) be consumer driven;
294.8 	(3) link services to individual needs and life goals;
294.9 	(4) be based on quality assurance and individual outcomes; 
294.10 	(5) utilize the people closest to the recipient, who may include family, friends, and 
294.11 	health and service providers, in conjunction with the recipient's risk management plan to 
294.12 	assist the recipient or the recipient's guardian in making decisions that meet the recipient's 
294.13 	needs in a cost-effective manner and assure the recipient's health and safety;
294.14 	(6) utilize person-centered planning; and
294.15 	(7) maximize federal financial participation.
294.16 	(b) The commissioner may consult with existing stakeholder groups convened under 
294.17 	the commissioner's authority, including the home and community-based expert services 
294.18 	panel established by the commissioner in 2008, to meet all or some of the requirements 
294.19 	of this section.
294.20 	(c) The commissioner shall provide the reports and plans required by this section to 
294.21 	the legislative committees and budget divisions with jurisdiction over health and human 
294.22 	services policy and finance by January 15, 2012.

294.23 	Sec. 82. COMMON SERVICE MENU FOR HOME AND COMMUNITY-BASED 
294.24 	WAIVER PROGRAMS.
 294.25 	The commissioner of human services shall confer with representatives of recipients, 
294.26 	advocacy groups, counties, providers, and health plans to develop and update a common 
294.27 	service menu for home and community-based waiver programs. The commissioner may 
294.28 	consult with existing stakeholder groups convened under the commissioner's authority to 
294.29 	meet all or some of the requirements of this section.

294.30 	Sec. 83. INTERMEDIATE CARE FACILITIES FOR PERSONS WITH 
294.31 	DEVELOPMENTAL DISABILITIES REPORT.
 294.32 	The commissioner of human services shall consult with providers and advocates of 
294.33 	intermediate care facilities for persons with developmental disabilities to monitor progress 
295.1 	made in response to the commissioner's December 15, 2008, report to the legislature 
295.2 	regarding intermediate care facilities for persons with developmental disabilities.

295.3 	Sec. 84. HOUSING OPTIONS.
 295.4 	The commissioner of human services, in consultation with the commissioner of 
295.5 	administration and the Minnesota Housing Finance Agency, and representatives of 
295.6 	counties, residents' advocacy groups, consumers of housing services, and provider 
295.7 	agencies shall explore ways to maximize the availability and affordability of housing 
295.8 	choices available to persons with disabilities or who need care assistance due to other 
295.9 	health challenges. A goal shall also be to minimize state physical plant costs in order to 
295.10 	serve more persons with appropriate program and care support. Consideration shall be 
295.11 	given to:
295.12 	(1) improved access to rent subsidies;
295.13 	(2) use of cooperatives, land trusts, and other limited equity ownership models;
295.14 	(3) whether a public equity housing fund should be established that would maintain 
295.15 	the state's interest, to the extent paid from state funds, including group residential housing 
295.16 	and Minnesota supplemental aid shelter-needy funds in provider-owned housing, so that 
295.17 	when sold, the state would recover its share for a public equity fund to be used for future 
295.18 	public needs under this chapter;
295.19 	(4) the desirability of the state acquiring an ownership interest or promoting the 
295.20 	use of publicly owned housing;
295.21 	(5) promoting more choices in the market for accessible housing that meets the 
295.22 	needs of persons with physical challenges; and
295.23 	(6) what consumer ownership models, if any, are appropriate.
295.24 	The commissioner shall provide a written report on the findings of the evaluation of 
295.25 	housing options to the chairs and ranking minority members of the house of representatives 
295.26 	and senate standing committees with jurisdiction over health and human services policy 
295.27 	and funding by December 15, 2010. This report shall replace the November 1, 2010, 
295.28 	annual report by the commissioner required in Minnesota Statutes, sections 256B.0916, 
295.29 	subdivision 7, and 256B.49, subdivision 21.

295.30 	Sec. 85. REVISOR'S INSTRUCTION.
 295.31 		Subdivision 1.Renumbering of Minnesota Statutes, section 256B.0652, 
295.32 	authorization and review of home care services. (a) The revisor of statutes shall 
295.33 	renumber each section of Minnesota Statutes listed in column A with the number in 
295.34 	column B.

296.1	Column A
	Column B
	
296.2	256B.0652, subdivision 3
	256B.0652, subdivision 14
	
296.3	256B.0651, subdivision 6, paragraph (a)
	256B.0652, subdivision 3
	
296.4	256B.0651, subdivision 6, paragraph (b)
	256B.0652, subdivision 4
	
296.5	256B.0651, subdivision 6, paragraph (c)
	256B.0652, subdivision 7
	
296.6	256B.0651, subdivision 7, paragraph (a)
	256B.0652, subdivision 8
	
296.7	256B.0651, subdivision 7, paragraph (b)
	256B.0652, subdivision 14
	
296.8	256B.0651, subdivision 8
	256B.0652, subdivision 9
	
296.9	256B.0651, subdivision 9
	256B.0652, subdivision 10
	
296.10	256B.0651, subdivision 11
	256B.0652, subdivision 11
	
296.11	256B.0654, subdivision 2
	256B.0652, subdivision 5
	
296.12	256B.0655, subdivision 4
	256B.0652, subdivision 6
	
296.13 	(b) The revisor of statutes shall make necessary cross-reference changes in statutes 
296.14 	and rules consistent with the renumbering in paragraph (a). The Department of Human 
296.15 	Services shall assist the revisor with any cross-reference changes. The revisor may make 
296.16 	changes necessary to correct the punctuation, grammar, or structure of the remaining text 
296.17 	to conform with the intent of the renumbering in paragraph (a).
296.18 		Subd. 2.Renumbering personal care assistance services. The revisor of statutes 
296.19 	shall replace any reference to Minnesota Statutes, section 256B.0655 with section 
296.20 	256B.0659, wherever it appears in statutes or rules. The revisor shall correct any cross 
296.21 	reference changes that are necessary as a result of this section. The Department of Human 
296.22 	Services shall assist the revisor in making these changes, and if necessary, shall draft a 
296.23 	corrections bill with changes for introduction in the 2010 legislative session. The revisor 
296.24 	may make changes to punctuation, grammar, or sentence structure to preserve the integrity 
296.25 	of statutes and effectuate the intention of this section.

296.26 	Sec. 86.  REPEALER.
 296.27 	(a) Minnesota Statutes 2008, sections 256B.0655, subdivisions 1, 1a, 1c, 1d, 1e, 
296.28 	1h, 1i, 3, 5, 6, 7, 8, 9, 10, 11, 12, and 13; and 256B.071, subdivisions 1, 2, 3, and 4, are 
296.29 	repealed.
296.30 	(b) Minnesota Statutes 2008, sections 256B.19, subdivision 1d; and 256B.431, 
296.31 	subdivision 23, are repealed effective May 1, 2009.
296.32 	(c) Minnesota Statutes 2008, section 256B.0655, subdivisions 1f, 1g, and 2, are 
296.33 	repealed effective January 1, 2010.

297.1 	ARTICLE 9
297.2 	STATE-COUNTY RESULTS, ACCOUNTABILITY, AND SERVICE 
297.3 	DELIVERY REFORM ACT

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

297.7 	Sec. 2. [402A.10] DEFINITIONS.
297.8 		Subdivision 1.Terms defined. For the purposes of this chapter, the terms defined 
297.9 	in this section have the meanings given.
297.10 		Subd. 2.Commissioner. "Commissioner" means the commissioner of human 
297.11 	services.
297.12 		Subd. 3.Council. "Council" means the State-County Results, Accountability, and 
297.13 	Service Delivery Redesign Council established in section 402A.20.
297.14 		Subd. 4.Essential human services or essential services. "Essential human 
297.15 	services" or "essential services" means assistance and services to recipients or potential 
297.16 	recipients of public welfare and other services delivered by counties that are mandated in 
297.17 	federal and state law that are to be available in all counties of the state.
297.18 		Subd. 5.Service delivery authority. "Service delivery authority" means a single 
297.19 	county, or group of counties operating by execution of a joint powers agreement under 
297.20 	section 471.59 or other contractual agreement, that has voluntarily chosen by resolution of 
297.21 	the county board of commissioners to participate in the redesign under this chapter.
297.22 		Subd. 6.Steering committee. "Steering committee" means the Steering Committee 
297.23 	on Performance and Outcome Reforms.

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

297.25 	Sec. 3. [402A.15] STEERING COMMITTEE ON PERFORMANCE AND 
297.26 	OUTCOME REFORMS.
297.27 		Subdivision 1.Duties. (a) The Steering Committee on Performance and Outcome 
297.28 	Reforms shall develop a uniform process to establish and review performance and 
297.29 	outcome standards for all essential human services based on the current level of resources 
297.30 	available, and to develop appropriate reporting measures and a uniform accountability 
297.31 	process for responding to a county's or human service authority's failure to make adequate 
297.32 	progress on achieving performance measures. The accountability process shall focus on 
297.33 	the performance measures rather than inflexible implementation requirements.
298.1 	(b) The steering committee shall:
298.2 	(1) by November 1, 2009, establish an agreed upon list of essential services;
298.3 	(2) by February 15, 2010, develop and recommend to the legislature a uniform, 
298.4 	graduated process, in addition to the remedies identified in section 402A.18, for responding 
298.5 	to a county's failure to make adequate progress on achieving performance measures; and
298.6 	(3) by December 15, 2012, for each essential service make recommendations to the 
298.7 	legislature regarding (1) performance measures and goals based on those measures for 
298.8 	each essential service, (2) a system for reporting on the performance measures and goals, 
298.9 	and (3) appropriate resources, including funding, needed to achieve those performance 
298.10 	measures and goals. The resource recommendations shall take into consideration program 
298.11 	demand and the unique differences of local areas in geography and the populations 
298.12 	served. Priority shall be given to services with the greatest variation in availability and 
298.13 	greatest administrative demands. By January 15 of each year starting January 15, 2011, 
298.14 	the steering committee shall report its recommendations to the governor and legislative 
298.15 	committees with jurisdiction over health and human services. As part of its report, the 
298.16 	steering committee shall, as appropriate, recommend statutory provisions, rules and 
298.17 	requirements, and reports that should be repealed or eliminated.
298.18 	(c) As far as possible, the performance measures, reporting system, and funding 
298.19 	shall be consistent across program areas. The development of performance measures shall 
298.20 	consider the manner in which data will be collected and performance will be reported. 
298.21 	The steering committee shall consider state and local administrative costs related to 
298.22 	collecting data and reporting outcomes when developing performance measures. The 
298.23 	steering committee shall correlate the performance measures and goals to available 
298.24 	levels of resources, including state and local funding. The steering committee shall 
298.25 	take into consideration that the goal of implementing changes to program monitoring 
298.26 	and reporting the progress toward achieving outcomes is to significantly minimize the 
298.27 	cost of administrative requirements and to allow funds freed by reduced administrative 
298.28 	expenditures to be used to provide additional services, allow flexibility in service design 
298.29 	and management, and focus energies on achieving program and client outcomes.
298.30 	(d) In making its recommendations, the steering committee shall consider input from 
298.31 	the council established in section 402A.20. The steering committee shall review the 
298.32 	measurable goals established in a memorandum of understanding entered into under 
298.33 	section 402A.30, subdivision 2, paragraph (b), and consider whether they may be applied 
298.34 	as statewide performance outcomes.
299.1 	(e) The steering committee shall form work groups that include persons who provide 
299.2 	or receive essential services and representatives of organizations who advocate on behalf 
299.3 	of those persons.
299.4 	(f) By December 15, 2009, the steering committee shall establish a three-year 
299.5 	schedule for completion of its work. The schedule shall be published on the Department of 
299.6 	Human Services Web site and reported to the legislative committees with jurisdiction over 
299.7 	health and human services. In addition, the commissioner shall post quarterly updates on 
299.8 	the progress of the steering committee on the Department of Human Services Web site.
299.9 		Subd. 2.Composition. (a) The steering committee shall include:
299.10 	(1) the commissioner of human services, or designee, and two additional 
299.11 	representatives of the department;
299.12 	(2) two county commissioners, representative of rural and urban counties, selected 
299.13 	by the Association of Minnesota Counties;
299.14 	(3) two county directors of human services, representative of rural and urban 
299.15 	counties, selected by the Minnesota Association of County Social Service Administrators; 
299.16 	and
299.17 	(4) three clients or client advocates representing different populations receiving 
299.18 	services from the Department of Human Services, who are appointed by the commissioner.
299.19 	(b) The commissioner, or designee, and a county commissioner shall serve as 
299.20 	cochairs of the committee. The committee shall be convened within 60 days of final 
299.21 	enactment of this legislation.
299.22 	(c) State agency staff shall serve as informational resources and staff to the steering 
299.23 	committee. Statewide county associations may assemble county program data as required.
299.24 	(d) To promote information sharing and coordination between the steering committee 
299.25 	and council, one of the county representatives from paragraph (a), clause (2), and one of the 
299.26 	county representatives from paragraph (a), clause (3), must also serve as a representative 
299.27 	on the council under section 402A.20, subdivision 1, paragraph (b), clause (5) or (6).

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

299.29 	Sec. 4. [402A.18] COMMISSIONER POWER TO REMEDY FAILURE TO 
299.30 	MEET PERFORMANCE OUTCOMES.
299.31 		Subdivision 1.Underperforming county; specific service. If the commissioner 
299.32 	determines that a county or service delivery authority is deficient in achieving minimum 
299.33 	performance outcomes for a specific essential service, the commissioner may impose 
299.34 	the following remedies:
300.1 	(1) voluntary incorporation of the administration and operation of the specific 
300.2 	essential service with an existing service delivery authority or another county. A 
300.3 	service delivery authority or county incorporating an underperforming county shall 
300.4 	not be financially liable for the costs associated with remedying performance outcome 
300.5 	deficiencies;
300.6 	(2) mandatory incorporation of the administration and operation of the specific 
300.7 	essential service with an existing service delivery authority or another county. A 
300.8 	service delivery authority or county incorporating an underperforming county shall 
300.9 	not be financially liable for the costs associated with remedying performance outcome 
300.10 	deficiencies; or 
300.11 	(3) transfer of authority for program administration and operation of the specific 
300.12 	essential service to the commissioner.
300.13 		Subd. 2.Underperforming county; more than one-half of service. If the 
300.14 	commissioner determines that a county or service delivery authority is deficient in 
300.15 	achieving minimum performance outcomes for more than one-half of the defined essential 
300.16 	service, the commissioner may impose the following remedies:
300.17 	(1) voluntary incorporation of the administration and operation of the specific 
300.18 	essential service with an existing service delivery authority or another county. A 
300.19 	service delivery authority or county incorporating an underperforming county shall 
300.20 	not be financially liable for the costs associated with remedying performance outcome 
300.21 	deficiencies;
300.22 	(2) mandatory incorporation of the administration and operation of the specific 
300.23 	essential service with an existing service delivery authority or another county. A 
300.24 	service delivery authority or county incorporating an underperforming county shall 
300.25 	not be financially liable for the costs associated with remedying performance outcome 
300.26 	deficiencies; or 
300.27 	(3) transfer of authority for program administration and operation of the specific 
300.28 	essential service to the commissioner.
300.29 		Subd. 3.Conditions prior to imposing remedies. Before the commissioner may 
300.30 	impose the remedies authorized under this section, the following conditions must be met:
300.31 	(1) the county or service delivery authority determined by the commissioner 
300.32 	to be deficient in achieving minimum performance outcomes has the opportunity, in 
300.33 	coordination with the council, to develop a program outcome improvement plan. The 
300.34 	program outcome improvement plan must be developed no later than six months from the 
300.35 	date of the deficiency determination; and
301.1 	(2) the council has conducted an assessment of the program outcome improvement 
301.2 	plan to determine if the county or service delivery authority has made satisfactory progress 
301.3 	toward performance outcomes and has made a recommendation about remedies to the 
301.4 	commissioner. The review and recommendation must be made to the commissioner within 
301.5 	12 months from the date of the deficiency determination.

301.6 	Sec. 5. [402A.20] COUNCIL.
301.7 		Subdivision 1.Council. (a) The State-County Results, Accountability, and Service 
301.8 	Delivery Redesign Council is established. Appointed council members must be appointed 
301.9 	by their respective agencies, associations, or governmental units by November 1, 2009. 
301.10 	The council shall be cochaired by the commissioner of human services, or designee, and a 
301.11 	county representative from paragraph (b), clause (4) or (5), appointed by the Association 
301.12 	of Minnesota Counties. Recommendations of the council must be approved by a majority 
301.13 	of the council members. The provisions of section 15.059 do not apply to this council, 
301.14 	and this council does not expire.
301.15 	(b) The council must consist of the following members:
301.16 	(1) two legislators appointed by the speaker of the house, one from the minority 
301.17 	and one from the majority;
301.18 	(2) two legislators appointed by the Senate Rules Committee, one from the majority 
301.19 	and one from the minority;
301.20 	(3) the commissioner of human services, or designee, and three employees from 
301.21 	the department;
301.22 	(4) two county commissioners appointed by the Association of Minnesota Counties;
301.23 	(5) two county representatives appointed by the Minnesota Association of County 
301.24 	Social Service Administrators; 
301.25 	(6) one representative appointed by AFSCME as a nonvoting member; and
301.26 	(7) one representative appointed by the Teamsters as a nonvoting member.
301.27 	(c) Administrative support to the council may be provided by the Association of 
301.28 	Minnesota Counties and affiliates.
301.29 	(d) Member agencies and associations are responsible for initial and subsequent 
301.30 	appointments to the council.
301.31 		Subd. 2.Council duties. The council shall:
301.32 	(1) provide review of the redesign process;
301.33 	(2) certify, in accordance with section 402A.30, subdivision 4, the formation of 
301.34 	a service delivery authority, including the memorandum of understanding in section 
301.35 	402A.30, subdivision 2, paragraph (b);
302.1 	(3) ensure the consistency of the memoranda of understanding entered into 
302.2 	under section 402A.30, subdivision 2, paragraph (b), with the performance standards 
302.3 	recommended by the steering committee and enacted by the legislature;
302.4 	(4) ensure the consistency of the memoranda of understanding, to the extent 
302.5 	appropriate, or other memoranda of understanding entered into by other service delivery 
302.6 	authorities; 
302.7 	(5) establish a process to take public input on the service delivery framework 
302.8 	specified in the memorandum of understanding in section 402A.30, subdivision 2, 
302.9 	paragraph (b);
302.10 	(6) form work groups as necessary to carry out the duties of the council under the 
302.11 	redesign;
302.12 	(7) serve as a forum for resolving conflicts among participating counties or between 
302.13 	participating counties and the commissioner of human services, provided nothing in this 
302.14 	section is intended to create a formal binding legal process;
302.15 	(8) engage in the program improvement process established in section 402A.18, 
302.16 	subdivision 3; and
302.17 	(9) identify and recommend incentives for counties to participate in human services 
302.18 	authorities.

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

302.20 	Sec. 6. [402A.30] DESIGNATION OF SERVICE DELIVERY AUTHORITY.
302.21 		Subdivision 1.Establishment. After certification by the council and approval by 
302.22 	the commissioner, in accordance with subdivision 4, a county or consortium of counties 
302.23 	may establish a service delivery authority to redesign the delivery of some or all essential 
302.24 	services. Once a county or consortium of counties establishes a service delivery authority, 
302.25 	no county that is a participant in the service delivery authority may participate in or be 
302.26 	a member of any other service delivery authority. The service delivery authority may 
302.27 	allow an additional county or counties to join the service delivery authority subject to the 
302.28 	approval of the council and the commissioner.
302.29 		Subd. 2.New state-county governance framework. (a) To establish a service 
302.30 	delivery authority, each participating county and the state must enter into a binding 
302.31 	memorandum of understanding to establish a joint state-county service delivery 
302.32 	framework:
302.33 	(b) The memorandum of understanding must:
302.34 	(1) comply with current state and federal law except where waivers are approved 
302.35 	under clause (7);
303.1 	(2) define the scope of essential services over which the service delivery authority 
303.2 	has jurisdiction;
303.3 	(3) designate a single administrative structure to oversee the delivery of services over 
303.4 	which the service delivery authority has jurisdiction and identify a single administrative 
303.5 	agent for purposes of contact and communication with the department;
303.6 	(4) define measurable performance and outcome goals in key operational areas 
303.7 	that the service delivery authority is expected to achieve, provided that the performance 
303.8 	goals must, at a minimum, satisfy performance outcomes recommended by the steering 
303.9 	committee and enacted into law;
303.10 	(5) identify the state and local resources, including funding and administrative and 
303.11 	information technology support, and other requirements necessary for the service delivery 
303.12 	authority to achieve the performance and outcome goals;
303.13 	(6) state the relief available to the service delivery authority if the resource 
303.14 	commitments identified in clause (5) are not met;
303.15 	(7) identify in the agreement the waivers from statutory requirements that are needed 
303.16 	to ensure greater local control and flexibility to determine the most cost-effective means 
303.17 	of achieving specified measurable goals and the date by which the commissioner shall 
303.18 	grant the identified waivers;
303.19 	(8) set forth a graduated accountability process and penalties for responding to a 
303.20 	county's failure to make adequate progress on achieving performance and outcome goals;
303.21 	(9) set forth a reasonable level of targeted reductions in overhead and administrative 
303.22 	costs for each county participating in the service delivery authority; and
303.23 	(10) set forth the terms under which a county may withdraw from participation.
303.24 	The memorandum of understanding may be later amended to add additional services over 
303.25 	which the service delivery authority has jurisdiction.
303.26 	(c) Nothing in this chapter precludes local governments from utilizing sections 
303.27 	465.81 and 465.82 to establish procedures for local governments to merge, with the 
303.28 	consent of the voters. Any agreement under paragraph (b) must be governed by this 
303.29 	chapter. Nothing in this chapter limits the authority of a county board to enter into 
303.30 	contractual agreements for services not covered by the provisions of a memorandum of 
303.31 	understanding establishing a service delivery authority with other agencies or with other 
303.32 	units of government.
303.33 		Subd. 3.Duties. The service delivery authority shall:
303.34 	(1) within the scope of essential services set forth in the memorandum of 
303.35 	understanding establishing the authority, carry out the responsibilities required of local 
303.36 	agencies under chapter 393 and human services boards under chapter 402;
304.1 	(2) manage the public resources devoted to human services and other public services 
304.2 	delivered or purchased by the counties that are subsidized or regulated by the Department 
304.3 	of Human Services under chapters 245 and 267;
304.4 	(3) employ staff to assist in carrying out its duties;
304.5 	(4) develop and maintain a continuity of operations plan to ensure the continued 
304.6 	operation or resumption of essential human services functions in the event of any business 
304.7 	interruption according to local, state, and federal emergency planning requirements;
304.8 	(5) receive and expend funds received for the redesign process under the 
304.9 	memorandum of understanding;
304.10 	(6) plan and deliver services directly or through contract with other governmental 
304.11 	or nongovernmental providers;
304.12 	(7) rent, purchase, sell, and otherwise dispose of real and personal property as 
304.13 	necessary to carry out the redesign; and
304.14 	(8) carry out any other service designated as a responsibility of a county.
304.15 		Subd. 4.Process for establishing a service delivery authority. (a) The county or 
304.16 	consortium of counties proposing to form a service delivery authority shall, in conjunction 
304.17 	with the commissioner, prevent a proposed memorandum of understanding to the council 
304.18 	accompanied by a resolution from the board of commissioners of each participating 
304.19 	county stating the county's intent to participate in a service delivery authority.
304.20 	(b) The council shall certify a county or consortium of counties as a service delivery 
304.21 	authority if:
304.22 	(1) the conditions in subdivision 2, paragraphs (a) and (b), are met; and
304.23 	(2) the county or consortium of counties are:
304.24 	(i) a single county with a population of 55,000 or more;
304.25 	(ii) a consortium of counties with a total combined population of 55,000 or more and 
304.26 	the counties comprising the consortium are in reasonable geographic proximity; or
304.27 	(iii) four or more counties in reasonable geographic proximity without regard 
304.28 	to population.
304.29 	The council may recommend that the commissioner of human services exempt a 
304.30 	single county or multicounty service delivery authority from the minimum population 
304.31 	standard if that service delivery authority can demonstrate that it can otherwise meet 
304.32 	the requirements of this chapter.
304.33 	(c) After the council has certified a county or consortium of counties as a service 
304.34 	delivery authority, the commissioner may enter into the memoranda of understanding with 
304.35 	the participating counties to form the service delivery authority.
305.1 		Subd. 5.Single county service delivery authority. For counties with populations 
305.2 	over 55,000, the board of county commissioners may be the service delivery authority and 
305.3 	retain existing authority under law.

305.4 	Sec. 7. [402A.45] ESSENTIAL SERVICES OUTSIDE THE JURISDICTION OF 
305.5 	A SERVICE DELIVERY AUTHORITY.
305.6 	(a) With the approval of the council, a county that is a participant in a service 
305.7 	delivery authority may enter into cooperative arrangements with other service delivery 
305.8 	authorities or other counties to provide essential services that are not within the jurisdiction 
305.9 	and duties of the service delivery authority.
305.10 	(b) With the approval of the council, a service delivery authority may enter into a 
305.11 	cooperative arrangement with a nonparticipating county to provide an essential service 
305.12 	within the jurisdiction and duties of the service delivery authority.

305.13 	Sec. 8. [402A.50] PRIVATE SECTOR FUNDING.
305.14 	The council may support stakeholder agencies, if not otherwise prohibited by law, to 
305.15 	separately or jointly seek and receive funds to provide expert technical assistance to the 
305.16 	council, the council's work group, and any subwork groups for executing the provisions 
305.17 	of the redesign. 

305.18 	Sec. 9. APPROPRIATION.
 305.19 	$350,000 is appropriated for the biennium beginning July 1, 2009, from the general 
305.20 	fund to the State-County Results, Accountability, and Service Delivery Redesign Council, 
305.21 	for the purposes of the State-County Results, Accountability, and Service Delivery Reform 
305.22 	Act under Minnesota Statutes, sections 402A.01 to 402A.50. The council shall establish a 
305.23 	methodology for distributing funds to certified service delivery authorities for the purposes 
305.24 	of carrying out the requirements of the redesign.

305.25 	ARTICLE 10
305.26 	PUBLIC HEALTH

305.27 	Section 1. Minnesota Statutes 2008, section 103I.208, subdivision 2, is amended to 
305.28 	read:
305.29 		Subd. 2.Permit fee. The permit fee to be paid by a property owner is:
305.30 	(1) for a water supply well that is not in use under a maintenance permit, $175 
305.31 	annually;
306.1 	(2) for construction of a monitoring well, $215, which includes the state core 
306.2 	function fee;
306.3 	(3) for a monitoring well that is unsealed under a maintenance permit, $175 annually;
306.4 	(4) for a monitoring well owned by a federal agency, state agency, or local unit of 
306.5 	government that is unsealed under a maintenance permit, $50 annually. "Local unit of 
306.6 	government" means a statutory or home rule charter city, town, county, or soil and water 
306.7 	conservation district, watershed district, an organization formed for the joint exercise of 
306.8 	powers under section 471.59, a board of health or community health board, or other 
306.9 	special purpose district or authority with local jurisdiction in water and related land 
306.10 	resources management;
306.11 	(5) for monitoring wells used as a leak detection device at a single motor fuel retail 
306.12 	outlet, a single petroleum bulk storage site excluding tank farms, or a single agricultural 
306.13 	chemical facility site, the construction permit fee is $215, which includes the state core 
306.14 	function fee, per site regardless of the number of wells constructed on the site, and 
306.15 	the annual fee for a maintenance permit for unsealed monitoring wells is $175 per site 
306.16 	regardless of the number of monitoring wells located on site;
306.17 	(5) (6) for a groundwater thermal exchange device, in addition to the notification fee 
306.18 	for water supply wells, $215, which includes the state core function fee;
306.19 	(6) (7) for a vertical heat exchanger with less than ten tons of heating/cooling 
306.20 	capacity, $215;
306.21 	(8) for a vertical heat exchanger with ten to 50 tons of heating/cooling capacity, $425;
306.22 	(9) for a vertical heat exchanger with greater than 50 tons of heating/cooling 
306.23 	capacity, $650;
306.24 	(7) (10) for a dewatering well that is unsealed under a maintenance permit, $175 
306.25 	annually for each dewatering well, except a dewatering project comprising more than five 
306.26 	dewatering wells shall be issued a single permit for $875 annually for dewatering wells 
306.27 	recorded on the permit; and
306.28 	(8) (11) for an elevator boring, $215 for each boring.

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

306.34	(1)
	medical or veterinary equipment
		$
	53100
	
306.35	(2)
	dental x-ray equipment
		$
	3340
	
307.1	(3)
	accelerator
		$
	66
	
307.2	(4)
	radiation therapy equipment
		$
	66
	
307.3
307.4	(5)(3)
	x-ray equipment not used on 
humans or animals
		$
	53100
	
307.5
307.6
307.7	(6)(4)
	devices with sources of ionizing 
radiation not used on humans or 
animals
		$
	53100
	
307.8 	(b) A facility with radiation therapy and accelerator equipment must pay an annual 
307.9 	registration fee of $500. A facility with an industrial accelerator must pay an annual 
307.10 	registration fee of $150.
307.11 	(c) Electron microscopy equipment is exempt from the registration fee requirements 
307.12 	of this section.

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

307.18 	Sec. 4. Minnesota Statutes 2008, section 144.1222, subdivision 1a, is amended to read:
307.19 		Subd. 1a. Fees. All plans and specifications for public pool and spa construction, 
307.20 	installation, or alteration or requests for a variance that are submitted to the commissioner 
307.21 	according to Minnesota Rules, part 4717.3975, shall be accompanied by the appropriate 
307.22 	fees. All public pool construction plans submitted for review after January 1, 2009, 
307.23 	must be certified by a professional engineer registered in the state of Minnesota. If the 
307.24 	commissioner determines, upon review of the plans, that inadequate fees were paid, the 
307.25 	necessary additional fees shall be paid before plan approval. For purposes of determining 
307.26 	fees, a project is defined as a proposal to construct or install a public pool, spa, special 
307.27 	purpose pool, or wading pool and all associated water treatment equipment and drains, 
307.28 	gutters, decks, water recreation features, spray pads, and those design and safety features 
307.29 	that are within five feet of any pool or spa. The commissioner shall charge the following 
307.30 	fees for plan review and inspection of public pools and spas and for requests for variance 
307.31 	from the public pool and spa rules: 
307.32 	(1) each pool, $800 $1,500; 
307.33 	(2) each spa pool, $500 $800; 
307.34 	(3) each slide, $400 $600; 
308.1 	(4) projects valued at $250,000 or more, the greater of the sum of the fees in clauses 
308.2 	(1), (2), and (3) or 0.5 percent of the documented estimated project cost to a maximum 
308.3 	fee of $10,000 $15,000; 
308.4 	(5) alterations to an existing pool without changing the size or configuration of 
308.5 	the pool, $400 $600; 
308.6 	(6) removal or replacement of pool disinfection equipment only, $75 $100; and 
308.7 	(7) request for variance from the public pool and spa rules, $500. 

308.8 	Sec. 5. Minnesota Statutes 2008, section 144.125, subdivision 1, is amended to read:
308.9 		Subdivision 1.Duty to perform testing. It is the duty of (1) the administrative 
308.10 	officer or other person in charge of each institution caring for infants 28 days or less 
308.11 	of age, (2) the person required in pursuance of the provisions of section 144.215, to 
308.12 	register the birth of a child, or (3) the nurse midwife or midwife in attendance at the 
308.13 	birth, to arrange to have administered to every infant or child in its care tests for heritable 
308.14 	and congenital disorders according to subdivision 2 and rules prescribed by the state 
308.15 	commissioner of health. Testing and the recording and reporting of test results shall be 
308.16 	performed at the times and in the manner prescribed by the commissioner of health. The 
308.17 	commissioner shall charge a fee so that the total of fees collected will approximate the 
308.18 	costs of conducting the tests and implementing and maintaining a system to follow-up 
308.19 	infants with heritable or congenital disorders, including hearing loss detected through the 
308.20 	early hearing detection and intervention program under section 144.966. The fee is $101 
308.21 	per specimen. Effective July 1, 2010, the fee shall be increased to $106 per specimen. The 
308.22 	increased fee amount shall be deposited in the general fund. Costs associated with capital 
308.23 	expenditures and the development of new procedures may be prorated over a three-year 
308.24 	period when calculating the amount of the fees. 

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

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

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

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

309.9 	Sec. 9. Minnesota Statutes 2008, section 144.9501, subdivision 22b, is amended to 
309.10 	read:
309.11 		Subd. 22b.Lead sampling technician. "Lead sampling technician" means an 
309.12 	individual who performs clearance inspections for nonabatement or nonorder lead hazard 
309.13 	reduction renovation sites, and lead dust sampling in other settings, or visual assessment 
309.14 	for deteriorated paint for nonabatement sites, and who is registered with the commissioner 
309.15 	under section 144.9505. 

309.16 	Sec. 10. Minnesota Statutes 2008, section 144.9501, subdivision 26a, is amended to 
309.17 	read:
309.18 		Subd. 26a.Regulated lead work. (a) "Regulated lead work" means:
309.19 	(1) abatement;
309.20 	(2) interim controls;
309.21 	(3) a clearance inspection;
309.22 	(4) a lead hazard screen;
309.23 	(5) a lead inspection;
309.24 	(6) a lead risk assessment;
309.25 	(7) lead project designer services;
309.26 	(8) lead sampling technician services; or
309.27 	(9) swab team services.;
309.28 	(10) renovation activities; or
309.29 	(11) activities performed to comply with lead orders issued by a board of health.
309.30 	(b) Regulated lead work does not include abatement, interim controls, swab team 
309.31 	services, or renovation activities that disturb painted surfaces that total no more than:
309.32 	(1) activities such as remodeling, renovation, installation, rehabilitation, or 
309.33 	landscaping activities, the primary intent of which is to remodel, repair, or restore a 
310.1 	structure or dwelling, rather than to permanently eliminate lead hazards, even though these 
310.2 	activities may incidentally result in a reduction in lead hazards; or
310.3 	(2) interim control activities that are not performed as a result of a lead order and 
310.4 	that do not disturb painted surfaces that total more than:
310.5 	(i) (1) 20 square feet (two square meters) on exterior surfaces; or
310.6 	(ii) two (2) six square feet (0.2 0.6 square meters) in an interior room; or.
310.7 	(iii) ten percent of the total surface area on an interior or exterior type of component 
310.8 	with a small surface area.

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

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

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

311.1 	Sec. 14. Minnesota Statutes 2008, section 144.9508, subdivision 2, is amended to read:
311.2 		Subd. 2.Regulated lead work standards and methods. (a) The commissioner 
311.3 	shall adopt rules establishing regulated lead work standards and methods in accordance 
311.4 	with the provisions of this section, for lead in paint, dust, drinking water, and soil in 
311.5 	a manner that protects public health and the environment for all residences, including 
311.6 	residences also used for a commercial purpose, child care facilities, playgrounds, and 
311.7 	schools.
311.8 	(b) In the rules required by this section, the commissioner shall require lead hazard 
311.9 	reduction of intact paint only if the commissioner finds that the intact paint is on a 
311.10 	chewable or lead-dust producing surface that is a known source of actual lead exposure to 
311.11 	a specific individual. The commissioner shall prohibit methods that disperse lead dust into 
311.12 	the air that could accumulate to a level that would exceed the lead dust standard specified 
311.13 	under this section. The commissioner shall work cooperatively with the commissioner 
311.14 	of administration to determine which lead hazard reduction methods adopted under this 
311.15 	section may be used for lead-safe practices including prohibited practices, preparation, 
311.16 	disposal, and cleanup. The commissioner shall work cooperatively with the commissioner 
311.17 	of the Pollution Control Agency to develop disposal procedures. In adopting rules under 
311.18 	this section, the commissioner shall require the best available technology for regulated 
311.19 	lead work methods, paint stabilization, and repainting.
311.20 	(c) The commissioner of health shall adopt regulated lead work standards and 
311.21 	methods for lead in bare soil in a manner to protect public health and the environment. 
311.22 	The commissioner shall adopt a maximum standard of 100 parts of lead per million in 
311.23 	bare soil. The commissioner shall set a soil replacement standard not to exceed 25 parts 
311.24 	of lead per million. Soil lead hazard reduction methods shall focus on erosion control 
311.25 	and covering of bare soil.
311.26 	(d) The commissioner shall adopt regulated lead work standards and methods for 
311.27 	lead in dust in a manner to protect the public health and environment. Dust standards 
311.28 	shall use a weight of lead per area measure and include dust on the floor, on the window 
311.29 	sills, and on window wells. Lead hazard reduction methods for dust shall focus on dust 
311.30 	removal and other practices which minimize the formation of lead dust from paint, soil, or 
311.31 	other sources.
311.32 	(e) The commissioner shall adopt lead hazard reduction standards and methods for 
311.33 	lead in drinking water both at the tap and public water supply system or private well 
311.34 	in a manner to protect the public health and the environment. The commissioner may 
311.35 	adopt the rules for controlling lead in drinking water as contained in Code of Federal 
312.1 	Regulations, title 40, part 141. Drinking water lead hazard reduction methods may include 
312.2 	an educational approach of minimizing lead exposure from lead in drinking water.
312.3 	(f) The commissioner of the Pollution Control Agency shall adopt rules to ensure that 
312.4 	removal of exterior lead-based coatings from residences and steel structures by abrasive 
312.5 	blasting methods is conducted in a manner that protects health and the environment.
312.6 	(g) All regulated lead work standards shall provide reasonable margins of safety that 
312.7 	are consistent with more than a summary review of scientific evidence and an emphasis on 
312.8 	overprotection rather than underprotection when the scientific evidence is ambiguous.
312.9 	(h) No unit of local government shall have an ordinance or regulation governing 
312.10 	regulated lead work standards or methods for lead in paint, dust, drinking water, or soil 
312.11 	that require a different regulated lead work standard or method than the standards or 
312.12 	methods established under this section.
312.13 	(i) Notwithstanding paragraph (h), the commissioner may approve the use by a unit 
312.14 	of local government of an innovative lead hazard reduction method which is consistent 
312.15 	in approach with methods established under this section.
312.16 	(j) The commissioner shall adopt rules for issuing lead orders required under section 
312.17 	144.9504, rules for notification of abatement or interim control activities requirements, 
312.18 	and other rules necessary to implement sections 144.9501 to 144.9512. 
312.19 	(k) The commissioner shall adopt rules consistent with section 402(c)(3) of the 
312.20 	Toxic Substances Control Act to ensure that renovation in a pre-1978 affected property 
312.21 	where a child or pregnant female resides is conducted in a manner that protects health 
312.22 	and the environment.
312.23 	(l) The commissioner shall adopt rules consistent with sections 406(a) and 406(b) of 
312.24 	the Toxic Substances Control Act.

312.25 	Sec. 15. Minnesota Statutes 2008, section 144.9508, subdivision 3, is amended to read:
312.26 		Subd. 3.Licensure and certification. The commissioner shall adopt rules to 
312.27 	license lead supervisors, lead workers, lead project designers, lead inspectors, and lead 
312.28 	risk assessors, and lead sampling technicians. The commissioner shall also adopt rules 
312.29 	requiring certification of firms that perform regulated lead work and rules requiring 
312.30 	registration of lead sampling technicians. The commissioner shall require periodic renewal 
312.31 	of licenses, and certificates, and registrations and shall establish the renewal periods.

312.32 	Sec. 16. Minnesota Statutes 2008, section 144.9508, subdivision 4, is amended to read:
312.33 		Subd. 4.Lead training course. The commissioner shall establish by rule 
312.34 	requirements for training course providers and the renewal period for each lead-related 
313.1 	training course required for certification or licensure. The commissioner shall establish 
313.2 	criteria in rules for the content and presentation of training courses intended to qualify 
313.3 	trainees for licensure under subdivision 3. The commissioner shall establish criteria 
313.4 	in rules for the content and presentation of training courses for lead interim control 
313.5 	workers renovation and lead sampling technicians. Training course permit fees shall be 
313.6 	nonrefundable and must be submitted with each application in the amount of $500 for an 
313.7 	initial training course, $250 for renewal of a permit for an initial training course, $250 for 
313.8 	a refresher training course, and $125 for renewal of a permit of a refresher training course.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

314.26 	Sec. 25. Minnesota Statutes 2008, section 144.98, subdivision 2, is amended to read:
314.27 		Subd. 2.Rules and standards. The commissioner may adopt rules to implement 
314.28 	this section, including: carry out the commissioner's responsibilities under the national 
314.29 	standards specified in subdivisions 1 and 2a.
315.1 	(1) procedures, requirements, and fee adjustments for laboratory certification, 
315.2 	including provisional status and recertification;
315.3 	(2) standards and fees for certificate approval, suspension, and revocation;
315.4 	(3) standards for environmental samples;
315.5 	(4) analysis methods that assure reliable test results;
315.6 	(5) laboratory quality assurance, including internal quality control, proficiency 
315.7 	testing, and personnel training; and
315.8 	(6) criteria for recognition of certification programs of other states and the federal 
315.9 	government.

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

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

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

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

315.26	Test Category
	Certification Fee
	
315.27	Clean water program bacteriology
	$800
	
315.28	Safe drinking water program bacteriology
	$800
	
315.29	Clean water program inorganic chemistry
	$800
	
315.30	Safe drinking water program inorganic chemistry
	$800
	
315.31	Clean water program chemistry metals
	$1,200
	
315.32	Safe drinking water program chemistry metals
	$1,200
	
315.33	Resource conservation and recovery program chemistry metals
	$1,200
	
315.34	Clean water program volatile organic compounds
	$1,500
	
316.1	Safe drinking water program volatile organic compounds
	$1,500
	
316.2
316.3	Resource conservation and recovery program volatile organic 
compounds
	$1,500
	
316.4	Underground storage tank program volatile organic compounds
	$1,500
	
316.5	Clean water program other organic compounds
	$1,500
	
316.6	Safe drinking water program other organic compounds
	$1,500
	
316.7	Resource conservation and recovery program other organic compounds
	$1,500
	
316.8	Clean water program radiochemistry
	$2,500
	
316.9	Safe drinking water program radiochemistry
	$2,500
	
316.10	Resource conservation and recovery program agricultural contaminants
	$2,500
	
316.11	Resource conservation and recovery program emerging contaminants
	$2,500
	
316.12 	(b) Laboratories located outside of this state that require an on-site inspection shall be 
316.13 	assessed an additional $3,750 fee. For the programs in subdivision 3a, the commissioner 
316.14 	may accredit laboratories for fields of testing under the categories listed in clauses (1) to 
316.15 	(10) upon completion of the application requirements provided by subdivision 6 and 
316.16 	receipt of the fees for each category under each program that accreditation is requested. 
316.17 	The categories offered and related fees include:
316.18 	(1) microbiology, $450;
316.19 	(2) inorganics, $450;
316.20 	(3) metals, $1,000;
316.21 	(4) volatile organics, $1,300;
316.22 	(5) other organics, $1,300;
316.23 	(6) radiochemistry, $1,500;
316.24 	(7) emerging contaminants, $1,500;
316.25 	(8) agricultural contaminants, $1,250;
316.26 	(9) toxicity (bioassay), $1,000; and
316.27 	(10) physical characterization, $250.
316.28 	(c) The total biennial certification annual fee includes the base fee, the sample 
316.29 	preparation techniques fees, the test category fees per program, and, when applicable, the 
316.30 	on-site inspection fee an administrative fee for out-of-state laboratories.
316.31 	(d) Fees must be set so that the total fees support the laboratory certification program. 
316.32 	Direct costs of the certification service include program administration, inspections, the 
316.33 	agency's general support costs, and attorney general costs attributable to the fee function.
316.34 	(e) A change fee shall be assessed if a laboratory requests additional analytes 
316.35 	or methods at any time other than when applying for or renewing its certification. The 
316.36 	change fee is equal to the test category certification fee for the analyte.
316.37 	(f) A variance fee shall be assessed if a laboratory requests and is granted a variance 
316.38 	from a rule adopted under this section. The variance fee is $500 per variance.
317.1 	(g) Refunds or credits shall not be made for analytes or methods requested but 
317.2 	not approved.
317.3 	(h) Certification of a laboratory shall not be awarded until all fees are paid.

317.4 	Sec. 28. Minnesota Statutes 2008, section 144.98, is amended by adding a subdivision 
317.5 	to read:
317.6 		Subd. 3a.Available programs, categories, and analytes. (a) The commissioner 
317.7 	shall accredit laboratories that test samples under the following programs:
317.8 	(1) the clean water program, such as compliance monitoring under the federal Clean 
317.9 	Water Act, and ambient monitoring of surface and groundwater, or analysis of biological 
317.10 	tissue;
317.11 	(2) the safe drinking water program, including compliance monitoring under the 
317.12 	federal Safe Drinking Water Act, and the state requirements for monitoring private wells;
317.13 	(3) the resource conservation and recovery program, including federal and state 
317.14 	requirements for monitoring solid and hazardous wastes, biological tissue, leachates, and 
317.15 	groundwater monitoring wells not intended as drinking water sources;
317.16 	(4) the underground storage tank program; and
317.17 	(5) the clean air program, including air and emissions testing under the federal Clean 
317.18 	Air Act, and state and federal requirements for vapor intrusion monitoring.
317.19 	(b) The commissioner shall maintain and publish a list of analytes available for 
317.20 	accreditation. The list must be reviewed at least once every six months and the changes 
317.21 	published in the State Register and posted on the program's Web site. The commissioner 
317.22 	shall publish the notification of changes and review comments on the changes no less than 
317.23 	30 days from the date the list is published.

317.24 	Sec. 29. Minnesota Statutes 2008, section 144.98, is amended by adding a subdivision 
317.25 	to read:
317.26 		Subd. 3b.Additional fees. (a) Laboratories located outside of this state that require 
317.27 	an on-site assessment more frequent than once every two years must pay an additional 
317.28 	assessed fee of $3,000 per assessment for each additional on-site assessment conducted. 
317.29 	The laboratory must pay the fee within 15 business days of receiving the commissioner's 
317.30 	notification that an on-site assessment is required. The commissioner may conduct 
317.31 	additional on-site assessments to determine a laboratory's continued compliance with 
317.32 	the standards provided in subdivision 2a.
317.33 	(b) A late fee of $200 shall be added to the annual fee for accredited laboratories 
317.34 	submitting renewal applications to the commissioner after November 1.
318.1 	(c) A change fee shall be assessed if a laboratory requests additional fields of testing 
318.2 	at any time other than when initially applying for or renewing its accreditation. A change 
318.3 	fee does not apply for applications to add fields of testing for new analytes in response 
318.4 	to the published notice under subdivision 3a, paragraph (b), if the laboratory holds valid 
318.5 	accreditation for the changed test category and applies for additional analytes within the 
318.6 	same test category. The change fee is equal to the applicable test category fee for the 
318.7 	field of testing requested. An application that requests accreditation of multiple fields of 
318.8 	testing within a test category requires a single payment of the applicable test category fee 
318.9 	per application submitted.
318.10 	(d) A variance fee shall be assessed if a laboratory requests a variance from a 
318.11 	standard provided in subdivision 2a. The variance fee is $500 per variance.
318.12 	(e) The commissioner shall assess a fee for changes to laboratory information 
318.13 	regarding ownership, name, address, or personnel. Laboratories must submit changes 
318.14 	through the application process under subdivision 6. The information update fee is $250 
318.15 	per application.
318.16 	(f) Fees must be set so that the total fees support the laboratory accreditation 
318.17 	program. Direct costs of the accreditation service include program administration, 
318.18 	assessments, the agency's general support costs, and attorney general costs attributable 
318.19 	to the fee function.

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

318.25 	Sec. 31. Minnesota Statutes 2008, section 144.98, is amended by adding a subdivision 
318.26 	to read:
318.27 		Subd. 6.Application. (a) Laboratories seeking accreditation must apply on a form 
318.28 	provided by the commissioner, include the laboratory's procedures and quality manual, 
318.29 	and pay the applicable fees.
318.30 	(b) Laboratories may be fixed-base or mobile. The commissioner shall accredit 
318.31 	mobile laboratories individually and require a vehicle identification number, license 
318.32 	plate number, or other uniquely identifying information in addition to the application 
318.33 	requirements of paragraph (a).
319.1 	(c) Laboratories maintained on separate properties, even though operated under the 
319.2 	same management or ownership, must apply separately. Laboratories with more than one 
319.3 	building on the same or adjoining properties do not need to submit a separate application.
319.4 	(d) The commissioner may accredit laboratories located out-of-state. Accreditation 
319.5 	for out-of-state laboratories may be obtained directly from the commissioner following 
319.6 	the requirements in paragraph (a), or out-of-state laboratories may be accredited through 
319.7 	a reciprocal agreement if the laboratory:
319.8 	(1) is accredited by a NELAP-recognized accreditation body for those fields of 
319.9 	testing in which the laboratory requests accreditation from the commissioner;
319.10 	(2) submits an application and documentation according to this subdivision; and
319.11 	(3) submits a current copy of the laboratory's unexpired accreditation from a 
319.12 	NELAP-recognized accreditation body showing the fields of accreditation for which the 
319.13 	laboratory is currently accredited.
319.14 	(e) Under the conflict of interest determinations provided in section 43A.38, 
319.15 	subdivision 6, clause (a), the commissioner shall not accredit governmental laboratories 
319.16 	operated by agencies of the executive branch of the state. If accreditation is required, 
319.17 	laboratories operated by agencies of the executive branch of the state must apply for 
319.18 	accreditation through any other NELAP-recognized accreditation body.

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

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

319.26 	Sec. 33. Minnesota Statutes 2008, section 144.98, is amended by adding a subdivision 
319.27 	to read:
319.28 		Subd. 7.Initial accreditation and annual accreditation renewal. (a) The 
319.29 	commissioner shall issue or renew accreditation after receipt of the completed application 
319.30 	and documentation required in this section, provided the laboratory maintains compliance 
319.31 	with the standards specified in subdivision 2a, and attests to the compliance on the 
319.32 	application form.
319.33 	(b) The commissioner shall prorate the fees in subdivision 3 for laboratories 
319.34 	applying for accreditation after December 31. The fees are prorated on a quarterly basis 
320.1 	beginning with the quarter in which the commissioner receives the completed application 
320.2 	from the laboratory.
320.3 	(c) Applications for renewal of accreditation must be received by November 1 and 
320.4 	no earlier than October 1 of each year. The commissioner shall send annual renewal 
320.5 	notices to laboratories 90 days before expiration. Failure to receive a renewal notice does 
320.6 	not exempt laboratories from meeting the annual November 1 renewal date.
320.7 	(d) The commissioner shall issue all accreditations for the calendar year for which 
320.8 	the application is made, and the accreditation shall expire on December 31 of that year.
320.9 	(e) The accreditation of any laboratory that fails to submit a renewal application 
320.10 	and fees to the commissioner expires automatically on December 31 without notice or 
320.11 	further proceeding. Any person who operates a laboratory as accredited after expiration of 
320.12 	accreditation or without having submitted an application and paid the fees is in violation 
320.13 	of the provisions of this section and is subject to enforcement action under sections 
320.14 	144.989 to 144.993, the Health Enforcement Consolidation Act. A laboratory with expired 
320.15 	accreditation may reapply under subdivision 6.

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

320.17 	Sec. 34. Minnesota Statutes 2008, section 144.99, subdivision 1, is amended to read:
320.18 		Subdivision 1.Remedies available. The provisions of chapters 103I and 157 and 
320.19 	sections 115.71 to 115.77; 144.12, subdivision 1, paragraphs (1), (2), (5), (6), (10), (12), 
320.20 	(13), (14), and (15); 144.1201 to 144.1204; 144.121; 144.1222; 144.35; 144.381 to 
320.21 	144.385; 144.411 to 144.417; 144.495; 144.71 to 144.74; 144.9501 to 144.9512; 144.97 
320.22 	to 144.98;144.992; 326.70 to 326.785; 327.10 to 327.131; and 327.14 to 327.28 and 
320.23 	all rules, orders, stipulation agreements, settlements, compliance agreements, licenses, 
320.24 	registrations, certificates, and permits adopted or issued by the department or under any 
320.25 	other law now in force or later enacted for the preservation of public health may, in 
320.26 	addition to provisions in other statutes, be enforced under this section. 

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

320.28 	Sec. 35. Minnesota Statutes 2008, section 153A.17, is amended to read:
320.29 	153A.17 EXPENSES; FEES.
320.30 	The expenses for administering the certification requirements including the 
320.31 	complaint handling system for hearing aid dispensers in sections 153A.14 and 153A.15
320.32 	and the Consumer Information Center under section 153A.18 must be paid from 
320.33 	initial application and examination fees, renewal fees, penalties, and fines. All fees 
321.1 	are nonrefundable. The certificate application fee is $350, the examination fee is $250 
321.2 	for the written portion and $250 for the practical portion each time one or the other is 
321.3 	taken, and the trainee application fee is $200. The penalty fee for late submission of a 
321.4 	renewal application is $200. The fee for verification of certification to other jurisdictions 
321.5 	or entities is $25. All fees, penalties, and fines received must be deposited in the state 
321.6 	government special revenue fund. The commissioner may prorate the certification fee for 
321.7 	new applicants based on the number of quarters remaining in the annual certification 
321.8 	period.(a) The expenses for administering the certification requirements, including the 
321.9 	complaint handling system for hearing aid dispensers in sections 153A.14 and 153A.15, 
321.10 	and the Consumer Information Center under section 153A.18, must be paid from initial 
321.11 	application and examination fees, renewal fees, penalties, and fines. 
321.12 	 (b) The fees are as follows:
321.13 	(1) the initial and annual renewal certification application fee is $600;
321.14 	(2) the initial examination fee for the written portion is $500, and for each time it 
321.15 	is taken, thereafter;
321.16 	(3) the initial examination fee for the practical portion is $1,200, and $600 for each 
321.17 	time it is taken, thereafter; for individuals meeting the requirements of section 148.515, 
321.18 	subdivision 2, the fee for the practical portion of the hearing instrument dispensing 
321.19 	examination is $250 each time it is taken;
321.20 	(4) the trainee application fee is $200;
321.21 	(5) the penalty fee for late submission of a renewal application is $200; and 
321.22 	(6) the fee for verification of certification to other jurisdictions or entities is $25.
321.23 	(c) The commissioner may prorate the certification fee for new applicants based on 
321.24 	the number of quarters remaining in the annual certification period.
321.25 	(d) All fees are nonrefundable. All fees, penalties, and fines received must be 
321.26 	deposited in the state government special revenue fund.
321.27 	(e) Beginning July 1, 2009, until June 30, 2016, a surcharge of $100 shall be paid 
321.28 	at the time of initial certification application or renewal to recover the commissioner's 
321.29 	accumulated direct expenditures for administering the requirements of this chapter.

321.30 	Sec. 36. Minnesota Statutes 2008, section 157.15, is amended by adding a subdivision 
321.31 	to read:
321.32 		Subd. 20.Youth camp. "Youth camp" has the meaning given in section 144.71, 
321.33 	subdivision 2.

322.1 	Sec. 37. Minnesota Statutes 2008, section 157.16, is amended to read:
322.2 	157.16 LICENSES REQUIRED; FEES. 
322.3 		Subdivision 1. License required annually. A license is required annually for every 
322.4 	person, firm, or corporation engaged in the business of conducting a food and beverage 
322.5 	service establishment, youth camp, hotel, motel, lodging establishment, public pool, or 
322.6 	resort. Any person wishing to operate a place of business licensed in this section shall 
322.7 	first make application, pay the required fee specified in this section, and receive approval 
322.8 	for operation, including plan review approval. Seasonal and temporary food stands and
322.9 	Special event food stands are not required to submit plans. Nonprofit organizations 
322.10 	operating a special event food stand with multiple locations at an annual one-day event 
322.11 	shall be issued only one license. Application shall be made on forms provided by the 
322.12 	commissioner and shall require the applicant to state the full name and address of the 
322.13 	owner of the building, structure, or enclosure, the lessee and manager of the food and 
322.14 	beverage service establishment, hotel, motel, lodging establishment, public pool, or resort; 
322.15 	the name under which the business is to be conducted; and any other information as may 
322.16 	be required by the commissioner to complete the application for license. 
322.17 		Subd. 2. License renewal. Initial and renewal licenses for all food and beverage 
322.18 	service establishments, youth camps, hotels, motels, lodging establishments, public pools, 
322.19 	and resorts shall be issued for the calendar year for which application is made and shall 
322.20 	expire on December 31 of such year on an annual basis. Any person who operates a place 
322.21 	of business after the expiration date of a license or without having submitted an application 
322.22 	and paid the fee shall be deemed to have violated the provisions of this chapter and shall 
322.23 	be subject to enforcement action, as provided in the Health Enforcement Consolidation 
322.24 	Act, sections 144.989 to 144.993. In addition, a penalty of $50 $60 shall be added to the 
322.25 	total of the license fee for any food and beverage service establishment operating without 
322.26 	a license as a mobile food unit, a seasonal temporary or seasonal permanent food stand, or 
322.27 	a special event food stand, and a penalty of $100 $120 shall be added to the total of the 
322.28 	license fee for all restaurants, food carts, hotels, motels, lodging establishments, youth 
322.29 	camps, public pools, and resorts operating without a license for a period of up to 30 days. 
322.30 	A late fee of $300 $360 shall be added to the license fee for establishments operating more 
322.31 	than 30 days without a license. 
322.32 		Subd. 2a. Food manager certification. An applicant for certification or certification 
322.33 	renewal as a food manager must submit to the commissioner a $28 $35 nonrefundable 
322.34 	certification fee payable to the Department of Health. The commissioner shall issue a 
322.35 	duplicate certificate to replace a lost, destroyed, or mutilated certificate if the applicant 
323.1 	submits a completed application on a form provided by the commissioner for a duplicate 
323.2 	certificate and pays $20 to the department for the cost of duplication.
323.3 		Subd. 3. Establishment fees; definitions. (a) The following fees are required 
323.4 	for food and beverage service establishments, youth camps, hotels, motels, lodging 
323.5 	establishments, public pools, and resorts licensed under this chapter. Food and beverage 
323.6 	service establishments must pay the highest applicable fee under paragraph (d), clause 
323.7 	(1), (2), (3), or (4), and establishments serving alcohol must pay the highest applicable 
323.8 	fee under paragraph (d), clause (6) or (7). The license fee for new operators previously 
323.9 	licensed under this chapter for the same calendar year is one-half of the appropriate annual 
323.10 	license fee, plus any penalty that may be required. The license fee for operators opening 
323.11 	on or after October 1 is one-half of the appropriate annual license fee, plus any penalty 
323.12 	that may be required. 
323.13 	(b) All food and beverage service establishments, except special event food stands, 
323.14 	and all hotels, motels, lodging establishments, public pools, and resorts shall pay an 
323.15 	annual base fee of $150. 
323.16 	(c) A special event food stand shall pay a flat fee of $40 $50 annually. "Special event 
323.17 	food stand" means a fee category where food is prepared or served in conjunction with 
323.18 	celebrations, county fairs, or special events from a special event food stand as defined 
323.19 	in section 157.15. 
323.20 	(d) In addition to the base fee in paragraph (b), each food and beverage service 
323.21 	establishment, other than a special event food stand, and each hotel, motel, lodging 
323.22 	establishment, public pool, and resort shall pay an additional annual fee for each fee 
323.23 	category, additional food service, or required additional inspection specified in this 
323.24 	paragraph: 
323.25 	(1) Limited food menu selection, $50 $60. "Limited food menu selection" means a 
323.26 	fee category that provides one or more of the following: 
323.27 	(i) prepackaged food that receives heat treatment and is served in the package; 
323.28 	(ii) frozen pizza that is heated and served; 
323.29 	(iii) a continental breakfast such as rolls, coffee, juice, milk, and cold cereal; 
323.30 	(iv) soft drinks, coffee, or nonalcoholic beverages; or 
323.31 	(v) cleaning for eating, drinking, or cooking utensils, when the only food served 
323.32 	is prepared off site. 
323.33 	(2) Small establishment, including boarding establishments, $100 $120. "Small 
323.34 	establishment" means a fee category that has no salad bar and meets one or more of 
323.35 	the following: 
324.1 	(i) possesses food service equipment that consists of no more than a deep fat fryer, a 
324.2 	grill, two hot holding containers, and one or more microwave ovens; 
324.3 	(ii) serves dipped ice cream or soft serve frozen desserts; 
324.4 	(iii) serves breakfast in an owner-occupied bed and breakfast establishment; 
324.5 	(iv) is a boarding establishment; or 
324.6 	(v) meets the equipment criteria in clause (3), item (i) or (ii), and has a maximum 
324.7 	patron seating capacity of not more than 50. 
324.8 	(3) Medium establishment, $260 $310. "Medium establishment" means a fee 
324.9 	category that meets one or more of the following: 
324.10 	(i) possesses food service equipment that includes a range, oven, steam table, salad 
324.11 	bar, or salad preparation area; 
324.12 	(ii) possesses food service equipment that includes more than one deep fat fryer, 
324.13 	one grill, or two hot holding containers; or 
324.14 	(iii) is an establishment where food is prepared at one location and served at one or 
324.15 	more separate locations. 
324.16 	Establishments meeting criteria in clause (2), item (v), are not included in this fee 
324.17 	category. 
324.18 	(4) Large establishment, $460 $540. "Large establishment" means either: 
324.19 	(i) a fee category that (A) meets the criteria in clause (3), items (i) or (ii), for a 
324.20 	medium establishment, (B) seats more than 175 people, and (C) offers the full menu 
324.21 	selection an average of five or more days a week during the weeks of operation; or 
324.22 	(ii) a fee category that (A) meets the criteria in clause (3), item (iii), for a medium 
324.23 	establishment, and (B) prepares and serves 500 or more meals per day. 
324.24 	(5) Other food and beverage service, including food carts, mobile food units, 
324.25 	seasonal temporary food stands, and seasonal permanent food stands, $50 $60. 
324.26 	(6) Beer or wine table service, $50 $60. "Beer or wine table service" means a fee 
324.27 	category where the only alcoholic beverage service is beer or wine, served to customers 
324.28 	seated at tables. 
324.29 	(7) Alcoholic beverage service, other than beer or wine table service, $135 $165. 
324.30 	"Alcohol beverage service, other than beer or wine table service" means a fee 
324.31 	category where alcoholic mixed drinks are served or where beer or wine are served from 
324.32 	a bar. 
324.33 	(8) Lodging per sleeping accommodation unit, $8 $10, including hotels, motels, 
324.34 	lodging establishments, and resorts, up to a maximum of $800 $1,000. "Lodging per 
324.35 	sleeping accommodation unit" means a fee category including the number of guest rooms, 
325.1 	cottages, or other rental units of a hotel, motel, lodging establishment, or resort; or the 
325.2 	number of beds in a dormitory. 
325.3 	(9) First public pool, $180 $325; each additional public pool, $100 $175. "Public 
325.4 	pool" means a fee category that has the meaning given in section 144.1222, subdivision 4. 
325.5 	(10) First spa, $110 $175; each additional spa, $50 $100. "Spa pool" means a fee 
325.6 	category that has the meaning given in Minnesota Rules, part 4717.0250, subpart 9. 
325.7 	(11) Private sewer or water, $50 $60. "Individual private water" means a fee 
325.8 	category with a water supply other than a community public water supply as defined in 
325.9 	Minnesota Rules, chapter 4720. "Individual private sewer" means a fee category with an 
325.10 	individual sewage treatment system which uses subsurface treatment and disposal. 
325.11 	(12) Additional food service, $130 $150. "Additional food service" means a location 
325.12 	at a food service establishment, other than the primary food preparation and service area, 
325.13 	used to prepare or serve food to the public. 
325.14 	(13) Additional inspection fee, $300 $360. "Additional inspection fee" means a 
325.15 	fee to conduct the second inspection each year for elementary and secondary education 
325.16 	facility school lunch programs when required by the Richard B. Russell National School 
325.17 	Lunch Act. 
325.18 	(e) A fee of $350 for review of the construction plans must accompany the initial 
325.19 	license application for restaurants, hotels, motels, lodging establishments, or resorts with 
325.20 	five or more sleeping units., seasonal food stands, and mobile food units. The fee for 
325.21 	this construction plan review is as follows:

325.22	Service Area
	Type
	Fee
	
325.23	Food
	limited food menu
	$275
	
325.24		small establishment
	$400
	
325.25		medium establishment
	$450
	
325.26		large food establishment
	$500
	
325.27		additional food service
	$150
	
325.28	Transient food service
	food cart
	$250
	
325.29		seasonal permanent food stand
	$250
	
325.30		seasonal temporary food stand
	$250
	
325.31		mobile food unit
	$350
	
325.32	Alcohol
	beer or wine table service
	$150
	
325.33		alcohol service from bar
	$250
	
325.34	Lodging
	less than 25 rooms
	$375
	
325.35		25 to less than 100 rooms
	$400
	
325.36		100 rooms or more
	$500
	
325.37		less than five cabins
	$350
	
325.38		five to less than ten cabins
	$400
	
325.39		ten cabins or more
	$450
	
326.1 	(f) When existing food and beverage service establishments, hotels, motels, lodging 
326.2 	establishments, or resorts, seasonal food stands, and mobile food units are extensively 
326.3 	remodeled, a fee of $250 must be submitted with the remodeling plans. A fee of $250 
326.4 	must be submitted for new construction or remodeling for a restaurant with a limited food 
326.5 	menu selection, a seasonal permanent food stand, a mobile food unit, or a food cart, or for 
326.6 	a hotel, motel, resort, or lodging establishment addition of less than five sleeping units.
326.7 	The fee for this construction plan review is as follows:

326.8	Service Area
	Type
	Fee
	
326.9	Food
	limited food menu
	$250
	
326.10		small establishment
	$300
	
326.11		medium establishment
	$350
	
326.12		large food establishment
	$400
	
326.13		additional food service
	$150
	
326.14	Transient food service
	food cart
	$250
	
326.15		seasonal permanent food stand
	$250
	
326.16		seasonal temporary food stand
	$250
	
326.17		mobile food unit
	$250
	
326.18	Alcohol
	beer or wine table service
	$150
	
326.19		alcohol service from bar
	$250
	
326.20	Lodging
	less than 25 rooms
	$250
	
326.21		25 to less than 100 rooms
	$300
	
326.22		100 rooms or more
	$450
	
326.23		less than five cabins
	$250
	
326.24		five to less than ten cabins
	$350
	
326.25		ten cabins or more
	$400
	
326.26 	(g) Seasonal temporary food stands and Special event food stands are not required to 
326.27 	submit construction or remodeling plans for review. 
326.28 	(h) Youth camps shall pay an annual single fee for food and lodging as follows:
326.29 	(1) camps with up to 99 campers, $325;
326.30 	(2) camps with 100 to 199 campers, $550; and
326.31 	(3) camps with 200 or more campers; $750.
326.32 		Subd. 3a. Statewide hospitality fee. Every person, firm, or corporation that 
326.33 	operates a licensed boarding establishment, food and beverage service establishment, 
326.34 	seasonal temporary or permanent food stand, special event food stand, mobile food unit, 
326.35 	food cart, resort, hotel, motel, or lodging establishment in Minnesota must submit to the 
326.36 	commissioner a $35 annual statewide hospitality fee for each licensed activity. The fee 
326.37 	for establishments licensed by the Department of Health is required at the same time the 
326.38 	licensure fee is due. For establishments licensed by local governments, the fee is due by 
326.39 	July 1 of each year. 
327.1 		Subd. 4. Posting requirements. Every food and beverage service establishment,
327.2 	for-profit youth camp, hotel, motel, lodging establishment, public pool, or resort must have 
327.3 	the license posted in a conspicuous place at the establishment. Mobile food units, food 
327.4 	carts, and seasonal temporary food stands shall be issued decals with the initial license and 
327.5 	each calendar year with license renewals. The current license year decal must be placed on 
327.6 	the unit or stand in a location determined by the commissioner. Decals are not transferable.

327.7 	Sec. 38. Minnesota Statutes 2008, section 157.22, is amended to read:
327.8 	157.22 EXEMPTIONS.
327.9 	This chapter shall not be construed to does not apply to:
327.10 	(1) interstate carriers under the supervision of the United States Department of 
327.11 	Health and Human Services;
327.12 	(2) any building constructed and primarily used for religious worship;
327.13 	(3) any building owned, operated, and used by a college or university in accordance 
327.14 	with health regulations promulgated by the college or university under chapter 14;
327.15 	(4) any person, firm, or corporation whose principal mode of business is licensed 
327.16 	under sections 28A.04 and 28A.05, is exempt at that premises from licensure as a food 
327.17 	or beverage establishment; provided that the holding of any license pursuant to sections 
327.18 	28A.04 and 28A.05 shall not exempt any person, firm, or corporation from the applicable 
327.19 	provisions of this chapter or the rules of the state commissioner of health relating to 
327.20 	food and beverage service establishments;
327.21 	(5) family day care homes and group family day care homes governed by sections 
327.22 	245A.01 to 245A.16;
327.23 	(6) nonprofit senior citizen centers for the sale of home-baked goods;
327.24 	(7) fraternal or patriotic organizations that are tax exempt under section 501(c)(3), 
327.25 	501(c)(4), 501(c)(6), 501(c)(7), 501(c)(10), or 501(c)(19) of the Internal Revenue Code of 
327.26 	1986, or organizations related to or affiliated with such fraternal or patriotic organizations. 
327.27 	Such organizations may organize events at which home-prepared food is donated by 
327.28 	organization members for sale at the events, provided:
327.29 	(i) the event is not a circus, carnival, or fair;
327.30 	(ii) the organization controls the admission of persons to the event, the event agenda, 
327.31 	or both; and
327.32 	(iii) the organization's licensed kitchen is not used in any manner for the event;
327.33 	(8) food not prepared at an establishment and brought in by individuals attending a 
327.34 	potluck event for consumption at the potluck event. An organization sponsoring a potluck 
327.35 	event under this clause may advertise the potluck event to the public through any means. 
328.1 	Individuals who are not members of an organization sponsoring a potluck event under this 
328.2 	clause may attend the potluck event and consume the food at the event. Licensed food 
328.3 	establishments other than schools cannot be sponsors of potluck events. A school may 
328.4 	sponsor and hold potluck events in areas of the school other than the school's kitchen, 
328.5 	provided that the school's kitchen is not used in any manner for the potluck event. For 
328.6 	purposes of this clause, "school" means a public school as defined in section 120A.05, 
328.7 	subdivisions 9, 11, 13, and 17, or a nonpublic school, church, or religious organization 
328.8 	at which a child is provided with instruction in compliance with sections 120A.22 and 
328.9 	120A.24. Potluck event food shall not be brought into a licensed food establishment 
328.10 	kitchen; and
328.11 	(9) a home school in which a child is provided instruction at home; and
328.12 	(10) concession stands operated in conjunction with school-sponsored events on 
328.13 	school property are exempt from the 21-day restriction.

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

328.19 	Sec. 40. Minnesota Statutes 2008, section 327.15, is amended to read:
328.20 	327.15 LICENSE REQUIRED; RENEWAL; PLANS FOR EXPANSION FEES.
328.21 		Subdivision 1.License required; plan review.  No person, firm or corporation shall 
328.22 	establish, maintain, conduct or operate a manufactured home park or recreational camping 
328.23 	area within this state without first obtaining a an annual license therefor from the state 
328.24 	Department of Health. Any person wishing to obtain a license shall submit an application, 
328.25 	pay the required fee specified in this section, and receive approval for operation, including 
328.26 	plan review approval. Application shall be made on forms provided by the commissioner 
328.27 	and shall require the applicant to state the full name and address of the owner of the 
328.28 	manufactured home park or recreational camping area, the name under which the business 
328.29 	is to be conducted, and any other information as may be required by the commissioner 
328.30 	to complete the application for license. Any person, firm, or corporation desiring to 
328.31 	operate either a manufactured home park or a recreational camping area on the same site 
328.32 	in connection with the other, need only obtain one license. A license shall expire and be 
328.33 	renewed as prescribed by the commissioner pursuant to section 144.122. The license shall 
328.34 	state the number of manufactured home sites and recreational camping sites allowed 
329.1 	according to state commissioner of health approval. No renewal license shall be issued if 
329.2 	the number of sites specified in the application exceeds those of the original application
329.3 	The number of licensed sites shall not be increased unless the plans for expansion or 
329.4 	the construction for expansion are first submitted and the expansion is approved by 
329.5 	the Department of Health. Any manufactured home park or recreational camping area 
329.6 	located in more than one municipality shall be dealt with as two separate manufactured 
329.7 	home parks or camping areas. The license shall be conspicuously displayed in the office 
329.8 	of the manufactured home park or camping area. The license is not transferable as toto 
329.9 	another person or  place. 
329.10 		Subd. 2.License renewal. Initial and renewal licenses for all manufactured home 
329.11 	parks and recreational camping areas shall be issued annually and shall have an expiration 
329.12 	date included on the license. Any person who operates a manufactured home park or 
329.13 	recreational camping area after the expiration date of a license or without having submitted 
329.14 	an application and paid the fee shall be deemed to have violated the provisions of this 
329.15 	chapter and shall be subject to enforcement action, as provided in the Health Enforcement 
329.16 	Consolidation Act, sections 144.989 to 144.993. In addition, a penalty of $120 shall 
329.17 	be added to the total of the license fee for any manufactured home park or recreational 
329.18 	camping area operating without a license for a period of up to 30 days. A late fee of $360 
329.19 	shall be added to the license fee for any manufactured home park or recreational camping 
329.20 	area operating more than 30 days without a license.
329.21 		Subd. 3.Fees, manufactured home parks and recreational camping areas. (a) 
329.22 	The following fees are required for manufactured home parks and recreational camping 
329.23 	areas licensed under this chapter. Recreational camping areas and manufactured home 
329.24 	parks shall pay the highest applicable fee under paragraph (c). The license fee for new 
329.25 	operators of a manufactured home park or recreational camping area previously licensed 
329.26 	under this chapter for the same calendar year is one-half of the appropriate annual license 
329.27 	fee, plus any penalty that may be required. The license fee for operators opening on 
329.28 	or after October 1 is one-half of the appropriate annual license fee, plus any penalty 
329.29 	that may be required.
329.30 	(b) All manufactured home parks and recreational camping areas shall pay the 
329.31 	following annual base fee:
329.32 	(1) a manufactured home park, $150; and
329.33 	(2) a recreational camping area with:
329.34 	(i) 24 or less sites, $50;
329.35 	(ii) 25-99 sites, $212; and
329.36 	(iii) 100 or more sites, $300.
330.1 	In addition to the base fee, manufactured home parks and recreational camping areas shall 
330.2 	pay $4 for each licensed site. This paragraph does not apply to special event recreational 
330.3 	camping areas or to operators of a manufactured home park or a recreational camping area 
330.4 	licensed under section 157.16 for the same location.
330.5 	(c) In addition to the fee in paragraph (b), each manufactured home park or 
330.6 	recreational camping area shall pay an additional annual fee for each fee category 
330.7 	specified in this paragraph:
330.8 	(1) Manufactured home parks and recreational camping areas with public swimming 
330.9 	pools and spas shall pay the appropriate fees specified in section 157.16.
330.10 	(2) Individual private sewer or water, $60. "Individual private water" means a fee 
330.11 	category with a water supply other than a community public water supply as defined in 
330.12 	Minnesota Rules, chapter 4720. "Individual private sewer" means a fee category with an 
330.13 	individual sewage treatment system which uses subsurface treatment and disposal.
330.14 	(d) The following fees must accompany a plan review application for initial 
330.15 	construction of a manufactured home park or recreational camping area:
330.16 	(1) for initial construction of less than 25 sites, $375;
330.17 	(2) for initial construction of 25 to less than 100 sites, $400; and
330.18 	(3) for initial construction of 100 or more sites, $500.
330.19 	(e) The following fees must accompany a plan review application when an existing 
330.20 	manufactured home park or recreational camping area is expanded:
330.21 	(1) for expansion of less than 25 sites, $250;
330.22 	(2) for expansion of 25 and less than 100 sites, $300; and
330.23 	(3) for expansion of 100 or more sites, $450.
330.24 		Subd. 4.Fees, special event recreational camping areas. (a) The following fees 
330.25 	are required for special event recreational camping areas licensed under this chapter.
330.26 	(b) All special event recreational camping areas shall pay an annual fee of $150 plus 
330.27 	$1 for each licensed site.
330.28 	(c) A special event recreational camping area shall pay a late fee of $360 for failing 
330.29 	to obtain a license prior to operating.
330.30 	(d) The following fees must accompany a plan review application for initial 
330.31 	construction of a special event recreational camping area:
330.32 	(1) for initial construction of less than 25 special event recreational camping sites, 
330.33 	$375;
330.34 	(2) for initial construction of 25 to less than 100 sites, $400; and
330.35 	(3) for initial construction of 100 or more sites, $500.
331.1 	(e) The following fees must accompany a plan review application for expansion of a 
331.2 	special event recreational camping area:
331.3 	(1) for expansion of less than 25 sites, $250;
331.4 	(2) for expansion of 25 and less than 100 sites, $300; and
331.5 	(3) for expansion of 100 or more sites, $450.

331.6 	Sec. 41. Minnesota Statutes 2008, section 327.16, is amended to read:
331.7 	327.16 LICENSE PLAN REVIEW APPLICATION.
331.8 		Subdivision 1.Made to state Department of Health. The plan review application 
331.9 	for license to operate and maintain a manufactured home park or recreational camping 
331.10 	area shall be made to the state Department of Health, at such office and in such manner 
331.11 	as may be prescribed by that department.
331.12 		Subd. 2.Contents. The applicant for a primary license or annual license shall make 
331.13 	application in writing plan review application shall be made upon a form provided by the 
331.14 	state Department of Health setting forth:
331.15 	(1) The full name and address of the applicant or applicants, or names and addresses 
331.16 	of the partners if the applicant is a partnership, or the names and addresses of the officers 
331.17 	if the applicant is a corporation.
331.18 	(2) A legal description of the site, lot, field, or tract of land upon which the applicant 
331.19 	proposes to operate and maintain a manufactured home park or recreational camping area.
331.20 	(3) The proposed and existing facilities on and about the site, lot, field, or tract of 
331.21 	land for the proposed construction or alteration and maintaining of a sanitary community 
331.22 	building for toilets, urinals, sinks, wash basins, slop-sinks, showers, drains, laundry 
331.23 	facilities, source of water supply, sewage, garbage and waste disposal; except that no 
331.24 	toilet facilities shall be required in any manufactured home park which permits only 
331.25 	manufactured homes equipped with toilet facilities discharging to water carried sewage 
331.26 	disposal systems; and method of fire and storm protection.
331.27 	(4) The proposed method of lighting the structures and site, lot, field, or tract of land 
331.28 	upon which the manufactured home park or recreational camping area is to be located.
331.29 	(5) The calendar months of the year which the applicant will operate the 
331.30 	manufactured home park or recreational camping area.
331.31 	(6) Plans and drawings for new construction or alteration, including buildings, wells, 
331.32 	plumbing and sewage disposal systems.
331.33 		Subd. 3.Fees; Approval. The application for the primary license plan review shall 
331.34 	be submitted with all plans and specifications enumerated in subdivision 2, and payment 
331.35 	of a fee in an amount prescribed by the state commissioner of health pursuant to section 
332.1 	144.122 and shall be accompanied by an approved zoning permit from the municipality or 
332.2 	county wherein the park is to be located, or a statement from the municipality or county 
332.3 	that it does not require an approved zoning permit. The fee for the annual license shall be 
332.4 	in an amount prescribed by the state commissioner of health pursuant to section 144.122. 
332.5 	All license fees paid to the commissioner of health shall be turned over to the state 
332.6 	treasury. The fee submitted for the primary license plan review shall be retained by the 
332.7 	state even though the proposed project is not approved and a license is denied. 
332.8 	When construction has been completed in accordance with approved plans and 
332.9 	specifications the state commissioner of health shall promptly cause the manufactured 
332.10 	home park or recreational camping area and appurtenances thereto to be inspected. When 
332.11 	the inspection and report has been made and the state commissioner of health finds that 
332.12 	all requirements of sections 327.10, 327.11, 327.14 to 327.28, and such conditions of 
332.13 	health and safety as the state commissioner of health may require, have been met by 
332.14 	the applicant, the state commissioner of health shall forthwith issue the primary license 
332.15 	in the name of the state. 
332.16 		Subd. 4.Sanitary facilities Compliance with current state law. During the 
332.17 	pendency of the application for such primary license any change in the sanitary or safety 
332.18 	facilities of the intended manufactured home park or recreational camping area shall be 
332.19 	immediately reported in writing to the state Department of Health through the office 
332.20 	through which the application was made. If no objection is made by the state Department 
332.21 	of Health to such change in such sanitary or safety facilities within 60 days of the date 
332.22 	such change is reported, it shall be deemed to have the approval of the state Department of 
332.23 	Health. Any manufactured home park or recreational camping area must be constructed 
332.24 	and operated according to all applicable state electrical, fire, plumbing, and building codes.
332.25 		Subd. 5.Permit. When the plans and specifications have been approved, the state 
332.26 	Department of Health shall issue an approval report permitting the applicant to construct 
332.27 	or make alterations upon a manufactured home park or recreational camping area and the 
332.28 	appurtenances thereto according to the plans and specifications presented.
332.29 	Such approval does not relieve the applicant from securing building permits in 
332.30 	municipalities that require permits or from complying with any other municipal ordinance 
332.31 	or ordinances, applicable thereto, not in conflict with this statute.
332.32 		Subd. 6.Denial of construction. If the application to construct or make alterations 
332.33 	upon a manufactured home park or recreational camping area and the appurtenances 
332.34 	thereto or a primary license to operate and maintain the same is denied by the state 
332.35 	commissioner of health, the commissioner shall so state in writing giving the reason 
332.36 	or reasons for denying the application. If the objections can be corrected the applicant 
333.1 	may amend the application and resubmit it for approval, and if denied the applicant may 
333.2 	appeal from the decision of the state commissioner of health as provided in section 
333.3 	144.99, subdivision 10. 

333.4 	Sec. 42. Minnesota Statutes 2008, section 327.20, subdivision 1, is amended to read:
333.5 		Subdivision 1.Rules. No domestic animals or house pets of occupants of 
333.6 	manufactured home parks or recreational camping areas shall be allowed to run at large, 
333.7 	or commit any nuisances within the limits of a manufactured home park or recreational 
333.8 	camping area. Each manufactured home park or recreational camping area licensed under 
333.9 	the provisions of sections 327.10, 327.11, and327.14 to 327.28 shall, among other things, 
333.10 	provide for the following, in the manner hereinafter specified: 
333.11 	(1) A responsible attendant or caretaker shall be in charge of every manufactured 
333.12 	home park or recreational camping area at all times, who shall maintain the park or 
333.13 	area, and its facilities and equipment in a clean, orderly and sanitary condition. In any 
333.14 	manufactured home park containing more than 50 lots, the attendant, caretaker, or other 
333.15 	responsible park employee, shall be readily available at all times in case of emergency.
333.16 	(2) All manufactured home parks shall be well drained and be located so that the 
333.17 	drainage of the park area will not endanger any water supply. No wastewater from 
333.18 	manufactured homes or recreational camping vehicles shall be deposited on the surface of 
333.19 	the ground. All sewage and other water carried wastes shall be discharged into a municipal 
333.20 	sewage system whenever available. When a municipal sewage system is not available, a 
333.21 	sewage disposal system acceptable to the state commissioner of health shall be provided.
333.22 	(3) No manufactured home shall be located closer than three feet to the side lot lines 
333.23 	of a manufactured home park, if the abutting property is improved property, or closer than 
333.24 	ten feet to a public street or alley. Each individual site shall abut or face on a driveway 
333.25 	or clear unoccupied space of not less than 16 feet in width, which space shall have 
333.26 	unobstructed access to a public highway or alley. There shall be an open space of at least 
333.27 	ten feet between the sides of adjacent manufactured homes including their attachments 
333.28 	and at least three feet between manufactured homes when parked end to end. The space 
333.29 	between manufactured homes may be used for the parking of motor vehicles and other 
333.30 	property, if the vehicle or other property is parked at least ten feet from the nearest 
333.31 	adjacent manufactured home position. The requirements of this paragraph shall not apply 
333.32 	to recreational camping areas and variances may be granted by the state commissioner 
333.33 	of health in manufactured home parks when the variance is applied for in writing and in 
333.34 	the opinion of the commissioner the variance will not endanger the health, safety, and 
333.35 	welfare of manufactured home park occupants.
334.1 	(4) An adequate supply of water of safe, sanitary quality shall be furnished at each 
334.2 	manufactured home park or recreational camping area. The source of the water supply 
334.3 	shall first be approved by the state Department of Health.
334.4 	(5) All plumbing shall be installed in accordance with the rules of the state 
334.5 	commissioner of labor and industry and the provisions of the Minnesota Plumbing Code.
334.6 	(6) In the case of a manufactured home park with less than ten manufactured homes, 
334.7 	a plan for the sheltering or the safe evacuation to a safe place of shelter of the residents of 
334.8 	the park in times of severe weather conditions, such as tornadoes, high winds, and floods. 
334.9 	The shelter or evacuation plan shall be developed with the assistance and approval of 
334.10 	the municipality where the park is located and shall be posted at conspicuous locations 
334.11 	throughout the park. The park owner shall provide each resident with a copy of the 
334.12 	approved shelter or evacuation plan, as provided by section 327C.01, subdivision 1c. 
334.13 	Nothing in this paragraph requires the Department of Health to review or approve any 
334.14 	shelter or evacuation plan developed by a park. Failure of a municipality to approve a plan 
334.15 	submitted by a park shall not be grounds for action against the park by the Department of 
334.16 	Health if the park has made a good faith effort to develop the plan and obtain municipal 
334.17 	approval. 
334.18 	(7) A manufactured home park with ten or more manufactured homes, licensed prior 
334.19 	to March 1, 1988, shall provide a safe place of shelter for park residents or a plan for the 
334.20 	evacuation of park residents to a safe place of shelter within a reasonable distance of the 
334.21 	park for use by park residents in times of severe weather, including tornadoes and high 
334.22 	winds. The shelter or evacuation plan must be approved by the municipality by March 1, 
334.23 	1989. The municipality may require the park owner to construct a shelter if it determines 
334.24 	that a safe place of shelter is not available within a reasonable distance from the park. A 
334.25 	copy of the municipal approval and the plan shall be submitted by the park owner to the 
334.26 	Department of Health. The park owner shall provide each resident with a copy of the 
334.27 	approved shelter or evacuation plan, as provided by section 327C.01, subdivision 1c. 
334.28 	(8) A manufactured home park with ten or more manufactured homes, receiving 
334.29 	a primary an initial license after March 1, 1988, must provide the type of shelter required 
334.30 	by section 327.205, except that for manufactured home parks established as temporary, 
334.31 	emergency housing in a disaster area declared by the President of the United States or 
334.32 	the governor, an approved evacuation plan may be provided in lieu of a shelter for a 
334.33 	period not exceeding 18 months. 
334.34 	(9) For the purposes of this subdivision, "park owner" and "resident" have the 
334.35 	meaning meanings given them in section 327C.01. 

335.1 	Sec. 43. Minnesota Statutes 2008, section 327.20, is amended by adding a subdivision 
335.2 	to read:
335.3 		Subd. 4.Special event recreational camping areas. Each special event camping 
335.4 	area licensed under sections 327.10, 327.11, and 327.14 to 327.28 is subject to this section.
335.5 	(1) Recreational camping vehicles and tents, including attachments, must be 
335.6 	separated from each other and other structures by at least seven feet.
335.7 	(2) A minimum area of 300 square feet per site must be provided and the total 
335.8 	number of sites must not exceed one site for every 300 square feet of usable land area.
335.9 	(3) Each site must abut or face a driveway or clear unoccupied space of at least 16 
335.10 	feet in width, which space must have unobstructed access to a public roadway.
335.11 	(4) If no approved on-site water supply system is available, hauled water may be 
335.12 	used, provided that persons using hauled water comply with Minnesota Rules, parts 
335.13 	4720.4000 to 4720.4600.
335.14 	(5) Nonburied sewer lines may be permitted provided they are of approved materials, 
335.15 	watertight, and properly maintained.
335.16 	(6) If a sanitary dumping station is not provided on-site, arrangements must be 
335.17 	made with a licensed sewage pumper to service recreational camping vehicle holding 
335.18 	tanks as needed.
335.19 	(7) Toilet facilities must be provided consisting of toilets connected to an approved 
335.20 	sewage disposal system, portable toilets, or approved, properly constructed privies.
335.21 	(8) Toilets must be provided in the ratio of one toilet for each sex for each 150 sites.
335.22 	(9) Toilets must be not more than 400 feet from any site.
335.23 	(10) If a central building or buildings are provided with running water, then toilets 
335.24 	and handwashing lavatories must be provided in the building or buildings that meet the 
335.25 	requirements of this subdivision.
335.26 	(11) Showers, if provided, must be provided in the ratio of one shower for each sex 
335.27 	for each 250 sites. Showerheads must be provided, where running water is available, for 
335.28 	each camping event exceeding two nights.
335.29 	(12) Central toilet and shower buildings, if provided, must be constructed with 
335.30 	adequate heating, ventilation, and lighting, and floors of impervious material sloped 
335.31 	to drain. Walls must be of a washable material. Permanent facilities must meet the 
335.32 	requirements of the Americans with Disabilities Act.
335.33 	(13) An adequate number of durable, covered, watertight containers must be 
335.34 	provided for all garbage and refuse. Garbage and refuse must be collected as often as 
335.35 	necessary to prevent nuisance conditions.
336.1 	(14) Campgrounds must be located in areas free of poison ivy or other noxious 
336.2 	weeds considered detrimental to health. Sites must not be located in areas of tall grass or 
336.3 	weeds and sites must be adequately drained.
336.4 	(15) Campsites for recreational vehicles may not be located on inclines of greater 
336.5 	than eight percent grade or one inch drop per lineal foot.
336.6 	(16) A responsible attendant or caretaker must be available on-site at all times during 
336.7 	the operation of any special event recreational camping area that has 50 or more sites.

336.8 	Sec. 44. MINNESOTA COLORECTAL CANCER PREVENTION 
336.9 	DEMONSTRATION PROJECT.
 336.10 		Subdivision 1.Establishment. The commissioner of health shall award grants 
336.11 	to Hennepin County Medical Center and MeritCare Bemidji for a colorectal screening 
336.12 	demonstration project to provide screening to uninsured and underinsured women and 
336.13 	men. The project shall expire December 31, 2010.
336.14 		Subd. 2.Eligibility. To be eligible for colorectal screening under this demonstration 
336.15 	project, an applicant must:
336.16 	(1) be at least 50 years of age, or under the age of 50 and at high risk for colon cancer;
336.17 	(2) be uninsured, or if insured, have coverage that does not cover the full cost of 
336.18 	colorectal cancer screenings;
336.19 	(3) not be eligible for medical assistance, general assistance medical care, or 
336.20 	MinnesotaCare programs; and
336.21 	(4) have a gross family income at or below 250 percent of the federal poverty level.
336.22 		Subd. 3.Services. Services provided under this project shall include:
336.23 	(1) colorectal cancer screening, according to standard practices of medicine, or 
336.24 	guidelines provided by the Institute for Clinical Systems Improvement or the American 
336.25 	Cancer Society;
336.26 	(2) follow-up services for abnormal tests; and
336.27 	(3) diagnostic services to determine the extent and proper course of treatment.
336.28 		Subd. 4.Project evaluation. The commissioner of health shall evaluate the 
336.29 	demonstration project and make recommendations for increasing the number of persons in 
336.30 	Minnesota who receive recommended colon cancer screening. The commissioner of health 
336.31 	shall submit the evaluation and recommendations to the legislature by January 15, 2011.

336.32 	Sec. 45. RESEARCH OF EXPOSURE PATHWAYS FOR 
336.33 	PERFLUOROCHEMICALS.
 337.1 	The commissioner of health shall study and report to the legislature by January 
337.2 	15, 2011, on the exposure pathways for perfluorochemicals, focusing on food sources 
337.3 	that might be affected by contact with contaminated water or air. This research will be 
337.4 	performed to the extent that nonstate funds and environmental health tracking funds are 
337.5 	available and include garden vegetables produced or consumed by a representative sample 
337.6 	of the population from the east metropolitan area including indigenous people and people 
337.7 	of color. In developing and performing the research, the commissioner must convene and 
337.8 	consult with a citizen advisory group consisting of residents from the east metropolitan 
337.9 	area, including indigenous people and people of color.

337.10 	Sec. 46. FEASIBILITY PILOT PROJECT FOR CANCER SURVEILLANCE.
 337.11 	The commissioner of health must provide a grant to the Hennepin County Medical 
337.12 	Center for a one-year feasibility pilot project to collect occupational, residential, and 
337.13 	military service history data from newly diagnosed cancer patients at the Hennepin 
337.14 	County Medical Center's Cancer Center. Funding for this grant shall come from the 
337.15 	Department of Health's current resources for the Chronic Disease and Environmental 
337.16 	Epidemiology Section.
337.17 	Under this pilot project, Hennepin County Medical Center will design an expansion 
337.18 	of its existing cancer registry to include the collection of additional data, including the 
337.19 	cancer patient's occupational, residential, and military service history. Patient consent is 
337.20 	required for collection of these additional data. The consent must be in writing and must 
337.21 	contain notice informing the patient about private and confidential data concerning the 
337.22 	patient pursuant to Minnesota Statutes, section 13.04, subdivision 2. The patient is entitled 
337.23 	to opt out of the project at any time. The data collection expansion may also include the 
337.24 	cancer patient's possible toxic environmental exposure history, if known. The purpose of 
337.25 	this pilot project is to determine the following:
337.26 	(1) the feasibility of collecting these data on a statewide scale; 
337.27 	(2) the potential design of a self-administered patient questionnaire template; and 
337.28 	(3) necessary qualifications for staff who will collect these data. 
337.29 	Hennepin County Medical Center must report the results of this pilot project to the 
337.30 	legislature by October 1, 2010.

337.31 	Sec. 47. SMOKING CESSATION.
 337.32 	The commissioner of health must prioritize smoking prevention and smoking 
337.33 	cessation activities in low-income, indigenous, and minority communities in their 
338.1 	collaborations with the organization specifically described in Minnesota Statutes, section 
338.2 	144.396, subdivision 8.

338.3 	Sec. 48. MEDICAL RESPONSE UNIT REIMBURSEMENT PILOT PROGRAM.
 338.4 	(a) The Department of Public Safety or its contract designee shall collaborate 
338.5 	with the Minnesota Ambulance Association to create the parameters of the medical 
338.6 	response unit reimbursement pilot program, including determining criteria for baseline 
338.7 	data reporting.
338.8 	(b) In conducting the pilot program, the Department of Public Safety must consult 
338.9 	with the Minnesota Ambulance Association, Minnesota Fire Chiefs Association, 
338.10 	Emergency Services Regulatory Board, and the Minnesota Council of Health Plans to:
338.11 	(1) identify no more than five medical response units registered as medical response 
338.12 	units with the Minnesota Emergency Medical Services Regulatory Board according to 
338.13 	Minnesota Statutes, chapter 144E, to participate in the program;
338.14 	(2) outline and develop criteria for reimbursement;
338.15 	(3) determine the amount of reimbursement for each unit response; and
338.16 	(4) collect program data to be analyzed for a final report.
338.17 	(c) Further criteria for the medical response unit reimbursement pilot program 
338.18 	shall include:
338.19 	(1) the pilot program will expire on December 31, 2010, or when the appropriation 
338.20 	is extended, whichever occurs first;
338.21 	(2) a report shall be made to the legislature by March 1, 2011, by the Department 
338.22 	of Public Safety or its contractor as to the effectiveness and value of this reimbursement 
338.23 	pilot program to the emergency medical services delivery system, any actual or potential 
338.24 	savings to the health care system, and impact on patient outcomes;
338.25 	(3) participating medical response units must adhere to the requirements of this 
338.26 	pilot program outlined in an agreement between the Department of Public Safety and 
338.27 	the medical response unit, including but not limited to, requirements relating to data 
338.28 	collection, response criteria, and patient outcomes and disposition;
338.29 	(4) individual entities licensed to provide ambulance care under Minnesota Statutes, 
338.30 	chapter 144E, are not eligible for participation in this pilot program;
338.31 	(5) if a participating medical response unit withdraws from the pilot program, the 
338.32 	Department of Public Safety in consultation with the Minnesota Ambulance Association 
338.33 	may choose another pilot site if funding is available;
339.1 	(6) medical response units must coordinate their operations under this pilot project 
339.2 	with the ambulance service or services licensed to provide care in their first response 
339.3 	geographic areas;
339.4 	(7) licensed ambulance services that participate with the medical response unit in 
339.5 	the pilot program assume no financial or legal liability for the actions of the participating 
339.6 	medical response unit; and
339.7 	(8) the Department of Public Safety and its pilot program partners have no ongoing 
339.8 	responsibility to reimburse medical response units beyond the parameters of the pilot 
339.9 	program.

339.10 	Sec. 49. REVIEW OF PROPOSED REGULATIONS FOR BODY ART 
339.11 	TECHNICIANS AND BODY ART ESTABLISHMENTS.
 339.12 	The commissioner of health shall review proposed regulatory legislation for 
339.13 	body art technicians and body art establishments and develop recommendations on the 
339.14 	proper level of regulation needed for body art technicians and establishments in order 
339.15 	to protect public health. The recommendations must include a review of how other 
339.16 	states comply with the American Association of Blood Banks standards, how regulatory 
339.17 	requirements affect currently operating body art establishments, and the appropriate level 
339.18 	of coordination between the state and local jurisdictions that currently regulate body art 
339.19 	establishments. The commissioner shall submit the results of the review and possible 
339.20 	regulatory recommendations for body art technicians and establishments to the chairs and 
339.21 	ranking minority members of the legislative committees with jurisdiction over health 
339.22 	care by January 15, 2010.

339.23 	Sec. 50. HEARING AIDS; ENFORCEMENT.
 339.24 	Costs incurred by the Minnesota Department of Health for conducting investigations 
339.25 	of unlicensed hearing aid dispensers shall be apportioned between all licensed or 
339.26 	credentialed professions that dispense hearing aids.

339.27 	EFFECTIVE DATE. This section is effect July 1, 2011.

339.28 	Sec. 51. REPEALER.
 339.29 	(a) Minnesota Statutes 2008, sections 103I.112; 144.9501, subdivision 17b; and 
339.30 	327.14, subdivisions 5 and 6, are repealed.
339.31 	(b) Minnesota Rules, part 4626.2015, subpart 9, is repealed.

340.1 	ARTICLE 11
340.2 	HEALTH-RELATED FEES

340.3 	Section 1. Minnesota Statutes 2008, section 148D.180, subdivision 1, is amended to 
340.4 	read:
340.5 		Subdivision 1.Application fees. Application fees for licensure are as follows:
340.6 	(1) for a licensed social worker, $45;
340.7 	(2) for a licensed graduate social worker, $45;
340.8 	(3) for a licensed independent social worker, $90 $45;
340.9 	(4) for a licensed independent clinical social worker, $90 $45;
340.10 	(5) for a temporary license, $50; and
340.11 	(6) for a licensure by endorsement, $150 $85.
340.12 	The fee for criminal background checks is the fee charged by the Bureau of Criminal 
340.13 	Apprehension. The criminal background check fee must be included with the application 
340.14 	fee as required pursuant to section 148D.055.

340.15 	Sec. 2. Minnesota Statutes 2008, section 148D.180, subdivision 2, is amended to read:
340.16 		Subd. 2.License fees. License fees are as follows:
340.17 	(1) for a licensed social worker, $115.20 $81;
340.18 	(2) for a licensed graduate social worker, $201.60 $144;
340.19 	(3) for a licensed independent social worker, $302.40 $216;
340.20 	(4) for a licensed independent clinical social worker, $331.20 $238.50;
340.21 	(5) for an emeritus license, $43.20; and
340.22 	(6) for a temporary leave fee, the same as the renewal fee specified in subdivision 3.
340.23 	If the licensee's initial license term is less or more than 24 months, the required 
340.24 	license fees must be prorated proportionately.

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

340.31 	Sec. 4. Minnesota Statutes 2008, section 148D.180, subdivision 5, is amended to read:
340.32 		Subd. 5.Late fees. Late fees are as follows:
341.1 	(1) renewal late fee, one-half one-fourth of the renewal fee specified in subdivision 
341.2 	3; and
341.3 	(2) supervision plan late fee, $40.

341.4 	Sec. 5. Minnesota Statutes 2008, section 148E.180, subdivision 1, is amended to read:
341.5 		Subdivision 1.Application fees. Application fees for licensure are as follows:
341.6 	(1) for a licensed social worker, $45;
341.7 	(2) for a licensed graduate social worker, $45;
341.8 	(3) for a licensed independent social worker, $90 $45;
341.9 	(4) for a licensed independent clinical social worker, $90 $45;
341.10 	(5) for a temporary license, $50; and
341.11 	(6) for a licensure by endorsement, $150 $85.
341.12 	The fee for criminal background checks is the fee charged by the Bureau of Criminal 
341.13 	Apprehension. The criminal background check fee must be included with the application 
341.14 	fee as required according to section 148E.055.

341.15 	Sec. 6. Minnesota Statutes 2008, section 148E.180, subdivision 2, is amended to read:
341.16 		Subd. 2.License fees. License fees are as follows:
341.17 	(1) for a licensed social worker, $115.20 $81;
341.18 	(2) for a licensed graduate social worker, $201.60 $144;
341.19 	(3) for a licensed independent social worker, $302.40 $216;
341.20 	(4) for a licensed independent clinical social worker, $331.20 $238.50;
341.21 	(5) for an emeritus license, $43.20; and
341.22 	(6) for a temporary leave fee, the same as the renewal fee specified in subdivision 3.
341.23 	If the licensee's initial license term is less or more than 24 months, the required 
341.24 	license fees must be prorated proportionately.

341.25 	Sec. 7. Minnesota Statutes 2008, section 148E.180, subdivision 3, is amended to read:
341.26 		Subd. 3.Renewal fees. Renewal fees for licensure are as follows:
341.27 	(1) for a licensed social worker, $115.20 $81;
341.28 	(2) for a licensed graduate social worker, $201.60 $144;
341.29 	(3) for a licensed independent social worker, $302.40 $216; and
341.30 	(4) for a licensed independent clinical social worker, $331.20 $238.50.

341.31 	Sec. 8. Minnesota Statutes 2008, section 148E.180, subdivision 5, is amended to read:
341.32 		Subd. 5.Late fees. Late fees are as follows:
342.1 	(1) renewal late fee, one-half one-fourth of the renewal fee specified in subdivision 
342.2 	3; and
342.3 	(2) supervision plan late fee, $40.

342.4 	Sec. 9. Minnesota Statutes 2008, section 152.126, subdivision 1, is amended to read:
342.5 		Subdivision 1.Definitions. For purposes of this section, the terms defined in this 
342.6 	subdivision have the meanings given.
342.7 	(a) "Board" means the Minnesota State Board of Pharmacy established under 
342.8 	chapter 151.
342.9 	(b) "Controlled substances" means those substances listed in section 152.02, 
342.10 	subdivisions 3 and 4 to 5, and those substances defined by the board pursuant to section 
342.11 	152.02, subdivisions 7, 8, and 12.
342.12 	(c) "Dispense" or "dispensing" has the meaning given in section 151.01, subdivision 
342.13 	30. Dispensing does not include the direct administering of a controlled substance to a 
342.14 	patient by a licensed health care professional.
342.15 	(d) "Dispenser" means a person authorized by law to dispense a controlled substance, 
342.16 	pursuant to a valid prescription. For the purposes of this section, a dispenser does not 
342.17 	include a licensed hospital pharmacy that distributes controlled substances for inpatient 
342.18 	hospital care or a veterinarian who is dispensing prescriptions under section 156.18.
342.19 	(e) "Prescriber" means a licensed health care professional who is authorized to 
342.20 	prescribe a controlled substance under section 152.12, subdivision 1.
342.21 	(f) "Prescription" has the meaning given in section 151.01, subdivision 16.

342.22 	Sec. 10. Minnesota Statutes 2008, section 152.126, subdivision 2, is amended to read:
342.23 		Subd. 2.Prescription electronic reporting system. (a) The board shall establish 
342.24 	by January 1, 2010, an electronic system for reporting the information required under 
342.25 	subdivision 4 for all controlled substances dispensed within the state. 
342.26 	(b) The board may contract with a vendor for the purpose of obtaining technical 
342.27 	assistance in the design, implementation, operation, and maintenance of the electronic 
342.28 	reporting system. The vendor's role shall be limited to providing technical support to the 
342.29 	board concerning the software, databases, and computer systems required to interface with 
342.30 	the existing systems currently used by pharmacies to dispense prescriptions and transmit 
342.31 	prescription data to other third parties.

342.32 	Sec. 11. Minnesota Statutes 2008, section 152.126, subdivision 6, is amended to read:
343.1 		Subd. 6.Access to reporting system data. (a) Except as indicated in this 
343.2 	subdivision, the data submitted to the board under subdivision 4 is private data on 
343.3 	individuals as defined in section 13.02, subdivision 12, and not subject to public disclosure.
343.4 	(b) Except as specified in subdivision 5, the following persons shall be considered 
343.5 	permissible users and may access the data submitted under subdivision 4 in the same or 
343.6 	similar manner, and for the same or similar purposes, as those persons who are authorized 
343.7 	to access similar private data on individuals under federal and state law:
343.8 	(1) a prescriber, to the extent the information relates specifically to a current patient, 
343.9 	to whom the prescriber is prescribing or considering prescribing any controlled substance;
343.10 	(2) a dispenser, to the extent the information relates specifically to a current patient 
343.11 	to whom that dispenser is dispensing or considering dispensing any controlled substance;
343.12 	(3) an individual who is the recipient of a controlled substance prescription for 
343.13 	which data was submitted under subdivision 4, or a guardian of the individual, parent or 
343.14 	guardian of a minor, or health care agent of the individual acting under a health care 
343.15 	directive under chapter 145C;
343.16 	(4) personnel of the board specifically assigned to conduct a bona fide investigation 
343.17 	of a specific licensee;
343.18 	(5) personnel of the board engaged in the collection of controlled substance 
343.19 	prescription information as part of the assigned duties and responsibilities under this 
343.20 	section;
343.21 	(6) authorized personnel of a vendor under contract with the board who are engaged 
343.22 	in the design, implementation, operation, and maintenance of the electronic reporting 
343.23 	system as part of the assigned duties and responsibilities of their employment, provided 
343.24 	that access to data is limited to the minimum amount necessary to test and maintain the 
343.25 	system databases carry out such duties and responsibilities;
343.26 	(7) federal, state, and local law enforcement authorities acting pursuant to a valid 
343.27 	search warrant; and
343.28 	(8) personnel of the medical assistance program assigned to use the data collected 
343.29 	under this section to identify recipients whose usage of controlled substances may warrant 
343.30 	restriction to a single primary care physician, a single outpatient pharmacy, or a single 
343.31 	hospital.
343.32 	For purposes of clause (3), access by an individual includes persons in the definition 
343.33 	of an individual under section 13.02.
343.34 	(c) Any permissible user identified in paragraph (b), who directly accesses 
343.35 	the data electronically, shall implement and maintain a comprehensive information 
343.36 	security program that contains administrative, technical, and physical safeguards that 
344.1 	are appropriate to the user's size and complexity, and the sensitivity of the personal 
344.2 	information obtained. The permissible user shall identify reasonably foreseeable internal 
344.3 	and external risks to the security, confidentiality, and integrity of personal information 
344.4 	that could result in the unauthorized disclosure, misuse, or other compromise of the 
344.5 	information and assess the sufficiency of any safeguards in place to control the risks.
344.6 	(d) The board shall not release data submitted under this section unless it is provided 
344.7 	with evidence, satisfactory to the board, that the person requesting the information is 
344.8 	entitled to receive the data.
344.9 	(e) The board shall not release the name of a prescriber without the written consent 
344.10 	of the prescriber or a valid search warrant or court order. The board shall provide a 
344.11 	mechanism for a prescriber to submit to the board a signed consent authorizing the release 
344.12 	of the prescriber's name when data containing the prescriber's name is requested.
344.13 	(f) The board shall maintain a log of all persons who access the data and shall ensure 
344.14 	that any permissible user complies with paragraph (c) prior to attaining direct access to 
344.15 	the data.
344.16 	(g) Section 13.05, subdivision 6, shall apply to any contract the board enters into 
344.17 	pursuant to subdivision 2. A vendor shall not use data collected under this section for 
344.18 	any purpose not specified in this section.

344.19 	Sec. 12.  REPEALER.
 344.20 	Minnesota Statutes 2008, section 148D.180, subdivision 8, is repealed.

344.21 	ARTICLE 12
344.22 	HUMAN SERVICES FORECAST ADJUSTMENTS

344.23
344.24	Section 1. SUMMARY OF APPROPRIATIONS; DEPARTMENT OF HUMAN 
SERVICES FORECAST ADJUSTMENT.
 	
344.25 	The dollar amounts shown are added to or, if shown in parentheses, are subtracted 
344.26 	from the appropriations in Laws 2008, chapter 363, from the general fund, or any other 
344.27 	fund named, to the Department of Human Services for the purposes specified in this 
344.28 	article, to be available for the fiscal year indicated for each purpose. The figure "2009" 
344.29 	used in this article means that the appropriation or appropriations listed are available 
344.30 	for the fiscal year ending June 30, 2009.

344.31
344.32	Sec. 2. COMMISSIONER OF HUMAN 
SERVICES

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

345.1	Appropriations by Fund
	
345.2			2009
	
345.3	General
		(445,130,000)
	
345.4	Health Care Access
		(19,460,000)
	
345.5	Federal TANF
		(14,404,000)

345.6	Subd. 2.Revenue and Pass-Through

345.7	Federal TANF
		1,107,000

345.8
345.9	Subd. 3.Children and Economic Assistance 
Grants

345.10	General
		27,002,000
	
345.11	Federal TANF
		(16,211,000)
	
345.12 	The amounts that may be spent from this 
345.13 	appropriation for each purpose are as follows:

345.14	(a) MFIP/DWP Grants

345.15	General
		17,530,000
	
345.16	Federal TANF
		(16,211,000)

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

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

345.19	(d) Minnesota Supplemental Aid Grants
				513,000

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

345.21	Subd. 4.Basic Health Care Grants

345.22	General
		(224,341,000)
	
345.23	Health Care Access
		(19,460,000)
	
345.24 	The amounts that may be spent from this 
345.25 	appropriation for each purpose are as follows:

345.26	(a) MinnesotaCare

345.27	 Health Care Access
		(19,460,000)

345.28
345.29	(b) MA Basic Health Care - Families and 
Children
				(100,055,000)

345.30
345.31	(c) MA Basic Health Care - Elderly and 
Disabled
				(136,795,000)

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

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

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

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

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

346.7 	Sec. 3. EFFECTIVE DATE.
 346.8 	Sections 1 and 2 are effective the day following final enactment.

346.9 	ARTICLE 13
346.10 	APPROPRIATIONS

346.11	Section 1. SUMMARY OF APPROPRIATIONS.
 	
346.12 	The amounts shown in this section summarize direct appropriations by fund made 
346.13 	in this article.

346.14			2010
		2011
		Total
	
346.15	General
	$
	4,452,323,000
	$
	5,280,470,000
	$
	9,732,793,000
	
346.16
346.17	State Government Special 
Revenue
		62,451,000
		61,515,000
		123,966,000
	
346.18	Health Care Access
		489,995,000
		568,298,000
		1,058,293,000
	
346.19	Federal TANF
		301,220,000
		268,711,000
		569,931,000
	
346.20	Lottery Prize
		1,665,000
		1,665,000
		3,330,000
	
346.21	Federal Fund
		110,000,000
		0
		110,000,000
	
346.22	Total
	$
	5,417,704,000
	$
	6,180,659,000
	$
	11,598,363,000

346.23	Sec. 2. HEALTH AND HUMAN SERVICES APPROPRIATION.
 	
346.24 	The sums shown in the columns marked "Appropriations" are appropriated to the 
346.25 	agencies and for the purposes specified in this article. The appropriations are from the 
346.26 	general fund, or another named fund, and are available for the fiscal years indicated 
346.27 	for each purpose. The figures "2010" and "2011" used in this article mean that the 
346.28 	appropriations listed under them are available for the fiscal year ending June 30, 2010, or 
346.29 	June 30, 2011, respectively. "The first year" is fiscal year 2010. "The second year" is fiscal 
346.30 	year 2011. "The biennium" is fiscal years 2010 and 2011. Appropriations for the fiscal 
346.31 	year ending June 30, 2009, are effective the day following final enactment.

347.1				APPROPRIATIONS
	
347.2				Available for the Year
	
347.3				Ending June 30
	
347.4					2010
		2011

347.5	Sec. 3. HUMAN SERVICES

347.6	Subdivision 1.Total Appropriation
 	$
	5,230,100,000
	$
	5,997,715,000

347.7	Appropriations by Fund
	
347.8		2010
	2011
	
347.9	General
	4,376,839,000
	5,211,018,000
	
347.10
347.11	State Government 
Special Revenue
	1,315,000
	565,000
	
347.12	Health Care Access
	450,792,000
	527,489,000
	
347.13	Federal TANF
	289,487,000
	256,978,000
	
347.14	Lottery Prize
	1,665,000
	1,665,000
	
347.15	Federal Fund
	110,000,000
	0
	
347.16 	Receipts for Systems Projects.
347.17 	Appropriations and federal receipts for 
347.18 	information systems projects for MAXIS, 
347.19 	PRISM, MMIS, and SSIS must be deposited 
347.20 	in the state system account authorized in 
347.21 	Minnesota Statutes, section 256.014. Money 
347.22 	appropriated for computer projects approved 
347.23 	by the Minnesota Office of Enterprise 
347.24 	Technology, funded by the legislature, and 
347.25 	approved by the commissioner of finance, 
347.26 	may be transferred from one project to 
347.27 	another and from development to operations 
347.28 	as the commissioner of human services 
347.29 	considers necessary, except that any transfers 
347.30 	to one project that exceed $1,000,000 or 
347.31 	multiple transfers to one project that exceed 
347.32 	$1,000,000 in total require the express 
347.33 	approval of the legislature. The preceding 
347.34 	requirement for legislative approval does not 
347.35 	apply to transfers made to establish a project's 
347.36 	initial operating budget each year; instead, 
347.37 	the requirements of section 11, subdivision 2, 
348.1 	of this article apply to those transfers. Any 
348.2 	unexpended balance in the appropriation 
348.3 	for these projects does not cancel but is 
348.4 	available for ongoing development and 
348.5 	operations. Any computer project with a 
348.6 	total cost exceeding $1,000,000, including, 
348.7 	but not limited to, a replacement for the 
348.8 	proposed HealthMatch system, shall not be 
348.9 	commenced without the express approval of 
348.10 	the legislature.
348.11 	HealthMatch Systems Project. In fiscal 
348.12 	year 2010, $3,054,000 shall be transferred 
348.13 	from the HealthMatch account in the state 
348.14 	systems account in the special revenue fund 
348.15 	to the general fund.
348.16 	Nonfederal Share Transfers. The 
348.17 	nonfederal share of activities for which 
348.18 	federal administrative reimbursement is 
348.19 	appropriated to the commissioner may be 
348.20 	transferred to the special revenue fund.
348.21 	TANF Maintenance of Effort.
348.22 	(a) In order to meet the basic maintenance 
348.23 	of effort (MOE) requirements of the TANF 
348.24 	block grant specified under Code of Federal 
348.25 	Regulations, title 45, section 263.1, the 
348.26 	commissioner may only report nonfederal 
348.27 	money expended for allowable activities 
348.28 	listed in the following clauses as TANF/MOE 
348.29 	expenditures:
348.30 	(1) MFIP cash, diversionary work program, 
348.31 	and food assistance benefits under Minnesota 
348.32 	Statutes, chapter 256J;
348.33 	(2) the child care assistance programs 
348.34 	under Minnesota Statutes, sections 119B.03 
348.35 	and 119B.05, and county child care 
349.1 	administrative costs under Minnesota 
349.2 	Statutes, section 119B.15;
349.3 	(3) state and county MFIP administrative 
349.4 	costs under Minnesota Statutes, chapters 
349.5 	256J and 256K;
349.6 	(4) state, county, and tribal MFIP 
349.7 	employment services under Minnesota 
349.8 	Statutes, chapters 256J and 256K;
349.9 	(5) expenditures made on behalf of 
349.10 	noncitizen MFIP recipients who qualify 
349.11 	for the medical assistance without federal 
349.12 	financial participation program under 
349.13 	Minnesota Statutes, section 256B.06, 
349.14 	subdivision 4, paragraphs (d), (e), and (j); 
349.15 	and
349.16 	(6) qualifying working family credit 
349.17 	expenditures under Minnesota Statutes, 
349.18 	section 290.0671.
349.19 	(b) The commissioner shall ensure that 
349.20 	sufficient qualified nonfederal expenditures 
349.21 	are made each year to meet the state's 
349.22 	TANF/MOE requirements. For the activities 
349.23 	listed in paragraph (a), clauses (2) to 
349.24 	(6), the commissioner may only report 
349.25 	expenditures that are excluded from the 
349.26 	definition of assistance under Code of 
349.27 	Federal Regulations, title 45, section 260.31.
349.28 	(c) For fiscal years beginning with state 
349.29 	fiscal year 2003, the commissioner shall 
349.30 	ensure that the maintenance of effort used 
349.31 	by the commissioner of finance for the 
349.32 	February and November forecasts required 
349.33 	under Minnesota Statutes, section 16A.103, 
349.34 	contains expenditures under paragraph (a), 
349.35 	clause (1), equal to at least 16 percent of 
350.1 	the total required under Code of Federal 
350.2 	Regulations, title 45, section 263.1.
350.3 	(d) For the federal fiscal years beginning on 
350.4 	or after October 1, 2007, the commissioner 
350.5 	may not claim an amount of TANF/MOE in 
350.6 	excess of the 75 percent standard in Code 
350.7 	of Federal Regulations, title 45, section 
350.8 	263.1(a)(2), except:
350.9 	(1) to the extent necessary to meet the 80 
350.10 	percent standard under Code of Federal 
350.11 	Regulations, title 45, section 263.1(a)(1), 
350.12 	if it is determined by the commissioner 
350.13 	that the state will not meet the TANF work 
350.14 	participation target rate for the current year;
350.15 	(2) to provide any additional amounts 
350.16 	under Code of Federal Regulations, title 45, 
350.17 	section 264.5, that relate to replacement of 
350.18 	TANF funds due to the operation of TANF 
350.19 	penalties; and
350.20 	(3) to provide any additional amounts that 
350.21 	may contribute to avoiding or reducing 
350.22 	TANF work participation penalties through 
350.23 	the operation of the excess MOE provisions 
350.24 	of Code of Federal Regulations, title 45, 
350.25 	section 261.43(a)(2).
350.26 	For the purposes of clauses (1) to (3), 
350.27 	the commissioner may supplement the 
350.28 	MOE claim with working family credit 
350.29 	expenditures to the extent such expenditures 
350.30 	or other qualified expenditures are otherwise 
350.31 	available after considering the expenditures 
350.32 	allowed in this section.
350.33 	(e) Minnesota Statutes, section 256.011, 
350.34 	subdivision 3, which requires that federal 
350.35 	grants or aids secured or obtained under that 
351.1 	subdivision be used to reduce any direct 
351.2 	appropriations provided by law, do not apply 
351.3 	if the grants or aids are federal TANF funds.
351.4 	(f) Notwithstanding any contrary provision 
351.5 	in this article, this provision expires June 30, 
351.6 	2013.
351.7 	Working Family Credit Expenditures as 
351.8 	TANF/MOE. The commissioner may claim 
351.9 	as TANF/MOE up to $6,707,000 per year of 
351.10 	working family credit expenditures for fiscal 
351.11 	year 2010 through fiscal year 2011.
351.12 	Working Family Credit Expenditures 
351.13 	to be Claimed for TANF/MOE. The 
351.14 	commissioner may count the following 
351.15 	amounts of working family credit expenditure 
351.16 	as TANF/MOE:
351.17 	(1) fiscal year 2010, $30,217,000;
351.18 	(2) fiscal year 2011, $55,596,000;
351.19 	(3) fiscal year 2012, $28,519,000; and
351.20 	(4) fiscal year 2013, $22,138,000.
351.21 	Notwithstanding any contrary provision in 
351.22 	this article, this rider expires June 30, 2013.
351.23 	TANF Transfer to Federal Child Care 
351.24 	and Development Fund. The following 
351.25 	TANF fund amounts are appropriated to the 
351.26 	commissioner for the purposes of MFIP and 
351.27 	transition year child care under Minnesota 
351.28 	Statutes, section 119B.05:
351.29 	(1) fiscal year 2010, $5,909,000;
351.30 	(2) fiscal year 2011, $9,808,000;
351.31 	(3) fiscal year 2012, $10,826,000; and
351.32 	(4) fiscal year 2013, $4,026,000.
352.1 	The commissioner shall authorize the 
352.2 	transfer of sufficient TANF funds to the 
352.3 	federal child care and development fund to 
352.4 	meet this appropriation and shall ensure that 
352.5 	all transferred funds are expended according 
352.6 	to federal child care and development fund 
352.7 	regulations.
352.8 	Food Stamps Employment and Training.
352.9 	(a) The commissioner shall apply for and 
352.10 	claim the maximum allowable federal 
352.11 	matching funds under United States Code, 
352.12 	title 7, section 2025, paragraph (h), for 
352.13 	state expenditures made on behalf of family 
352.14 	stabilization services participants voluntarily 
352.15 	engaged in food stamp employment and 
352.16 	training activities, where appropriate.
352.17 	(b) Notwithstanding Minnesota Statutes, 
352.18 	sections 256D.051, subdivisions 1a, 6b, 
352.19 	and 6c, and 256J.626, federal food stamps 
352.20 	employment and training funds received 
352.21 	as reimbursement of MFIP consolidated 
352.22 	fund grant expenditures for diversionary 
352.23 	work program participants and child 
352.24 	care assistance program expenditures for 
352.25 	two-parent families must be deposited in the 
352.26 	general fund. The amount of funds must be 
352.27 	limited to $3,350,000 in fiscal year 2010 
352.28 	and $4,440,000 in fiscal years 2011 through 
352.29 	2013, contingent on approval by the federal 
352.30 	Food and Nutrition Service. 
352.31 	(c) Consistent with the receipt of these federal 
352.32 	funds, the commissioner may adjust the 
352.33 	level of working family credit expenditures 
352.34 	claimed as TANF maintenance of effort. 
353.1 	Notwithstanding any contrary provision in 
353.2 	this article, this rider expires June 30, 2013.
353.3 	ARRA Food Support Administration.
353.4 	The funds available for food support 
353.5 	administration under the American Recovery 
353.6 	and Reinvestment Act (ARRA) of 2009 
353.7 	are appropriated to the commissioner 
353.8 	to pay actual costs of implementing the 
353.9 	food support benefit increases, increased 
353.10 	eligibility determinations, and outreach. Of 
353.11 	these funds, 20 percent shall be allocated 
353.12 	to the commissioner and 80 percent shall 
353.13 	be allocated to counties. The commissioner 
353.14 	shall allocate the county portion based on 
353.15 	caseload. Reimbursement shall be based on 
353.16 	actual costs reported by counties through 
353.17 	existing processes. Tribal reimbursement 
353.18 	must be made from the state portion based 
353.19 	on a caseload factor equivalent to that of a 
353.20 	county.
353.21 	ARRA Food Support Benefit Increases.
353.22 	The funds provided for food support benefit 
353.23 	increases under the Supplemental Nutrition 
353.24 	Assistance Program provisions of the 
353.25 	American Recovery and Reinvestment Act 
353.26 	(ARRA) of 2009 must be used for benefit 
353.27 	increases beginning July 1, 2009.
353.28 	Emergency Fund for the TANF Program.
353.29 	TANF Emergency Contingency funds 
353.30 	available under the American Recovery 
353.31 	and Reinvestment Act of 2009 (Public Law 
353.32 	111-5) are appropriated to the commissioner. 
353.33 	The commissioner must request TANF 
353.34 	Emergency Contingency funds from the 
353.35 	Secretary of the Department of Health 
354.1 	and Human Services to the extent the 
354.2 	commissioner meets or expects to meet the 
354.3 	requirements of section 403(c) of the Social 
354.4 	Security Act. The commissioner must seek 
354.5 	to maximize such grants. The funds received 
354.6 	must  be used as appropriated. Each county 
354.7 	must maintain the county's current level of 
354.8 	emergency assistance funding under the 
354.9 	MFIP consolidated fund and use the funds 
354.10 	under this paragraph to supplement existing 
354.11 	emergency assistance funding levels.

354.12	Subd. 2.Agency Management
 					
354.13 	The amounts that may be spent from the 
354.14 	appropriation for each purpose are as follows:

354.15	(a) Financial Operations

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

354.20	(b) Legal and Regulatory Operations

354.21	Appropriations by Fund
	
354.22	General
	13,749,000
	13,534,000
	
354.23
354.24	State Government 
Special Revenue
	440,000
	440,000
	
354.25	Health Care Access
	943,000
	943,000
	
354.26	Federal TANF
	100,000
	100,000

354.27	(c) Management Operations

354.28	Appropriations by Fund
	
354.29	General
	4,334,000
	4,562,000
	
354.30	Health Care Access
	242,000
	242,000
	
354.31 	Lease Cost Reduction. Base level funding 
354.32 	to the commissioner shall be reduced by 
354.33 	$381,000 in fiscal year 2010, and $153,000 
354.34 	in fiscal year 2011, to reflect a reduction in 
355.1 	lease costs related to the Minnehaha Avenue 
355.2 	building.
355.3 	Base Adjustment. The general fund base is 
355.4 	increased by $153,000 in each of fiscal years 
355.5 	2012 and 2013.

355.6	(d) Information Technology Operations

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

355.10
355.11	Subd. 3.Revenue and Pass-Through Revenue 
Expenditures
 		65,746,000
		67,068,000
	
355.12 	This appropriation is from the federal TANF 
355.13 	fund.

355.14
355.15	Subd. 4.Children and Economic Assistance 
Grants
 					
355.16 	The amounts that may be spent from this 
355.17 	appropriation for each purpose are as follows:

355.18	(a) MFIP/DWP Grants

355.19	Appropriations by Fund
	
355.20	General
	63,205,000
	89,033,000
	
355.21	Federal TANF
	100,404,000
	85,789,000

355.22	(b) Support Services Grants

355.23	Appropriations by Fund
	
355.24	General
	8,715,000
	12,498,000
	
355.25	Federal TANF
	121,257,000
	102,757,000
	
355.26 	MFIP Consolidated Fund. The MFIP 
355.27 	consolidated fund TANF appropriation is 
355.28 	reduced by $1,854,000 in fiscal year 2011 
355.29 	and fiscal year 2012.
355.30 	Notwithstanding Minnesota Statutes, section 
355.31 	256J.626, subdivision 8, paragraph (b), the 
355.32 	commissioner shall reduce proportionately 
355.33 	the reimbursement to counties for 
355.34 	administrative expenses.
356.1 	Subsidized Employment Funding Through 
356.2 	ARRA. The commissioner is authorized to 
356.3 	apply for TANF emergency fund grants for 
356.4 	subsidized employment activities. Growth 
356.5 	in expenditures for subsidized employment 
356.6 	within the supported work program and the 
356.7 	MFIP consolidated fund over the amount 
356.8 	expended in the calendar quarters in the 
356.9 	TANF emergency fund base year shall be 
356.10 	used to leverage the TANF emergency fund 
356.11 	grants for subsidized employment and to 
356.12 	fund supported work. The commissioner 
356.13 	shall develop procedures to maximize 
356.14 	reimbursement of these expenditures over the 
356.15 	TANF emergency fund base year quarters, 
356.16 	and may contract directly with employers 
356.17 	and providers to maximize these TANF 
356.18 	emergency fund grants.
356.19 	Supported Work. Of the TANF 
356.20 	appropriation, $6,400,000 in fiscal year 
356.21 	2011 is to the commissioner for supported 
356.22 	work for MFIP recipients and is available 
356.23 	until expended. Supported work includes 
356.24 	paid transitional work experience and 
356.25 	a continuum of employment assistance, 
356.26 	including outreach and recruitment, 
356.27 	program orientation and intake, testing and 
356.28 	assessment, job development and marketing, 
356.29 	preworksite training, supported worksite 
356.30 	experience, job coaching, and postplacement 
356.31 	follow-up, in addition to extensive case 
356.32 	management and referral services.
356.33 	Base Adjustment. The general fund base 
356.34 	is reduced by $3,783,000 in each of fiscal 
356.35 	years 2012 and 2013. The TANF fund base 
357.1 	is increased by $9,704,000 in each of fiscal 
357.2 	years 2012 and 2013.
357.3 	Integrated Services Program Funding.
357.4 	The TANF appropriation for integrated 
357.5 	services program funding is $1,250,000 in 
357.6 	fiscal year 2010 and $2,500,000 in fiscal year 
357.7 	2011.
357.8 	TANF Emergency Fund; Nonrecurrent 
357.9 	Short-Term Benefits. TANF emergency 
357.10 	contingency fund grants received due to 
357.11 	increases in expenditures for nonrecurrent 
357.12 	short-term benefits must be used to offset the 
357.13 	increase in these expenditures for counties 
357.14 	under the MFIP consolidated fund, under 
357.15 	Minnesota Statutes, section 256J.626, 
357.16 	and the diversionary work program. The 
357.17 	commissioner shall develop procedures 
357.18 	to maximize reimbursement of these 
357.19 	expenditures over the TANF emergency fund 
357.20 	base year quarters. Growth in expenditures 
357.21 	for the diversionary work program over the 
357.22 	amount expended in the calendar quarters in 
357.23 	the TANF emergency fund base year shall be 
357.24 	used to leverage these funds.

357.25	(c) MFIP Child Care Assistance Grants

357.26	Appropriations by Fund
	
357.27	General
	61,171,000
	65,214,000
	
357.28	Federal TANF
	1,022,000
	406,000
	
357.29 	ARRA Child Care Development Block 
357.30 	Grant Funds. The funds available from the 
357.31 	child care development block grant under 
357.32 	ARRA must be used for MFIP child care to 
357.33 	the extent that those funds are not earmarked 
357.34 	for quality expansion or to improve the 
357.35 	quality of infant and toddler care.
358.1 	Acceleration of ARRA Child Care and 
358.2 	Development Fund Expenditure. The 
358.3 	commissioner must liquidate all child care 
358.4 	and development money available under 
358.5 	the American Recovery and Reinvestment 
358.6 	Act (ARRA) of 2009, Public Law 111-5, 
358.7 	by September 30, 2010. In order to expend 
358.8 	those funds by September 30, 2010, the 
358.9 	commissioner may redesignate and expend 
358.10 	the ARRA child care and development funds 
358.11 	appropriated in fiscal year 2011 for purposes 
358.12 	under this section for related purposes that 
358.13 	will allow liquidation by September 30, 
358.14 	2010. Child care and development funds 
358.15 	otherwise available to the commissioner 
358.16 	for those related purposes shall be used to 
358.17 	fund the purposes from which the ARRA 
358.18 	child care and development funds had been 
358.19 	redesignated.

358.20
358.21	(d) Basic Sliding Fee Child Care Assistance 
Grants
		40,104,000
		45,096,000
	
358.22 	Base Adjustment. The general fund base is 
358.23 	decreased by $260,000 in each of fiscal years 
358.24 	2012 and 2013.
358.25 	School Readiness Service Agreements.
358.26 	$261,000 in fiscal year 2010 and $261,000 
358.27 	in fiscal year 2011 are from the federal 
358.28 	child care development funds received from 
358.29 	the American Recovery and Reinvestment 
358.30 	Act of 2009, Public Law 111-5, to the 
358.31 	commissioner of human services consistent 
358.32 	with federal regulations for the purpose of 
358.33 	school readiness service agreements under 
358.34 	Minnesota Statutes, section 119B.231. This 
358.35 	is a onetime appropriation. Any unexpended 
359.1 	balance the first year is available in the 
359.2 	second year.
359.3 	Child Care Development Fund 
359.4 	Unexpended Balance. In addition to 
359.5 	the amount provided in this section, the 
359.6 	commissioner shall expend $5,244,000 in 
359.7 	fiscal year 2010 from the federal child care 
359.8 	development fund unexpended balance 
359.9 	for basic sliding fee child care under 
359.10 	Minnesota Statutes, section 119B.03. The 
359.11 	commissioner shall ensure that all child 
359.12 	care and development funds are expended 
359.13 	according to the federal child care and 
359.14 	development fund regulations.
359.15 	Basic Sliding Fee. $7,045,000 in fiscal year 
359.16 	2010 and $6,974,000 in fiscal year 2011 are 
359.17 	from the federal child care development 
359.18 	funds received from the American Recovery 
359.19 	and Reinvestment Act of 2009, Public 
359.20 	Law 111-5, to the commissioner of human 
359.21 	services consistent with federal regulations 
359.22 	for the purpose of basic sliding fee child care 
359.23 	assistance under Minnesota Statutes, section 
359.24 	119B.03. This is a onetime appropriation. 
359.25 	Any unexpended balance the first year is 
359.26 	available in the second year.
359.27 	Basic Sliding Fee Allocation for Calendar 
359.28 	Year 2010. Notwithstanding Minnesota 
359.29 	Statutes, section 119B.03, subdivision 6, 
359.30 	in calendar year 2010, basic sliding fee 
359.31 	funds shall be distributed according to 
359.32 	this provision. Funds shall be allocated 
359.33 	first in amounts equal to each county's 
359.34 	guaranteed floor, according to Minnesota 
359.35 	Statutes, section 119B.03, subdivision 8, 
360.1 	with any remaining available funds allocated 
360.2 	according to the following formula:
360.3 	(a) Up to one-fourth of the funds shall be 
360.4 	allocated in proportion to the number of 
360.5 	families participating in the transition year 
360.6 	child care program as reported during and 
360.7 	averaged over the most recent six months 
360.8 	completed at the time of the notice of 
360.9 	allocation. Funds in excess of the amount 
360.10 	necessary to serve all families in this category 
360.11 	shall be allocated according to paragraph (d).
360.12 	(b) Up to three-fourths of the funds shall 
360.13 	be allocated in proportion to the average 
360.14 	of each county's most recent six months of 
360.15 	reported waiting list as defined in Minnesota 
360.16 	Statutes, section 119B.03, subdivision 2, and 
360.17 	the reinstatement list of those families whose 
360.18 	assistance was terminated with the approval 
360.19 	of the commissioner under Minnesota Rules, 
360.20 	part 3400.0183, subpart 1. Funds in excess 
360.21 	of the amount necessary to serve all families 
360.22 	in this category shall be allocated according 
360.23 	to paragraph (d).
360.24 	(c) The amount necessary to serve all families 
360.25 	in paragraphs (a) and (b) shall be calculated 
360.26 	based on the basic sliding fee average cost of 
360.27 	care per family in the county with the highest 
360.28 	cost in the most recently completed calendar 
360.29 	year.
360.30 	(d) Funds in excess of the amount necessary 
360.31 	to serve all families in paragraphs (a) and 
360.32 	(b) shall be allocated in proportion to each 
360.33 	county's total expenditures for the basic 
360.34 	sliding fee child care program reported 
360.35 	during the most recent fiscal year completed 
361.1 	at the time of the notice of allocation. To 
361.2 	the extent that funds are available, and 
361.3 	notwithstanding Minnesota Statutes, section 
361.4 	119B.03, subdivision 8, for the period 
361.5 	January 1, 2011, to December 31, 2011, each 
361.6 	county's guaranteed floor must be equal to its 
361.7 	original calendar year 2010 allocation.

361.8	(e) Child Care Development Grants
		1,487,000
		1,487,000
	
361.9 	Family, friends, and neighbor grants.
361.10 	$375,000 in fiscal year 2010 and $375,000 
361.11 	in fiscal year 2011 are from the child 
361.12 	care development fund required targeted 
361.13 	quality funds for quality expansion and 
361.14 	infant/toddler from the American Recovery 
361.15 	and Reinvestment Act of 2009, Public 
361.16 	Law 111-5, to the commissioner of human 
361.17 	services for family, friends, and neighbor 
361.18 	grants under Minnesota Statutes, section 
361.19 	119B.232. This appropriation may be used 
361.20 	on programs receiving family, friends, and 
361.21 	neighbor grant funds as of June 30, 2009, 
361.22 	or on new programs or projects. This is a 
361.23 	onetime appropriation. Any unexpended 
361.24 	balance the first year is available in the 
361.25 	second year.
361.26 	Voluntary quality rating system training, 
361.27 	coaching, consultation, and supports.
361.28 	$633,000 in fiscal year 2010 and $633,000 
361.29 	in fiscal year 2011 are from the federal child 
361.30 	care development fund required targeted 
361.31 	quality funds for quality expansion and 
361.32 	infant/toddler from the American Recovery 
361.33 	and Reinvestment Act of 2009, Public 
361.34 	Law 111-5, to the commissioner of human 
361.35 	services consistent with federal regulations 
362.1 	for the purpose of providing grants to provide 
362.2 	statewide child-care provider training, 
362.3 	coaching, consultation, and supports to 
362.4 	prepare for the voluntary Minnesota quality 
362.5 	rating system rating tool. This is a onetime 
362.6 	appropriation. Any unexpended balance the 
362.7 	first year is available in the second year.
362.8 	Voluntary quality rating system. $184,000 
362.9 	in fiscal year 2010 and $1,200,000 in fiscal 
362.10 	year 2011 are from the federal child care 
362.11 	development fund required targeted funds for 
362.12 	quality expansion and infant/toddler from the 
362.13 	American Recovery and Reinvestment Act of 
362.14 	2009, Public Law 111-5, to the commissioner 
362.15 	of human services consistent with federal 
362.16 	regulations for the purpose of implementing 
362.17 	the voluntary Parent Aware quality star 
362.18 	rating system pilot in coordination with the 
362.19 	Minnesota Early Learning Foundation. The 
362.20 	appropriation for the first year is to complete 
362.21 	and promote the voluntary Parent Aware 
362.22 	quality rating system pilot program through 
362.23 	June 30, 2010, and the appropriation for the 
362.24 	second year is to continue the voluntary 
362.25 	Minnesota quality rating system pilot 
362.26 	through June 30, 2011. This is a onetime 
362.27 	appropriation. Any unexpended balance the 
362.28 	first year is available in the second year.

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

362.30	(g) Children's Services Grants

362.31	Appropriations by Fund
	
362.32	General
	 48,333,000
	50,498,000
	
362.33	Federal TANF
	340,000
	240,000
	
363.1 	Base Adjustment. The general fund base is 
363.2 	decreased by $5,371,000 in fiscal year 2012 
363.3 	and increased $8,737,000 in fiscal year 2013.
363.4 	Privatized Adoption Grants. Federal 
363.5 	reimbursement for privatized adoption grant 
363.6 	and foster care recruitment grant expenditures 
363.7 	is appropriated to the commissioner for 
363.8 	adoption grants and foster care and adoption 
363.9 	administrative purposes.
363.10 	Adoption Assistance Incentive Grants.
363.11 	Federal funds available during fiscal year 
363.12 	2010 and fiscal year 2011 for the adoption 
363.13 	incentive grants are appropriated to the 
363.14 	commissioner for these purposes.
363.15 	Adoption Assistance and Relative Custody 
363.16 	Assistance. The commissioner may transfer 
363.17 	unencumbered appropriation balances for 
363.18 	adoption assistance and relative custody 
363.19 	assistance between fiscal years and between 
363.20 	programs.

363.21	(h) Children and Community Services Grants
		67,663,000
		67,542,000
	
363.22 	Targeted Case Management Temporary 
363.23 	Funding Adjustment. The commissioner 
363.24 	shall recover from each county and tribe 
363.25 	receiving a targeted case management 
363.26 	temporary funding payment in fiscal year 
363.27 	2008 an amount equal to that payment. The 
363.28 	commissioner shall recover one-half of the 
363.29 	funds by February 1, 2010, and the remainder 
363.30 	by February 1, 2011. At the commissioner's 
363.31 	discretion and at the request of a county 
363.32 	or tribe, the commissioner may revise 
363.33 	the payment schedule, but full payment 
363.34 	must not be delayed beyond May 1, 2011. 
363.35 	The commissioner may use the recovery 
364.1 	procedure under Minnesota Statutes, section 
364.2 	256.017, to recover the funds. Recovered 
364.3 	funds must be deposited into the general 
364.4 	fund.

364.5	(i) General Assistance Grants
		48,215,000
		48,608,000
	
364.6 	General Assistance Standard. The 
364.7 	commissioner shall set the monthly standard 
364.8 	of assistance for general assistance units 
364.9 	consisting of an adult recipient who is 
364.10 	childless and unmarried or living apart 
364.11 	from parents or a legal guardian at $203. 
364.12 	The commissioner may reduce this amount 
364.13 	according to Laws 1997, chapter 85, article 
364.14 	3, section 54.
364.15 	Emergency General Assistance. The 
364.16 	amount appropriated for emergency general 
364.17 	assistance funds is limited to no more 
364.18 	than $7,889,812 in fiscal year 2010 and 
364.19 	$7,889,812 in fiscal year 2011. Funds 
364.20 	to counties must be allocated by the 
364.21 	commissioner using the allocation method 
364.22 	specified in Minnesota Statutes, section 
364.23 	256D.06.

364.24	(j) Minnesota Supplemental Aid Grants
		33,930,000
		35,191,000
	
364.25 	Emergency Minnesota Supplemental 
364.26 	Aid Funds. The amount appropriated for 
364.27 	emergency Minnesota supplemental aid 
364.28 	funds is limited to no more than $1,100,000 
364.29 	in fiscal year 2010 and $1,100,000 in fiscal 
364.30 	year 2011. Funds to counties must be 
364.31 	allocated by the commissioner using the 
364.32 	allocation method specified in Minnesota 
364.33 	Statutes, section 256D.46.

364.34	(k) Group Residential Housing Grants
		111,778,000
		114,034,000
	
365.1 	Group Residential Housing Costs 
365.2 	Refinanced. (a) Effective July 1, 2011, the 
365.3 	commissioner shall increase the home and 
365.4 	community-based service rates and county 
365.5 	allocations provided to programs for persons 
365.6 	with disabilities established under section 
365.7 	1915(c) of the Social Security Act to the 
365.8 	extent that these programs will be paying 
365.9 	for the costs above the rate established 
365.10 	in Minnesota Statutes, section 256I.05, 
365.11 	subdivision 1.
365.12 	(b) For persons receiving services under 
365.13 	Minnesota Statutes, section 245A.02, who 
365.14 	reside in licensed adult foster care beds 
365.15 	for which a difficulty of care payment 
365.16 	was being made under Minnesota Statutes, 
365.17 	section 256I.05, subdivision 1c, paragraph 
365.18 	(b), counties may request an exception to 
365.19 	the individual's service authorization not to 
365.20 	exceed the difference between the client's 
365.21 	monthly service expenditures plus the 
365.22 	amount of the difficulty of care payment.

365.23	(l) Children's Mental Health Grants
		16,885,000
		16,882,000
	
365.24 	Funding Usage. Up to 75 percent of a fiscal 
365.25 	year's appropriation for children's mental 
365.26 	health grants may be used to fund allocations 
365.27 	in that portion of the fiscal year ending 
365.28 	December 31.

365.29
365.30	(m) Other Children and Economic Assistance 
Grants
		16,047,000
		15,339,000
	
365.31 	Fraud Prevention Grants. Of this 
365.32 	appropriation, $379,000 in fiscal year 2010 
365.33 	and $379,000 in fiscal year 2011 is to the 
365.34 	commissioner for fraud prevention grants to 
365.35 	counties.
366.1 	Homeless and Runaway Youth. $218,000 
366.2 	in fiscal year 2010 is for the Runaway 
366.3 	and Homeless Youth Act under Minnesota 
366.4 	Statutes, section 256K.45. Funds shall be 
366.5 	spent in each area of the continuum of care 
366.6 	to ensure that programs are meeting the 
366.7 	greatest need. Any unexpended balance in 
366.8 	the first year is available in the second year. 
366.9 	Beginning July 1, 2011, the base is increased 
366.10 	by $119,000 each year.
366.11 	ARRA Homeless Youth Funds. To the 
366.12 	extent permitted under federal law, the 
366.13 	commissioner shall designate $2,500,000 
366.14 	of the Homeless Prevention and Rapid 
366.15 	Re-Housing Program funds provided under 
366.16 	the American Recovery and Reinvestment 
366.17 	Act of 2009, Public Law 111-5, for agencies 
366.18 	providing homelessness prevention and rapid 
366.19 	rehousing services to youth.
366.20 	Supportive Housing Services. $1,500,000 
366.21 	each year is for supportive services under 
366.22 	Minnesota Statutes, section 256K.26. This is 
366.23 	a onetime appropriation. Beginning in fiscal 
366.24 	year 2012, the base is increased by $68,000 
366.25 	per year.
366.26 	Community Action Grants. Community 
366.27 	action grants are reduced one time by 
366.28 	$1,764,000 each year. This reduction is due 
366.29 	to the availability of federal funds under the 
366.30 	American Recovery and Reinvestment Act.
366.31 	Base Adjustment. The general fund base 
366.32 	is increased by $773,000 in fiscal year 2012 
366.33 	and $773,000 in fiscal year 2013.
366.34 	Federal ARRA Funds for Existing 
366.35 	Programs. (a) Federal funds received by the 
367.1 	commissioner for the emergency food and 
367.2 	shelter program from the American Recovery 
367.3 	and Reinvestment Act of 2009, Public 
367.4 	Law 111-5, but not previously approved 
367.5 	by the legislature are appropriated to the 
367.6 	commissioner for the purposes of the grant 
367.7 	program.
367.8 	(b) Federal funds received by the 
367.9 	commissioner for the emergency shelter 
367.10 	grant program including the Homelessness 
367.11 	Prevention and Rapid Re-Housing 
367.12 	Program from the American Recovery and 
367.13 	Reinvestment Act of 2009, Public Law 
367.14 	111-5, are appropriated to the commissioner 
367.15 	for the purposes of the grant programs.
367.16 	(c) Federal funds received by the 
367.17 	commissioner for the emergency food 
367.18 	assistance program from the American 
367.19 	Recovery and Reinvestment Act of 2009, 
367.20 	Public Law 111-5, are appropriated to the 
367.21 	commissioner for the purposes of the grant 
367.22 	program.
367.23 	(d) Federal funds received by the 
367.24 	commissioner for senior congregate meals 
367.25 	and senior home-delivered meals from the 
367.26 	American Recovery and Reinvestment Act 
367.27 	of 2009, Public Law 111-5, are appropriated 
367.28 	to the commissioner for the Minnesota Board 
367.29 	on Aging, for purposes of the grant programs.
367.30 	(e) Federal funds received by the 
367.31 	commissioner for the community services 
367.32 	block grant program from the American 
367.33 	Recovery and Reinvestment Act of 2009, 
367.34 	Public Law 111-5, are appropriated to the 
368.1 	commissioner for the purposes of the grant 
368.2 	program.
368.3 	Long-Term Homeless Supportive 
368.4 	Service Fund Appropriation. To the 
368.5 	extent permitted under federal law, the 
368.6 	commissioner shall designate $3,000,000 
368.7 	of the Homelessness Prevention and Rapid 
368.8 	Re-Housing Program funds provided under 
368.9 	the American Recovery and Reinvestment 
368.10 	Act of 2009, Public Law, 111-5, to the 
368.11 	long-term homeless service fund under 
368.12 	Minnesota Statutes, section 256K.26. This 
368.13 	appropriation shall become available by July 
368.14 	1, 2009. This paragraph is effective the day 
368.15 	following final enactment.

368.16
368.17	Subd. 5.Children and Economic Assistance 
Management
 					
368.18 	The amounts that may be spent from the 
368.19 	appropriation for each purpose are as follows:

368.20
368.21	(a) Children and Economic Assistance 
Administration

368.22	Appropriations by Fund
	
368.23	General
	10,318,000
	10,308,000
	
368.24	Federal TANF
	496,000
	496,000
	
368.25 	Base Adjustment. The federal TANF base 
368.26 	is increased by $700,000 in each of fiscal 
368.27 	years 2012 and 2013.
368.28 	School Readiness Service Agreements.
368.29 	$406,000 in fiscal year 2010 and $406,000 
368.30 	in fiscal year 2011 are from the federal 
368.31 	child care development funds received from 
368.32 	the American Recovery and Reinvestment 
368.33 	Act of 2009, Public Law 111-5, to the 
368.34 	commissioner of human services consistent 
368.35 	with federal regulations for the purpose of 
369.1 	school readiness service agreements under 
369.2 	Minnesota Statutes, section 119B.231. This 
369.3 	is a onetime appropriation. Any unexpended 
369.4 	balance the first year is available in the 
369.5 	second year.

369.6
369.7	(b) Children and Economic Assistance 
Operations

369.8	Appropriations by Fund
	
369.9	General
	33,590,000
	33,423,000
	
369.10	Health Care Access
	361,000
	361,000
	
369.11 	Financial Institution Data Match and 
369.12 	Payment of Fees. The commissioner is 
369.13 	authorized to allocate up to $310,000 each 
369.14 	year in fiscal years 2010 and 2011 from the 
369.15 	PRISM special revenue account to make 
369.16 	payments to financial institutions in exchange 
369.17 	for performing data matches between account 
369.18 	information held by financial institutions 
369.19 	and the public authority's database of child 
369.20 	support obligors as authorized by Minnesota 
369.21 	Statutes, section 13B.06, subdivision 7.
369.22 	School Readiness Service Agreements.
369.23 	$106,000 in fiscal year 2010 and $241,000 
369.24 	in fiscal year 2011 are from the federal 
369.25 	child care development funds received from 
369.26 	the American Recovery and Reinvestment 
369.27 	Act of 2009, Public Law 111-5, to the 
369.28 	commissioner of human services consistent 
369.29 	with federal regulations for the purpose of 
369.30 	school readiness service agreements under 
369.31 	Minnesota Statutes, section 119B.231. This 
369.32 	is a onetime appropriation.
369.33 	Use of Federal Stabilization Funds.
369.34 	$33,000,000 in fiscal year 2010 is 
369.35 	appropriated from the fiscal stabilization 
369.36 	account in the federal fund to the 
370.1 	commissioner. This appropriation must not 
370.2 	be used for any activity or service for which 
370.3 	federal reimbursement is claimed. This is a 
370.4 	onetime appropriation.

370.5	Subd. 6.Basic Health Care Grants
 					
370.6 	The amounts that may be spent from this 
370.7 	appropriation for each purpose are as follows:

370.8	(a) MinnesotaCare Grants
		391,915,000
		485,448,000
	
370.9 	This appropriation is from the health care 
370.10 	access fund.

370.11
370.12	(b) MA Basic Health Care Grants - Families 
and Children
		751,988,000
		973,088,000
	
370.13 	Medical Education Research Costs 
370.14 	(MERC). Of these funds, the commissioner 
370.15 	of human services shall transfer $38,000,000 
370.16 	in fiscal year 2010 to the medical education 
370.17 	research fund. These funds must restore the 
370.18 	fiscal year 2009 unallotment of the transfers 
370.19 	under Minnesota Statutes, section 256B.69, 
370.20 	subdivision 5c, paragraph (a), for the July 1, 
370.21 	2008, through June 30, 2009, period.
370.22 	Newborn Screening Fee. Of the general 
370.23 	fund appropriation, $34,000 in fiscal 
370.24 	year 2011 is to the commissioner for the 
370.25 	hospital reimbursement increase described 
370.26 	under Minnesota Statutes, section 256.969, 
370.27 	subdivision 28.
370.28 	Local Share Payment Modification 
370.29 	Required for ARRA Compliance.
370.30 	Effective from July 1, 2009, to December 
370.31 	31, 2010, Hennepin County's monthly 
370.32 	contribution to the nonfederal share of 
370.33 	medical assistance costs must be reduced 
370.34 	to the percentage required on September 
371.1 	1, 2008, to meet federal requirements for 
371.2 	enhanced federal match under the American 
371.3 	Reinvestment and Recovery Act (ARRA) 
371.4 	of 2009. Notwithstanding  the requirements 
371.5 	of Minnesota Statutes, section 256B.19, 
371.6 	subdivision 1c, paragraph (d), for the period 
371.7 	beginning July 1, 2009, to December 31, 
371.8 	2010, Hennepin County's monthly payment 
371.9 	under that provision is reduced to $434,688.
371.10 	Capitation Payments. Effective from 
371.11 	July 1, 2009, to December 31, 2010, 
371.12 	notwithstanding the provisions of Minnesota 
371.13 	Statutes 2008, section 256B.19, subdivision 
371.14 	1c, paragraph (c), the commissioner shall 
371.15 	increase capitation payments made to the 
371.16 	Metropolitan Health Plan under Minnesota 
371.17 	Statutes 2008, section 256B.69, by 
371.18 	$6,800,000 to recognize higher than average 
371.19 	medical education costs. The increased 
371.20 	amount includes federal matching funds.
371.21 	Use of Savings. Any savings derived 
371.22 	from implementation of the prohibition in 
371.23 	Minnesota Statutes, section 256B.032, on the 
371.24 	enrollment of low-quality, high-cost health 
371.25 	care providers as vendors of state health care 
371.26 	program services shall be used to offset on a 
371.27 	pro rata basis the reimbursement reductions 
371.28 	for basic care services in Minnesota Statutes, 
371.29 	section 256B.766.

371.30
371.31	(c) MA Basic Health Care Grants - Elderly and 
Disabled
		970,183,000
		1,142,310,000
	
371.32 	Minnesota Disability Health Options. 
371.33 	Notwithstanding Minnesota Statutes, section 
371.34 	256B.69, subdivision 5a, paragraph (b), for 
371.35 	the period beginning July 1, 2009, to June 
371.36 	30, 2011, the monthly enrollment of persons 
372.1 	receiving home and community-based 
372.2 	waivered services under Minnesota 
372.3 	Disability Health Options shall not exceed 
372.4 	1,000. If the budget neutrality provision 
372.5 	in Minnesota Statutes, section 256B.69, 
372.6 	subdivision 23, paragraph (f), is reached 
372.7 	prior to June 30, 2013, the commissioner may 
372.8 	waive this monthly enrollment requirement.
372.9 	Hospital Fee-for-Service Payment Delay.
372.10 	Payments from the Medicaid Management 
372.11 	Information System that would otherwise 
372.12 	have been made for inpatient hospital 
372.13 	services for Minnesota health care program 
372.14 	enrollees must be delayed as follows: for 
372.15 	fiscal year 2011, payments in the month of 
372.16 	June equal to $15,937,000 must be included 
372.17 	in the first payment of fiscal year 2012 and 
372.18 	for fiscal year 2013, payments in the month 
372.19 	of June equal to $6,666,000 must be included 
372.20 	in the first payment of fiscal year 2014. The 
372.21 	provisions of Minnesota Statutes, section 
372.22 	16A.124, do not apply to these delayed 
372.23 	payments. Notwithstanding any contrary 
372.24 	provision in this article, this paragraph 
372.25 	expires December 31, 2014.
372.26 	Nonhospital Fee-for-Service Payment 
372.27 	Delay. Payments from the Medicaid 
372.28 	Management Information System that would 
372.29 	otherwise have been made for nonhospital 
372.30 	acute care services for Minnesota health 
372.31 	care program enrollees must be delayed as 
372.32 	follows: payments in the month of June equal 
372.33 	to $23,438,000 for fiscal year 2011 must be 
372.34 	included in the first payment for fiscal year 
372.35 	2012, and payments in the month of June 
372.36 	equal to $27,156,000 for fiscal year 2013 
373.1 	must be included in the first payment for 
373.2 	fiscal year 2014. This payment delay must 
373.3 	not include nursing facilities, intermediate 
373.4 	care facilities for persons with developmental 
373.5 	disabilities, home and community-based 
373.6 	services, prepaid health plans, personal care 
373.7 	provider organizations, and home health 
373.8 	agencies. The provisions of Minnesota 
373.9 	Statutes, section 16A.124, do not apply to 
373.10 	these delayed payments. Notwithstanding 
373.11 	any contrary provision in this article, this 
373.12 	paragraph expires December 31, 2014.

373.13	(d) General Assistance Medical Care Grants
		345,223,000
		381,081,000

373.14	(e) Other Health Care Grants

373.15	Appropriations by Fund
	
373.16	General
	295,000
	295,000
	
373.17	Health Care Access
	23,533,000
	7,080,000
	
373.18 	Base Adjustment. The health care access 
373.19 	fund base is reduced to $190,000 in each of 
373.20 	fiscal years 2012 and 2013.

373.21	Subd. 7.Health Care Management
 					
373.22 	The amounts that may be spent from the 
373.23 	appropriation for each purpose are as follows:

373.24	(a) Health Care Administration

373.25	Appropriations by Fund
	
373.26	General
	7,831,000
	7,742,000
	
373.27	Health Care Access
	1,812,000
	906,000

373.28	(b) Health Care Operations

373.29	Appropriations by Fund
	
373.30	General
	19,914,000
	18,949,000
	
373.31	Health Care Access
	25,099,000
	25,875,000
	
373.32 	Base Adjustment. The health care access 
373.33 	fund base is increased by $1,006,000 in 
373.34 	fiscal year 2012 and $1,781,000 in fiscal year 
374.1 	2013. The general fund base is decreased by 
374.2 	$237,000 in fiscal year 2012 and $237,000 in 
374.3 	fiscal year 2013.

374.4	Subd. 8.Continuing Care Grants
 					
374.5 	The amounts that may be spent from the 
374.6 	appropriation for each purpose are as follows:

374.7	(a) Aging and Adult Services Grants

374.8	Appropriations by Fund
	
374.9	General
	13,488,000
	15,779,000
	
374.10	Federal
	500,000
	0
	
374.11 	Base Adjustment. The general fund base is 
374.12 	increased by $5,751,000 in fiscal year 2012 
374.13 	and $6,705,000 in fiscal year 2013.
374.14 	Information and Assistance 
374.15 	Reimbursement. Federal administrative 
374.16 	reimbursement obtained from information 
374.17 	and assistance services provided by the 
374.18 	Senior LinkAge or Disability Linkage lines 
374.19 	to people who are identified as eligible for 
374.20 	medical assistance shall be appropriated to 
374.21 	the commissioner for this activity.
374.22 	Community Service Development Grant 
374.23 	Reduction. Funding for community service 
374.24 	development grants must be reduced by 
374.25 	$251,000 for fiscal year 2010; $266,000 in 
374.26 	fiscal year 2011; $25,000 in fiscal year 2012; 
374.27 	and $25,000 in fiscal year 2013. Base level 
374.28 	funding shall be restored in fiscal year 2014.
374.29 	Senior Nutrition Use of Federal Funds.
374.30 	For fiscal year 2010, general fund grants 
374.31 	for home-delivered meals and congregate 
374.32 	dining shall be reduced by $500,000. The 
374.33 	commissioner must replace these general 
374.34 	fund reductions with equal amounts from 
375.1 	federal funding for senior nutrition from the 
375.2 	American Recovery and Reinvestment Act 
375.3 	of 2009.

375.4	(b) Alternative Care Grants
		50,234,000
		48,576,000
	
375.5 	Base Adjustment. The general fund base is 
375.6 	decreased by $3,598,000 in fiscal year 2012 
375.7 	and $3,470,000 in fiscal year 2013.
375.8 	Alternative Care Transfer. Any money 
375.9 	allocated to the alternative care program that 
375.10 	is not spent for the purposes indicated does 
375.11 	not cancel but must be transferred to the 
375.12 	medical assistance account.

375.13
375.14	(c) Medical Assistance Grants; Long-Term 
Care Facilities.
		367,444,000
		419,749,000

375.15
375.16	(d) Medical Assistance Long-Term Care 
Waivers and Home Care Grants
		854,373,000
		1,043,411,000
	
375.17 	Manage Growth in TBI and CADI 
375.18 	Waivers. During the fiscal years beginning 
375.19 	on July 1, 2009, and July 1, 2010, the 
375.20 	commissioner shall allocate money for home 
375.21 	and community-based waiver programs 
375.22 	under Minnesota Statutes, section 256B.49, 
375.23 	to ensure a reduction in state spending that is 
375.24 	equivalent to limiting the caseload growth of 
375.25 	the TBI waiver to 12.5 allocations per month 
375.26 	each year of the biennium and the CADI 
375.27 	waiver to 95 allocations per month each year 
375.28 	of the biennium. Limits do not apply: (1) 
375.29 	when there is an approved plan for nursing 
375.30 	facility bed closures for individuals under 
375.31 	age 65 who require relocation due to the 
375.32 	bed closure; (2) to fiscal year 2009 waiver 
375.33 	allocations delayed due to unallotment; or (3) 
375.34 	to transfers authorized by the commissioner 
375.35 	from the personal care assistance program 
376.1 	of individuals having a home care rating 
376.2 	of "CS," "MT," or "HL." Priorities for the 
376.3 	allocation of funds must be for individuals 
376.4 	anticipated to be discharged from institutional 
376.5 	settings or who are at imminent risk of a 
376.6 	placement in an institutional setting.
376.7 	Manage Growth in DD Waiver. The 
376.8 	commissioner shall manage the growth in 
376.9 	the DD waiver by limiting the allocations 
376.10 	included in the February 2009 forecast to 15 
376.11 	additional diversion allocations each month 
376.12 	for the calendar years that begin on January 
376.13 	1, 2010, and January 1, 2011. Additional 
376.14 	allocations must be made available for 
376.15 	transfers authorized by the commissioner 
376.16 	from the personal care program of individuals 
376.17 	having a home care rating of "CS," "MT," 
376.18 	or "HL."
376.19 	Adjustment to Lead Agency Waiver 
376.20 	Allocations. Prior to the availability of the 
376.21 	alternative license defined in Minnesota 
376.22 	Statutes, section 245A.11, subdivision 8, 
376.23 	the commissioner shall reduce lead agency 
376.24 	waiver allocations for the purposes of 
376.25 	implementing a moratorium on corporate 
376.26 	foster care.
376.27 	Alternatives to Personal Care Assistance 
376.28 	Services. Base level funding of $3,237,000 
376.29 	in fiscal year 2012 and $4,856,000 in 
376.30 	fiscal year 2013 is to implement alternative 
376.31 	services to personal care assistance services 
376.32 	for persons with mental health and other 
376.33 	behavioral challenges who can benefit 
376.34 	from other services that more appropriately 
376.35 	meet their needs and assist them in living 
377.1 	independently in the community. These 
377.2 	services may include, but not be limited to, a 
377.3 	1915(i) state plan option.

377.4	(e) Mental Health Grants

377.5	Appropriations by Fund
	
377.6	General
	77,739,000
	77,739,000
	
377.7	Health Care Access
	750,000
	750,000
	
377.8	Lottery Prize
	1,508,000
	1,508,000
	
377.9 	Funding Usage. Up to 75 percent of a fiscal 
377.10 	year's appropriation for adult mental health 
377.11 	grants may be used to fund allocations in that 
377.12 	portion of the fiscal year ending December 
377.13 	31.

377.14	(f) Deaf and Hard-of-Hearing Grants
		1,930,000
		1,917,000

377.15	(g) Chemical Dependency Entitlement Grants
		111,303,000
		122,822,000
	
377.16 	Payments for Substance Abuse Treatment.
377.17 	For services provided during fiscal years 
377.18 	2010 and 2011, county-negotiated rates and 
377.19 	provider claims to the consolidated chemical 
377.20 	dependency fund must not exceed rates 
377.21 	charged for these services on January 1, 2009. 
377.22 	For services provided in fiscal years 2012 
377.23 	and 2013, statewide average rates under the 
377.24 	new rate methodology to be developed under 
377.25 	Minnesota Statutes, section 254B.12, must 
377.26 	not exceed the average rates charged for these 
377.27 	services on January 1, 2009, plus $3,787,000 
377.28 	for fiscal year 2012 and $5,023,000 for fiscal 
377.29 	year 2013. Notwithstanding any provision 
377.30 	to the contrary in this article, this provision 
377.31 	expires on June 30, 2013.
377.32 	Chemical Dependency Special Revenue 
377.33 	Account. For fiscal year 2010, $750,000 
377.34 	must be transferred from the consolidated 
377.35 	chemical dependency treatment fund 
378.1 	administrative account and deposited into the 
378.2 	general fund.
378.3 	County CD Share of MA Costs for 
378.4 	ARRA Compliance. Notwithstanding the 
378.5 	provisions of Minnesota Statutes, chapter 
378.6 	254B, for chemical dependency services 
378.7 	provided during the period July 1, 2009, 
378.8 	to December 31, 2010, and reimbursed by 
378.9 	medical assistance at the enhanced federal 
378.10 	matching rate provided under the American 
378.11 	Recovery and Reinvestment Act of 2009, the 
378.12 	county share is 30 percent of the nonfederal 
378.13 	share.

378.14
378.15	(h) Chemical Dependency Nonentitlement 
Grants
		1,729,000
		1,729,000
	
378.16 	Base Adjustment. The general fund base is 
378.17 	decreased by $3,000 in each of fiscal years 
378.18 	2012 and 2013.

378.19	(i) Other Continuing Care Grants
		18,272,000
		13,139,000
	
378.20 	Base Adjustment. The general fund base is 
378.21 	increased by $7,028,000 in fiscal year 2012 
378.22 	and increased by $8,243,000 in fiscal year 
378.23 	2013.
378.24 	Technology Grants. $650,000 in fiscal 
378.25 	year 2010 and $1,000,000 in fiscal year 
378.26 	2011 are for technology grants, case 
378.27 	consultation, evaluation, and consumer 
378.28 	information grants related to developing and 
378.29 	supporting alternatives to shift-staff foster 
378.30 	care residential service models.
378.31 	Other Continuing Care Grants; HIV 
378.32 	Grants. Money appropriated for the HIV 
378.33 	drug and insurance grant program in fiscal 
378.34 	year 2010 may be used in either year of the 
378.35 	biennium.

379.1	Subd. 9.Continuing Care Management

379.2	Appropriations by Fund
	
379.3	General
	24,927,000
	25,314,000
	
379.4
379.5	State Government 
Special Revenue
	875,000
	125,000
	
379.6	Lottery Prize
	157,000
	157,000
	
379.7 	Quality Assurance Commission. Effective 
379.8 	July 1, 2009, state funding for the quality 
379.9 	assurance commission under Minnesota 
379.10 	Statutes, section 256B.0951, is canceled.
379.11 	County Maintenance of Effort. $350,000 in 
379.12 	fiscal year 2010 is from the general fund for 
379.13 	the State-County Results Accountability and 
379.14 	Service Delivery Reform under Minnesota 
379.15 	Statutes, chapter 402A.
379.16 	Base Adjustment.  The general fund base is 
379.17 	decreased $2,697,000 in fiscal year 2012 and 
379.18 	$2,791,000 in fiscal year 2013.

379.19	Subd. 10.State-Operated Services
 		258,794,000
		266,191,000
	
379.20 	The amounts that may be spent from the 
379.21 	appropriation for each purpose are as follows:
379.22 	Transfer Authority Related to 
379.23 	State-Operated Services. Money 
379.24 	appropriated to finance state-operated 
379.25 	services may be transferred between the 
379.26 	fiscal years of the biennium with the approval 
379.27 	of the commissioner of finance.
379.28 	County Past Due Receivables. The 
379.29 	commissioner is authorized to withhold 
379.30 	county federal administrative reimbursement 
379.31 	when the county of financial responsibility 
379.32 	for cost-of-care payments due the state 
379.33 	under Minnesota Statutes, section 246.54 
379.34 	or 253B.045, is 90 days past due. The 
379.35 	commissioner shall deposit the withheld 
380.1 	federal administrative earnings for the county 
380.2 	into the general fund to settle the claims with 
380.3 	the county of financial responsibility. The 
380.4 	process for withholding funds is governed by 
380.5 	Minnesota Statutes, section 256.017.
380.6 	Forecast and Census Data. The 
380.7 	commissioner shall include census data and 
380.8 	fiscal projections for state-operated services 
380.9 	and Minnesota sex offender services with the 
380.10 	November and February budget forecasts. 
380.11 	Notwithstanding any contrary provision in 
380.12 	this article, this paragraph shall not expire.

380.13	(a) Adult Mental Health Services
		107,702,000
		107,201,000
	
380.14 	Appropriation Limitation. No part of 
380.15 	the appropriation in this article to the 
380.16 	commissioner for mental health treatment 
380.17 	services provided by state-operated services 
380.18 	shall be used for the Minnesota sex offender 
380.19 	program.
380.20 	Community Behavioral Health Hospitals.
380.21 	Under Minnesota Statutes, section 246.51, 
380.22 	subdivision 1, a determination order for the 
380.23 	clients served in a community behavioral 
380.24 	health hospital operated by the commissioner 
380.25 	of human services is only required when 
380.26 	a client's third-party coverage has been 
380.27 	exhausted.
380.28 	Base Adjustment. The general fund base is 
380.29 	decreased by $500,000 for fiscal year 2012 
380.30 	and by $500,000 for fiscal year 2013.

380.31	(b) Minnesota Sex Offender Services

380.32	Appropriations by Fund
	
380.33	General 
	38,348,000
	67,503,000
	
380.34	Federal Fund
	26,495,000
	0
	
381.1 	Use of Federal Stabilization Funds. Of 
381.2 	this appropriation, $26,495,000 in fiscal year 
381.3 	2010 is from the fiscal stabilization account 
381.4 	in the federal fund to the commissioner. 
381.5 	This appropriation must not be used for 
381.6 	any activity or service for which federal 
381.7 	reimbursement is claimed. This is a onetime 
381.8 	appropriation.

381.9381.10
	(c) Minnesota Security Hospital and METO 
Services

381.11	Appropriations by Fund
	
381.12	General 
	230,000,000
	83,735,000
	
381.13	Federal Fund
	83,504,000
	0
	
381.14 	Minnesota Security Hospital.  For the 
381.15 	purposes of enhancing the safety of 
381.16 	the public, improving supervision, and 
381.17 	enhancing community-based mental health 
381.18 	treatment, state-operated services may 
381.19 	establish additional community capacity 
381.20 	for providing treatment and supervision 
381.21 	of clients who have been ordered into a 
381.22 	less restrictive alternative of care from the 
381.23 	state-operated services transitional services 
381.24 	program consistent with Minnesota Statutes, 
381.25 	section 246.014.
381.26 	Use of Federal Stabilization Funds.
381.27 	$83,505,000 in fiscal year 2010 is 
381.28 	appropriated from the fiscal stabilization 
381.29 	account in the federal fund to the 
381.30 	commissioner. This appropriation must not 
381.31 	be used for any activity or service for which 
381.32 	federal reimbursement is claimed. This is a 
381.33 	onetime appropriation.

381.34	Sec. 4. COMMISSIONER OF HEALTH

381.35	Subdivision 1.Total Appropriation
 	$
	165,717,000
	$
	161,841,000

382.1	Appropriations by Fund
	
382.2		2010
	2011
	
382.3	General
	69,366,000
	63,884,000
	
382.4
382.5	State Government 
Special Revenue
	45,415,000
	45,415,000
	
382.6	Health Care Access
	39,203,000
	40,809,000
	
382.7	Federal TANF
	11,733,000
	11,733,000

382.8
382.9	Subd. 2.Community and Family Health 
Promotion

382.10	Appropriations by Fund
	
382.11	General
	44,814,000
	39,671,000
	
382.12
382.13	State Government 
Special Revenue
	1,033,000
	 1,304,000
	
382.14	Federal TANF
	11,733,000
	11,733,000
	
382.15	Health Care Access
	21,642,000
	28,719,000
	
382.16 	Newborn Screening Fee. Of the general 
382.17 	fund appropriation, $300,000 in fiscal year 
382.18 	2011 is to the commissioner for the purpose 
382.19 	of providing support services to families as 
382.20 	required under Minnesota Statutes, section 
382.21 	144.966, subdivision 3a. $74,000 of this 
382.22 	appropriation in fiscal year 2011 and $51,000 
382.23 	of this appropriation in subsequent fiscal 
382.24 	years may be used by the commissioner 
382.25 	for administrative costs associated with 
382.26 	increasing the fee, contract administration, 
382.27 	program oversight, and provide follow-up to 
382.28 	families who need assistance beyond those 
382.29 	available through the contractor.
382.30 	Support Services for Families With 
382.31 	Children Who are Deaf or Have Hearing 
382.32 	Loss. Of the general fund amount, $16,000 
382.33 	in fiscal year 2010 and $284,000 in fiscal 
382.34 	year 2011 is for support services to families 
382.35 	with children who are deaf or have hearing 
382.36 	loss. Of this amount, in fiscal year 2011, 
382.37 	$223,000 is for grants and the balance is for 
383.1 	administrative costs. Base funding in fiscal 
383.2 	years 2012 and 2013 is $300,000 each year. 
383.3 	Of this amount, $241,000 each year is for 
383.4 	grants and the balance is for administrative 
383.5 	costs.
383.6 	Funding Usage. Up to 75 percent of the 
383.7 	fiscal year 2012 appropriation for local public 
383.8 	health grants may be used to fund calendar 
383.9 	year 2011 allocations for this program. The 
383.10 	general fund reduction of $5,193,000 in 
383.11 	fiscal year 2011 for local public health grants 
383.12 	is onetime and the base funding for local 
383.13 	public health grants for fiscal year 2012 is 
383.14 	increased by $5,193,000.
383.15 	Colorectal Screening. $88,000 in fiscal year 
383.16 	2010 and $62,000 in fiscal year 2011 are 
383.17 	for grants to the Hennepin County Medical 
383.18 	Center and MeritCare Bemidji for colorectal 
383.19 	screening demonstration projects.
383.20 	Feasibility Pilot Project for Cancer 
383.21 	Surveillance. Of the general fund 
383.22 	appropriation for fiscal year 2010, $100,000 
383.23 	is to the commissioner to provide grant 
383.24 	funding to cover the cost of one full-time 
383.25 	equivalent position at the Hennepin County 
383.26 	Medical Center to carry out the feasibility 
383.27 	pilot project.
383.28 	American Recovery and Reinvestment 
383.29 	Act Funds. Federal funds received by the 
383.30 	commissioner for WIC program management 
383.31 	information systems from the American 
383.32 	Recovery and Reinvestment Act of 2009, 
383.33 	Public Law 111-5, are appropriated to the 
383.34 	commissioner for the purpose of the grant.
384.1 	TANF Appropriations. (1) $1,156,000 of 
384.2 	the TANF funds are appropriated each year to 
384.3 	the commissioner for family planning grants 
384.4 	under Minnesota Statutes, section 145.925.
384.5 	(2) $3,579,000 of the TANF funds are 
384.6 	appropriated each year to the commissioner 
384.7 	for home visiting and nutritional services 
384.8 	listed under Minnesota Statutes, section 
384.9 	145.882, subdivision 7, clauses (6) and (7). 
384.10 	Funds must be distributed to community 
384.11 	health boards according to Minnesota 
384.12 	Statutes, section 145A.131, subdivision 1.
384.13 	(3) $2,000,000 of the TANF funds are 
384.14 	appropriated each year to the commissioner 
384.15 	for decreasing racial and ethnic disparities 
384.16 	in infant mortality rates under Minnesota 
384.17 	Statutes, section 145.928, subdivision 7.
384.18 	(4) $4,998,000 of the TANF funds are 
384.19 	appropriated each year to the commissioner 
384.20 	for the family home visiting grant program 
384.21 	according to Minnesota Statutes, section 
384.22 	145A.17. $4,000,000 of the funding must 
384.23 	be distributed to community health boards 
384.24 	according to Minnesota Statutes, section 
384.25 	145A.131, subdivision 1. $998,000 of 
384.26 	the funding must be distributed to tribal 
384.27 	governments based on Minnesota Statutes, 
384.28 	section 145A.14, subdivision 2a. The 
384.29 	commissioner may use five percent of 
384.30 	the funds appropriated each fiscal year to 
384.31 	conduct the ongoing evaluations required 
384.32 	under Minnesota Statutes, section 145A.17, 
384.33 	subdivision 7, and may use ten percent of 
384.34 	the funds appropriated each fiscal year to 
384.35 	provide training and technical assistance as 
385.1 	required under Minnesota Statutes, section 
385.2 	145A.17, subdivisions 4 and 5.
385.3 	Base Adjustment. The general fund base 
385.4 	is increased by $10,302,000 for fiscal year 
385.5 	2012 and increased by $5,109,000 for fiscal 
385.6 	year 2013. The health care access fund base 
385.7 	is reduced to $1,719,000 for both fiscal years 
385.8 	2012 and 2013.
385.9 	TANF Carryforward. Any unexpended 
385.10 	balance of the TANF appropriation in the 
385.11 	first year of the biennium does not cancel but 
385.12 	is available for the second year.

385.13	Subd. 3.Policy Quality and Compliance

385.14	Appropriations by Fund
	
385.15	General
	7,491,000
	7,242,000
	
385.16
385.17	State Government 
Special Revenue
	14,173,000
	14,173,000
	
385.18	Health Care Access
	17,561,000
	12,090,000
	
385.19 	Community-Based Health Care 
385.20 	Demonstration Project. Notwithstanding 
385.21 	the provisions of Laws 2007, chapter 147, 
385.22 	article 19, section 3, subdivision 6, paragraph 
385.23 	(e), base level funding to the commissioner 
385.24 	for the demonstration project grant described 
385.25 	in Minnesota Statutes, section 62Q.80, 
385.26 	subdivision 1a, shall be zero for fiscal years 
385.27 	2011 and 2012.
385.28 	Medical Education and Research Cost 
385.29 	Federal Compliance. Notwithstanding 
385.30 	Laws 2008, chapter 363, article 18, section 
385.31 	4, subdivision 3, the base level funding 
385.32 	for the commissioner to distribute to the 
385.33 	Mayo Clinic for transitional funding while 
385.34 	federal compliance changes are made to the 
385.35 	medical education and research cost funding 
386.1 	distribution formula shall be $0 for fiscal 
386.2 	years 2010 and 2011.
386.3 	Autism Clinical Research. The 
386.4 	commissioner, in partnership with a 
386.5 	Minnesota research institution, shall apply 
386.6 	for funds available for research grants under 
386.7 	the American Recovery and Reinvestment 
386.8 	Act (ARRA) of 2009 in order to expand 
386.9 	research and treatment of autism spectrum 
386.10 	disorders.
386.11 	Health Information Technology. (a) Of 
386.12 	the health care access fund appropriation, 
386.13 	$4,000,000 is to fund the revolving loan 
386.14 	account under Minnesota Statutes, section 
386.15 	62J.496. This appropriation must not be 
386.16 	expended unless it is matched with federal 
386.17 	funding under the federal Health Information 
386.18 	Technology for Economic and Clinical 
386.19 	Health (HITECH) Act. This appropriation 
386.20 	must not be included in the agency's base 
386.21 	budget for the fiscal year beginning July 1, 
386.22 	2012.
386.23 	(b) On or before June 30, 2013, $1,200,000 
386.24 	shall be transferred from the revolving loan 
386.25 	account under Minnesota Statutes, section 
386.26 	62J.496, to the health care access fund. 
386.27 	This is a onetime transfer and must not be 
386.28 	included in the agency's base budget for the 
386.29 	fiscal year beginning July 1, 2014.
386.30 	Base Adjustment. The general fund 
386.31 	base is $8,243,000 in fiscal year 2012 and 
386.32 	$8,243,000 in fiscal year 2013. The health 
386.33 	care access fund base is $10,950,000 in fiscal 
386.34 	year 2012 and $6,816,000 in fiscal year 2013.

386.35	Subd. 4.Health Protection

387.1	Appropriations by Fund
	
387.2	General
	9,871,000
	9,780,000
	
387.3
387.4	State Government 
Special Revenue
	30,209,000
	30,209,000
	
387.5 	Base Adjustment. The general fund base is 
387.6 	reduced by $50,000 in each of fiscal years 
387.7 	2012 and 2013.
387.8 	Health Protection Appropriations. (a) 
387.9 	$163,000 each year is for the lead abatement 
387.10 	grant program. 
387.11 	(b) $100,000 each year is for emergency 
387.12 	preparedness and response activities. 
387.13 	(c) $50,000 each year is for tuberculosis 
387.14 	prevention and control. This is a onetime 
387.15 	appropriation.
387.16 	American Recovery and Reinvestment 
387.17 	Act Funds. Federal funds received 
387.18 	by the commissioner for immunization 
387.19 	operations from the American Recovery 
387.20 	and Reinvestment Act of 2009, Public Law 
387.21 	111-5, are appropriated to the commissioner 
387.22 	for the purposes of the grant.

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

387.24	Sec. 5. HEALTH-RELATED BOARDS

387.25	Subdivision 1.Total Appropriation 
 	$
	15,017,000
	$
	14,831,000
	
387.26 	This appropriation is from the state 
387.27 	government special revenue fund.
387.28 	Transfer. In fiscal year 2010, $6,000,000 
387.29 	shall be transferred from the state government 
387.30 	special revenue fund to the general fund. 
387.31 	The amounts that may be spent for each 
387.32 	purpose are specified in the following 
387.33 	subdivisions.

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

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

388.3
388.4	Subd. 4.Board of Dietetic and Nutrition 
Practice
 		105,000
		105,000

388.5
388.6	Subd. 5.Board of Marriage and Family 
Therapy
 		137,000
		137,000

388.7	Subd. 6.Board of Medical Practice
 		3,674,000
		3,674,000

388.8	Subd. 7.Board of Nursing
 		4,217,000
		4,219,000

388.9388.10
	Subd. 8.Board of Nursing Home 
Administrators
 		1,146,000
		958,000
	
388.11 	Administrative Services Unit - Operating 
388.12 	Costs. Of this appropriation, $524,000 
388.13 	in fiscal year 2010 and $526,000 in 
388.14 	fiscal year 2011 are for operating costs 
388.15 	of the administrative services unit. The 
388.16 	administrative services unit may receive 
388.17 	and expend reimbursements for services 
388.18 	performed by other agencies.
388.19 	Administrative Services Unit - Retirement 
388.20 	Costs. Of this appropriation in fiscal year 
388.21 	2010, $201,000 is for onetime retirement 
388.22 	costs in the health-related boards. This 
388.23 	funding may be transferred to the health 
388.24 	boards incurring those costs for their 
388.25 	payment. These funds are available either 
388.26 	year of the biennium.
388.27 	Administrative Services Unit - Volunteer 
388.28 	Health Care Provider Program. Of this 
388.29 	appropriation, $79,000 in fiscal year 2010 
388.30 	and $89,000 in fiscal year 2011 are to pay 
388.31 	for medical professional liability coverage 
388.32 	required under Minnesota Statutes, section 
388.33 	214.40.
389.1 	Administrative Services Unit - Contested 
389.2 	Cases and Other Legal Proceedings. Of 
389.3 	this appropriation, $200,000 in fiscal year 
389.4 	2010 and $200,000 in fiscal year 2011 
389.5 	are for costs of contested case hearings 
389.6 	and other unanticipated costs of legal 
389.7 	proceedings involving health-related 
389.8 	boards funded under this section. Upon 
389.9 	certification of a health-related board to the 
389.10 	administrative services unit that the costs 
389.11 	will be incurred and that there is insufficient 
389.12 	money available to pay for the costs out of 
389.13 	money currently available to that board, the 
389.14 	administrative services unit is authorized 
389.15 	to transfer money from this appropriation 
389.16 	to the board for payment of those costs 
389.17 	with the approval of the commissioner of 
389.18 	finance. This appropriation does not cancel. 
389.19 	Any unencumbered and unspent balances 
389.20 	remain available for these expenditures in 
389.21 	subsequent fiscal years.

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

389.23	Subd. 10.Board of Pharmacy
 		1,413,000
		1,413,000

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

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

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

389.27	Subd. 14.Board of Social Work
 		1,022,000
		1,022,000

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

389.29
389.30	Subd. 16.Board of Behavioral Health and 
Therapy
 		394,000
		394,000

389.31
389.32	Sec. 6. EMERGENCY MEDICAL SERVICES 
BOARD
 	$
	 4,378,000
	$
	3,828,000

390.1	Appropriations by Fund
	
390.2		2010
	2011
	
390.3	General
	 3,674,000
	3,124,000
	
390.4
390.5	State Government 
Special Revenue
	704,000
	704 ,000
	
390.6 	Longevity Award and Incentive Program.
390.7 	Of the general fund appropriation, $700,000 
390.8 	in fiscal year 2010 and $700,000 in fiscal year 
390.9 	2011 are to the board for the Cooper/Sams 
390.10 	volunteer ambulance program, under 
390.11 	Minnesota Statutes, section 144E.40.
390.12 	Transfer. In fiscal year 2010, $6,182,000 
390.13 	is transferred from the Cooper/Sams 
390.14 	volunteer ambulance trust, established under 
390.15 	Minnesota Statutes, section 144E.42, to the 
390.16 	general fund.
390.17 	Health Professional Services Program.
390.18 	$704,000 in fiscal year 2010 and $704,000 in 
390.19 	fiscal year 2011 from the state government 
390.20 	special revenue fund are for the health 
390.21 	professional services program.
390.22 	Comprehensive Advanced Life-Support 
390.23 	Educational (CALS) Program.$100,000 in 
390.24 	the first year from the Cooper/Sams volunteer 
390.25 	ambulance trust is for the comprehensive 
390.26 	advanced life-support educational (CALS) 
390.27 	program established under Minnesota 
390.28 	Statutes, section 144E.37. This appropriation 
390.29 	is to extend availability and affordability 
390.30 	of the CALS program for rural emergency 
390.31 	medical personnel and to assist hospital staff 
390.32 	in attaining the credentialing levels necessary 
390.33 	for implementation of the statewide trauma 
390.34 	system.

391.1
391.2	Sec. 7. DEPARTMENT OF VETERANS 
AFFAIRS
 	$
	200,000
	$
	0
	
391.3 	Veterans Paramedic Apprenticeship 
391.4 	Program. Of this appropriation, $200,000 
391.5 	in the first year is from the Cooper/Sams 
391.6 	volunteer ambulance trust for transfer 
391.7 	to the commissioner of veterans affairs 
391.8 	for a grant to the Minnesota Ambulance 
391.9 	Association to implement a veterans 
391.10 	paramedic apprenticeship program to 
391.11 	reintegrate returning military medics into 
391.12 	Minnesota's workforce in the field of 
391.13 	paramedic and emergency services, thereby 
391.14 	guaranteeing returning military medics 
391.15 	gainful employment with livable wages and 
391.16 	benefits. This appropriation is available until 
391.17 	expended.

391.18	Sec. 8. DEPARTMENT OF PUBLIC SAFETY
 	$
	250,000
	$
	0
	
391.19 	Medical Response Unit Reimbursement 
391.20 	Pilot Program. (a) $250,000 in the first 
391.21 	year is from the Cooper/Sams volunteer 
391.22 	ambulance trust for a transfer to the 
391.23 	Department of Public Safety for a medical 
391.24 	response unit reimbursement pilot program. 
391.25 	Of this appropriation, $75,000 is for 
391.26 	administrative costs to the Department of 
391.27 	Public Safety, including providing contract 
391.28 	staff support and technical assistance to the 
391.29 	pilot program partners if necessary.
391.30 	(b) Of the amount in paragraph (a), $175,000 
391.31 	is to be used to provide a predetermined 
391.32 	reimbursement amount to the participating 
391.33 	medical response units. The Department 
391.34 	of Public Safety or its contract designee 
391.35 	will develop an agreement with the medical 
392.1 	response units outlining reimbursement and 
392.2 	program requirements to include HIPAA 
392.3 	compliance while participating in the pilot 
392.4 	program.

392.5	Sec. 9. COUNCIL ON DISABILITY
 	$
	524,000
	$
	524,000

392.6
392.7
392.8	Sec. 10. OMBUDSMAN FOR MENTAL 
HEALTH AND DEVELOPMENTAL 
DISABILITIES
 	$
	1,655,000
	$
	1,655,000

392.9	Sec. 11. OMBUDSPERSON FOR FAMILIES
 	$
	265,000
	$
	265,000

392.10 	Sec. 12. Laws 2007, chapter 147, article 19, section 3, subdivision 4, as amended 
392.11 	by Laws 2008, chapter 277, article 5, section 1; and Laws 2008, chapter 363, article 
392.12 	18, section 7, is amended to read:

392.13
392.14	Subd. 4. Children and Economic Assistance 
Grants
 					
392.15 	The amounts that may be spent from this 
392.16 	appropriation for each purpose are as follows: 

392.17	(a) MFIP/DWP Grants 

392.18	Appropriations by Fund 
	
392.19	General 
	62,069,000 
	62,405,000 
	
392.20	Federal TANF 
	75,904,000 
	80,841,000 

392.21	(b) Support Services Grants 

392.22	Appropriations by Fund 
	
392.23	General 
	8,715,000 
	8,715,000 
	
392.24	Federal TANF 
	113,429,000 
	115,902,000 
	
392.25 	TANF Prior Appropriation Cancellation.
392.26 	Notwithstanding Laws 2001, First Special 
392.27 	Session chapter 9, article 17, section 
392.28 	2, subdivision 11, paragraph (b), any 
392.29 	unexpended TANF funds appropriated to the 
392.30 	commissioner to contract with the Board of 
392.31 	Trustees of Minnesota State Colleges and 
392.32 	Universities, to provide tuition waivers to 
393.1 	employees of health care and human service 
393.2 	providers that are members of qualifying 
393.3 	consortia operating under Minnesota 
393.4 	Statutes, sections 116L.10 to 116L.15, must 
393.5 	cancel at the end of fiscal year 2007. 
393.6 	MFIP Pilot Program. Of the TANF 
393.7 	appropriation, $100,000 in fiscal year 2008 
393.8 	and $750,000 in fiscal year 2009 are for a 
393.9 	grant to the Stearns-Benton Employment and 
393.10 	Training Council for the Workforce U pilot 
393.11 	program. Base level funding for this program 
393.12 	shall be $750,000 in 2010 and $0 in 2011. 
393.13 	Supported Work. (1) Of the TANF 
393.14 	appropriation, $5,468,000 in fiscal year 2008 
393.15 	is for supported work for MFIP participants, 
393.16 	to be allocated to counties and tribes based 
393.17 	on the criteria under clauses (2) and (3), and 
393.18 	is available until expended. Paid transitional 
393.19 	work experience and other supported 
393.20 	employment under this rider provides 
393.21 	a continuum of employment assistance, 
393.22 	including outreach and recruitment, 
393.23 	program orientation and intake, testing and 
393.24 	assessment, job development and marketing, 
393.25 	preworksite training, supported worksite 
393.26 	experience, job coaching, and postplacement 
393.27 	follow-up, in addition to extensive case 
393.28 	management and referral services. * (The 
393.29 	preceding text "and $7,291,000 in fiscal 
393.30 	year 2009" was indicated as vetoed by the 
393.31 	governor.) 
393.32 	(2) A county or tribe is eligible to receive an 
393.33 	allocation under this rider if: 
393.34 	(i) the county or tribe is not meeting the 
393.35 	federal work participation rate; 
394.1 	(ii) the county or tribe has participants who 
394.2 	are required to perform work activities under 
394.3 	Minnesota Statutes, chapter 256J, but are not 
394.4 	meeting hourly work requirements; and 
394.5 	(iii) the county or tribe has assessed 
394.6 	participants who have completed six weeks 
394.7 	of job search or are required to perform 
394.8 	work activities and are not meeting the 
394.9 	hourly requirements, and the county or tribe 
394.10 	has determined that the participant would 
394.11 	benefit from working in a supported work 
394.12 	environment. 
394.13 	(3) A county or tribe may also be eligible for 
394.14 	funds in order to contract for supplemental 
394.15 	hours of paid work at the participant's child's 
394.16 	place of education, child care location, or the 
394.17 	child's physical or mental health treatment 
394.18 	facility or office. This grant to counties and 
394.19 	tribes is specifically for MFIP participants 
394.20 	who need to work up to five hours more 
394.21 	per week in order to meet the hourly work 
394.22 	requirement, and the participant's employer 
394.23 	cannot or will not offer more hours to the 
394.24 	participant. 
394.25 	Work Study. Of the TANF appropriation, 
394.26 	$750,000 each year are to the commissioner 
394.27 	to contract with the Minnesota Office of 
394.28 	Higher Education for the biennium beginning 
394.29 	July 1, 2007, for work study grants under 
394.30 	Minnesota Statutes, section 136A.233, 
394.31 	specifically for low-income individuals who 
394.32 	receive assistance under Minnesota Statutes, 
394.33 	chapter 256J, and for grants to opportunities 
394.34 	industrialization centers. * (The preceding 
394.35 	text beginning "Work Study. Of the TANF 
395.1 	appropriation," was indicated as vetoed 
395.2 	by the governor.) 
395.3 	Integrated Service Projects. $2,500,000 
395.4 	in fiscal year 2008 and $2,500,000 in fiscal 
395.5 	year 2009 are appropriated from the TANF 
395.6 	fund to the commissioner to continue to 
395.7 	fund the existing integrated services projects 
395.8 	for MFIP families, and if funding allows, 
395.9 	additional similar projects. 
395.10 	Base Adjustment. The TANF base for fiscal 
395.11 	year 2010 is $115,902,000 and for fiscal year 
395.12 	2011 is $115,152,000. 

395.13	(c) MFIP Child Care Assistance Grants 

395.14	General 
	74,654,000 
	71,951,000 

395.15
395.16	(d) Basic Sliding Fee Child Care Assistance 
Grants 

395.17	General 
	42,995,000 
	45,008,000 
	
395.18 	Base Adjustment. The general fund base 
395.19 	is $44,881,000 for fiscal year 2010 and 
395.20 	$44,852,000 for fiscal year 2011. 
395.21 	At-Home Infant Care Program. No 
395.22 	funding shall be allocated to or spent on 
395.23 	the at-home infant care program under 
395.24 	Minnesota Statutes, section 119B.035. 

395.25	(e) Child Care Development Grants 

395.26	General 
	4,390,000 
	6,390,000 
	
395.27 	Prekindergarten Exploratory Projects. Of 
395.28 	the general fund appropriation, $2,000,000 
395.29 	the first year and $4,000,000 the second 
395.30 	year are for grants to the city of St. Paul, 
395.31 	Hennepin County, and Blue Earth County to 
395.32 	establish scholarship demonstration projects 
395.33 	to be conducted in partnership with the 
396.1 	Minnesota Early Learning Foundation to 
396.2 	promote children's school readiness. This 
396.3 	appropriation is available until June 30, 2009. 
396.4 	Child Care Services Grants. Of this 
396.5 	appropriation, $250,000 each year are for 
396.6 	the purpose of providing child care services 
396.7 	grants under Minnesota Statutes, section 
396.8 	119B.21, subdivision 5. This appropriation 
396.9 	is for the 2008-2009 biennium only, and does 
396.10 	not increase the base funding. 
396.11 	Early Childhood Professional 
396.12 	Development System. Of this appropriation, 
396.13 	$250,000 each year are for purposes of the 
396.14 	early childhood professional development 
396.15 	system, which increases the quality and 
396.16 	continuum of professional development 
396.17 	opportunities for child care practitioners. 
396.18 	This appropriation is for the 2008-2009 
396.19 	biennium only, and does not increase the 
396.20 	base funding. 
396.21 	Base Adjustment. The general fund base 
396.22 	is $1,515,000 for each of fiscal years 2010 
396.23 	and 2011. 

396.24	(f) Child Support Enforcement Grants 

396.25	General 
	11,038,000 
	3,705,000 
	
396.26 	Child Support Enforcement. $7,333,000 
396.27 	for fiscal year 2008 is to make grants to 
396.28 	counties for child support enforcement 
396.29 	programs to make up for the loss under the 
396.30 	2005 federal Deficit Reduction Act of federal 
396.31 	matching funds for federal incentive funds 
396.32 	passed on to the counties by the state. 
396.33 	This appropriation is available until June 30, 
396.34 	2009. 

397.1	(g) Children's Services Grants 

397.2	Appropriations by Fund 
	
397.3	General 
	63,647,000 
	71,147,000 
	
397.4	Health Care Access 
	250,000 
	-0- 
	
397.5	TANF 
	240,000 
	340,000 
	
397.6 	Grants for Programs Serving Young 
397.7 	Parents. Of the TANF fund appropriation, 
397.8 	$140,000 each year is for a grant to a program 
397.9 	or programs that provide comprehensive 
397.10 	services through a private, nonprofit agency 
397.11 	to young parents in Hennepin County who 
397.12 	have dropped out of school and are receiving 
397.13 	public assistance. The program administrator 
397.14 	shall report annually to the commissioner on 
397.15 	skills development, education, job training, 
397.16 	and job placement outcomes for program 
397.17 	participants. 
397.18 	County Allocations for Rate Increases.
397.19 	County Children and Community Services 
397.20 	Act allocations shall be increased by 
397.21 	$197,000 effective October 1, 2007, and 
397.22 	$696,000 effective October 1, 2008, to help 
397.23 	counties pay for the rate adjustments to 
397.24 	day training and habilitation providers for 
397.25 	participants paid by county social service 
397.26 	funds. Notwithstanding the provisions of 
397.27 	Minnesota Statutes, section 256M.40, the 
397.28 	allocation to a county shall be based on 
397.29 	the county's proportion of social services 
397.30 	spending for day training and habilitation 
397.31 	services as determined in the most recent 
397.32 	social services expenditure and grant 
397.33 	reconciliation report. 
397.34 	Privatized Adoption Grants. Federal 
397.35 	reimbursement for privatized adoption grant 
398.1 	and foster care recruitment grant expenditures 
398.2 	is appropriated to the commissioner for 
398.3 	adoption grants and foster care and adoption 
398.4 	administrative purposes. 
398.5 	Adoption Assistance Incentive Grants.
398.6 	Federal funds available during fiscal year 
398.7 	2008 and fiscal year 2009 for the adoption 
398.8 	incentive grants are appropriated to the 
398.9 	commissioner for these purposes. 
398.10 	Adoption Assistance and Relative Custody 
398.11 	Assistance. The commissioner may transfer 
398.12 	unencumbered appropriation balances for 
398.13 	adoption assistance and relative custody 
398.14 	assistance between fiscal years and between 
398.15 	programs. 
398.16 	Children's Mental Health Grants. Of the 
398.17 	general fund appropriation, $5,913,000 in 
398.18 	fiscal year 2008 and $6,825,000 in fiscal year 
398.19 	2009 are for children's mental health grants. 
398.20 	The purpose of these grants is to increase and 
398.21 	maintain the state's children's mental health 
398.22 	service capacity, especially for school-based 
398.23 	mental health services. The commissioner 
398.24 	shall require grantees to utilize all available 
398.25 	third party reimbursement sources as a 
398.26 	condition of using state grant funds. At 
398.27 	least 15 percent of these funds shall be 
398.28 	used to encourage efficiencies through early 
398.29 	intervention services. At least another 15 
398.30 	percent shall be used to provide respite care 
398.31 	services for children with severe emotional 
398.32 	disturbance at risk of out-of-home placement. 
398.33 	Mental Health Crisis Services. Of the 
398.34 	general fund appropriation, $2,528,000 in 
398.35 	fiscal year 2008 and $2,850,000 in fiscal year 
399.1 	2009 are for statewide funding of children's 
399.2 	mental health crisis services. Providers must 
399.3 	utilize all available funding streams. 
399.4 	Children's Mental Health Evidence-Based 
399.5 	and Best Practices. Of the general fund 
399.6 	appropriation, $375,000 in fiscal year 2008 
399.7 	and $750,000 in fiscal year 2009 are for 
399.8 	children's mental health evidence-based and 
399.9 	best practices including, but not limited 
399.10 	to: Adolescent Integrated Dual Diagnosis 
399.11 	Treatment services; school-based mental 
399.12 	health services; co-location of mental 
399.13 	health and physical health care, and; the 
399.14 	use of technological resources to better 
399.15 	inform diagnosis and development of 
399.16 	treatment plan development by mental 
399.17 	health professionals. The commissioner 
399.18 	shall require grantees to utilize all available 
399.19 	third-party reimbursement sources as a 
399.20 	condition of using state grant funds. 
399.21 	Culturally Specific Mental Health 
399.22 	Treatment Grants. Of the general fund 
399.23 	appropriation, $75,000 in fiscal year 2008 
399.24 	and $300,000 in fiscal year 2009 are for 
399.25 	children's mental health grants to support 
399.26 	increased availability of mental health 
399.27 	services for persons from cultural and 
399.28 	ethnic minorities within the state. The 
399.29 	commissioner shall use at least 20 percent 
399.30 	of these funds to help members of cultural 
399.31 	and ethnic minority communities to become 
399.32 	qualified mental health professionals and 
399.33 	practitioners. The commissioner shall assist 
399.34 	grantees to meet third-party credentialing 
399.35 	requirements and require them to utilize all 
400.1 	available third-party reimbursement sources 
400.2 	as a condition of using state grant funds. 
400.3 	Mental Health Services for Children with 
400.4 	Special Treatment Needs. Of the general 
400.5 	fund appropriation, $50,000 in fiscal year 
400.6 	2008 and $200,000 in fiscal year 2009 are 
400.7 	for children's mental health grants to support 
400.8 	increased availability of mental health 
400.9 	services for children with special treatment 
400.10 	needs. These shall include, but not be limited 
400.11 	to: victims of trauma, including children 
400.12 	subjected to abuse or neglect, veterans and 
400.13 	their families, and refugee populations; 
400.14 	persons with complex treatment needs, such 
400.15 	as eating disorders; and those with low 
400.16 	incidence disorders. 
400.17 	MFIP and Children's Mental Health 
400.18 	Pilot Project. Of the TANF appropriation, 
400.19 	$100,000 in fiscal year 2008 and $200,000 
400.20 	in fiscal year 2009 are to fund the MFIP 
400.21 	and children's mental health pilot project. 
400.22 	Of these amounts, up to $100,000 may be 
400.23 	expended on evaluation of this pilot. 
400.24 	Prenatal Alcohol or Drug Use. Of the 
400.25 	general fund appropriation, $75,000 each 
400.26 	year is to award grants beginning July 1, 
400.27 	2007, to programs that provide services 
400.28 	under Minnesota Statutes, section 254A.171, 
400.29 	in Pine, Kanabec, and Carlton Counties.
400.30 	the second year is for a grant to A Circle 
400.31 	of Women for program services. This 
400.32 	appropriation shall become part of the base 
400.33 	appropriation.
401.1 	Base Adjustment. The general fund base 
401.2 	is $62,572,000 in fiscal year 2010 and 
401.3 	$62,575,000 in fiscal year 2011.

401.4	(h) Children and Community Services Grants

401.5	General
	101,369,000 
	69,208,000 
	
401.6 	Base Adjustment. The general fund base 
401.7 	is $69,274,000 in each of fiscal years 2010 
401.8 	and 2011.
401.9 	Targeted Case Management Temporary 
401.10 	Funding. (a) Of the general fund 
401.11 	appropriation, $32,667,000 in fiscal year 
401.12 	2008 is transferred to the targeted case 
401.13 	management contingency reserve account in 
401.14 	the general fund to be allocated to counties 
401.15 	and tribes affected by reductions in targeted 
401.16 	case management federal Medicaid revenue 
401.17 	as a result of the provisions in the federal 
401.18 	Deficit Reduction Act of 2005, Public Law 
401.19 	109-171. 
401.20 	(b) Contingent upon (1) publication by the 
401.21 	federal Centers for Medicare and Medicaid 
401.22 	Services of final regulations implementing 
401.23 	the targeted case management provisions 
401.24 	of the federal Deficit Reduction Act of 
401.25 	2005, Public Law 109-171, or (2) the 
401.26 	issuance of a finding by the Centers for 
401.27 	Medicare and Medicaid Services of federal 
401.28 	Medicaid overpayments for targeted case 
401.29 	management expenditures, up to $32,667,000 
401.30 	is appropriated to the commissioner of human 
401.31 	services. Prior to distribution of funds, the 
401.32 	commissioner shall estimate and certify the 
401.33 	amount by which the federal regulations or 
401.34 	federal disallowance will reduce targeted 
402.1 	case management Medicaid revenue over the 
402.2 	2008-2009 biennium. 
402.3 	(c) Within 60 days of a contingency described 
402.4 	in paragraph (b), the commissioner shall 
402.5 	distribute the grants proportionate to each 
402.6 	affected county or tribe's targeted case 
402.7 	management federal earnings for calendar 
402.8 	year 2005, not to exceed the lower of (1) the 
402.9 	amount of the estimated reduction in federal 
402.10 	revenue or (2) $32,667,000. 
402.11 	(d) These funds are available in either year of 
402.12 	the biennium. Counties and tribes shall use 
402.13 	these funds to pay for social service-related 
402.14 	costs, but the funds are not subject to 
402.15 	provisions of the Children and Community 
402.16 	Services Act grant under Minnesota Statutes, 
402.17 	chapter 256M. 
402.18 	(e) This appropriation shall be available to 
402.19 	pay counties and tribes for expenses incurred 
402.20 	on or after July 1, 2007. The appropriation 
402.21 	shall be available until expended. 

402.22	(i) General Assistance Grants 

402.23	General 
	37,876,000 
	38,253,000 
	
402.24 	General Assistance Standard. The 
402.25 	commissioner shall set the monthly standard 
402.26 	of assistance for general assistance units 
402.27 	consisting of an adult recipient who is 
402.28 	childless and unmarried or living apart 
402.29 	from parents or a legal guardian at $203. 
402.30 	The commissioner may reduce this amount 
402.31 	according to Laws 1997, chapter 85, article 
402.32 	3, section 54. 
402.33 	Emergency General Assistance. The 
402.34 	amount appropriated for emergency general 
403.1 	assistance funds is limited to no more 
403.2 	than $7,889,812 in fiscal year 2008 and 
403.3 	$7,889,812 in fiscal year 2009. Funds 
403.4 	to counties must be allocated by the 
403.5 	commissioner using the allocation method 
403.6 	specified in Minnesota Statutes, section 
403.7 	256D.06. 

403.8	(j) Minnesota Supplemental Aid Grants 

403.9	General 
	30,505,000 
	30,812,000 
	
403.10 	Emergency Minnesota Supplemental 
403.11 	Aid Funds. The amount appropriated for 
403.12 	emergency Minnesota supplemental aid 
403.13 	funds is limited to no more than $1,100,000 
403.14 	in fiscal year 2008 and $1,100,000 in fiscal 
403.15 	year 2009. Funds to counties must be 
403.16 	allocated by the commissioner using the 
403.17 	allocation method specified in Minnesota 
403.18 	Statutes, section 256D.46. 

403.19	(k) Group Residential Housing Grants 

403.20	General 
	91,069,000 
	98,671,000 
	
403.21 	People Incorporated. Of the general fund 
403.22 	appropriation, $460,000 each year is to 
403.23 	augment community support and mental 
403.24 	health services provided to individuals 
403.25 	residing in facilities under Minnesota 
403.26 	Statutes, section 256I.05, subdivision 1m. 

403.27
403.28	(l) Other Children and Economic Assistance 
Grants 

403.29	General 
	20,183,000 
	16,333,000 
	
403.30	Federal TANF 
	1,500,000 
	1,500,000 
	
403.31 	Base Adjustment. The general fund base 
403.32 	shall be $16,033,000 in fiscal year 2010 and 
403.33 	$15,533,000 in fiscal year 2011. The TANF 
404.1 	base shall be $1,500,000 in fiscal year 2010 
404.2 	and $1,181,000 in fiscal year 2011. 
404.3 	Homeless and Runaway Youth. Of the 
404.4 	general fund appropriation, $500,000 each 
404.5 	year are for the Runaway and Homeless 
404.6 	Youth Act under Minnesota Statutes, section 
404.7 	256K.45. Funds shall be spent in each area 
404.8 	of the continuum of care to ensure that 
404.9 	programs are meeting the greatest need. This 
404.10 	is a onetime appropriation. 
404.11 	Long-Term Homelessness. Of the general 
404.12 	fund appropriation, $2,000,000 in fiscal year 
404.13 	2008 is for implementation of programs 
404.14 	to address long-term homelessness and is 
404.15 	available in either year of the biennium. This 
404.16 	is a onetime appropriation. 
404.17 	Minnesota Community Action Grants. (a) 
404.18 	Of the general fund appropriation, $250,000 
404.19 	each year is for the purposes of Minnesota 
404.20 	community action grants under Minnesota 
404.21 	Statutes, sections 256E.30 to 256E.32. This 
404.22 	is a onetime appropriation. 
404.23 	(b) Of the TANF appropriation, $1,500,000 
404.24 	each year is for community action agencies 
404.25 	for auto repairs, auto loans, and auto 
404.26 	purchase grants to individuals who are 
404.27 	eligible to receive benefits under Minnesota 
404.28 	Statutes, chapter 256J, or who have lost 
404.29 	eligibility for benefits under Minnesota 
404.30 	Statutes, chapter 256J, due to earnings in the 
404.31 	prior 12 months. Base level funding for this 
404.32 	activity shall be $1,500,000 in fiscal year 
404.33 	2010 and $1,181,000 in fiscal year 2011. * 
404.34 	(The preceding text beginning "(b) Of the 
405.1 	TANF appropriation," was indicated as 
405.2 	vetoed by the governor.) 
405.3 	(c) Money appropriated under paragraphs (a) 
405.4 	and (b) that is not spent in the first year does 
405.5 	not cancel but is available for the second 
405.6 	year.

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

405.8 	Sec. 13. EMERGENCY SERVICES SHELTER GRANTS FROM AMERICAN 
405.9 	RECOVERY AND REINVESTMENT ACT.
 405.10 	(a) To the extent permitted under federal law, the commissioner of human services, 
405.11 	when determining the uses of the emergency services shelter grants provided under the 
405.12 	American Recovery and Reinvestment Act, shall give priority to programs that serve 
405.13 	the following:
405.14 	(1) homeless youth;
405.15 	(2) American Indian women who are victims of trafficking; 
405.16 	(3) high-risk adult males considered to be very likely to enter or reenter state or 
405.17 	county correctional programs, or chemical and mental health programs;
405.18 	(4) battered women; and
405.19 	(5) families affected by foreclosure.
405.20 	(b) Paragraph (a) does not supersede use of ARRA funds as otherwise provided 
405.21 	in this act.

405.22 	Sec. 14. TRANSFERS.
 405.23 		Subdivision 1.Grants. The commissioner of human services, with the approval 
405.24 	of the commissioner of finance, and after notification of the chairs of the relevant senate 
405.25 	budget division and house of representatives finance division committee, may transfer 
405.26 	unencumbered appropriation balances for the biennium ending June 30, 2011, within 
405.27 	fiscal years among the MFIP, general assistance, general assistance medical care, medical 
405.28 	assistance, MinnesotaCare, MFIP child care assistance under Minnesota Statutes, section 
405.29 	119B.05, Minnesota supplemental aid, and group residential housing programs, and the 
405.30 	entitlement portion of the chemical dependency consolidated treatment fund, and between 
405.31 	fiscal years of the biennium.
405.32 		Subd. 2.Administration. Positions, salary money, and nonsalary administrative 
405.33 	money may be transferred within the Departments of Human Services and Health as the 
406.1 	commissioners consider necessary, with the advance approval of the commissioner of 
406.2 	finance. The commissioner shall inform the chairs of the relevant house and senate health 
406.3 	committees quarterly about transfers made under this provision.

406.4 	Sec. 15. 2007 AND 2008 APPROPRIATION AMENDMENTS.
 406.5 	(a) Notwithstanding Laws 2007, chapter 147, article 19, section 3, subdivision 4, 
406.6 	paragraph (g), as amended by Laws 2008, chapter 363, article 18, section 7, the TANF 
406.7 	fund base for the Children's Mental Health Pilots is $0 in fiscal year 2011. This paragraph 
406.8 	is effective retroactively from July 1, 2008.
406.9 	(b) The appropriation for patient incentive programs under Laws 2007, chapter 147, 
406.10 	article 19, section 3, subdivision 6, paragraph (e), is canceled. This paragraph is effective 
406.11 	retroactively from July 1, 2007.
406.12 	(c) The onetime general fund base reduction for Child Care Development Grants 
406.13 	under Laws 2008, chapter 363, article 18, section 3, subdivision 4, paragraph (d), is 
406.14 	increased by $4,000. This paragraph is effective retroactively from July 1, 2008.
406.15 	(d) The base for Children Services Grants under Laws 2008, chapter 363, article 18, 
406.16 	section 3, subdivision 4, paragraph (e), is decreased $1,000 in each year of the fiscal year 
406.17 	2010 and 2011 biennium. This paragraph is effective retroactively from July 1, 2008.
406.18 	(e) Notwithstanding Laws 2008, chapter 363, article 18, section 3, subdivision 4, the 
406.19 	general fund base adjustment for Children and Community Services Grants under Laws 
406.20 	2008, chapter 363, article 18, section 3, subdivision 4, paragraph (f), is increased by 
406.21 	$98,000 each year of fiscal years 2010 and 2011. This paragraph is effective retroactively 
406.22 	from July 1, 2008.
406.23 	(f) The base for Other Continuing Care Grants under Laws 2008, chapter 363, article 
406.24 	18, section 3, subdivision 6, paragraph (h), is decreased by $10,000 in fiscal year 2010. 
406.25 	This paragraph is effective retroactively from July 1, 2008.

406.26 	Sec. 16. INDIRECT COSTS NOT TO FUND PROGRAMS.
 406.27 	The commissioners of health and human services shall not use indirect cost 
406.28 	allocations to pay for the operational costs of any program for which they are responsible.

406.29 	Sec. 17. EXPIRATION OF UNCODIFIED LANGUAGE.
 406.30 	All uncodified language contained in this article expires on June 30, 2011, unless a 
406.31 	different expiration date is explicit.

406.32 	Sec. 18. EFFECTIVE DATE.
 407.1 	The provisions in this article are effective July 1, 2009, unless a different effective 
407.2 	date is specified.